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Diemar MG, Vinken M, Teunis M, Krul CAM, Busquet F, Zajac JD, Kandarova H, Corvi R, Rosso MZ, Kharina A, Bryndum LS, Santillo M, Bloch D, Kucheryavenko O, Panagiotakos D, Rogiers V, Beekhuijzen M, Giusti A, Najjar A, Courage C, Koenig T, Kolle S, Boonen H, Dhalluin S, Boberg J, Müller BP, Kukic P, Ritskes-Hoitinga M, Grasselli E, Zietek T, Stoddart G, Heusinkveld HJ, Castell JV, Benfenati E, Yang H, Perera S, Paini A, Kramer NI, Hartung T, Janssen M, Fritsche E, Jennen DGJ, Piumatti M, Rathman J, Marusczyk J, Milec L, Roggen EL. Report of the First ONTOX Stakeholder Network Meeting: Digging Under the Surface of ONTOX Together With the Stakeholders. Altern Lab Anim 2024; 52:117-131. [PMID: 38235727 DOI: 10.1177/02611929231225730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
The first Stakeholder Network Meeting of the EU Horizon 2020-funded ONTOX project was held on 13-14 March 2023, in Brussels, Belgium. The discussion centred around identifying specific challenges, barriers and drivers in relation to the implementation of non-animal new approach methodologies (NAMs) and probabilistic risk assessment (PRA), in order to help address the issues and rank them according to their associated level of difficulty. ONTOX aims to advance the assessment of chemical risk to humans, without the use of animal testing, by developing non-animal NAMs and PRA in line with 21st century toxicity testing principles. Stakeholder groups (regulatory authorities, companies, academia, non-governmental organisations) were identified and invited to participate in a meeting and a survey, by which their current position in relation to the implementation of NAMs and PRA was ascertained, as well as specific challenges and drivers highlighted. The survey analysis revealed areas of agreement and disagreement among stakeholders on topics such as capacity building, sustainability, regulatory acceptance, validation of adverse outcome pathways, acceptance of artificial intelligence (AI) in risk assessment, and guaranteeing consumer safety. The stakeholder network meeting resulted in the identification of barriers, drivers and specific challenges that need to be addressed. Breakout groups discussed topics such as hazard versus risk assessment, future reliance on AI and machine learning, regulatory requirements for industry and sustainability of the ONTOX Hub platform. The outputs from these discussions provided insights for overcoming barriers and leveraging drivers for implementing NAMs and PRA. It was concluded that there is a continued need for stakeholder engagement, including the organisation of a 'hackathon' to tackle challenges, to ensure the successful implementation of NAMs and PRA in chemical risk assessment.
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Affiliation(s)
| | - Mathieu Vinken
- Department of Pharmaceutical and Pharmacological Sciences, Vrije Universiteit Brussel, Brussel, Belgium
| | - Marc Teunis
- Innovative Testing in Life Sciences & Chemistry, University of Applied Sciences, Utrecht, The Netherlands
| | - Cyrille A M Krul
- Innovative Testing in Life Sciences & Chemistry, University of Applied Sciences, Utrecht, The Netherlands
| | | | - Julia Dominika Zajac
- Department of Pharmaceutical and Pharmacological Sciences, Vrije Universiteit Brussel, Brussel, Belgium
| | - Helena Kandarova
- Institute of Experimental Pharmacology and Toxicology, Centre of Experimental Medicine, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Raffaella Corvi
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | | | | | | | - Michael Santillo
- Center for Food Safety and Applied Nutrition (CFSAN), US Food and Drug Administration (FDA), Laurel, MD, USA
| | - Denise Bloch
- Department of Pesticides Safety, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Olena Kucheryavenko
- Department of Chemicals and Product Safety, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Demosthenes Panagiotakos
- SCHEER/EC-Scientific Committee on Health, Environmental and Emerging Risks/European Commission, European Commission, Brussels, Belgium
| | - Vera Rogiers
- Department of Pharmaceutical and Pharmacological Sciences, Vrije Universiteit Brussel, Brussel, Belgium
- SCCS-Scientific Committee on Consumer Safety, European Commission, Brussels, Belgium
| | | | - Arianna Giusti
- Cosmetics Europe-The Personal Care Association, Brussels, Belgium
| | - Abdulkarim Najjar
- Beiersdorf AG, Hamburg, Germany
- International Collaboration on Cosmetics Safety (ICCS), Mt Royal, NJ, USA
| | - Carol Courage
- International Collaboration on Cosmetics Safety (ICCS), Mt Royal, NJ, USA
| | - Torben Koenig
- International Collaboration on Cosmetics Safety (ICCS), Mt Royal, NJ, USA
| | - Susanne Kolle
- Experimental Toxicology and Ecology, BASF SE, Ludwigshafen am Rhein, Germany (for CEFIC)
| | | | | | | | | | - Predrag Kukic
- Safety & Environmental Assurance Centre, Unilever, Bedfordshire, UK
| | - Merel Ritskes-Hoitinga
- Institute for Risk Assessment Sciences Toxicology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Elena Grasselli
- Department of Earth, Environment, and Life Science, University of Genoa, Genova, Italy
- Interuniversity Center for the Promotion of 3R Principles in Teaching and Research (Centro 3R), Pisa, Italy
| | - Tamara Zietek
- Doctors Against Animal Experiments, Cologne, Germany
| | - Gilly Stoddart
- PETA Science Consortium International e.V., Stuttgart, Germany
| | - Harm J Heusinkveld
- Dutch National Institute for Public Health and the Environment, Centre for Health Protection, Bilthoven, The Netherlands
| | - Jose V Castell
- Department of Biochemistry, IIS Hospital La Fe and CIBERHED, University of Valencia, Valencia, Spain
| | - Emilio Benfenati
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | | | - Simón Perera
- ProtoQSAR SL, Centro Europeo de Empresas Innovadoras, Paterna, Spain
- Departament de Medicina i Ciències de la Vida, Institut de Biologia Evolutiva (CSIC-UPF), Universitat Pompeu Fabra, Barcelona, Spain
| | | | - Nynke I Kramer
- Toxicology Chair Group, Wageningen University, Wageningen, The Netherlands
| | - Thomas Hartung
- Center for Alternatives to Animal Testing Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Manoe Janssen
- The Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Ellen Fritsche
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
- Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
- DNTOX GmbH, Düsseldorf, Germany
| | - Danyel G J Jennen
- Department of Toxicogenomics, GROW School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
| | | | - James Rathman
- Molecular Networks GMBH Computerchemie, Nuremberg, Germany
| | - Jörg Marusczyk
- Molecular Networks GMBH Computerchemie, Nuremberg, Germany
| | - Lucia Milec
- Institute of Experimental Pharmacology and Toxicology, Centre of Experimental Medicine, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Erwin L Roggen
- 3Rs Management and Consulting ApS, Kongens Lyngby, Denmark
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Roos T, Leenaars C, Schaffert A, Paparella M, Murugadoss S, Mertens B, Linzalone N, Donzelli G, Ritskes-Hoitinga M, Gehring R. Pollutant exposure and myocardial injury: Protocol and progress report for a toxicological systematic mapping review. ALTEX 2023; 41:248-259. [PMID: 37983382 DOI: 10.14573/altex.2304111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 11/13/2023] [Indexed: 11/22/2023]
Abstract
An increasing body of evidence identifies pollutant exposure as a risk factor for cardiovascular disease (CVD), while CVD incidence rises steadily with the aging population. Although numerous experimental studies are now available, the mechanisms through which lifetime exposure to environmental pollutants can result in CVD are not fully understood. To comprehensively describe and understand the pathways through which pollutant exposure leads to cardiotoxicity, a systematic mapping review of the available toxicological evidence is needed. This protocol outlines a step-by-step framework for conducting this review. Using the National Toxicology Program (NTP) Health Assessment and Translation (HAT) approach for conducting toxicological systematic reviews, we selected 362 out of 8111 in vitro (17%), in vivo (67%), and combined (16%) studies for 129 potential cardiotoxic environmental pollutants, including heavy metals (29%), air pollutants (16%), pesticides (27%), and other chemicals (28%). The internal validity of included studies is being assessed with HAT and SYRCLE Risk of Bias tools. Tabular templates are being used to extract key study elements regarding study setup, methodology, techniques, and (qualitative and quantitative) outcomes. Subsequent synthesis will consist of an explorative meta-analysis of possible pollutant-related cardiotoxicity. Evidence maps and interactive knowledge graphs will illustrate evidence streams, cardiotoxic effects and associated quality of evidence, helping researchers and regulators to efficiently identify pollutants of interest. The evidence will be integrated in novel Adverse Outcome Pathways to facilitate regulatory acceptance of non-animal methods for cardiotoxicity testing. The current article describes the progress of the steps made in the systematic mapping review process.
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Affiliation(s)
- Tom Roos
- Department of Population Health Sciences, Institute for Risk Assessment Sciences (IRAS), Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Cathalijn Leenaars
- Institute for Laboratory Animal Science, Hannover Medical School, Hannover, Germany
| | - Alexandra Schaffert
- Institute of Medical Biochemistry, Medical University Innsbruck, Innsbruck, Austria
| | - Martin Paparella
- Institute of Medical Biochemistry, Medical University Innsbruck, Innsbruck, Austria
| | - Sivakumar Murugadoss
- Scientific Direction of Chemical and Physical Health Risks, Sciensano, Brussels, Belgium
| | - Birgit Mertens
- Scientific Direction of Chemical and Physical Health Risks, Sciensano, Brussels, Belgium
| | - Nunzia Linzalone
- Institute of Clinical Physiology of the National Research Council (CNR-IFC), Pisa, Italy
| | - Gabriele Donzelli
- Institute of Clinical Physiology of the National Research Council (CNR-IFC), Pisa, Italy
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Merel Ritskes-Hoitinga
- Department of Population Health Sciences, Institute for Risk Assessment Sciences (IRAS), Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
- AUGUST, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Ronette Gehring
- Department of Population Health Sciences, Institute for Risk Assessment Sciences (IRAS), Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
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van Beuningen N, Alkema S, Hijlkema N, Ulfhake B, Frias R, Ritskes-Hoitinga M, Alkema W. The 3Ranker: An AI-based Algorithm for Finding Non-animal Alternative Methods. Altern Lab Anim 2023; 51:376-386. [PMID: 37864460 DOI: 10.1177/02611929231210777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2023]
Abstract
The search for existing non-animal alternative methods for use in experiments is currently challenging because of the lack of both comprehensive structured databases and balanced keyword-based search strategies to mine unstructured textual databases. In this paper we describe 3Ranker, which is a fast, keyword-independent algorithm for finding non-animal alternative methods for use in biomedical research. The 3Ranker algorithm was created by using a machine learning approach, consisting of a Random Forest model built on a dataset of 35 million abstracts and constructed with weak supervision, followed by iterative model improvement with expert curated data. We found a satisfactory trade-off between sensitivity and specificity, with Area Under the Curve (AUC) values ranging from 0.85-0.95. Trials showed that the AI-based classifier was able to identify articles that describe potential alternatives to animal use, among the thousands of articles returned by generic PubMed queries on dermatitis and Parkinson's disease. Application of the classification models on time series data showed the earlier implementation and acceptance of Three Rs principles in the area of cosmetics and skin research, as compared to the area of neurodegenerative disease research. The 3Ranker algorithm is freely available at www.open3r.org; the future goal is to expand this framework to cover multiple research domains and to enable its broad use by researchers, policymakers, funders and ethical review boards, in order to promote the replacement of animal use in research wherever possible.
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Affiliation(s)
| | | | | | - Brun Ulfhake
- Department of Laboratory Medicine, Karolinska Institute, Solna, Sweden
| | - Rafael Frias
- Department of Comparative Medicine, Karolinska Institute, Solna, Sweden
| | - Merel Ritskes-Hoitinga
- Department Population Health Sciences - IRAS Toxicology, Utrecht University, Utrecht, The Netherlands
- Department Clinical Medicine, Aarhus University, Denmark
| | - Wynand Alkema
- TenWise BV, Leiden, The Netherlands
- Institute for Life Science and Technology, Centre for Biobased Economy, Hanze University of Applied Sciences, Groningen, The Netherlands
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Kousholt BS, Præstegaard KF, Stone JC, Thomsen AF, Johansen TT, Ritskes-Hoitinga M, Wegener G. Reporting of 3Rs Approaches in Preclinical Animal Experimental Studies-A Nationwide Study. Animals (Basel) 2023; 13:3005. [PMID: 37835611 PMCID: PMC10571812 DOI: 10.3390/ani13193005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/11/2023] [Accepted: 09/13/2023] [Indexed: 10/15/2023] Open
Abstract
The 3Rs aim to refine animal welfare, reduce animal numbers, and replace animal experiments. Investigations disclose that researchers are positive towards 3Rs recommendations from peers. Communication of 3Rs approaches via primary preclinical animal experimental literature may become a fast-forward extension to learn relevant 3Rs approaches if such are reported. This study investigates 3Rs-reporting in peer-reviewed preclinical animal research with at least one author affiliated to a Danish university. Using a systematic search and random sampling, we included 500 studies from 2009 and 2018. Reporting was low and improvement over time limited. A word search for 3R retrieved zero results in 2009 and 3.2% in 2018. Reporting on 3Rs-related sentences increased from 6.4% in 2009 to 18.4% in 2018, "reduction" increased from 2.4% to 8.0%, and "refinement" from 5.2% to 14.4%. Replacement was not reported. Reporting of the methodology was missing. For "reduction", methodology was mentioned in one study in 2009 and 11 studies in 2018, and for "refinement" in 9 and 21, respectively. Twenty-one studies stated compliance with ARRIVE-guidelines or similar without disclosure of details. Reporting of 3Rs approaches in preclinical publications is currently insufficient to guide researchers. Other strategies, e.g., education, interdisciplinary collaboration, and 3Rs funding initiatives, are needed.
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Affiliation(s)
- Birgitte S. Kousholt
- Department of Clinical Medicine, AUGUST, Aarhus University, 8200 Aarhus, Denmark; (K.F.P.); (A.F.T.); (T.T.J.); (M.R.-H.); (G.W.)
| | - Kirstine F. Præstegaard
- Department of Clinical Medicine, AUGUST, Aarhus University, 8200 Aarhus, Denmark; (K.F.P.); (A.F.T.); (T.T.J.); (M.R.-H.); (G.W.)
| | - Jennifer C. Stone
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA 5005, Australia;
- Department of Health Services Research and Policy, Research School of Population Health, Australian National University, Canberra, ACT 2600, Australia
| | - Anders F. Thomsen
- Department of Clinical Medicine, AUGUST, Aarhus University, 8200 Aarhus, Denmark; (K.F.P.); (A.F.T.); (T.T.J.); (M.R.-H.); (G.W.)
| | - Thea T. Johansen
- Department of Clinical Medicine, AUGUST, Aarhus University, 8200 Aarhus, Denmark; (K.F.P.); (A.F.T.); (T.T.J.); (M.R.-H.); (G.W.)
| | - Merel Ritskes-Hoitinga
- Department of Clinical Medicine, AUGUST, Aarhus University, 8200 Aarhus, Denmark; (K.F.P.); (A.F.T.); (T.T.J.); (M.R.-H.); (G.W.)
- Institute for Risk Assessment Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584 CM Utrecht, The Netherlands
| | - Gregers Wegener
- Department of Clinical Medicine, AUGUST, Aarhus University, 8200 Aarhus, Denmark; (K.F.P.); (A.F.T.); (T.T.J.); (M.R.-H.); (G.W.)
