Katherine M. Newton, PhD; Susan D. Reed, MD, MPH; Andrea Z. LaCroix, PhD
Potential Financial Conflicts of Interest: None disclosed.
Newton K., Reed S., LaCroix A.; Alternative Treatments of Vasomotor Symptoms of Menopause. Ann Intern Med. 2007;147:347. doi: 10.7326/0003-4819-147-5-200709040-00015
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Published: Ann Intern Med. 2007;147(5):347.
We do not agree with Mr. Krueger that a within-participant design would have been preferable. A valid crossover study requires sufficient time for the effects of 1 drug to “wash out” before treatment with a second drug can begin. The time needed for the effects of herbal treatments to wash out is unknown, so a crossover study would be subject to the criticism that the effects of 1 drug contaminated the effects of the others. Exposing each woman in our study to all treatments would have required 14 months of participation, introducing unnecessary logistical and analytic complexity. This approach would have negated our opportunity to evaluate bone mineral density and to examine adverse events associated with longer duration of therapy. Menopausal symptoms change through time, further complicating the interpretation of crossover studies.
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