WHI study. Publications and citations As of September 2018, the WHI has reviewed 3,154 writing proposals, of which 1,725 have been published in scientific journals. According to a 2013 analysis of extramural clinical trials supported by the NHLBI, the components of the WHI study have been some of the most frequently cited in the literature, with the E+P trial ranking first among all NHLBI-sponsored clinical trials, alone averaging 812.5 citations annually (total average annual number of citations for the WHI study interventions, 1233.3). In addition, the WHI study component findings were found to reach publication in a timely manner, despite the study's negative trial findings (see NEJM Supplementary Appendix for detailed findings). Awards and accolades In 2015, the WHI study was awarded the 2015 Team Science Award from the Association for Clinical and Translational Science (ACTS), "given in recognition of the WHI team's success in the translation of research discoveries into clinical applications and, eventually, widespread clinical practice." In April 2016, the American Association for Cancer Research (AACR), the oldest and largest research society of its kind, awarded the WHI study the 2016 Team Science Award in recognition of its more than 20 years of work, which ultimately "singularly changed the face of women's medicine around the world." Criticisms of the WHI's design and findings The WHI trial was limited by low adherence, high attrition, inadequate power to detect risks for some outcomes, and evaluation of few regimens. Subsequent to publication of the WHI, controversy arose regarding the applicability of its findings to women just entering menopause. To be properly double blinded, the study required that women not be perimenopausal or have symptoms of menopause. As the average age of menopause is 51, this resulted in an older study population, with an average age of 63. Only 3.5% of the women were 50–54 years of age, the time when women usually decide whether to initiate hormonal therapy. Further analysis of WHI data, however, demonstrated that there is no gained preventive benefit in starting hormone therapy soon after menopause. Most fundamentally, the WHI did not address the major indication for MHT use: relief of symptoms. Rather, the stated goal of the HT component was to test the long-term cardiovascular-protective effects (rather than treatment of menopausal symptoms) of HT in postmenopausal women, which had been supported by previous observational studies in terms of how it reduces atherosclerotic diseases by lowering serum lipid