Wednesday, November 6, 2013

Testosterone: Getting to the Heart of the Matter

In case you missed it, USA Today published an article yesterday about a study published today in JAMA in which the authors linked testosterone use to an increase risk of heart attack, stroke & death.  Now before you peel off your patch, scrub off your gel, or throw away your vial & syringes, read the editorial.  Then ask yourself why you're taking it in the first place.  If it's for antiaging purposes, I would suggest you reconsider.  But if you're taking it because you have clinical hypogonadism, then dig further into this study and its editorial along with the USA Today article which might make it a little easier to understand.

Let's first talk about what a statistical anomaly I found: the confidence interval crossed 0.  The authors pointed out that the risk of adverse outcomes was higher at year 1, 2 & 3 for those who elected to take testosterone.  Yet, when they compared the absolute risk difference, the confidence intervals always crossed 0 for each year.  In other words, the purported risks are not statistically significant!  Check out page 1832 for yourself.  If you agree, then there's no need to tear this study apart any further.

But in case you don't agree, I'll analyze the study in more depth over the next day.  Hint: several issues that I always address w/my patients considering testosterone therapy were not mentioned in the study.



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