IDEAS home Printed from https://ideas.repec.org/p/nbr/nberwo/33635.html
   My bibliography  Save this paper

Instrumental Variables Methods Reveal Larger Effects of Menopausal Hormone Therapy in the Landmark Women’s Health Initiative Clinical Trial

Author

Listed:
  • Joshua Angrist
  • Amanda E. Kowalski
  • Ljubica Ristovska
  • Marcia L. Stefanick

Abstract

Landmark results from the Women's Health Initiative trial showed that random assignment to menopausal hormone therapy (MHT) elevated risks of breast cancer and other adverse events. Recent analyses argue that MHT risks are small. These analyses report intention-to-treat (ITT) effects, ignoring the fact that many women assigned intervention were non-adherent, while many women assigned control initiated treatment. Instrumental variable (IV) methods and adherence data allow us to estimate effects of MHT on compliers who took MHT if and only if assigned. IV estimates show risks and benefits that are substantially larger than the ITT estimates used to inform MHT guidelines.

Suggested Citation

  • Joshua Angrist & Amanda E. Kowalski & Ljubica Ristovska & Marcia L. Stefanick, 2025. "Instrumental Variables Methods Reveal Larger Effects of Menopausal Hormone Therapy in the Landmark Women’s Health Initiative Clinical Trial," NBER Working Papers 33635, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:33635
    Note: AG EH LS PE TWP
    as

    Download full text from publisher

    File URL: http://www.nber.org/papers/w33635.pdf
    Download Restriction: Access to the full text is generally limited to series subscribers, however if the top level domain of the client browser is in a developing country or transition economy free access is provided. More information about subscriptions and free access is available at http://www.nber.org/wwphelp.html. Free access is also available to older working papers.
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    More about this item

    JEL classification:

    • C26 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Instrumental Variables (IV) Estimation
    • H0 - Public Economics - - General
    • I1 - Health, Education, and Welfare - - Health

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:nbr:nberwo:33635. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: the person in charge (email available below). General contact details of provider: https://edirc.repec.org/data/nberrus.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.