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark
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Struijs F, Hooijmans CR, Buijs M, Dahan A, Hoffmann S, Kiffen R, Mandrioli D, Menon J, Ritskes-Hoitinga M, Roeleveld N, de Ruijter A, Scheffer GJ, Schlünssen V, Scheepers PTJ. Establishing a health-based recommended occupational exposure limit for isoflurane using experimental animal data: a systematic review protocol. Syst Rev 2023; 12:166. [PMID: 37710304 PMCID: PMC10503167 DOI: 10.1186/s13643-023-02331-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 08/18/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Isoflurane is used as an inhalation anesthetic in medical, paramedical, and veterinary practice. Epidemiological studies suggest an increased risk of miscarriages and malformations at birth related to maternal exposure to isoflurane and other inhalation anesthetics. However, these studies cannot be used to derive an occupational exposure level (OEL), because exposure was not determined quantitatively and other risk factors such as co-exposures to other inhalation anesthetics and other work-related factors may also have contributed to the observed adverse outcomes. The aim of this systematic review project is to assess all available evidence on the effects of isoflurane in studies of controlled exposures in laboratory animals to derive a health-based recommended OEL. METHODS A comprehensive search strategy was developed to retrieve all animal studies addressing isoflurane exposure from PubMed, EMBASE, and Web of Science. Title-abstract screening will be performed by machine learning, and full-text screening by one reviewer. Discrepancies will be resolved by discussion. We will include primary research in healthy, sexually mature (non human) vertebrates of single exposure to isoflurane. Studies describing combined exposure and treatments with > = 1 vol% isoflurane will be excluded. Subsequently, details regarding study identification, study design, animal model, and intervention will be summarized. All relevant exposure characteristics and outcomes will be extracted. The risk of bias will be assessed by two independent reviewers using an adapted version of the SYRCLE's risk of bias tool and an addition of the OHAT tool. For all outcomes for which dose-response curves can be derived, the benchmark dose (BMD) approach will be used to establish a point of departure for deriving a recommended health-based recommended OEL for 8 h (workshift exposure) and for 15 min (short-term exposure). DISCUSSION Included studies should be sufficiently sensitive to detect the adverse health outcomes of interest. Uncertainties in the extrapolation from animals to humans will be addressed using assessment factor. These factors are justified in accordance with current practice in chemical risk assessment. A panel of experts will be involved to reach consensus decisions regarding significant steps in this project, such as determination of the critical effects and how to extrapolate from animals to humans. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42022308978.
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Affiliation(s)
- Fréderique Struijs
- Radboud Institute for Biological and Environmental Sciences, Radboud University, Nijmegen, The Netherlands
| | - Carlijn R Hooijmans
- Department of Anaesthesiology, Pain and Palliative Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marije Buijs
- Radboud Institute for Biological and Environmental Sciences, Radboud University, Nijmegen, The Netherlands
| | - Albert Dahan
- Leiden University Medical Center, Leiden, The Netherlands
| | - Sebastian Hoffmann
- The Evidence-Based Toxicology Collaboration (EBTC), Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Romy Kiffen
- Radboud Institute for Biological and Environmental Sciences, Radboud University, Nijmegen, The Netherlands
| | - Daniele Mandrioli
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy
| | - Julia Menon
- Netherlands Heart Institute, Utrecht, The Netherlands
| | | | - Nel Roeleveld
- Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anne de Ruijter
- Radboud Institute for Biological and Environmental Sciences, Radboud University, Nijmegen, The Netherlands
| | - Gert Jan Scheffer
- Department of Anaesthesiology, Pain and Palliative Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Vivi Schlünssen
- Department of Public Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
- National Research Center for the Working Environment, Copenhagen, Denmark
| | - Paul T J Scheepers
- Radboud Institute for Biological and Environmental Sciences, Radboud University, Nijmegen, The Netherlands.
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Barker TH, Aromataris E, Ritskes-Hoitinga M, Sears K, Klugar M, Leonardi-Bee J, Munn Z. In reply to "Bias assessment: mQ or RoB?". JBI Evid Synth 2023; 21:1346-1347. [PMID: 37282722 DOI: 10.11124/jbies-23-00213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Timothy H Barker
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
- Health Evidence Synthesis, Recommendations and Impact (HESRI), School of Public Health, The University of Adelaide, Adelaide, SA, Australia
| | - Edoardo Aromataris
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Merel Ritskes-Hoitinga
- Institute for Risk Assessment Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Kim Sears
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Queen's University, Kingston, ON, Canada
| | - Miloslav Klugar
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Faculty of Medicine, Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic
| | - Jo Leonardi-Bee
- Centre for Evidence Based Healthcare, Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK
| | - Zachary Munn
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
- Health Evidence Synthesis, Recommendations and Impact (HESRI), School of Public Health, The University of Adelaide, Adelaide, SA, Australia
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7
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Van de Wall G, Van Hattem A, Timmermans J, Ritskes-Hoitinga M, Bleich A, Leenaars C. Comparing translational success rates across medical research fields - A combined analysis of literature and clinical trial data. ALTEX 2023; 40:584-594. [PMID: 37158378 DOI: 10.14573/altex.2208261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 03/23/2023] [Indexed: 05/10/2023]
Abstract
Many interventions that show promising results in preclinical development do not pass clinical tests. Part of this may be explained by poor animal-to-human translation. Using animal models with low predictability for humans is neither ethical nor efficient. If translational success shows variation between medical research fields, analyses of common practices in these fields could identify factors contributing to successful translation. We assessed translational success rates in medical research fields using two approaches: through literature and clinical trial registers. Literature: We comprehensively searched PubMed for pharmacology, neuroscience, cancer research, animal models, clinical trials, and translation. After screening, 117 review papers were included in this scoping review. Translational success rates were not different within pharmacology (72%), neuroscience (62%), and cancer research (69%). Clinical trials: The fraction of phase-2 clinical trials with a positive outcome was used as a proxy (i.e., an indirect resemblance measure) for translational success. Trials were retrieved from the WHO trial register and categorized into medical research fields following the international classification of disease (ICD-10). Of the phase-2 trials analyzed, 65.2% were successful. Fields with the highest success rates were disorders of lipoprotein metabolism (86.0%) and epilepsy (85.0%). Fields with the lowest success rates were schizophrenia (45.4%) and pancreatic cancer (46.0%). Our combined analyses suggest relevant differences in success rates between medical research fields. Based on the clinical trials, comparisons of practice, e.g., between epilepsy and schizophrenia, might identify factors that influence translational success.
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Affiliation(s)
- Gwen Van de Wall
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Astrid Van Hattem
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Joy Timmermans
- PXL University of Applied Sciences and Arts, Hasselt, Belgium
| | - Merel Ritskes-Hoitinga
- Faculty of Veterinary Medicine, Department of Population Health Sciences, Utrecht University, The Netherlands
- AUGUST, Department of Clinical Medicine, Aarhus University, Denmark
| | - André Bleich
- Institute for Laboratory Animal Science, Hannover Medical School, Hannover, Germany
| | - Cathalijn Leenaars
- Institute for Laboratory Animal Science, Hannover Medical School, Hannover, Germany
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8
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Stone JC, Glass K, Ritskes-Hoitinga M, Munn Z, Tugwell P, Doi SAR. Methodological quality assessment should move beyond design specificity. JBI Evid Synth 2023; 21:507-519. [PMID: 36683451 DOI: 10.11124/jbies-22-00362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE This study aimed to assess the utility of a unified tool (MASTER) for bias assessment against design-specific tools in terms of content and coverage. METHODS Each of the safeguards in the design-specific tools was compared and matched to safeguards in the unified MASTER scale. The design-specific tools were the JBI, Scottish Intercollegiate Guidelines Network (SIGN), and the Newcastle-Ottawa Scale (NOS) tools for analytic study designs. Duplicates, safeguards that could not be mapped to the MASTER scale, and items not applicable as safeguards against bias were flagged and described. RESULTS Many safeguards across the JBI, SIGN, and NOS tools were common, with a minimum of 10 to a maximum of 23 unique safeguards across various tools. These 3 design-specific toolsets were missing 14 to 26 safeguards from the MASTER scale. The MASTER scale had complete coverage of safeguards within the 3 toolsets for analytic designs. CONCLUSIONS The MASTER scale provides a unified framework for bias assessment of analytic study designs, has good coverage, avoids duplication, has less redundancy, and is more convenient when used for methodological quality assessment in evidence synthesis. It also allows assessment across designs that cannot be done using a design-specific tool.
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Affiliation(s)
- Jennifer C Stone
- Department of Health Services Research and Policy, Research School of Population Health, Australian National University, Canberra, ACT, Australia.,JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Kathryn Glass
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Merel Ritskes-Hoitinga
- SYRCLE, Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands.,Department for Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Zachary Munn
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Peter Tugwell
- Department of Medicine, University of Ottawa, Ottawa, Canada
| | - Suhail A R Doi
- Department of Population Medicine, College of Medicine, Qatar University, Doha, Qatar
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9
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Stone JC, Barker TH, Aromataris E, Ritskes-Hoitinga M, Sears K, Klugar M, Leonardi-Bee J, Munn Z. From critical appraisal to risk of bias assessment: clarifying the terminology for study evaluation in JBI systematic reviews. JBI Evid Synth 2023; 21:472-477. [PMID: 36882947 DOI: 10.11124/jbies-22-00434] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
The foundations for critical appraisal of literature have largely progressed through the development of epidemiologic research methods and the use of research to inform medical teaching and practice. This practical application of research is referred to as evidence-based medicine and has delivered a standard for the health care profession where clinicians are equally as engaged in conducting scientific research as they are in the practice of delivering treatments. Evidence-based medicine, now referred to as evidence-based health care, has generally been operationalized through empirically supported treatments, whereby the choice of treatments is substantiated by scientific support, usually by means of an evidence synthesis. As evidence synthesis methodology has advanced, guidance for the critical appraisal of primary research has emphasized a distinction from the assessment of internal validity required for synthesized research. This assessment is conceptualized and branded in various ways in the literature, such as risk of bias, critical appraisal, study validity, methodological quality, and methodological limitations. This paper provides a discussion of the definitions and characteristics of these terms, concluding with a recommendation for JBI to adopt the term "risk of bias" assessment.
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Affiliation(s)
- Jennifer C Stone
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Timothy Hugh Barker
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Edoardo Aromataris
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Merel Ritskes-Hoitinga
- Institute for Risk Assessment Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Kim Sears
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Queen's University, Kingston, ON, Canada
| | - Miloslav Klugar
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Faculty of Medicine, Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic
| | - Jo Leonardi-Bee
- Centre for Evidence Based Healthcare, Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK
| | - Zachary Munn
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
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10
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Fosse V, Oldoni E, Bietrix F, Budillon A, Daskalopoulos EP, Fratelli M, Gerlach B, Groenen PMA, Hölter SM, Menon JML, Mobasheri A, Osborne N, Ritskes-Hoitinga M, Ryll B, Schmitt E, Ussi A, Andreu AL, McCormack E, Demotes J, Garcia P, Gerardi C, Glaab E, Haro JM, Hulstaert F, Miguel LS, Mirete JS, Niubo AS, Porcher R, Rauschenberger A, Rodriguez MC, Superchi C, Torres T. Recommendations for robust and reproducible preclinical research in personalised medicine. BMC Med 2023; 21:14. [PMID: 36617553 PMCID: PMC9826728 DOI: 10.1186/s12916-022-02719-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 12/19/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Personalised medicine is a medical model that aims to provide tailor-made prevention and treatment strategies for defined groups of individuals. The concept brings new challenges to the translational step, both in clinical relevance and validity of models. We have developed a set of recommendations aimed at improving the robustness of preclinical methods in translational research for personalised medicine. METHODS These recommendations have been developed following four main steps: (1) a scoping review of the literature with a gap analysis, (2) working sessions with a wide range of experts in the field, (3) a consensus workshop, and (4) preparation of the final set of recommendations. RESULTS Despite the progress in developing innovative and complex preclinical model systems, to date there are fundamental deficits in translational methods that prevent the further development of personalised medicine. The literature review highlighted five main gaps, relating to the relevance of experimental models, quality assessment practices, reporting, regulation, and a gap between preclinical and clinical research. We identified five points of focus for the recommendations, based on the consensus reached during the consultation meetings: (1) clinically relevant translational research, (2) robust model development, (3) transparency and education, (4) revised regulation, and (5) interaction with clinical research and patient engagement. Here, we present a set of 15 recommendations aimed at improving the robustness of preclinical methods in translational research for personalised medicine. CONCLUSIONS Appropriate preclinical models should be an integral contributor to interventional clinical trial success rates, and predictive translational models are a fundamental requirement to realise the dream of personalised medicine. The implementation of these guidelines is ambitious, and it is only through the active involvement of all relevant stakeholders in this field that we will be able to make an impact and effectuate a change which will facilitate improved translation of personalised medicine in the future.
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Affiliation(s)
- Vibeke Fosse
- Department of Clinical Science, Centre for Cancer Biomarkers, University of Bergen, Bergen, Norway.
| | - Emanuela Oldoni
- EATRIS ERIC, European Infrastructure for Translational Medicine, Amsterdam, The Netherlands
| | - Florence Bietrix
- EATRIS ERIC, European Infrastructure for Translational Medicine, Amsterdam, The Netherlands
| | - Alfredo Budillon
- Istituto Nazionale per lo Studio e la Cura dei Tumori "Fondazione G. Pascale" - IRCCS, Naples, Italy
| | | | - Maddalena Fratelli
- Department of Biochemistry and Molecular Pharmacology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Björn Gerlach
- PAASP GmbH, Guarantors of EQIPD e.V., Central Institute for Mental Health in Mannheim, Mannheim, Germany
| | | | | | - Julia M L Menon
- Preclinicaltrials.eu, Netherlands Heart Institute, Utrecht, The Netherlands
| | - Ali Mobasheri
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, 90570, Oulu, Finland.,Department of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, LT-08406, Vilnius, Lithuania.,Department of Joint Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, China.,Departments of Orthopedics, Rheumatology and Clinical Immunology, University Medical Center Utrecht, 508, GA, Utrecht, The Netherlands.,World Health Organization Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Université de Liège, B-4000, Liège, Belgium
| | | | - Merel Ritskes-Hoitinga
- Department of Population Health Sciences, IRAS, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.,Department of Clinical Medicine, AUGUST, Aarhus University, Aarhus, Denmark
| | - Bettina Ryll
- Melanoma Patient Network Europe, Uppsala, Sweden
| | - Elmar Schmitt
- Global Regulatory Oncology, Merck Healthcare KGaA, Frankfurter Str. 250, 64293, Darmstadt, Germany
| | - Anton Ussi
- EATRIS ERIC, European Infrastructure for Translational Medicine, Amsterdam, The Netherlands
| | - Antonio L Andreu
- EATRIS ERIC, European Infrastructure for Translational Medicine, Amsterdam, The Netherlands
| | - Emmet McCormack
- Department of Clinical Science, Centre for Cancer Biomarkers, University of Bergen, Bergen, Norway.,Department of Clinical Science, Centre for Pharmacy, The University of Bergen, Bergen, Norway
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11
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Abarkan FZ, Wijen AMA, van Eijden RMG, Struijs F, Dennis P, Ritskes-Hoitinga M, Visseren-Hamakers I. Identifying Key Factors for Accelerating the Transition to Animal-Testing-Free Medical Science through Co-Creative, Interdisciplinary Learning between Students and Teachers. Animals (Basel) 2022; 12:ani12202757. [PMID: 36290142 PMCID: PMC9597726 DOI: 10.3390/ani12202757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/09/2022] [Accepted: 10/10/2022] [Indexed: 11/16/2022] Open
Abstract
Even with the introduction of the replacement, reduction, refinement (the three Rs) approach and promising technological developments in animal-testing-free alternatives over the past two decades, a significant number of animal tests are still performed in medical science today. This article analyses which factors could accelerate the transition to animal-free medical science, applying the multi-level perspective (MLP) framework. The analysis was based on qualitative research, including a desk study (literature review and document analysis), lectures from experts, and nine online focus group sessions with experts on 26 July 2021. These were undertaken as part of an honours project between May and September 2021 to identify barriers, levers, and opportunities for accelerating this transition. The MLP framework identifies required changes at three levels: innovations and new practices (niche level), the current (bio)medical research system (regime level), and larger societal forces (landscape level). All three levels interact in a non-linear fashion. The model enabled us to identify many relevant factors influencing the transition to animal-testing-free medical science and enabled priority setting. Our findings supported the formulation of six "focus areas" to which stakeholders could devote efforts in order to accelerate the transition to animal-testing-free medical science: (1) thorough and translatable new approach methods (NAMs) for human-relevant medical research; (2) open science and sharing data; (3) targeted funding for NAMs; (4) implementing and modernising legislation for NAMs; (5) interdisciplinary education on animal-testing-free medical science; and (6) facilitating a shift in societal views, as this would be of benefit to both animals and humans. It is proposed that these focus areas should be implemented in parallel.
