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Grant MD, Marbella A, Wang AT, et al. Menopausal Symptoms: Comparative Effectiveness of Therapies [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2015 Mar. (Comparative Effectiveness Reviews, No. 147.)

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Menopausal Symptoms: Comparative Effectiveness of Therapies [Internet].

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Appendix GQuality of Life Supplemental Tables and Plots

Figure 1G-B53+B53 is a forest plot for the pairwise comparison of standard dose estrogens compared with placebo (N=26 trials) for quality of life symptoms, Key Question 1. Two trials had negative point estimates, one trial had a point estimate of zero, and an additional seven trials had 95 percent confidence intervals including zero. The remaining 15 trials showed significant improvements individually. The pooled SMD is 0.55 (95% CI: 0.41 to 0.69).

Figure G-1

Forest plot of estrogen (standard) versus placebo.

Figure G-2 is a forest plot for the pairwise comparison of high dose estrogens compared with placebo (N=5 trials) for quality of life symptoms, Key Question 1. All five trials showed significant improvements in quality of life. The pooled SMD is 0.76 (95% CI: 0.48 to 1.03).

Figure G-2

Forest plot of estrogen (high) versus placebo.

Figure G-3 is a forest plot for the pairwise comparison of low/ultralow dose estrogens compared with placebo (N=17 trials) for quality of life symptoms, Key Question 1. One point estimate was zero, and an additional five trials had 95 percent confidence intervals including zero. The remaining 11 trials showed significant improvements in quality of life. The pooled SMD is 0.36 (95% CI: 0.27 to 0.45).

Figure G-3

Forest plot of estrogen (low/ultralow) versus placebo.

Figure G-4 is a forest plot for the pairwise comparison of SSRI/SNRIs compared with placebo (N=6 trials) for quality of life, Key Question 1. Two trials had confidence intervals including zero, with the remaining four trials showing significant improvements in quality of life. The pooled SMD is 0.28 (95% CI: 0.17 to 0.39).B56

Figure G-4

Forest plot of SSRI/SNRI versus placebo.

Figure G-5 is a forest plot for the pairwise comparison of isoflavones compared with placebo (N=24 trials) for quality of life symptoms, Key Question 1. Three trials had point estimates less than zero, and an additional 14 trials had 95 percent confidence intervals including zero. The remaining seven trials showed significant improvements in quality of life. The pooled SMD is 0.27 (95% CI: 0.17 to 0.37).

Figure G-5

Forest plot of isoflavones versus placebo.

Figure G-6 is a forest plot for the pairwise comparison of black cohosh compared with placebo (N=4 trials) for quality of life symptoms, Key Question 1. One trial had a negative point estimate and one trial has a 95 percent confidence interval including zero. The remaining two trials showed significant improvements in quality of life. The pooled SMD is 0.26 (95% CI: -0.15 to 0.66).

Figure G-6

Forest plot of black cohosh versus placebo.

Figure G-7 is a forest plot for the pairwise comparison of ginseng compared with placebo (N=3 trials) for quality of life symptoms, Key Question 1. Two trials had 95 percent confidence intervals including zero. The remaining trial showed significant improvements in quality of life. The pooled SMD is 0.19 (95% CI: 0.01 to 0.36).

Figure G-7

Forest plot of ginseng versus placebo.

Figure G-8 is a forest plot for the pairwise comparison of high dose estrogens compared with standard dose estrogens (N=7 trials) for quality of life, Key Question 1. Six of the seven trials had confidence intervals including zero. The pooled analysis reflects no difference between the two doses (SMD: -0.06; 95% CI: -0.16 to 0.04).

Figure G-8

Forest plot of estrogen (high) versus estrogen (standard).

Figure G-9 is a forest plot for the pairwise comparison of standard dose estrogens compared with low/ultralow dose estrogens (N=12 trials) for quality of life, Key Question 1. Two trials had negative point estimates. Eight of the remaining trials had confidence intervals including zero. The pooled analysis reflects slightly more improvement with standard dose estrogen compared with low/ultralow dose estrogen (SMD: 0.13; 95% CI:-0.02 to 0.24).

Figure G-9

Forest plot of estrogen (standard) versus estrogen (low/ultralow).

Table G-1. Network analysis excluding trials utilizing general quality of life instruments (SMDs and 95% credible intervals).

Table G-1

Network analysis excluding trials utilizing general quality of life instruments (SMDs and 95% credible intervals).

Table G-2. Quality-of-life rankings of comparative efficacy excluding trials utilizing general quality of life instruments, standard deviations, and 95% credible intervals (integer values because they arise from a distribution of integers).

Table G-2

Quality-of-life rankings of comparative efficacy excluding trials utilizing general quality of life instruments, standard deviations, and 95% credible intervals (integer values because they arise from a distribution of integers).

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