Holmes M M, Rovner D R, Rothert M L, Elstein A S, Holzman G B, Hoppe R B, Metheny W P, Ravitch M M
J Gen Intern Med. 1987 May-Jun;2(3):178-82. doi: 10.1007/BF02596148.
Estrogen replacement therapy (ERT) prevents fractures and relieves vasomotor symptoms, but it increases the risk of endometrial cancer. Previous studies and national prescribing patterns show that physicians are conservative in their approach to this therapy. The authors interviewed physicians and perimenopausal women to assess their utilities for the various health outcomes of estrogen replacement therapy. On all outcomes, physicians rated illness episodes followed by recovery as being closer to perfect health than did perimenopausal women. Physicians, in judging which outcomes were most important to women, estimated relief of symptoms above fracture prevention, whereas women rated fracture prevention above symptom relief. These results emphasize the need to assess patients' utilities directly, particularly when utilities for the outcome of a particular therapy may influence the choice of a therapeutic regimen.
雌激素替代疗法（ERT）可预防骨折并缓解血管舒缩症状，但会增加子宫内膜癌的风险。以往的研究和全国的处方模式表明，医生在采用这种疗法时较为保守。作者采访了医生和围绝经期女性，以评估他们对雌激素替代疗法各种健康结果的效用。在所有结果方面，与围绝经期女性相比，医生将疾病发作后康复的情况评为更接近完美健康状态。在判断哪些结果对女性最重要时，医生认为缓解症状比预防骨折更重要，而女性则认为预防骨折比缓解症状更重要。这些结果强调了直接评估患者效用的必要性，尤其是当特定疗法结果的效用可能影响治疗方案的选择时。
