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- HEALTH, Page 59Research for Men Only
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-
- Doctors could use more data on treating women
-
-
- The huge research project included 22,071 volunteer
- subjects. And the main conclusion, published in 1988, was
- headline material: taking small doses of aspirin can reduce the
- risk of a heart attack. But women who read the fine print
- discovered that the study had little apparent relevance to
- them. Reason: not one of the 22,071 subjects was a woman.
- Admittedly, the overall risk of heart disease is greater in
- men, but after women reach menopause that difference in
- susceptibility largely disappears. Many older women would have
- been interested to know whether taking aspirin would improve
- their chances of avoiding a heart attack.
-
- The for-men-only bias of the aspirin study was not unusual.
- As an article in last week's Journal of the American Medical
- Association points out, medical research often appears to
- ignore women. In studies of everything from the link between
- smoking and cataracts to the benefits of eating fish after
- having heart attacks, the subjects have all been men. That
- concerns some medical experts and political leaders.
-
- In December the Congressional Caucus for Women's Issues
- asked for a review of National Institutes of Health grants in
- the past two years to see whether the studies fairly
- represented women. The report is due in April. Says
- Representative Pat Schroeder, a Colorado Democrat: "At this
- point, doctors just aren't getting the kind of guidance they
- need when they try to prescribe to women."
-
- In most cases, if a drug is proved effective in men, it will
- do the same job in women. But not always. The information gap
- becomes important when the sexes respond differently to a given
- treatment. For example, the menstrual cycle is known to alter
- the effect of some antidepressant drugs.
-
- For many drugs and treatments, doctors simply cannot be sure
- how well they will work in women. Because of the predominance
- of male-only studies, physicians do not have clear scientific
- proof that women can lower their cholesterol with drugs and
- low-fat diets. For similar reasons, little is known about the
- specific effects of AIDS drugs on women.
-
- Why are women so often excluded from medical studies? Cost
- is usually the reason. In a well-designed trial, the subjects
- must be as similar as possible so that the treatment is the
- only variable. A study that includes both men and women must
- generally be larger -- and more expensive -- than a males-only
- trial to have the same degree of statistical validity. Though
- the costs may be steep, an increase in testing of women is
- called for. As for pharmaceuticals that are already available,
- some researchers feel that the Government should make a
- greater effort to monitor their effects on women.
-
- The one-sided nature of medical testing reflects a broader
- neglect of female health issues, some experts say. For example,
- the NIH reportedly spends just 13% of its budget studying
- women's health. The research shortfall, observes Dr. Florence
- Haseltine, director of the NIH's Center for Population
- Research, has left uncertainties on many vital questions,
- including the causes of infertility and the effect of diet on
- breast cancer.
-
-
- By Andrew Purvis.
-
-
- ______________________________________________________________
- THE FORGOTTEN FEMALE
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-
- Number of men Number of women
- in study in study
-
- 22,071 0
-
- Nature of Study
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- To determine if taking aspirin can reduce the chances of
- heart attack.
-
-
- Number of men Number of women
- in study in study
-
- 838 0
-
- Nature of Study
-
- To see if smoking increases the odds of getting cataracts.
-
-
- Number of men Number of women
- in study in study
-
- 12,866 0
-
- Nature of Study
-
- To explore the links between heart disease and high
- cholesterol, lack of exercise and smoking.
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