Sources of information influencing the state-of-the-science gap in hormone replacement therapy usage.
OBJECTIVE
Medical reviews and research comprise a key information source for news media stories on medical therapies and innovations as well as for physicians in updating their practice. The present study examined medical review journal articles, physician surveys and news media coverage of hormone replacement therapy (HT) to assess the relationship between the three information sources and whether/if they contributed to a state-of-the-science gap (a condition when the evaluation of a medical condition or therapy ascertained by the highest standards of investigation is incongruent with the science-in-practice such as physician recommendations and patient actions).


METHODS
We content-analyzed 177 randomly sampled HT medical reviews between 2002 and 2014, and HT news valence in three major TV networks, newspapers and magazines/internet sites in 2002-2003, 2008-2009 and 2012-14. The focus in both analyses was whether HT benefits outweighed risks, risks outweighed benefits or both risks and benefits were presented. We also qualitatively content-analyzed all 19 surveys of US physicians' HT recommendations from 2002 to 2009, and 2012 to 2014.


RESULTS
Medical reviews yielded a mixed picture about HT (40.1% benefits, 26.0% risks, and 33.9% both benefits and risks). While a majority of physician surveys were pro-HT 10/19), eight showed varied attitudes and one was negative. Newspaper and television coverage reflected a pro and con balance while magazine stories were more positive in the later reporting period.


CONCLUSIONS
Medical journal review articles, physicians, and media reports all provide varying view points towards hormone therapy use thus leading to limited knowledge about the actual risks and benefits of HT among peri- and menopausal women and a state-of-the-science gap.
S.I. Newhouse School of Public Communications, Syracuse University, Syracuse, New York, United States of America.
Fiona
http://orcid.org/0000-0002-9092-4885
F
Chew
School of Journalism and Mass Communication, The University of Iowa, Iowa City, Iowa, United States of America.
Xianwei
X
Wu
D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D018156:Journalism, Medical; D008402:Mass Media; D008875:Middle Aged; D010820:Physicians; D012586:Science