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Affiliation(s)
- Fatima Zohra Abarkan
- Faculty of Science, Radboud University, Radboud Honours Academy, 6525 AJ Nijmegen, The Netherlands; (F.Z.A.); (F.S.)
| | - Anna M. A. Wijen
- Faculty of Medical Science, Radboud University, Radboud Honours Academy, 6525 AJ Nijmegen, The Netherlands;
| | - Rebecca M. G. van Eijden
- Institute for Management Research, Radboud University, Radboud Honours Academy, 6525 AJ Nijmegen, The Netherlands; (R.M.G.v.E.); (P.D.)
| | - Fréderique Struijs
- Faculty of Science, Radboud University, Radboud Honours Academy, 6525 AJ Nijmegen, The Netherlands; (F.Z.A.); (F.S.)
| | - Phoebe Dennis
- Institute for Management Research, Radboud University, Radboud Honours Academy, 6525 AJ Nijmegen, The Netherlands; (R.M.G.v.E.); (P.D.)
| | - Merel Ritskes-Hoitinga
- Faculty of Veterinary Medicine, Utrecht University, 3584 CL Utrecht, The Netherlands
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
- Correspondence:
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12
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Abstract
The contemporary pharmaceutical industry is voicing growing concerns about the translatability and reproducibility of animal models. In addition, the usefulness of certain of the required regulatory safety tests in animals is being increasingly questioned. It remains difficult, however, to make the move toward alternative testing methods, not least because of legislative demands. A historical analysis was performed, in order to study how the mandatory animal studies in legislative requirements came about. This article reflects on the role that specific public health disasters played in the creation of (more) regulatory requirements for animal testing. It will show how the regulatory changes prompted by the sulfanilamide elixir disaster in the 1930s and the thalidomide disaster in the early 1960s were based on the belief that extensive animal testing would prevent similar future human health tragedies. As scientists increasingly highlight issues with translatability between non-human animals and humans, the belief that current regulatory requirements ensure safety becomes more difficult to maintain. In addition, it means that some of the regulations now in place require animal tests that do not contribute to the safety of a drug, as shown in a third case study of the court case by Vanda industries against the FDA. We finally argue that regulations should be critically examined and altered where necessary, so that they are no longer a barrier in the transition toward animal-free testing and more human-relevant science.
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Affiliation(s)
- Doortje Swaters
- Radboud Institute for Culture and History, 6029Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Anne van Veen
- Nijmegen School of Management, 6029Radboud Universiteit Nijmegen, Nijmegen, The Netherlands
| | - Wim van Meurs
- Radboud Institute for Culture and History, 6029Radboud University Nijmegen, Nijmegen, The Netherlands
| | | | - Merel Ritskes-Hoitinga
- SYRCLE, Department for Health Evidence, 6029Radboudumc (Radboud University Medical Center), Nijmegen, The Netherlands.,AUGUST, Department for Clinical Medicine, Aarhus University, Aarhus, Denmark
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13
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Ritskes-Hoitinga M, Pound P. The role of systematic reviews in identifying the limitations of preclinical animal research, 2000–2022: part 2. J R Soc Med 2022; 115:231-235. [DOI: 10.1177/01410768221100970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
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14
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Ritskes-Hoitinga M, Pound P. The role of systematic reviews in identifying the limitations of preclinical animal research, 2000-2022: part 1. J R Soc Med 2022; 115:186-192. [PMID: 35502678 DOI: 10.1177/01410768221093551] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
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15
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Menon JML, Ritskes-Hoitinga M, Pound P, van Oort E. The impact of conducting preclinical systematic reviews on researchers and their research: A mixed method case study. PLoS One 2021; 16:e0260619. [PMID: 34898637 PMCID: PMC8668092 DOI: 10.1371/journal.pone.0260619] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 11/15/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Systematic reviews (SRs) are cornerstones of evidence-based medicine and have contributed significantly to breakthroughs since the 1980's. However, preclinical SRs remain relatively rare despite their many advantages. Since 2011 the Dutch health funding organisation (ZonMw) has run a grant scheme dedicated to promoting the training, coaching and conduct of preclinical SRs. Our study focuses on this funding scheme to investigate the relevance, effects and benefits of conducting preclinical SRs on researchers and their research. METHODS We recruited researchers who attended funded preclinical SR workshops and who conducted, are still conducting, or prematurely stopped a SR with funded coaching. We gathered data using online questionnaires followed by semi-structured interviews. Both aimed to explore the impact of conducting a SR on researchers' subsequent work, attitudes, and views about their research field. Data-analysis was performed using Excel and ATLAS.ti. RESULTS Conducting preclinical SRs had two distinct types of impact. First, the researchers acquired new skills and insights, leading to a change in mindset regarding the quality of animal research. This was mainly seen in the way participants planned, conducted and reported their subsequent animal studies, which were more transparent and of a higher quality than their previous work. Second, participants were eager to share their newly acquired knowledge within their laboratories and to advocate for change within their research teams and fields of interest. In particular, they emphasised the need for preclinical SRs and improved experimental design within preclinical research, promoting these through education and published opinion papers. CONCLUSION Being trained and coached in the conduct of preclinical SRs appears to be a contributing factor to many beneficial changes which will impact the quality of preclinical research in the long-term. Our findings suggest that this ZonMw funding scheme is helpful in improving the quality and transparency of preclinical research. Similar funding schemes should be encouraged, preferably by a broader group of funders or financers, in the future.
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Affiliation(s)
- Julia M. L. Menon
- Department for Health Evidence, Systematic Review Centre for Laboratory (animal) Experimentation (SYRCLE), Radboud University Medical Center, Nijmegen, The Netherlands
- Preclinicaltrials.eu, Netherlands Heart Institute, Utrecht, The Netherlands
| | - Merel Ritskes-Hoitinga
- Department for Health Evidence, Systematic Review Centre for Laboratory (animal) Experimentation (SYRCLE), Radboud University Medical Center, Nijmegen, The Netherlands
- Department for Clinical Medicine, AUGUST, Aarhus University, Aarhus, Denmark
| | | | - Erica van Oort
- ZonMw (Netherlands Organisation for Health Research and Development), The Hague, The Netherlands
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16
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Menon JML, van Luijk JAKR, Swinkels J, Lukas E, Ritskes-Hoitinga M, Roeleveld N, Schlünssen V, Mandrioli D, Hoffmann S, Popa M, Scheepers PTJ. A health-based recommended occupational exposure limit for nitrous oxide using experimental animal data based on a systematic review and dose-response analysis. Environ Res 2021; 201:111575. [PMID: 34174259 DOI: 10.1016/j.envres.2021.111575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 06/18/2021] [Accepted: 06/20/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Nitrous oxide (N2O) is a common inhalation anaesthetic used in medical, paramedical, and veterinary practice. Since the mid 1950's, concerns have been raised regarding occupational exposure to N2O, leading to many epidemiological and experimental animal studies. Previous evaluations resulted in the classification of N2O as a possible risk factor for adverse reproductive health outcomes based on animal data. Human data were deemed inadequate primarily because of simultaneous co-exposures to other risk factors for adverse reproductive and developmental outcomes, including other anaesthetic gases. Since previous evaluations, controversies regarding N2O use remained and new approaches for dose response modelling have been adopted, calling for an update and re-evaluation of the body of evidence. This review aims to assess available animal evidence on N2O reproductive and developmental outcomes to inform a health-based recommended occupational exposure limit (OEL) for N2O with a benchmark dose-response modelling (BMD) approach. METHODS Comprehensive searches in PubMed, EMBASE, and Web of Science were performed to retrieve all relevant studies addressing reproductive and developmental outcomes related to inhalation of N2O in animals. The articles retrieved were screened based on title-abstract and full text by two independent reviewers. After data extraction, an overview of all studies was created for the different endpoints, namely foetal outcomes (e.g., resorption), female outcomes (e.g. implantations), and male outcomes (e.g. sperm count). A subset of studies reporting on exposure relevant to workplace settings and with a sufficient number of tested doses were included in dose-response modelling using the BMD approach. RESULTS In total, 15.816 articles were retrieved, of which 47 articles were finally included while 4 of those were used for the quantitative data synthesis. The overall risk of bias was judged to be probably high (using OHAT risk of bias tool) and unclear (using SYRCLE's risk of bias tool). From eligible rat studies, three studies provided an acceptable result by fitting a Hill model to the dose-response data. The resulting benchmark dose lower bounds (BMDLs) from three studies converged to an average (±sd) exposure level of 925 ± 2 mg/m3 at an additional risk of one standard deviation of implantation losses above those observed in the control group (i.e. reduced number of live foetuses/mother). For extrapolation from rats to humans, an uncertainty factor of 10 was used and an additional factor of 5 was applied to account for interindividual variability within the population of workers. CONCLUSION With this systematic review, all available evidence for reproductive toxicity and adverse developmental outcomes in animals resulting from inhalation exposure to N2O was used to derive a health-based OEL recommendation of 20 mg/m3 as 8-h time-weighted average.
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Affiliation(s)
- Julia M L Menon
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboudumc, Nijmegen, the Netherlands
| | - Judith A K R van Luijk
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboudumc, Nijmegen, the Netherlands
| | - Janne Swinkels
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboudumc, Nijmegen, the Netherlands
| | - Eva Lukas
- Faculty of Science, Radboud University, Nijmegen, the Netherlands
| | - Merel Ritskes-Hoitinga
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboudumc, Nijmegen, the Netherlands; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Nel Roeleveld
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboudumc, Nijmegen, the Netherlands
| | - Vivi Schlünssen
- Department of Public Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark and National Research Center for the Working Environment, Copenhagen, Denmark
| | - Daniele Mandrioli
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy
| | - Sebastian Hoffmann
- The Evidence-Based Toxicology Collaboration (EBTC), Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | | | - Paul T J Scheepers
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboudumc, Nijmegen, the Netherlands.
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17
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Ritskes-Hoitinga M, Alkema W. The Use of Artificial Intelligence for the Fast and Effective Identification of Three Rs-based Literature. Altern Lab Anim 2021; 49:133-136. [PMID: 34581190 DOI: 10.1177/02611929211048447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Merel Ritskes-Hoitinga
- SYRCLE, Department for Health Evidence, 221034Radboudumc, Nijmegen, the Netherlands.,AUGUST, Department for Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Wynand Alkema
- Institute for Life Science and Technology, 3645Hanze University of Applied Sciences, Groningen, the Netherlands.,TenWise BV, Oss, the Netherlands
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18
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Bespalov A, Bernard R, Gilis A, Gerlach B, Guillén J, Castagné V, Lefevre IA, Ducrey F, Monk L, Bongiovanni S, Altevogt B, Arroyo-Araujo M, Bikovski L, de Bruin N, Castaños-Vélez E, Dityatev A, Emmerich CH, Fares R, Ferland-Beckham C, Froger-Colléaux C, Gailus-Durner V, Hölter SM, Hofmann MCJ, Kabitzke P, Kas MJH, Kurreck C, Moser P, Pietraszek M, Popik P, Potschka H, Prado Montes de Oca E, Restivo L, Riedel G, Ritskes-Hoitinga M, Samardzic J, Schunn M, Stöger C, Voikar V, Vollert J, Wever KE, Wuyts K, MacLeod MR, Dirnagl U, Steckler T. Introduction to the EQIPD quality system. eLife 2021; 10:e63294. [PMID: 34028353 PMCID: PMC8184207 DOI: 10.7554/elife.63294] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 05/20/2021] [Indexed: 02/06/2023] Open
Abstract
While high risk of failure is an inherent part of developing innovative therapies, it can be reduced by adherence to evidence-based rigorous research practices. Supported through the European Union's Innovative Medicines Initiative, the EQIPD consortium has developed a novel preclinical research quality system that can be applied in both public and private sectors and is free for anyone to use. The EQIPD Quality System was designed to be suited to boost innovation by ensuring the generation of robust and reliable preclinical data while being lean, effective and not becoming a burden that could negatively impact the freedom to explore scientific questions. EQIPD defines research quality as the extent to which research data are fit for their intended use. Fitness, in this context, is defined by the stakeholders, who are the scientists directly involved in the research, but also their funders, sponsors, publishers, research tool manufacturers, and collaboration partners such as peers in a multi-site research project. The essence of the EQIPD Quality System is the set of 18 core requirements that can be addressed flexibly, according to user-specific needs and following a user-defined trajectory. The EQIPD Quality System proposes guidance on expectations for quality-related measures, defines criteria for adequate processes (i.e. performance standards) and provides examples of how such measures can be developed and implemented. However, it does not prescribe any pre-determined solutions. EQIPD has also developed tools (for optional use) to support users in implementing the system and assessment services for those research units that successfully implement the quality system and seek formal accreditation. Building upon the feedback from users and continuous improvement, a sustainable EQIPD Quality System will ultimately serve the entire community of scientists conducting non-regulated preclinical research, by helping them generate reliable data that are fit for their intended use.
