ATTITUDES OF OBSTETRICIANS AND GYNECOLOGISTS TOWARD HORMONE REPLACEMENT THERAPY

Objective. To determine the attitudes of obstetricians and gynecologis ts toward hormone replacement therapy (HRT), and the beliefs and intui tions that affected those attitudes. Design. A questionnaire was sent to 1,000 gynecologists in the United States; 328 replies were received . The questionnaire asked about effects of HRT, practices concerning H RT, and decisions in hypothetical scenarios. Results. The respondents strongly favored HRT, and they were well informed about its effects on osteoporosis, cardiovascular disease, and breast cancer. They were aw are of conflicting findings concerning breast cancer. The strength of their recommendation of HRT was sensitive to patient differences in ri sk factors. The respondents also showed four biases hypothesized to ca use resistance to HRT: omission bias (more concern about harmful acts than harmful omissions); proportionality bias (attention to relative r isk rather than risk differences); naturalness bias (preference for th e natural); and ambiguity (avoiding options with missing information). Proportion bias, naturalness bias, and (weakly) omission bias were re lated to less favorable attitudes toward HRT. Conclusion. Although spe cialists are highly favorable toward HRT in general, some negativity t oward HRT may result from decision biases.