蝌蚪网 Papers and Proceedings
ISSN 2574-0768 (Print) | ISSN 2574-0776 (Online)
Instrumental Variables Methods Reveal Larger Effects of Menopausal Hormone Therapy in the Landmark Women's Health Initiative Clinical Trial
蝌蚪网 Papers and Proceedings
vol. 115,
May 2025
(pp. 215–20)
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 nonadherent, 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.Citation
Angrist, Joshua, Amanda E. Kowalski, Ljubica Ristovska, and Marcia L. Stefanick. 2025. "Instrumental Variables Methods Reveal Larger Effects of Menopausal Hormone Therapy in the Landmark Women's Health Initiative Clinical Trial." 蝌蚪网 Papers and Proceedings 115: 215–20. DOI: 10.1257/pandp.20251064Additional Materials
JEL Classification
- C26 Single Equation Models: Single Variables: Instrumental Variables (IV) Estimation
- I12 Health Behavior
- I18 Health: Government Policy; Regulation; Public Health
- J16 Economics of Gender; Non-labor Discrimination