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Affiliation(s)
| | - René Bernard
- Department of Experimental Neurology, Charité UniversitätsmedizinBerlinGermany
- NeuroCure Cluster of Excellence, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of HealthBerlinGermany
- QUEST Center for Transforming Biomedical Research, Berlin Institute of Health at ChariteBerlinGermany
| | | | | | | | | | - Isabel A Lefevre
- Rare and Neurologic Diseases Research, SanofiChilly-MazarinFrance
| | - Fiona Ducrey
- Integrity and Global Research Practices, SanofiChilly-MazarinFrance
| | - Lee Monk
- Research and Clinical Development Quality, UCBSloughUnited Kingdom
| | - Sandrine Bongiovanni
- Quality Assurance, Novartis Institutes for BioMedical Research, Novartis PharmaBaselSwitzerland
| | | | - María Arroyo-Araujo
- Groningen Institute for Evolutionary Life Sciences, University of GroningenGroningenNetherlands
| | - Lior Bikovski
- School of Behavioral Sciences, Netanya Academic CollegeNetanyaIsrael
- The Myers Neuro-Behavioral Core Facility, Sackler School of Medicine, Tel Aviv UniversityTel AvivIsrael
| | - Natasja de Bruin
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMPFrankfurt am MainGermany
| | | | - Alexander Dityatev
- Molecular Neuroplasticity, German Center for Neurodegenerative DiseasesMagdeburgGermany
- Center for Behavioral Brain SciencesMagdeburgGermany
- Medical Faculty, Otto-von-Guericke UniversityMagdeburgGermany
| | | | - Raafat Fares
- Charles River Laboratories, Safety AssessmentLyonFrance
| | | | | | - Valerie Gailus-Durner
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental HealthNeuherbergGermany
| | - Sabine M Hölter
- Institute of Developmental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, and Technical University MunichMunichGermany
| | - Martine CJ Hofmann
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMPFrankfurt am MainGermany
| | - Patricia Kabitzke
- PAASP USRidgefieldUnited States
- The Stanley Center for Psychiatric Research, Broad Institute of MIT and HarvardCambridgeUnited States
| | - Martien JH Kas
- Groningen Institute for Evolutionary Life Sciences, University of GroningenGroningenNetherlands
| | - Claudia Kurreck
- Department of Experimental Neurology, Charité UniversitätsmedizinBerlinGermany
| | - Paul Moser
- CerbascienceToulouseFrance
- PAASP FranceToulouseFrance
| | | | - Piotr Popik
- Maj Institute of Pharmacology, Polish Academy of SciencesKrakowPoland
| | - Heidrun Potschka
- Institute of Pharmacology, Toxicology and Pharmacy, Ludwig-Maximilians-UniversityMunichGermany
| | - Ernesto Prado Montes de Oca
- Personalized Medicine Laboratory (LAMPER), Research Center inTechnology and Design Assistance of Jalisco State, National Council of Science andTechnology (CIATEJ-CONACYT)MexicoMexico
- Scripps Research Translational InstituteLa JollaUnited States
- Integrative Structural and Computational Biology, Scripps ResearchLa JollaUnited States
| | - Leonardo Restivo
- Neuro-BAU, Department of Fundamental Neurosciences, Faculty of Biology and Medicine,University of LausanneLausanneSwitzerland
| | - Gernot Riedel
- Institute of Medical Sciences, University of AberdeenScotlandUnited Kingdom
| | - Merel Ritskes-Hoitinga
- SYRCLE, Department for Health Evidence, Radboud University Medical CenterNijmegenNetherlands
- Department for Clinical Medicine, Aarhus UniversityAarhusDenmark
| | - Janko Samardzic
- Institute of Pharmacology, Medical Faculty, University of BelgradeBelgradeSerbia
| | - Michael Schunn
- Institute of Science and TechnologyKlosterneuburgAustria
| | - Claudia Stöger
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental HealthNeuherbergGermany
| | - Vootele Voikar
- Neuroscience Center and Laboratory Animal Center, Helsinki Institute of Life Science, University of HelsinkiHelsinkiFinland
| | - Jan Vollert
- Pain Research, Department of Surgery and Cancer, Faculty of Medicine, Imperial College LondonLondonUnited Kingdom
| | - Kimberley E Wever
- SYRCLE, Department for Health Evidence, Radboud University Medical CenterNijmegenNetherlands
| | | | - Malcolm R MacLeod
- Centre for Clinical Brain Sciences, University of EdinburghScotlandUnited Kingdom
| | - Ulrich Dirnagl
- Department of Experimental Neurology, Charité UniversitätsmedizinBerlinGermany
- NeuroCure Cluster of Excellence, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of HealthBerlinGermany
- QUEST Center for Transforming Biomedical Research, Berlin Institute of Health at ChariteBerlinGermany
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19
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Leenaars C, Tsaioun K, Stafleu F, Rooney K, Meijboom F, Ritskes-Hoitinga M, Bleich A. Reviewing the animal literature: how to describe and choose between different types of literature reviews. Lab Anim 2021; 55:129-141. [PMID: 33135562 PMCID: PMC8044607 DOI: 10.1177/0023677220968599] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 10/01/2020] [Indexed: 12/15/2022]
Abstract
Before starting any (animal) research project, review of the existing literature is good practice. From both the scientific and the ethical perspective, high-quality literature reviews are essential. Literature reviews have many potential advantages besides synthesising the evidence for a research question. First, they can show if a proposed study has already been performed, preventing redundant research. Second, when planning new experiments, reviews can inform the experimental design, thereby increasing the reliability, relevance and efficiency of the study. Third, reviews may even answer research questions using already available data. Multiple definitions of the term literature review co-exist. In this paper, we describe the different steps in the review process, and the risks and benefits of using various methodologies in each step. We then suggest common terminology for different review types: narrative reviews, mapping reviews, scoping reviews, rapid reviews, systematic reviews and umbrella reviews. We recommend which review to select, depending on the research question and available resources. We believe that improved understanding of review methods and terminology will prevent ambiguity and increase appropriate interpretation of the conclusions of reviews.
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Affiliation(s)
- Cathalijn Leenaars
- Institute for Laboratory Animal Science, Hannover Medical School, Germany
- Department of Animals in Science and Society, Utrecht University, the Netherlands
| | - Katya Tsaioun
- Evidence-based Toxicology Collaboration, Johns Hopkins Bloomberg School of Public Health (EBTC), USA
| | - Frans Stafleu
- Department of Animals in Science and Society, Utrecht University, the Netherlands
| | - Kieron Rooney
- Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Australia
| | - Franck Meijboom
- Department of Animals in Science and Society, Utrecht University, the Netherlands
| | - Merel Ritskes-Hoitinga
- SYRCLE, Department for Health Evidence (section HTA), Radboud Institute for Health Sciences, The Netherlands
- AUGUST, Department for Clinical Medicine, Aarhus University, Denmark
| | - André Bleich
- Institute for Laboratory Animal Science, Hannover Medical School, Germany
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20
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Pires GN, Oliveira TB, Mello VFF, Bezerra AG, Leenaars CHC, Ritskes-Hoitinga M, Tufik S, Andersen ML. Effects of sleep deprivation on maternal behaviour in animal models: A systematic review and meta-analysis. J Sleep Res 2021; 30:e13333. [PMID: 33719116 DOI: 10.1111/jsr.13333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/18/2021] [Accepted: 02/20/2021] [Indexed: 01/12/2023]
Abstract
Pregnancy is a period of numerous physical and emotional changes in women's lives, including alterations in sleep patterns and worsening of pre-existing sleep disturbances, which possibly lead to impaired postpartum maternal behaviour and mother-infant relationship. The effects of sleep deprivation during pregnancy in maternal behaviour have been evaluated in preclinical studies, but have provided inconsistent results. Thus, in the present study, we aimed to evaluate the effects of sleep deprivation during pregnancy on maternal behaviour of animals through a systematic review and meta-analyses. After a two-step selection process, six articles were included, all of them describing rat studies. The most frequently used method of sleep deprivation was rapid eye movement sleep restriction, using the multiple-platform method. Four meta-analyses were performed, none of them presenting significant impact of sleep deprivation on maternal behaviour, failing to reproduce the results observed in previous clinical studies. In conclusion, our results show a lack of translational applicability of animal models to evaluate the effects of sleep deprivation during pregnancy on maternal behaviour.
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Affiliation(s)
- Gabriel N Pires
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil.,Department of Physiological Sciences, Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil
| | - Thainá B Oliveira
- Department of Physiological Sciences, Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil
| | - Victoria F F Mello
- Department of Physiological Sciences, Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil
| | - Andréia G Bezerra
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Merel Ritskes-Hoitinga
- Systematic Review Centre for Laboratory (animal) Experimentation (SYRCLE), Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands.,AUGUST, Department for Clinical Medicine, Aarhus University, Denmark
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Monica L Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
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21
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Leenaars CH, Vries RBD, Reijmer J, Holthaus D, Visser D, Heming A, Elzinga J, Kempkes RW, Beumer W, Punt C, Meijboom FL, Ritskes-Hoitinga M. Animal models for cystic fibrosis: a systematic search and mapping review of the literature. Part 2: nongenetic models. Lab Anim 2021; 55:307-316. [PMID: 33557683 DOI: 10.1177/0023677221990688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Various animal models are available to study cystic fibrosis (CF). These models may help to enhance our understanding of the pathology and contribute to the development of new treatments. We systematically searched all publications on CF animal models. Because of the large number of models retrieved, we split this mapping review into two parts. Previously, we presented the genetic CF animal models. In this paper we present the nongenetic CF animal models. While genetic animal models may, in theory, be preferable for genetic diseases, the phenotype of a genetic model does not automatically resemble human disease. Depending on the research question, other animal models may thus be more informative.We searched Pubmed and Embase and identified 12,303 unique publications (after duplicate removal). All references were screened for inclusion by two independent reviewers. The genetic animal models for CF (from 636 publications) were previously described. The non-genetic CF models (from 189 publications) are described in this paper, grouped by model type: infection-based, pharmacological, administration of human materials, xenografts and other. As before for the genetic models, an overview of basic model characteristics and outcome measures is provided. This CF animal model overview can be the basis for an objective, evidence-based model choice for specific research questions. Besides, it can help to retrieve relevant background literature on outcome measures of interest.
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Affiliation(s)
- Cathalijn Hc Leenaars
- SYRCLE, Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, The Netherlands.,Faculty of Veterinary Medicine, Department of Animals in Science and Society, Utrecht University, The Netherlands.,Institute for Laboratory Animal Science, Hannover Medical School, Germany
| | - Rob Bm de Vries
- SYRCLE, Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, The Netherlands
| | - Joey Reijmer
- SYRCLE, Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, The Netherlands
| | - David Holthaus
- SYRCLE, Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, The Netherlands
| | - Damian Visser
- SYRCLE, Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, The Netherlands
| | - Anna Heming
- SYRCLE, Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, The Netherlands
| | - Janneke Elzinga
- SYRCLE, Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, The Netherlands
| | - Rosalie Wm Kempkes
- SYRCLE, Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, The Netherlands
| | | | - Carine Punt
- ProQR Therapeutics NV,Leiden, the Netherlands; Present position: BunyaVax BV, Lelystad, The Netherlands
| | - Franck Lb Meijboom
- Faculty of Veterinary Medicine, Department of Animals in Science and Society, Utrecht University, The Netherlands
| | - Merel Ritskes-Hoitinga
- SYRCLE, Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, The Netherlands.,Department of Clinical Medicine, Aarhus University, Denmark
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22
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Gurusamy KS, Moher D, Loizidou M, Ahmed I, Avey MT, Barron CC, Davidson B, Dwek M, Gluud C, Jell G, Katakam K, Montroy J, McHugh TD, Osborne NJ, Ritskes-Hoitinga M, van Laarhoven K, Vollert J, Lalu M. Clinical relevance assessment of animal preclinical research (RAA) tool: development and explanation. PeerJ 2021; 9:e10673. [PMID: 33569250 DOI: 10.7717/peerj.10673] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 12/09/2020] [Indexed: 12/09/2022] Open
Abstract
Background Only a small proportion of preclinical research (research performed in animal models prior to clinical trials in humans) translates into clinical benefit in humans. Possible reasons for the lack of translation of the results observed in preclinical research into human clinical benefit include the design, conduct, and reporting of preclinical studies. There is currently no formal domain-based assessment of the clinical relevance of preclinical research. To address this issue, we have developed a tool for the assessment of the clinical relevance of preclinical studies, with the intention of assessing the likelihood that therapeutic preclinical findings can be translated into improvement in the management of human diseases. Methods We searched the EQUATOR network for guidelines that describe the design, conduct, and reporting of preclinical research. We searched the references of these guidelines to identify further relevant publications and developed a set of domains and signalling questions. We then conducted a modified Delphi-consensus to refine and develop the tool. The Delphi panel members included specialists in evidence-based (preclinical) medicine specialists, methodologists, preclinical animal researchers, a veterinarian, and clinical researchers. A total of 20 Delphi-panel members completed the first round and 17 members from five countries completed all three rounds. Results This tool has eight domains (construct validity, external validity, risk of bias, experimental design and data analysis plan, reproducibility and replicability of methods and results in the same model, research integrity, and research transparency) and a total of 28 signalling questions and provides a framework for researchers, journal editors, grant funders, and regulatory authorities to assess the potential clinical relevance of preclinical animal research. Conclusion We have developed a tool to assess the clinical relevance of preclinical studies. This tool is currently being piloted.
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Affiliation(s)
- Kurinchi S Gurusamy
- Research Department of Surgical Biotechnology, University College London, London, England, UK.,Surgery and Interventional Trials Unit, University College London, London, England, UK
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada.,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Marilena Loizidou
- Research Department of Surgical Biotechnology, University College London, London, England, UK
| | - Irfan Ahmed
- Department of Surgery, NHS Grampian, Aberdeen, Scotland, UK
| | - Marc T Avey
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada.,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Carly C Barron
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada.,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.,Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Brian Davidson
- Research Department of Surgical Biotechnology, University College London, London, England, UK
| | - Miriam Dwek
- School of Life Sciences, University of Westminster, London, England, UK
| | - Christian Gluud
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copehagen, Denmark
| | - Gavin Jell
- Research Department of Surgical Biotechnology, University College London, London, England, UK
| | - Kiran Katakam
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copehagen, Denmark
| | - Joshua Montroy
- Department of Anesthesiology and Pain Medicine, Blueprint Translational Research Group, Clinical Epidemiology and Regenerative Medicine Programs, Ottawa Hospital Research Institute, Ottawa Hospital, Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Timothy D McHugh
- UCL Centre for Clinical Microbiology, Division of Infection & Immunity, University College London, London, England, UK
| | | | - Merel Ritskes-Hoitinga
- SYRCLE, Department for Health Evidence, Radboud University Medical Center, Nijmegen, Netherlands
| | - Kees van Laarhoven
- Department of Surgery, Radboud Institute for Health Sciences, Nijmegen, Netherlands
| | - Jan Vollert
- Pain Research, Department of Surgery & Cancer, Imperial College, London, England, UK.,Center of Biomedicine and Medical Technology Mannheim CBTM, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Manoj Lalu
- Department of Anesthesiology and Pain Medicine, Blueprint Translational Research Group, Clinical Epidemiology and Regenerative Medicine Programs, Ottawa Hospital Research Institute, Ottawa Hospital, Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
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23
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Stone JC, Glass K, Clark J, Ritskes-Hoitinga M, Munn Z, Tugwell P, Doi SAR. The MethodologicAl STandards for Epidemiological Research (MASTER) scale demonstrated a unified framework for bias assessment. J Clin Epidemiol 2021; 134:52-64. [PMID: 33485928 DOI: 10.1016/j.jclinepi.2021.01.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 12/28/2020] [Accepted: 01/18/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVE This paper presents a unified framework for assessment of the methodological quality of analytic study designs. STUDY DESIGN AND SETTING A systematic review of 393 methodological quality assessment tools that updated a previous assessment with 100 tools. Tool items were extracted, examined and reworded. Bias domains and finally methodological standards to be fulfilled were defined. RESULTS There were 36 unique methodological safeguards that were categorized into seven methodological standards to be fulfilled in the MASTER scale. These methodological standards reflect initial and ongoing equivalence in particular areas, including equal recruitment, equal retention, equal ascertainment, equal implementation, equal prognosis, sufficient analysis, and temporal precedence. CONCLUSION This approach unifies existing methods for methodological quality assessment and will be useful for (1) clinical researchers when a bias assessment of clinical research studies is required across analytical designs, (2) promoting a unified framework for bias assessment.
