{
  "dataset_name": "U.S. Menopause Racial Disparities Evidence Matrix, 2026",
  "version": "1.0",
  "last_verified": "2026-08-01",
  "row_count": 66,
  "publisher": "The HRT Index",
  "creator": "The HRT Index Editorial Team",
  "geographic_scope": "United States",
  "scope": "Original U.S. quantitative studies reporting race/ethnicity-stratified estimates or directly relevant structural correlates for menopause timing, vasomotor symptoms, symptom severity, clinical documentation, prescribing, and menopausal hormone-therapy use.",
  "not_a_meta_analysis": true,
  "important_interpretation_rules": [
    "Source race and ethnicity labels are preserved because classifications differ across studies and periods.",
    "Odds ratios are not percentage-point differences, prevalence ratios, or individual probabilities.",
    "Natural and surgical final menstrual periods are separate outcomes.",
    "Group estimates do not predict an individual person's menopause experience.",
    "Race and ethnicity are social classifications, not stand-alone biological mechanisms.",
    "Rows labeled as The HRT Index calculations are arithmetic derived from published values and are not study-reported estimates.",
    "Incompatible outcomes, samples, periods, and models are not pooled into one effect.",
    "Publication year is not data year; current national MHT-use estimates in this release end in March 2020.",
    "The 2026 insurance study measured self-reported history of use, not current 2026 treatment."
  ],
  "inclusion_criteria": [
    "Original quantitative U.S. research.",
    "A defined menopause-related outcome or directly relevant structural correlate.",
    "A traceable primary-source publication.",
    "A stated population, comparator, estimate, and method sufficient for accurate quotation."
  ],
  "exclusion_criteria": [
    "Consumer summaries when the underlying paper was available.",
    "Unsourced statistics or estimates with an undefined population or comparator.",
    "Narrative reviews as quantitative evidence rows.",
    "General postmenopausal health differences without a direct menopause-experience or care outcome.",
    "Claims converting an association into a biological or causal statement about race.",
    "Non-U.S. estimates in the core Version 1.0 matrix."
  ],
  "columns": {
    "record_id": "Stable row identifier.",
    "domain": "Evidence domain.",
    "publication_year": "Year of the primary study.",
    "study_title": "Primary study title or disclosed derived-calculation source.",
    "cohort_or_dataset": "Named cohort, EHR system, telehealth sample, or national survey.",
    "study_period": "Period in which source data were collected.",
    "analytic_sample": "Unweighted/model sample and weighted population where relevant.",
    "outcome": "Construct summarized by the row.",
    "source_group_label": "Race, ethnicity, insurance, or exposure label used by the source.",
    "comparison_group": "Reference group or trajectory.",
    "estimate_type": "Median, prevalence, OR, HR, conclusion, or derived comparison.",
    "estimate_value": "Point estimate when applicable.",
    "estimate_unit": "Years, percent, OR, HR, or other unit.",
    "ci_level_percent": "Confidence level when reported.",
    "ci_low": "Lower confidence bound.",
    "ci_high": "Upper confidence bound.",
    "adjustment_or_method": "Essential analytical method or adjustment context.",
    "result_interpretation": "Plain-language interpretation constrained to the estimate.",
    "key_limitation": "Limitation that must travel with the estimate.",
    "provenance": "Study-reported estimate or The HRT Index calculation.",
    "primary_source_url": "DOI URL for the primary publication.",
    "doi": "Digital Object Identifier.",
    "last_verified": "Date checked against the primary source."
  },
  "calculation_notes": {
    "VMS_absolute_difference_years": "group median minus non-Hispanic White median",
    "VMS_relative_difference_percent": "((group median - White median) / White median) × 100",
    "Gold_2013_unadjusted_Black_White_difference": "52.17 - 52.88 = -0.71 years = -8.52 months",
    "Gold_2013_adjusted_Black_White_difference": "52.59 - 52.85 = -0.26 years = -3.12 months",
    "Reeves_2023_natural_FMP_difference": "51.4 - 52.0 = -0.6 years",
    "Reeves_2023_surgical_FMP_difference": "47.1 - 48.9 = -1.8 years",
    "Yang_relative_decline": "((later prevalence - earlier prevalence) / earlier prevalence) × 100",
    "Yang_White_to_Black_point_estimate_ratio": "White prevalence divided by Black prevalence; no confidence interval inferred"
  }
}