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Comparative Safety of Testosterone Dosage Forms

Overview of attention for article published in JAMA Internal Medicine, May 2015
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (97th percentile)
  • Good Attention Score compared to outputs of the same age and source (67th percentile)

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2 news outlets
1 blog
92 X users
13 Facebook pages
1 Google+ user
1 Redditor


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Comparative Safety of Testosterone Dosage Forms
Published in
JAMA Internal Medicine, May 2015
DOI 10.1001/jamainternmed.2015.1573
Pubmed ID

J. Bradley Layton, Christoph R. Meier, Julie L. Sharpless, Til Stürmer, Susan S. Jick, M. Alan Brookhart


Increases in testosterone use and mixed reports of adverse events have raised concerns about the cardiovascular safety of testosterone. Testosterone is available in several delivery mechanisms with varying pharmacokinetics; injections cause spikes in testosterone levels, and transdermal patches and gels cause more subtle but sustained increases. The comparative cardiovascular safety of gels, injections, and patches has not been studied. To determine the comparative cardiovascular safety of testosterone injections, patches, and gels. A retrospective cohort study was conducted using administrative claims from a commercially insured (January 1, 2000, to December 31, 2012) and Medicare (January 1, 2007, to December 31, 2010) population in the United States and general practitioner records from the United Kingdom (January 1, 2000, to June 30, 2012). Participants included 13 men (aged ≥18 years) who initiated use of testosterone patches, gels, or 14 injections following 180 days with no testosterone use. Our analysis was conducted from December 11, 2013, to November 12, 2014. New initiation of a testosterone dosage form, with use monitored for up to 1 year. Inpatient or outpatient medical records, diagnoses, or claims for cardiovascular and cerebrovascular events including myocardial infarction (MI), unstable angina, stroke, and composite acute event (MI, unstable angina, or stroke); venous thromboembolism (VTE); mortality; and all-cause hospitalization. We identified 544 115 testosterone initiators between the 3 data sets: 37.4% injection, 6.9% patch, and 55.8% gel. The majority of men in the Medicare cohort were injection initiators (51.2%), most in the US commercially insured population were gel initiators (56.5%), and the UK database included equal proportions of injections and gel users (approximately 41%). With analysis conducted using hazard ratios and 95% CIs, compared with men using gels, injection initiators had higher hazards of cardiovascular events (ie, MI, unstable angina, and stroke) (1.26; 1.18-1.35), hospitalization (1.16; 1.13-1.19), and death (1.34; 1.15-1.56) but not VTE (0.92; 0.76-1.11). Compared with gels, patches did not confer increased hazards of cardiovascular events (1.10; 0.94-1.29), hospitalization (1.04; 1.00-1.08), death (1.02; 0.77-1.33), or VTE (1.08; 0.79-1.47). Testosterone injections were associated with a greater risk of cardiovascular events, hospitalizations, and deaths compared with gels. Patches and gels had similar risk profiles. However, this study did not assess whether patients met criteria for use of testosterone and did not assess the safety of testosterone among users compared with nonusers of the drug.

X Demographics

X Demographics

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 98 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 98 100%

Demographic breakdown

Readers by professional status Count As %
Other 14 14%
Student > Master 13 13%
Student > Postgraduate 10 10%
Student > Bachelor 10 10%
Student > Doctoral Student 8 8%
Other 27 28%
Unknown 16 16%
Readers by discipline Count As %
Medicine and Dentistry 51 52%
Pharmacology, Toxicology and Pharmaceutical Science 8 8%
Biochemistry, Genetics and Molecular Biology 4 4%
Agricultural and Biological Sciences 4 4%
Unspecified 2 2%
Other 8 8%
Unknown 21 21%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 84. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 10 December 2015.
All research outputs
of 24,775,802 outputs
Outputs from JAMA Internal Medicine
of 5,240 outputs
Outputs of similar age
of 269,625 outputs
Outputs of similar age from JAMA Internal Medicine
of 155 outputs
Altmetric has tracked 24,775,802 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 98th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 5,240 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 162.5. This one has gotten more attention than average, scoring higher than 67% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 269,625 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 97% of its contemporaries.
We're also able to compare this research output to 155 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 67% of its contemporaries.