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Affiliation(s)
- Jennifer C Stone
- Department of Health Services Research and Policy, Research School of Population Health, Australian National University, 62 Mills Road, Acton, ACT 2601, Australia; Department for Health Evidence, SYRCLE, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Kathryn Glass
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Justin Clark
- Centre for Research in Evidence Based Practice, Bond University, QLD, Australia
| | - Merel Ritskes-Hoitinga
- Department for Health Evidence, SYRCLE, Radboud University Medical Center, Nijmegen, The Netherlands; Department for Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Zachary Munn
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Peter Tugwell
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Suhail A R Doi
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar P.O. Box 2713, Qatar University Drive, Al Tarfa, Doha, Qatar.
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24
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Turner PV, Hickman DL, van Luijk J, Ritskes-Hoitinga M, Sargeant JM, Kurosawa TM, Agui T, Baumans V, Choi WS, Choi YK, Flecknell PA, Lee BH, Otaegui PJ, Pritchett-Corning KR, Shimada K. Welfare Impact of Carbon Dioxide Euthanasia on Laboratory Mice and Rats: A Systematic Review. Front Vet Sci 2020; 7:411. [PMID: 32793645 PMCID: PMC7387666 DOI: 10.3389/fvets.2020.00411] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 06/09/2020] [Indexed: 12/27/2022] Open
Abstract
Background: There has been increased concern about the suitability of CO2 as a method for euthanasia of laboratory mice and rats, including the potential discomfort, pain or distress that animals may experience prior to loss of consciousness; time to loss of consciousness; best methods for use of CO2; and the availability of better alternatives. These discussions have been useful in providing new information, but have resulted in significant confusion regarding the acceptability of CO2 for rodent euthanasia. In some cases, researchers and veterinarians have become uncertain as to which techniques to recommend or use for euthanasia of laboratory mice and rats. Methods: The International Association of Colleges of Laboratory Animal Medicine (IACLAM) convened a taskforce to examine the evidence for adverse welfare indicators in laboratory rats and mice undergoing CO2 euthanasia using a SYRCLE-registered systematic review protocol. Of 3,772 papers identified through a database search (PubMed, Web of Science, CAB Direct, Agricola, and grey literature) from 1900 to 2017, 37 studies were identified for detailed review (some including more than one species or age group), including 15 in adult mice, 21 in adult rats, and 5 in neonates of both species. Experiments or reports were excluded if they only assessed parameters other than those directly affecting animal welfare during CO2 induction and/or euthanasia. Results: Study design and outcome measures were highly variable and there was an unclear to high risk of bias in many of the published studies. Changes in the outcome measures evaluated were inconsistent or poorly differentiated. It is likely that repeated exposures to carbon dioxide inhalation are aversive to adult rats and mice, based on avoidance behavior studies; however, this effect is largely indistinguishable from aversion induced by repeated exposures to other inhalant anesthetic gasses. Conclusion: There is insufficient evidence to permit an unbiased assessment of the effect of CO2 inhalation during euthanasia on welfare indicators in laboratory mice and rats. Additional well-designed, unbiased, and adequately powered studies are needed to accurately assess the welfare of laboratory mice and rats undergoing euthanasia via CO2 gas.
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Affiliation(s)
- Patricia V. Turner
- Department of Pathobiology, University of Guelph, Guelph, ON, Canada
- Global Animal Welfare and Training, Charles River, Wilmington, MA, United States
| | - Debra L. Hickman
- Laboratory Animal Resource Center, School of Medicine, Indiana University, Indianapolis, IN, United States
| | - Judith van Luijk
- Department of Health Evidence, SYstematic Review Center for Laboratory Experimentation (SYRCLE), Radboud University, Nijmegen, Netherlands
| | - Merel Ritskes-Hoitinga
- Department of Health Evidence, SYstematic Review Center for Laboratory Experimentation (SYRCLE), Radboud University, Nijmegen, Netherlands
| | - Jan M. Sargeant
- Department of Population Medicine, University of Guelph, Guelph, ON, Canada
- Centre for Public Health and Zoonoses, University of Guelph, Guelph, ON, Canada
| | - T. Miki Kurosawa
- Faculty of Veterinary Medicine, Kagoshima University, Kagoshima, Japan
| | - Takashi Agui
- Department of Applied Veterinary Science, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - Vera Baumans
- Department of Animals, Science and Society, Utrecht University, Utrecht, Netherlands
| | - Woo Sung Choi
- National New Drug Development Cluster, Woojung Bio, Suwon-si, South Korea
| | - Yang-Kyu Choi
- Department of Laboratory Animal Medicine, College of Veterinary Medicine, Konkuk University, Seoul, South Korea
| | - Paul A. Flecknell
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Byeong H. Lee
- Osong Medical Innovation Foundation, Cheongju, South Korea
| | - Pedro J. Otaegui
- Laboratory Animal Facilities, Autonomous University of Barcelona, Barcelona, Spain
| | - Kathleen R. Pritchett-Corning
- Office of Animal Resources, Harvard University Faculty of Arts and Sciences, Cambridge, MA, United States
- Department of Comparative Medicine, University of Washington, Seattle, WA, United States
| | - Keisuke Shimada
- Animal Resource Center for Infectious Diseases, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
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25
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Ritskes-Hoitinga M, Leenaars C, Beumer W, Coenen-de Roo T, Stafleu F, Meijboom FLB. Improving Translation by Identifying Evidence for More Human-Relevant Preclinical Strategies. Animals (Basel) 2020; 10:E1170. [PMID: 32664195 PMCID: PMC7401546 DOI: 10.3390/ani10071170] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/02/2020] [Accepted: 07/08/2020] [Indexed: 12/13/2022] Open
Abstract
Preclinical animal studies are performed to analyse the safety and efficacy of new treatments, with the aim to protect humans. However, there are questions and concerns about the quality and usefulness of preclinical animal research. Translational success rates vary between 0 and 100%, and no clear relationship has been found with possible predictive factors such as animal species or field of research. Therefore, it is not yet possible to indicate what factors predict successful translation. Translational strategies were therefore discussed at an international conference held in the Netherlands in November 2019, aiming to develop practical guidelines for more robust animal-to-human translation. The conference was organised during the course of a research project funded by the Dutch Research Council (313-99-310), addressing possible solutions for the low translational values that had been published for a multitude of animal studies in human health care. This article provides an overview of the project and the conference discussions. Based on the conference results and the findings from the research project, we define four points of attention that are crucial in the search for improved translational success rates: (a) optimising the methods and design of studies; (b) incorporation of the complexity of the human patient in research; (c) start with the patient rather than existing animal models as the gold standard; and (d) more and better collaboration within the chain from funding to pharmacy. We conclude that this requires improved organization and use of procedures, as well as a change of attitude and culture in research, including a consideration of the translational value of animal-free innovations and human-relevant science.
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Affiliation(s)
- Merel Ritskes-Hoitinga
- SYRCLE, Department for Health Evidence (section HTA), Radboud Institute for Health Sciences, Radboud University Medical Centre, 6500 HB Nijmegen, The Netherlands
| | - Cathalijn Leenaars
- Unit Animals in Science and Society, Department of Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, 3508 TD Utrecht, The Netherlands
- Institute for Laboratory Animal Science, Hannover Medical School, 30625 Hannover, Germany
| | - Wouter Beumer
- ProQR Therapeutics NV, 2333 CK Leiden, The Netherlands
| | - Tineke Coenen-de Roo
- Central Animal Facility, Leiden University Medical Centre, 2300 RC Leiden, The Netherlands
| | - Frans Stafleu
- Ethics Institute, Faculty of Humanities, Utrecht University, 3508 TC Utrecht, The Netherlands
| | - Franck L B Meijboom
- Unit Animals in Science and Society, Department of Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, 3508 TD Utrecht, The Netherlands
- Ethics Institute, Faculty of Humanities, Utrecht University, 3508 TC Utrecht, The Netherlands
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26
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Gough D, Davies P, Jamtvedt G, Langlois E, Littell J, Lotfi T, Masset E, Merlin T, Pullin AS, Ritskes-Hoitinga M, Røttingen JA, Sena E, Stewart R, Tovey D, White H, Yost J, Lund H, Grimshaw J. Evidence Synthesis International (ESI): Position Statement. Syst Rev 2020; 9:155. [PMID: 32650823 PMCID: PMC7353688 DOI: 10.1186/s13643-020-01415-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 06/28/2020] [Indexed: 01/08/2023] Open
Abstract
This paper is the initial Position Statement of Evidence Synthesis International, a new partnership of organizations that produce, support and use evidence synthesis around the world. The paper (i) argues for the importance of synthesis as a research exercise to clarify what is known from research evidence to inform policy, practice and personal decision making; (ii) discusses core issues for research synthesis such as the role of research evidence in decision making, the role of perspectives, participation and democracy in research and synthesis as a core component of evidence ecosystems; (iii) argues for 9 core principles for ESI on the nature and role of research synthesis; and (iv) lists the 5 main goals of ESI as a coordinating partnership for promoting and enabling the production and use of research synthesis.
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Affiliation(s)
- David Gough
- EPPI-Centre, University College London, London, UK.
| | | | | | - Etienne Langlois
- Partnership for Maternal, Newborn and Child Health, World Health Organization, Geneva, Switzerland
| | | | - Tamara Lotfi
- School of Medicine, American University of Beirut, Beirut, Lebanon
| | - Edoardo Masset
- Centre of Excellence for Development Impact and Learning, London International Development Centre, London, UK
| | - Tracy Merlin
- School of Public Health, University of Adelaide, Adelaide, Australia
| | | | - Merel Ritskes-Hoitinga
- SYRCLE, Department for Health Evidence, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Emily Sena
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Ruth Stewart
- Africa Centre for Evidence, University of Johannesburg, Johannesburg, South Africa
| | | | | | - Jennifer Yost
- Louise Fitzpatrick College of Nursing, Villanova University, Villanova, USA
| | - Hans Lund
- Centre for Evidence-based Practice, Western Norway University of Applied Sciences, Bergen, Norway
| | - Jeremy Grimshaw
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
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27
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Pound P, Ritskes-Hoitinga M. Can prospective systematic reviews of animal studies improve clinical translation? J Transl Med 2020; 18:15. [PMID: 31918734 PMCID: PMC6953128 DOI: 10.1186/s12967-019-02205-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 12/31/2019] [Indexed: 01/27/2023] Open
Abstract
Systematic reviews are powerful tools with the potential to generate high quality evidence. Their application to animal studies has been instrumental in exposing the poor quality of these studies, as well as a catalyst for improvements in study design, conduct and reporting. It has been suggested that prospective systematic reviews of animal studies (i.e. systematic reviews conducted prior to clinical trials) would allow scrutiny of the preclinical evidence, providing valuable information on safety and efficacy, and helping to determine whether clinical trials should proceed. However, while prospective systematic reviews allow valuable scrutiny of the preclinical animal data, they are not necessarily able to reliably predict the safety and efficacy of an intervention when trialled in humans. Consequently, they may not reliably safeguard humans participating in clinical trials and might potentially result in lost opportunities for beneficial clinical treatments. Furthermore, animal and human studies are often conducted concurrently, which not only makes prospective systematic reviews of animal studies impossible, but suggests that animal studies do not inform human studies in the manner presumed. We suggest that this points to a confused attitude regarding animal studies, whereby tradition demands that they precede human studies but practice indicates that their findings are often ignored. We argue that it is time to assess the relative contributions of animal and human research in order to better understand how clinical knowledge is actually produced.
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Affiliation(s)
- Pandora Pound
- Safer Medicines Trust, PO Box 122, Kingsbridge, TQ7 9AX, UK.
| | - Merel Ritskes-Hoitinga
- SYRCLE, Department for Health Evidence, Radboud University Medical Center, PO Box 9101, Route 133, 6500 HB, Nijmegen, The Netherlands
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Ritskes-Hoitinga M, van Luijk J. How Can Systematic Reviews Teach Us More about the Implementation of the 3Rs and Animal Welfare? Animals (Basel) 2019; 9:ani9121163. [PMID: 31861205 PMCID: PMC6941037 DOI: 10.3390/ani9121163] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 12/12/2019] [Accepted: 12/14/2019] [Indexed: 02/06/2023] Open
Abstract
Simple Summary The three Rs stand for Replacement, Reduction, and Refinement of animal studies and were published for the first time in 1959 by Russell and Burch. Replacement refers to avoiding the use of (non-human) animals in research. Reduction implies using fewer animals, for example, by better statistical methods and better literature studies, and Refinement means reducing the discomfort and improving the welfare of animals used in experiments. The three Rs have gained more interest and popularity since the 1970s, and have now become the crucial central element in the revised legislation in Europe, the EU Directive 2010/63EU, controlling the proper use of animals in experiments in the European member states. Animals are used in order to improve the health and welfare of other non-human animals, in veterinary medicine, and of humans, for toxicological purposes and in clinical medicine. Using animals in experiments has always been subject to ethical and societal debate. At Syrcle, we have introduced the methodology of systematic reviews for preclinical animal studies since 2012. This methodology comes from the clinical field and is a key element in evidence-based medicine, as systematic reviews summarise the scientific evidence as objectively as possible. A systematic review (SR) is defined as a literature review focused on a single question that tries to identify, appraise, select, and synthesise all high-quality research evidence relevant to that question. Introducing this methodology for the preclinical animal studies seems very logical, as animal studies in clinical medicine are performed for protecting humans from ineffective or unsafe treatments. Systematic reviews thus lead to summarising evidence from preclinical studies before entering clinical trials. In addition to protecting humans, systematic reviews can also be used to implement the three Rs. Examples of how systematic reviews contribute to implementing the three Rs are provided in the following article, thus demonstrating the value for protecting animals as well. Abstract This paper describes the introduction of the systematic review methodology in animal-based research and the added value of this methodology in relation to the 3Rs and beyond. The 3Rs refer to Replacement, Reduction, and Refinement of animal studies. A systematic review (SR) is defined as a literature review focused on a single question that tries to identify, appraise, select, and synthesise all high-quality research evidence relevant to that question. Examples are given on how SRs lead to the implementation of the 3Rs and better science. Additionally, a broader context is given regarding societal, political, and scientific developments. Various examples of systematic reviews are given to illustrate the current situation regarding reporting, quality, and translatability of animal-based research. Furthermore, initiatives that have emerged to move further towards more responsible and sustainable research is of benefit for both animals and humans.
