Kimmelman Jonathan, Mogil Jeffrey S, Dirnagl Ulrich
Studies of Translation, Ethics, and Medicine (STREAM), Biomedical Ethics Unit, Experimental Medicine, McGill University, Montreal, Quebec, Canada.
Department of Psychology and Alan Edwards Centre for Research on Pain, McGill University, Montreal, Quebec, Canada.
PLoS Biol. 2014 May 20;12(5):e1001863. doi: 10.1371/journal.pbio.1001863. eCollection 2014 May.
Preclinical researchers confront two overarching agendas related to drug development: selecting interventions amid a vast field of candidates, and producing rigorous evidence of clinical promise for a small number of interventions. We suggest that each challenge is best met by two different, complementary modes of investigation. In the first (exploratory investigation), researchers should aim at generating robust pathophysiological theories of disease. In the second (confirmatory investigation), researchers should aim at demonstrating strong and reproducible treatment effects in relevant animal models. Each mode entails different study designs, confronts different validity threats, and supports different kinds of inferences. Research policies should seek to disentangle the two modes and leverage their complementarity. In particular, policies should discourage the common use of exploratory studies to support confirmatory inferences, promote a greater volume of confirmatory investigation, and customize design and reporting guidelines for each mode.
在大量候选药物中选择干预措施,以及为少数干预措施提供严格的临床前景证据。我们认为,应对每一项挑战的最佳方式是两种不同的、互补的研究模式。在第一种模式(探索性研究)中,研究人员应致力于生成强大的疾病病理生理学理论。在第二种模式(验证性研究)中,研究人员应致力于在相关动物模型中证明强大且可重复的治疗效果。每种模式都需要不同的研究设计,面临不同的效度威胁,并支持不同类型的推断。研究政策应寻求区分这两种模式并利用它们的互补性。特别是,政策应不鼓励常用探索性研究来支持验证性推断,促进更多的验证性研究,并为每种模式定制设计和报告指南。