Evidence mapPaperPMID 29039146Full record

SynthesisEndocrine2017

Estrogen-based hormone therapy in women with primary ovarian insufficiency: a systematic review.

Nydia Burgos, Dahima Cintron, Paula Latortue-Albino, Valentina Serrano, Rene Rodriguez Gutierrez, Stephanie Faubion, Gabriela Spencer-Bonilla, Patricia J Erwin, Mohammad Hassan Murad

Erratum issuedOpen access · greenAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Endocrine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 15 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 4 pooled it
2.5field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 4 syntheses or guidelines pooled it, 42 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Article
  6. Article
  7. Review
  8. Article
  9. Review
  10. Frontiers in endocrinology · 2023
    Review
  11. Article
  12. Article
  13. Review
  14. Review
  15. Estrogen-inducedChinese medical journal · 2018
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 6 institutions in 4 countries.

Nydia BurgosInternal Medicine Department, VA Caribbean Health Care System, San Juan, PR, 00921, USA.
Dahima CintronMayo Graduate School, Mayo Clinic, Rochester, MN, 55905, USA. Dahima.cintron1@upr.edu.ORCID 0000-0003-4607-0234
Paula Latortue-AlbinoUniversity of Puerto Rico-Medical Sciences Campus, San Juan, PR, 00921, USA.
Valentina SerranoDepartment of Medicine, Knowledge and Evaluation Research Unit in Endocrinology, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN, 55905, USA.
Rene Rodriguez GutierrezDepartment of Medicine, Knowledge and Evaluation Research Unit in Endocrinology, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN, 55905, USA.
Stephanie FaubionWomen's Health Clinic, Division of General Internal Medicine, Mayo Clinic, Rochester, MN, 55905, USA.
Gabriela Spencer-BonillaMayo Graduate School, Mayo Clinic, Rochester, MN, 55905, USA.
Patricia J ErwinMayo Clinic Libraries, Rochester, MN, 55905, USA.
Mohammad Hassan MuradEvidence-Based Practice Center, Mayo Clinic, Rochester, MN, 55905, USA.
Mayo Clinic · USMayo Clinic in Arizona · USMayo Clinic in Florida · USPontificia Universidad Católica de Chile · CLUniversity of Puerto Rico, Medical Sciences Campus · PRVA Caribbean Healthcare System · PR

Funding

NCATS NIH HHS TL1 TR000137NCATS NIH HHS TL1 TR00137NHLBI NIH HHS R01 HL131535
6 · The paper itself

Abstract

purposeSex hormones play a role in bone density, cardiovascular health, and wellbeing throughout reproductive lifespan. Women with primary ovarian insufficiency (POI) have lower estrogen levels requiring hormone therapy (HT) to manage symptoms and to protect against adverse long-term health outcomes. Yet, the effectiveness of HT in preventing adverse outcomes has not been systematically assessed. We summarize the evidence regarding effects of HT on bone and cardiovascular health in women with POI.

methodsA comprehensive search of the electronic databases MEDLINE, EMBASE, and Scopus was conducted by a medical reference librarian from database inception to January 2016. Randomized trials and observational cohort studies with an estrogen-based HT intervention in women with POI under the age of 40 were included. Reviewers worked independently and in duplicate to assess eligibility and risk of bias, and extract data of interest from each study.

resultsThe search identified 1670 articles; 12 met inclusion criteria. Four randomized clinical trials and eight cohort studies at high risk of bias enrolled 806 women with POI. The most common HT formulations were transdermal estradiol and oral conjugated equine estrogen combined with medroxyprogesterone acetate. Bone mineral density was the most frequent outcome, with three out of eight studies showing HT associated increase benefits. Only one study reported effects on fractures or vasomotor symptoms and none on cardiovascular mortality. Results regarding lipid profiles were inconsistent.

conclusionsEvidence supporting bone and cardiovascular benefits of HT in women with POI is limited by high risk of bias, reliance on surrogate outcomes, and heterogeneity of trials regarding the formulation, dose, route of administration, and regimen of HT. Further research addressing patient important outcomes such as fractures, stroke, and cardiovascular mortality are crucial to optimize benefits of this therapy.

Indexed as

AdultEstrogen Replacement TherapyEstrogensFemaleHumansMiddle AgedPrimary Ovarian InsufficiencyEstrogensCardiovascularEstrogenFractureLipidsOvarian insufficiencyQuality of life

Identifiers

PMID29039146
PMCPMC5765545
OpenAlexW2765303418

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.