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van Luijk JAKR, Popa M, Swinkels J, Menon JML, Alkema W, Roeleveld N, Hoffmann SE, Schlünssen V, Mandrioli D, Ritskes-Hoitinga M, Scheepers PTJ. Establishing a health-based recommended occupational exposure limit for nitrous oxide using experimental animal data - A systematic review protocol. Environ Res 2019; 178:108711. [PMID: 31520819 DOI: 10.1016/j.envres.2019.108711] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 07/24/2019] [Accepted: 08/30/2019] [Indexed: 06/10/2023]
Abstract
Nitrous oxide (N 2 O) is widely used as inhalation analgesic and anaesthetic in medical, paramedical, and veterinary practice. Previous evaluations resulted in classification of N 2 O as a possible risk factor for adverse reproductive health outcomes based on evidence from animal data. Available human data were considered inadequate, partly due to the possibility that other risk factors, such as co-exposures to other inhalation anaesthetics may have contributed to the adverse outcomes. As no substantial new human evidence has emerged since previous evaluations, this protocol describes a planned systematic review of the evidence obtained from animal studies. The aim is to assess the available evidence on the effects of N 2 O on reproductive and developmental outcomes in animals to inform a health-based recommended occupational exposure limit (OEL) for N 2 O. Comprehensive search strategies were designed to retrieve animal studies addressing N 2 O exposure from PubMed, EMBASE, and Web of Science. Screening of the studies retrieved will be performed by at least two independent reviewers, while discrepancies will be resolved by reaching consensus through repeated review and discussions. Articles will be included according to criteria specified in this protocol. Outcome data relevant for reproduction and development will be extracted and risk of bias will be assessed by two independent reviewers using the SYRCLE's risk of bias tool. Primary reproductive and developmental outcomes of interest will be the number of resorptions, malformations, and birth weight. We will focus on dose-response studies that allow to derive an OEL with the benchmark dose (BMD) approach. Adverse outcomes occurring at doses that are equivalent to the exposures occurring in human occupational settings will be particularly relevant for dose-response modelling. The proposed review has not been performed before. We will follow the procedures specified in this protocol. We will adhere to guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), adapted for animal studies. Ethical approval will not be required, as the review will use existing data available in the public domain.
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Affiliation(s)
- Judith A K R van Luijk
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboudumc, Nijmegen, the Netherlands.
| | - Madalina Popa
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboudumc, Nijmegen, the Netherlands.
| | - Janne Swinkels
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboudumc, Nijmegen, the Netherlands.
| | - Julia M L Menon
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboudumc, Nijmegen, the Netherlands.
| | - Wynand Alkema
- Center for Molecular and Biomolecular Informatics, Radboud Institue for Molecular Life Sciences, Radboudumc, Nijmegen, the Netherlands.
| | - Nel Roeleveld
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboudumc, Nijmegen, the Netherlands.
| | - Sebastian E Hoffmann
- The Evidence-Based Toxicology Collaboration (EBTC), Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
| | - Vivi Schlünssen
- Aarhus University, Aarhus, and National Research Center for the Working Environment, Copenhagen, Denmark.
| | - Daniele Mandrioli
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy.
| | - Merel Ritskes-Hoitinga
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboudumc, Nijmegen, the Netherlands.
| | - Paul T J Scheepers
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboudumc, Nijmegen, the Netherlands.
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Leenaars CH, De Vries RB, Heming A, Visser D, Holthaus D, Reijmer J, Elzinga J, Kempkes RW, Punt C, Beumer W, Meijboom FL, Ritskes-Hoitinga M. Animal models for cystic fibrosis: A systematic search and mapping review of the literature - Part 1: genetic models. Lab Anim 2019; 54:330-340. [PMID: 31411127 DOI: 10.1177/0023677219868502] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Animal models for cystic fibrosis (CF) have enhanced our understanding of the pathology and contributed to the development of new treatments. In the field of CF, many animal models have been developed and described. To our knowledge, thus far, none of the reviews of CF animal models has used a systematic methodology. A systematic approach to creating model overviews can lead to an objective, evidence-based choice of an animal model for new research questions. We searched Pubmed and Embase for the currently available animal models for CF. Two independent reviewers screened the results. We included all primary studies describing an animal model for CF. After duplicate removal, 12,304 publications were left. Because of the large number of models, in the current paper, only the genetic models are presented. A total of 636 publications were identified describing genetic animal models for CF in mice, pigs, ferrets, rats and zebrafish. Most of these models have an altered Cftr gene. An overview of basic model characteristics and outcome measures for these genetic models is provided, together with advice on using these data. As far as the authors are aware, this is one of the largest systematic mapping reviews on genetic animal models for CF. It can aid in selecting a suitable model and outcome measures. In general, the reporting quality of the included publications was poor. Further systematic reviews are warranted to determine the quality and translational value of these models further.
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Affiliation(s)
- Cathalijn Hc Leenaars
- SYRCLE, Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands.,Faculty of Veterinary Medicine, Department of Animals in Science and Society, Utrecht University, Utrecht, The Netherlands.,Institute for Laboratory Animal Science, Hannover Medical School, Hannover, Germany
| | - Rob Bm De Vries
- SYRCLE, Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anna Heming
- SYRCLE, Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Damian Visser
- SYRCLE, Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - David Holthaus
- SYRCLE, Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Joey Reijmer
- SYRCLE, Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Janneke Elzinga
- SYRCLE, Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rosalie Wm Kempkes
- SYRCLE, Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Carine Punt
- ProQR Therapeutics NV, Leiden, The Netherlands
| | | | - Franck Lb Meijboom
- Faculty of Veterinary Medicine, Department of Animals in Science and Society, Utrecht University, Utrecht, The Netherlands
| | - Merel Ritskes-Hoitinga
- SYRCLE, Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
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Leenaars CHC, Kouwenaar C, Stafleu FR, Bleich A, Ritskes-Hoitinga M, De Vries RBM, Meijboom FLB. Animal to human translation: a systematic scoping review of reported concordance rates. J Transl Med 2019; 17:223. [PMID: 31307492 PMCID: PMC6631915 DOI: 10.1186/s12967-019-1976-2] [Citation(s) in RCA: 129] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 07/08/2019] [Indexed: 12/14/2022] Open
Abstract
Background Drug development is currently hampered by high attrition rates; many developed treatments fail during clinical testing. Part of the attrition may be due to low animal-to-human translational success rates; so-called “translational failure”. As far as we know, no systematic overview of published translational success rates exists. Systematic scoping review The following research question was examined: “What is the observed range of the animal-to-human translational success (and failure) rates within the currently available empirical evidence?”. We searched PubMed and Embase on 16 October 2017. We included reviews and all other types of “umbrella”-studies of meta-data quantitatively comparing the translational results of studies including at least two species with one being human. We supplemented our database searches with additional strategies. All abstracts and full-text papers were screened by two independent reviewers. Our scoping review comprises 121 references, with various units of measurement: compound or intervention (k = 104), study/experiment (k = 10), and symptom or event (k = 7). Diagnostic statistics corresponded with binary and continuous definitions of successful translation. Binary definitions comprise percentages below twofold error, percentages accurately predicted, and predictive values. Quantitative definitions comprise correlation/regression (r2) and meta-analyses (percentage overlap of 95% confidence intervals). Translational success rates ranged from 0 to 100%. Conclusion The wide range of translational success rates observed in our study might indicate that translational success is unpredictable; i.e. it might be unclear upfront if the results of primary animal studies will contribute to translational knowledge. However, the risk of bias of the included studies was high, and much of the included evidence is old, while newer models have become available. Therefore, the reliability of the cumulative evidence from current papers on this topic is insufficient. Further in-depth “umbrella”-studies of translational success rates are still warranted. These are needed to evaluate the probabilistic evidence for predictivity of animal studies for the human situation more reliably, and to determine which factors affect this process.
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Affiliation(s)
- Cathalijn H C Leenaars
- Department of Animals in Science and Society, Faculty of Veterinary Sciences, Utrecht University, Utrecht, The Netherlands. .,Institute for Laboratory Animal Science, Hannover Medical School, Hannover, Germany. .,SYRCLE, Department for Health Evidence (section HTA), Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Carien Kouwenaar
- Department of Animals in Science and Society, Faculty of Veterinary Sciences, Utrecht University, Utrecht, The Netherlands
| | - Frans R Stafleu
- Department of Animals in Science and Society, Faculty of Veterinary Sciences, Utrecht University, Utrecht, The Netherlands
| | - André Bleich
- Institute for Laboratory Animal Science, Hannover Medical School, Hannover, Germany
| | - Merel Ritskes-Hoitinga
- SYRCLE, Department for Health Evidence (section HTA), Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rob B M De Vries
- SYRCLE, Department for Health Evidence (section HTA), Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Franck L B Meijboom
- Department of Animals in Science and Society, Faculty of Veterinary Sciences, Utrecht University, Utrecht, The Netherlands
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Hollyer TR, Bordoni L, Kousholt BS, van Luijk J, Ritskes-Hoitinga M, Østergaard L. The evidence for the physiological effects of lactate on the cerebral microcirculation: a systematic review. J Neurochem 2019; 148:712-730. [PMID: 30472728 PMCID: PMC6590437 DOI: 10.1111/jnc.14633] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 10/22/2018] [Accepted: 11/20/2018] [Indexed: 12/15/2022]
Abstract
Abstract Lactate's role in the brain is understood as a contributor to brain energy metabolism, but it may also regulate the cerebral microcirculation. The purpose of this systematic review was to evaluate evidence of lactate as a physiological effector within the normal cerebral microcirculation in reports ranging from in vitro experiments to in vivo studies in animals and humans. Following pre‐registration of a review protocol, we systematically searched the PubMed, EMBASE, and Cochrane databases for literature covering themes of ‘lactate’, ‘the brain’, and ‘microcirculation’. Abstracts were screened, and data extracted independently by two individuals. We excluded studies evaluating lactate in disease models. Twenty‐eight papers were identified, 18 of which were in vivo animal experiments (65%), four on human studies (14%), and six on in vitro or ex vivo experiments (21%). Approximately half of the papers identified lactate as an augmenter of the hyperemic response to functional activation by a visual stimulus or as an instigator of hyperemia in a dose‐dependent manner, without external stimulation. The mechanisms are likely to be coupled to NAD+/NADH redox state influencing the production of nitric oxide. Unfortunately, only 38% of these studies demonstrated any control for bias, which makes reliable generalizations of the conclusions insecure. This systematic review identifies that lactate may act as a dose‐dependent regulator of cerebral microcirculation by augmenting the hyperemic response to functional activation below 5 mmol/kg, and by initiating a hyperemic response above 5 mmol/kg. Open Science Badges
This article has received a badge for *Pre‐registration* because it made the data publicly available. The data can be accessed at www.radboudumc.nl/getmedia/53625326-d1df-432c-980f-27c7c80d1a90/THollyer_lactate_protocol.aspx. The complete Open Science Disclosure form for this article can be found at the end of the article. More information about the Open Practices badges can be found at https://cos.io/our-services/open-science-badges/. ![]()
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Affiliation(s)
- Tristan R Hollyer
- Centre for Functionally Integrative Neuroscience (CFIN), Aarhus University, Aarhus C, Denmark.,Institute for Clinical Medicine, Aarhus N, Denmark
| | - Luca Bordoni
- Department of Biomedicine South, Aarhus University, Aarhus C, Denmark
| | - Birgitte S Kousholt
- Institute for Clinical Medicine, Aarhus N, Denmark.,Department of Clinical Medicine, AUGUST Centre, Aarhus University, Risskov, Denmark
| | - Judith van Luijk
- SYstematic Review Centre for Laboratory Animal Experimentation (SYRCLE), Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Merel Ritskes-Hoitinga
- SYstematic Review Centre for Laboratory Animal Experimentation (SYRCLE), Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Leif Østergaard
- Centre for Functionally Integrative Neuroscience (CFIN), Aarhus University, Aarhus C, Denmark.,Institute for Clinical Medicine, Aarhus N, Denmark.,Department of Neuroradiology, Aarhus University Hospital, Aarhus C, Denmark
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Pires GN, Bezerra AG, de Vries RBM, Leenaars CHC, Ritskes-Hoitinga M, Tufik S, Andersen ML. Effects of experimental sleep deprivation on aggressive, sexual and maternal behaviour in animals: a systematic review protocol. BMJ Open Science 2018; 2:e000041. [PMID: 35047677 PMCID: PMC8749292 DOI: 10.1136/bmjos-2017-000041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 10/24/2018] [Indexed: 12/11/2022] Open
Abstract
Objective Because of the relevance for the research on sleep deprivation and human behaviour, many preclinical studies have been conducted on aggressive, sexual and maternal behaviours in this field. Considering the available data and the complexity of the factors involved, the most appropriate way to summarise the effects of sleep deprivation on these behaviours is through systematic reviews and meta-analyses. This article describes the protocol for three independent systematic reviews and meta-analyses, evaluating the effects of sleep deprivation on aggressive, sexual and maternal behaviours in animals. Search strategy A bibliographic search will be performed in four databases: Pubmed, Scopus, Web of Science and Psychinfo, searching for three domains: sleep deprivation (as the intervention), animals (as the population) and behaviour (as the outcome). Screening and annotation Titles and abstracts will first be screened, followed by analysis of the full text and data extraction. Data management and reporting SYstematic Review Centre for Laboratory Animal Experimentation ’s risk of bias tool will be used to evaluate risk of bias; visual analysis of funnel plots, Egger’s regression and trim-and-fill will be employed to evaluate publication bias. Effect sizes will be calculated from the articles by either direct or standardised mean difference, depending on the nature of the data. Overall estimates will then be calculated using a random effects model. Heterogeneity will be assessed using both I2 index and Cochran’s Q test. These meta-analyses should be useful to summarise the available data on the relationship between sleep deprivation and behaviour, providing a solid background for future behavioural sleep deprivation experiments, improving their validity.
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Affiliation(s)
- Gabriel Natan Pires
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
- Department of Physiological Sciences, Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil
| | | | - Rob B M de Vries
- SYstematic Review Centre for Laboratory Animal Experimentation (SYRCLE) at Central Animal Facility, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Merel Ritskes-Hoitinga
- SYstematic Review Centre for Laboratory Animal Experimentation (SYRCLE) at Central Animal Facility, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Monica Levy Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
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Pound P, Ritskes-Hoitinga M. Is it possible to overcome issues of external validity in preclinical animal research? Why most animal models are bound to fail. J Transl Med 2018; 16:304. [PMID: 30404629 PMCID: PMC6223056 DOI: 10.1186/s12967-018-1678-1] [Citation(s) in RCA: 156] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 10/31/2018] [Indexed: 12/12/2022] Open
Abstract
Background The pharmaceutical industry is in the midst of a productivity crisis and rates of translation from bench to bedside are dismal. Patients are being let down by the current system of drug discovery; of the several 1000 diseases that affect humans, only a minority have any approved treatments and many of these cause adverse reactions in humans. A predominant reason for the poor rate of translation from bench to bedside is generally held to be the failure of preclinical animal models to predict clinical efficacy and safety. Attempts to explain this failure have focused on problems of internal validity in preclinical animal studies (e.g. poor study design, lack of measures to control bias). However there has been less discussion of another key factor that influences translation, namely the external validity of preclinical animal models. Review of problems of external validity External validity is the extent to which research findings derived in one setting, population or species can be reliably applied to other settings, populations and species. This paper argues that the reliable translation of findings from animals to humans will only occur if preclinical animal studies are both internally and externally valid. We review several key aspects that impact external validity in preclinical animal research, including unrepresentative animal samples, the inability of animal models to mimic the complexity of human conditions, the poor applicability of animal models to clinical settings and animal–human species differences. We suggest that while some problems of external validity can be overcome by improving animal models, the problem of species differences can never be overcome and will always undermine external validity and the reliable translation of preclinical findings to humans. Conclusion We conclude that preclinical animal models can never be fully valid due to the uncertainties introduced by species differences. We suggest that even if the next several decades were spent improving the internal and external validity of animal models, the clinical relevance of those models would, in the end, only improve to some extent. This is because species differences would continue to make extrapolation from animals to humans unreliable. We suggest that to improve clinical translation and ultimately benefit patients, research should focus instead on human-relevant research methods and technologies.
