Tom A. Elasy, MD, MPH; Matthew J. Levinsky, MD
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Elasy TA, Levinsky MJ. Effect of Low-Dose Continuous Estrogen and Progesterone Therapy with Calcium and Vitamin D on Bone in Elderly Women. Ann Intern Med. 2000;132:244. doi: 10.7326/0003-4819-132-3-200002010-00014
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Published: Ann Intern Med. 2000;132(3):244.
TO THE EDITOR:
Recker and colleagues (1) add to the body of knowledge on the bone-sparing efficacy and tolerability of low-dose estrogen and progesterone. We have two substantial concerns about aspects of the analysis and presentation of the data that detract from an otherwise well-done study. Figure 2 compares changes in the treatment and placebo groups. By presenting only one standard error of the mean with the effect measure, a reader may be led to believe that the differences are statistically significant. That is not the case. The authors have effectively presented a 68% confidence interval. Although we do not have access to the data, it is clear that many of those comparisons are not statistically significant at the more conservative 95% confidence intervals. Lang and Secic (2) have commented on this common occurrence in the medical literature. The authors state that before the study began, the minimal important difference in spinal and femoral bone mineral density between placebo and hormone replacement therapy would be 4.5% at the end of the 3.5 years. Neither site achieved this supposedly important threshold.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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