what they said (Hover the mouse cursor over underlined words for more info)

Hormone replacement therapy (HRT) patches that deliver low doses of estrogen via the skin pose a lower stroke risk than HRT in tablet form, new research suggests.

HRT, which is prescribed to women to ease the symptoms of menopause, such as hot flashes and a decrease in libido, has been linked to an increased risk of stroke in previous studies...

The original article can be found at: http://www.cbc.ca/health/story/2010/06/04/hrt-patch-stroke.html

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what we said (Hover the mouse cursor over underlined words for more info)

This article is reporting on a database study comparing the occurrence of strokes in women taking tablet and patch forms of HRT.

The story was missing some important elements and would have benefited from a much clearer explanation of the numbers. For example, readers are told that the study looked at 870,000 women of whom 15,710 suffered a stroke allegedly related to the woman's use of HRT. They are then told that women who took HRT tablets (as opposed to using the HRT patch) increased their stroke risk by 25 to 30 per cent, regardless of whether they were estrogen-only or contained progesterone. In other words, the article suggests that HRT tablets are considered more dangerous than the patch.

But let's be clear here folks: the overall risk of women for a HRT-related stoke was 1.8% (that is 15,710 out of 870,000 participants). If you increase that risk by "30%" your risk goes up from 1.8% to 2.34%. So should this be worrisome? By reporting only the relative risk increases (and not the absolute numbers calculated above), the article is potentially misleading in suggesting that the HRT tablets increase stroke risk by 30%- with articles like this one we need to get accustomed to asking "30% of what?"

In addition to the unclear reporting of the risk reduction number, there was no mention of alternatives to HRT, costs of treatment, other harms related to HRT, or sources from whom the story is drawn.

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