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Affiliation(s)
- Pandora Pound
- Safer Medicines Trust, PO Box 122, Kingsbridge, TQ7 9AX, UK.
| | - Merel Ritskes-Hoitinga
- SYRCLE, Department for Health Evidence, Radboud University Medical Center, PO Box 9101, Route 133, 6500 HB, Nijmegen, The Netherlands
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Osborne N, Avey MT, Anestidou L, Ritskes-Hoitinga M, Griffin G. Improving animal research reporting standards: HARRP, the first step of a unified approach by ICLAS to improve animal research reporting standards worldwide. EMBO Rep 2018; 19:embr.201846069. [PMID: 29669797 PMCID: PMC5934777 DOI: 10.15252/embr.201846069] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The HAARP guidelines aim to set a global minimum standard for reporting results from and details of research experiments using animals. Their adoption would contribute to more transparency in research and improve reproducibility.
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Affiliation(s)
- Nikki Osborne
- Royal Society for the Prevention of Cruelty to Animals, Southwater, UK
| | - Marc T Avey
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Lida Anestidou
- Institute for Laboratory Animal Research, National Academies of Sciences, Engineering and Medicine, Washington, DC, USA
| | - Merel Ritskes-Hoitinga
- SYstematic Review Center for Laboratory animal Experimentation (SYRCLE) Radboud University Medical Center, Nijmegen, The Netherlands
| | - Gilly Griffin
- Canadian Council for Animal Care, Ottawa, ON, Canada
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Hesen NA, Riksen NP, Aalders B, Brouwer MAE, Ritskes-Hoitinga M, El Messaoudi S, Wever KE. Correction: A systematic review and meta-analysis of the protective effects of metformin in experimental myocardial infarction. PLoS One 2018; 13:e0195858. [PMID: 29630663 PMCID: PMC5891025 DOI: 10.1371/journal.pone.0195858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Hooijmans CR, de Vries RBM, Ritskes-Hoitinga M, Rovers MM, Leeflang MM, IntHout J, Wever KE, Hooft L, de Beer H, Kuijpers T, Macleod MR, Sena ES, ter Riet G, Morgan RL, Thayer KA, Rooney AA, Guyatt GH, Schünemann HJ, Langendam MW. Facilitating healthcare decisions by assessing the certainty in the evidence from preclinical animal studies. PLoS One 2018; 13:e0187271. [PMID: 29324741 PMCID: PMC5764235 DOI: 10.1371/journal.pone.0187271] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 10/17/2017] [Indexed: 12/23/2022] Open
Abstract
Laboratory animal studies are used in a wide range of human health related research areas, such as basic biomedical research, drug research, experimental surgery and environmental health. The results of these studies can be used to inform decisions regarding clinical research in humans, for example the decision to proceed to clinical trials. If the research question relates to potential harms with no expectation of benefit (e.g., toxicology), studies in experimental animals may provide the only relevant or controlled data and directly inform clinical management decisions. Systematic reviews and meta-analyses are important tools to provide robust and informative evidence summaries of these animal studies. Rating how certain we are about the evidence could provide important information about the translational probability of findings in experimental animal studies to clinical practice and probably improve it. Evidence summaries and certainty in the evidence ratings could also be used (1) to support selection of interventions with best therapeutic potential to be tested in clinical trials, (2) to justify a regulatory decision limiting human exposure (to drug or toxin), or to (3) support decisions on the utility of further animal experiments. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach is the most widely used framework to rate the certainty in the evidence and strength of health care recommendations. Here we present how the GRADE approach could be used to rate the certainty in the evidence of preclinical animal studies in the context of therapeutic interventions. We also discuss the methodological challenges that we identified, and for which further work is needed. Examples are defining the importance of consistency within and across animal species and using GRADE's indirectness domain as a tool to predict translation from animal models to humans.
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Affiliation(s)
- Carlijn R. Hooijmans
- Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE), Department of Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rob B. M. de Vries
- Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE), Department of Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Merel Ritskes-Hoitinga
- Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE), Department of Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maroeska M. Rovers
- Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE), Department of Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Mariska M. Leeflang
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Joanna IntHout
- Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE), Department of Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Kimberley E. Wever
- Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE), Department of Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Lotty Hooft
- Cochrane Netherlands, University Medical Center, Utrecht, The Netherlands
| | | | - Ton Kuijpers
- Dutch College of General Practitioners, Utrecht, The Netherlands
| | - Malcolm R. Macleod
- Center for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Emily S. Sena
- Center for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Gerben ter Riet
- Department of General Practice, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Rebecca L. Morgan
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Department of Medicine, McMaster University, Hamilton, Canada
| | - Kristina A. Thayer
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Washington, D.C., United States of America
| | - Andrew A. Rooney
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Washington, D.C., United States of America
| | - Gordon H. Guyatt
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Department of Medicine, McMaster University, Hamilton, Canada
| | - Holger J. Schünemann
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Department of Medicine, McMaster University, Hamilton, Canada
| | - Miranda W. Langendam
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Affiliation(s)
| | - Kim Wever
- SYRCLE, Department for Health Evidence, Radboudumc, Nijmegen, Netherlands
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Osborne NJ, Ritskes-Hoitinga M, Ahluwahlia A, Alam S, Brown M, Henderson H, de Leeuw W, Marsh J, Moher D, van Oort E, Rawle F, Riederer BM, Sanchez-Morgado J, Sena ES, Struthers C, Westmore M, Avey MT, Kalman R, O'Connor A, Sargeant J, Petrie A, Smith A. Letter to the editor - round table unites to tackle culture change in an effort to improve animal research reporting. BMC Vet Res 2017; 13:314. [PMID: 29115951 PMCID: PMC5678589 DOI: 10.1186/s12917-017-1235-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 10/30/2017] [Indexed: 11/18/2022] Open
Abstract
A round table discussion was held during the LAVA-ESLAV-ECLAM conference on Reproducibility of Animal Studies on the 25th of September 2017 in Edinburgh. The aim of the round table was to discuss how to enhance the rate at which the quality of reporting animal research can be improved. This signed statement acknowledges the efforts that participant organizations have made towards improving the reporting of animal studies and confirms an ongoing commitment to drive further improvements, calling upon both academics and laboratory animal veterinarians to help make this cultural change.
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Affiliation(s)
- Nicola J Osborne
- Responsible Research in Practice, Bailey House, 4-10 Barttelot Road, Horsham, West Sussex, RH12 1DQ, UK.
| | | | - Amrita Ahluwahlia
- Barts & The London School of Medicine & Dentistry, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK
| | - Sabina Alam
- Faculty of 1000, Middlesex House, 34-42 Cleveland St, London, W1T 4LB, UK
| | - Matthew Brown
- Wellcome Trust, Gibbs Building, 215 Euston Road, London, NW1 2BE, UK
| | - Hayley Henderson
- BMC Veterinary Research, BioMed Central, 236 Grays Inn Road, London, WC1X 8HB, UK
| | - Wim de Leeuw
- Animal Welfare Body Utrecht, Nieuw Gildestein, Room 1.81, Box 80125, NL - 3508 TC Utrecht, Utrecht, The Netherlands.,, kamer 1.82, PO Box 12007, 3501 AA, Utrecht, The Netherlands
| | - Joan Marsh
- The Lancet Psychiatry, 125 London Wall, London, EC2Y 5AS, UK
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital - General Campus, 501 Smyth Rd, Room L1288, Ottawa, ON, K1H 8L6, Canada
| | - Erica van Oort
- ZonMw, PO Box 93 245, 2509 AE, The Hague, The Netherlands
| | - Frances Rawle
- Medical Research Council, 13th floor, One Kemble Street, London, WC2B 4AN, UK
| | - Beat M Riederer
- Platform of Morphology, Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 9, CH-1005, Lausanne, Switzerland.,Centre for Psychiatric Neuroscience, Department of Psychiatry, University Hospital of the Canton Vaud, route de Prilly, CH-1008, Lausanne-Prilly, Switzerland
| | - Jose Sanchez-Morgado
- Trinity College Dublin, The University of Dublin, College Green, Dublin 2, Ireland
| | - Emily S Sena
- Centre for Clinical Brain Sciences, University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh, EH16 4SB, UK
| | - Caroline Struthers
- Centre for Statistics in Medicine, Nuffield Dept. of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Botnar Research Centre, Nuffield Orthopaedic Centre, Windmill Road, Oxford, OX3 7LD, UK
| | - Matthew Westmore
- National Institute for Health Research Evaluation, Trials and Studies Coordinating Centre, University of Southampton, Alpha House, Enterprise Road, Southampton, SO16 7NS, UK
| | - Marc T Avey
- ICF, 2635 Meridian Parkway Suite 200, Durham, NC, 27713, USA
| | - Rony Kalman
- Authority for Biological and Biomedical Models, The Hebrew University of Jerusalem, Ein Kerem, 91120, Jerusalém, Israel
| | - Annette O'Connor
- Lloyd Vet Med Center Rm 2424, College of Veterinary Medicine, Iowa State University, 1809 S Riverside Drive, Ames, IA, 50011-3619, USA
| | - Jan Sargeant
- Centre for Public Health and Zoonoses, and Department of Population Medicine, 2502 Stewart Building, Ontario Veterinary College, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - Anja Petrie
- The University of Aberdeen, Medical Research Facility, Aberdeen, AB25 2ZD, UK
| | - Adrian Smith
- Norecopa, c/o Norwegian Veterinary Institute, P.O. Box 750 Sentrum, 0106, Oslo, Norway
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Hesen NA, Riksen NP, Aalders B, Brouwer MAE, Ritskes-Hoitinga M, El Messaoudi S, Wever KE. A systematic review and meta-analysis of the protective effects of metformin in experimental myocardial infarction. PLoS One 2017; 12:e0183664. [PMID: 28832637 PMCID: PMC5568412 DOI: 10.1371/journal.pone.0183664] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 08/01/2017] [Indexed: 02/07/2023] Open
Abstract
Metformin improves cardiovascular prognosis in patients with diabetes mellitus, compared to alternative glucose-lowering drugs, despite similar glycemic control. Direct cardiovascular protective properties have therefore been proposed, and studied in preclinical models of myocardial infarction. We now aim to critically assess the quality and outcome of these studies. We present a systematic review, quality assessment and meta-analysis of the effect of metformin in animal studies of experimental myocardial infarction. Through a comprehensive search in Pubmed and EMBASE, we identified 27 studies, 11 reporting on ex vivo experiments and 18 reporting on in vivo experiments. The primary endpoint infarct size as percentage of area at risk was significantly reduced by metformin in vivo (MD -18.11[-24.09,-12.14]) and ex vivo (MD -18.70[-25.39, -12.02]). Metformin improved the secondary endpoints left ventricular ejection fraction (LVEF) and left ventricular end systolic diameter. A borderline significant effect on mortality was observed, and there was no overall effect on cardiac hypertrophy. Subgroup analyses could be performed for comorbidity and timing of treatment (infarct size and mortality) and species and duration of ischemia (LVEF), but none of these variables accounted for significant amounts of heterogeneity. Reporting of possible sources of bias was extremely poor, including randomization (reported in 63%), blinding (33%), and sample size calculation (0%). As a result, risk of bias (assessed using SYRCLE’s risk of bias tool) was unclear in the vast majority of studies. We conclude that metformin limits infarct-size and improves cardiac function in animal models of myocardial infarction, but our confidence in the evidence is lowered by the unclear risk of bias and residual unexplained heterogeneity. We recommend an adequately powered, high quality confirmatory animal study to precede a randomized controlled trial of acute administration of metformin in patients undergoing reperfusion for acute myocardial infarction.
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Affiliation(s)
- Nienke A Hesen
- SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE), Department for Health Evidence, Nijmegen Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Niels P Riksen
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bart Aalders
- SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE), Department for Health Evidence, Nijmegen Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Merel Ritskes-Hoitinga
- SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE), Department for Health Evidence, Nijmegen Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Saloua El Messaoudi
- Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Kimberley E Wever
- SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE), Department for Health Evidence, Nijmegen Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
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Abstract
Toe clipping and ear clipping (also ear notching or ear punching) are frequently used methods for individual identification of laboratory rodents. These procedures potentially cause severe discomfort, which can reduce animal welfare and distort experimental results. However, no systematic summary of the evidence on this topic currently exists. We conducted a systematic review of the evidence for discomfort due to toe or ear clipping in rodents. The review methodology was pre-specified in a registered review protocol. The population, intervention, control, outcome (PICO) question was: In rodents, what is the effect of toe clipping or ear clipping, compared with no clipping or sham clipping, on welfare-related outcomes? Through a systematic search in PubMed, Embase, Web of Science and grey literature, we identified seven studies on the effect of ear clipping on animal welfare, and five such studies on toe clipping. Studies were included in the review if they contained original data from an in vivo experiment in rodents, assessing the effect of toe clipping or ear clipping on a welfare-related outcome. Case studies and studies applying unsuitable co-interventions were excluded. Study quality was appraised using an extended version of SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE)'s risk of bias tool for animal studies. Study characteristics and outcome measures were highly heterogeneous, and there was an unclear or high risk of bias in all studies. We therefore present a narrative synthesis of the evidence identified. None of the studies reported a sample size calculation. Out of over 60 different outcomes, we found evidence of discomfort due to ear clipping in the form of increased respiratory volume, vocalization and blood pressure. For toe clipping, increased vocalization and decreased motor activity in pups were found, as well as long-term effects in the form of reduced grip strength and swimming ability in adults. In conclusion, there is too little evidence to reliably assess discomfort due to toe or ear clipping, and the quality of the available evidence is uncertain. Adequately powered, high-quality studies reporting reliable, relevant outcome measures are needed to accurately assess the impact of these identification techniques. Until more reliable evidence is available, any effect of toe clipping or ear clipping on animal welfare and study results cannot be confirmed or excluded.
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Affiliation(s)
- Kimberley E Wever
- 1 SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE)
| | | | | | - Alice Tillema
- 2 Medical Library, Radboud University Medical Center, Nijmegen, The Netherlands
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Hooijmans CR, Wever KE, Ritskes-Hoitinga M, Scheffer GJ. The usefulness of systematic reviews of animal studies: shooting the messenger. Paediatr Anaesth 2016; 26:852-3. [PMID: 27370518 DOI: 10.1111/pan.12938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Carlijn R Hooijmans
- Department of SYRCLE, Radboud University Medical Centre, Nijmegen, The Netherlands. .,Department of Anesthesiology, Radboud University Medical Centre, Nijmegen, The Netherlands.
| | - Kimberley E Wever
- Department of SYRCLE, Radboud University Medical Centre, Nijmegen, The Netherlands
| | | | - Gert-Jan Scheffer
- Department of Anesthesiology, Radboud University Medical Centre, Nijmegen, The Netherlands
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Abstract
Renal epithelial proliferation has previously been found to be a common condition in a colony of Lewis × Brown Norway (BN) F2 hybrid rats. The aim of this study was to investigate the prevalence and clinical consequences of this condition in pure inbred BN and Lewis rats. Renal epithelial proliferation was found in 29 of 49 BN rats (59%) examined and in four of 50 Lewis rats (8%) examined. Serum creatinine and serum corticosterone was not influenced by the condition. Haematuria was more common in BN rats with (74%) than without renal papillary proliferation (35%, P < 0.05), but it may not be used to diagnose renal epithelial proliferation, as we found rats having renal epithelial proliferation without showing haematuria and rats showing haematuria without having renal epithelial proliferation. Haematuria was also common in Lewis rats (16-56% dependent of age and gender), in which renal epithelial proliferation were found in only 8%. Fluctuating asymmetry, which was used as a measure of developmental instability, was found to be increased in rats with renal epithelial proliferation ( P < 0.05). Haematuria was also found to be related to the degree of fluctuating asymmetry ( P < 0.01). Although the prevalence of renal epithelial proliferation is clearly higher in BN rats than in Lewis rats ( P < 0.01), and although in previous reports the condition was found in F2 BN × Lewis hybrids and not in F1 BN × Lewis hybrids it cannot clearly be defined as having been caused by a single Mendelian gene, as we found it in both inbred strains. Futhermore, we found that morphologically the proliferations could be placed on the papillary as well as the medullary wall of the renal pelvis, while previously it has only been described on the papillary wall.
