TABLE 2-2Postmenopausal Hormone Therapy and CHD: Potential Explanations for Divergent Findings from Clinical Trials and Observational Studies

Potential Explanations for the Divergent Findings
  • Methodological Differences

    Confounding (“healthy user”) bias

    Compliance bias

    Incomplete capture of early clinical events

  • Biological Differences

    Characteristics of study population (time since menopause, stage of atherosclerosis)

    Hormone regimen (formulation and dose)

SOURCE: Derived from Grodstein, F., T. B. Clarkson, and J. E. Manson. 2003. Understanding the divergent data on postmenopausal hormone therapy. New England Journal of Medicine 348:645–650.

From: 2, Cases in Point: Learning from Experience

Cover of Redesigning the Clinical Effectiveness Research Paradigm
Redesigning the Clinical Effectiveness Research Paradigm: Innovation and Practice-Based Approaches: Workshop Summary.
Institute of Medicine (US) Roundtable on Value & Science-Driven Health Care; Olsen LA, McGinnis JM, editors.
Washington (DC): National Academies Press (US); 2010.
Copyright © 2010, National Academy of Sciences.

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