Power Michael L, Schulkin Jay, Rossouw Jacques E
Department of Research, American College of Obstetricians and Gynecologists, Washington, DC 20024, USA.
Menopause. 2007 Jan-Feb;14(1):20-8. doi: 10.1097/01.gme.0000229571.44505.cb.
The objective of this study was to examine the opinions and prescribing practices of obstetrician-gynecologists regarding hormone therapy (HT) and the results from the Women's Health Initiative.
Surveys were sent to 2,500 randomly selected American College of Obstetrics and Gynecology fellows during December 2004 to March 2005; their responses are compared with those from a survey conducted in November to December 2003.
Respondents remained skeptical of the combined HT results (49.1% did not find the results convincing). Compared with the 2003 survey, men were more skeptical (58.8% did not consider the findings convincing in 2004 vs 53.4% in 2003, P = 0.045), and women were somewhat less skeptical (39.5% did not consider the findings convincing in 2004 vs 45.3% in 2003, P = 0.056). There was less skepticism about the estrogen-only trial, although 4 of 10 did not find the results convincing. Men were more skeptical than women; a majority of men disagreed with the decisions to stop the trials. Physicians who completed their residency more recently were more likely to accept the trial results. Respondents reported a reduction in HT prescription practice relative to the year 2000, but 62.7% reported they did not expect their prescribing practices to change further in the near future. The proportion of respondents who considered alternative therapies to HT as viable treatment options increased between 2003 and 2004 (37.1% vs 28.1%, P < 0.001). There was strong support for the use of HT for vasomotor symptoms, vaginal dryness, and osteoporosis, but most physicians did not consider HT useful for cardiovascular disease or dementia.
Many obstetrician-gynecologists continue to express skepticism about the results and conduct of the Women's Health Initiative trials. The survey could not determine the reasons for skepticism.
本研究的目的是调查妇产科医生关于激素疗法（HT）的观点和处方习惯以及妇女健康倡议的结果。
在2004年12月至2005年3月期间，向随机挑选的2500名美国妇产科医师学会会员发送了调查问卷；将他们的回答与2003年11月至12月进行的一项调查的结果进行比较。
受访者对联合激素疗法的结果仍持怀疑态度（49.1%的人认为结果不可信）。与2003年的调查相比，男性更持怀疑态度（2004年有58.8%的人认为结果不可信，2003年为53.4%，P = 0.045），女性的怀疑程度有所降低（2004年有39.5%的人认为结果不可信，2003年为45.3%，P = 0.056）。对单纯雌激素试验的怀疑较少，尽管十分之四的人认为结果不可信。男性比女性更持怀疑态度；大多数男性不同意停止试验的决定。最近完成住院医师培训的医生更有可能接受试验结果。受访者报告称，与2000年相比，激素疗法处方有所减少，但62.7%的人表示他们预计近期处方习惯不会进一步改变。2003年至2004年间，认为激素疗法替代疗法是可行治疗选择的受访者比例有所增加（37.1%对28.1%，P < 0.001）。对于使用激素疗法治疗血管舒缩症状、阴道干燥和骨质疏松症有强烈支持，但大多数医生认为激素疗法对心血管疾病或痴呆无用。
许多妇产科医生对妇女健康倡议试验的结果和开展仍持怀疑态度。该调查无法确定怀疑的原因。