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Affiliation(s)
- C Stub
- Division of Laboratory Animal Science and Welfare, Department of Pharmacology and Pathobiology, Royal Veterinary and Agricultural University, 3 Ridebanevej, DK-1870 Frederiksberg C, Denmark
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Howard B, van Herck H, Guillen J, Bacon B, Joffe R, Ritskes-Hoitinga M. Report of the FELASA Working Group on evaluation of quality systems for animal units. Lab Anim 2016; 38:103-18. [PMID: 15070450 DOI: 10.1258/002367704322968786] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This report compares and considers the merits of existing, internationally available quality management systems suitable for implementation in experimental animal facilities. These are: the Good Laboratory Practice Guidelines, ISO 9000:2000 (International Organization for Standardization) and AAALAC International (Association for Assessment and Accreditation of Laboratory Animal Care International). Good laboratory practice (GLP) is a legal requirement for institutions undertaking non-clinical health and environmental studies for the purpose of registering or licensing for use and which have to be 'GLP-compliant'. GLP guidelines are often only relevant for and obtainable by those institutions. ISO is primarily an external business standard, which provides a management tool to master and optimize a business activity; it aims to implement and enhance 'customer satisfaction'. AAALAC is primarily a peer-reviewed system of accreditation which evaluates the organization and procedures in programmes of animal care and use to ensure the appropriate use of animals, safeguard animal well-being (ensuring state-of-the-art housing, management, procedural techniques, etc.) as well as the management of health and safety of staff. Management needs to determine, on the basis of a facility's specific goals, whether benefits would arise from the introduction of a quality system and, if so, which system is most appropriate. The successful introduction of a quality system confers peer-recognition against an independent standard, thereby providing assurance of standards of animal care and use, improving the quality of animal studies, and contributing to the three Rs—reduction, refinement and replacement.
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Affiliation(s)
- B Howard
- University of Sheffield, Western Bank, Sheffield S10 2TN, UK
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45
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Sørensen DB, Stub C, Jensen HE, Ritskes-Hoitinga M, Hjorth P, Ottesen JL, Hansen AK. The impact of tail tip amputation and ink tattoo on C57BL/6JBomTac mice. Lab Anim 2016; 41:19-29. [PMID: 17234047 DOI: 10.1258/002367707779399383] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Genetic material for polymerase chain reaction (PCR) and Southern blot analysis on transgenic mice is normally obtained by tail biopsy. Additionally, it may be necessary to tattoo the mice, as it is essential to have a good and permanent identification. The aim of this study was to evaluate the effects of amputating the tip of the tail to obtain a biopsy for genetic analysis and of ink tattooing on welfare in C57BL/6J mice, a strain often used as genetic background for transgenes. The behaviour of the animals, fluctuating asymmetry (FA, a measure of developmental instability) and the level of restitution in the remaining part of the tail were evaluated and used for an assessment of the impact of these procedures on the welfare of the animals. One group of mice was marked by tail tattooing at various ages. Another group of mice were tail amputated at 12 or 20 days of age. Body weight and FA were followed, and at the end of the experiment, the level of fear/anxiety was assessed using a light–dark box. In the group of tail-amputated animals observation of climbing behaviour and a beam walking test for balance was performed. Seven weeks after tail amputation, the animals were euthanized. The remaining part of the tail was evaluated histopathologically. Body weight, behaviour in the light–dark box and balance test results were not influenced by tail amputation or tattooing. FA was only transiently increased by tattooing. Climbing behaviour was reduced just after tail amputation at 20 days of age. No signs of neuromas were found in the amputated tails, but seven weeks after amputation a significant number of mice did not have fully regenerated glandular tissue and hair follicles in the tail. It is concluded that both tail amputation and tail tattooing seem to have minor short-term negative effects on welfare and that the tissues on the tail probably do not regenerate fully after amputation.
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Affiliation(s)
- Dorte Bratbo Sørensen
- Centre for Bioethics and Risk Assessment, Division of Laboratory Animal Science, Department of Veterinary Pathobiology, Royal Veterinary and Agricultural University, Groennegaardsvej 15, DK-1870 Frederiksberg C, Denmark.
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Hooijmans CR, Geessink FJ, Ritskes-Hoitinga M, Scheffer GJ. A Systematic Review of the Modifying Effect of Anaesthetic Drugs on Metastasis in Animal Models for Cancer. PLoS One 2016; 11:e0156152. [PMID: 27227779 PMCID: PMC4882001 DOI: 10.1371/journal.pone.0156152] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 05/10/2016] [Indexed: 12/09/2022] Open
Abstract
Background Distant metastasis or local recurrence after primary tumour resection remain a major clinical problem. The anaesthetic technique used during oncologic surgery is suggested to influence the metastatic process. While awaiting the results of ongoing randomised controlled trials (RCTs), we have analyzed the evidence regarding the influence of anaesthetic drugs on experimental tumour metastasis in animal studies. Methods PubMed and Embase were searched until April 21st, 2015. Studies were included in the systematic review when they 1) assessed the effect of an anaesthetic drug used in clinical practice on the number or incidence of metastasis in animal models with experimental cancer, 2) included an appropriate control group, and 3) presented unique data. Results 20 studies met the inclusion criteria (published between 1958–2010). Data on number of metastases could be retrieved from 17 studies. These studies described 41 independent comparisons, 33 of which could be included in the meta-analysis (MA). The incidence of metastases was studied in 3 unique papers. From these 3 papers, data on 7 independent comparisons could be extracted and included in the MA. Locally administered local anaesthetics appear to decrease the number of metastases (SMD -6.15 [-8.42; -3.88]), whereas general anaesthetics (RD: 0.136 [0.045, 0.226]), and more specifically volatile anaesthetics (SMD 0.54 [0.24; 0.84]), appear to increase the number and risk of metastases in animal models for cancer. Conclusions Anaesthetics influence the number and incidence of metastases in experimental cancer models. Although more high quality experimental research is necessary, based on the currently available evidence from animal studies, there is no indication to suggest that locally administered local anaesthetics are harmful during surgery in cancer patients. Volatile anaesthetics, however, might increase metastasis in animal models and clinical trials investigating this possibly harmful effect should receive priority. The results of our systematic review in animal studies are broadly consistent with clinical reports that anaesthetic technique does seem to affect the tumour metastasis process.
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Affiliation(s)
- Carlijn R. Hooijmans
- Department of SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE), Radboud University Medical Centre, 6500 HB, Nijmegen, the Netherlands
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Centre, 6500 HB, Nijmegen, the Netherlands
- * E-mail:
| | - Florentine J. Geessink
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Centre, 6500 HB, Nijmegen, the Netherlands
| | - Merel Ritskes-Hoitinga
- Department of SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE), Radboud University Medical Centre, 6500 HB, Nijmegen, the Netherlands
| | - Gert Jan Scheffer
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Centre, 6500 HB, Nijmegen, the Netherlands
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Jonker SJ, Menting TP, Warlé MC, Ritskes-Hoitinga M, Wever KE. Preclinical Evidence for the Efficacy of Ischemic Postconditioning against Renal Ischemia-Reperfusion Injury, a Systematic Review and Meta-Analysis. PLoS One 2016; 11:e0150863. [PMID: 26963819 PMCID: PMC4786316 DOI: 10.1371/journal.pone.0150863] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 02/20/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Renal ischemia-reperfusion injury (IRI) is a major cause of kidney damage after e.g. renal surgery and transplantation. Ischemic postconditioning (IPoC) is a promising treatment strategy for renal IRI, but early clinical trials have not yet replicated the promising results found in animal studies. METHOD We present a systematic review, quality assessment and meta-analysis of the preclinical evidence for renal IPoC, and identify factors which modify its efficacy. RESULTS We identified 39 publications studying >250 control animals undergoing renal IRI only and >290 animals undergoing renal IRI and IPoC. Healthy, male rats undergoing warm ischemia were used in the vast majority of studies. Four studies applied remote IPoC, all others used local IPoC. Meta-analysis showed that both local and remote IPoC ameliorated renal damage after IRI for the outcome measures serum creatinine, blood urea nitrogen and renal histology. Subgroup analysis indicated that IPoC efficacy increased with the duration of index ischemia. Measures to reduce bias were insufficiently reported. CONCLUSION High efficacy of IPoC is observed in animal models, but factors pertaining to the internal and external validity of these studies may hamper the translation of IPoC to the clinical setting. The external validity of future animal studies should be increased by including females, comorbid animals, and transplantation models, in order to better inform clinical trial design. The severity of renal damage should be taken into account in the design and analysis of future clinical trials.
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Affiliation(s)
- Simone J. Jonker
- SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE), Radboud university medical center, Nijmegen, The Netherlands
| | - Theo P. Menting
- Department of surgery, Radboud university medical center, Nijmegen, The Netherlands
| | - Michiel C. Warlé
- Department of surgery, Radboud university medical center, Nijmegen, The Netherlands
| | - Merel Ritskes-Hoitinga
- SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE), Radboud university medical center, Nijmegen, The Netherlands
| | - Kimberley E. Wever
- SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE), Radboud university medical center, Nijmegen, The Netherlands
- * E-mail:
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Hooijmans CR, IntHout J, Ritskes-Hoitinga M, Rovers MM. Meta-analyses of animal studies: an introduction of a valuable instrument to further improve healthcare. ILAR J 2015; 55:418-26. [PMID: 25541544 PMCID: PMC4276598 DOI: 10.1093/ilar/ilu042] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
In research aimed at improving human health care, animal studies still play a crucial role, despite political and scientific efforts to reduce preclinical experimentation in laboratory animals. In animal studies, the results and their interpretation are not always straightforward, as no single study is executed perfectly in all steps. There are several possible sources of bias, and many animal studies are replicates of studies conducted previously. Use of meta-analysis to combine the results of studies may lead to more reliable conclusions and a reduction of unnecessary duplication of animal studies. In addition, due to the more exploratory nature of animal studies as compared to clinical trials, meta-analyses of animal studies have greater potential in exploring possible sources of heterogeneity. There is an abundance of literature on how to perform meta-analyses on clinical data. Animal studies, however, differ from clinical studies in some aspects, such as the diversity of animal species studied, experimental design, and study characteristics. In this paper, we will discuss the main principles and practices for meta-analyses of experimental animal studies.
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49
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Kleikers PWM, Hooijmans C, Göb E, Langhauser F, Rewell SSJ, Radermacher K, Ritskes-Hoitinga M, Howells DW, Kleinschnitz C, HHW Schmidt H. A combined pre-clinical meta-analysis and randomized confirmatory trial approach to improve data validity for therapeutic target validation. Sci Rep 2015; 5:13428. [PMID: 26310318 PMCID: PMC4550831 DOI: 10.1038/srep13428] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 07/27/2015] [Indexed: 12/30/2022] Open
Abstract
Biomedical research suffers from a dramatically poor translational success. For example, in ischemic stroke, a condition with a high medical need, over a thousand experimental drug targets were unsuccessful. Here, we adopt methods from clinical research for a late-stage pre-clinical meta-analysis (MA) and randomized confirmatory trial (pRCT) approach. A profound body of literature suggests NOX2 to be a major therapeutic target in stroke. Systematic review and MA of all available NOX2(-/y) studies revealed a positive publication bias and lack of statistical power to detect a relevant reduction in infarct size. A fully powered multi-center pRCT rejects NOX2 as a target to improve neurofunctional outcomes or achieve a translationally relevant infarct size reduction. Thus stringent statistical thresholds, reporting negative data and a MA-pRCT approach can ensure biomedical data validity and overcome risks of bias.
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Affiliation(s)
- Pamela WM. Kleikers
- Department of Pharmacology, CARIM, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands
| | - Carlijn Hooijmans
- SYRCLE at Central Animal Laboratory, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Eva Göb
- Neurologische Klinik und Poliklinik der Universitätsklinik Würzburg, Würzburg, Germany
| | - Friederike Langhauser
- Neurologische Klinik und Poliklinik der Universitätsklinik Würzburg, Würzburg, Germany
| | - Sarah SJ. Rewell
- Florey Institute of Neuroscience and Mental Health, Austin Health, Melbourne, Victoria, Australia
| | - Kim Radermacher
- Department of Pharmacology, CARIM, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands
| | - Merel Ritskes-Hoitinga
- SYRCLE at Central Animal Laboratory, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - David W. Howells
- Florey Institute of Neuroscience and Mental Health, Austin Health, Melbourne, Victoria, Australia
| | | | - Harald HHW Schmidt
- Department of Pharmacology, CARIM, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands
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Yauw STK, Wever KE, Hoesseini A, Ritskes-Hoitinga M, van Goor H. Systematic review of experimental studies on intestinal anastomosis. Br J Surg 2015; 102:726-34. [PMID: 25846745 DOI: 10.1002/bjs.9776] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 12/04/2014] [Accepted: 12/18/2014] [Indexed: 01/19/2023]
Abstract
BACKGROUND The contribution of animal research to a reduction in clinical intestinal anastomotic leakage is unknown, despite numerous experimental studies. In view of the current societal call to replace, reduce and refine animal experiments, this study examined the quality of animal research related to anastomotic healing and leakage. METHODS Animal studies on intestinal anastomotic healing were retrieved systematically from PubMed and Embase. Study objective, conclusion and animal model were recorded. Reporting quality and internal validity (reporting of randomization and blinding) were assessed. RESULTS A total of 1342 studies were identified, with a rising publication rate. The objectives of most studies were therapeutic interventions (64·8 per cent) and identification of risk factors (27·5 per cent). Of 350 articles studying experimental therapies, 298 (85·1 per cent) reported a positive effect on anastomotic healing. On average, 44·7 per cent of relevant study characteristics were not reported, in particular details on anastomotic complications (31·6 per cent), use of antibiotics (75·7 per cent), sterile surgery (83·4 per cent) and postoperative analgesia (91·4 per cent). The proportion of studies with randomization, blinding of surgery and blinding of primary outcome assessment has increased in the past two decades but remains insufficient, being included in only 62·4, 4·9 and 8·5 per cent of publications respectively. Animal models varied widely in terms of species, method to compromise healing, intestinal segment and outcome measures used. CONCLUSION Animal research on anastomotic leakage is of poor quality and still increasing, contrary to societal aims. Reporting and study quality must improve if results are to impact on patients.
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Affiliation(s)
- S T K Yauw
- Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
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