Ramirez F Daniel, Motazedian Pouya, Jung Richard G, Di Santo Pietro, MacDonald Zachary D, Moreland Robert, Simard Trevor, Clancy Aisling A, Russo Juan J, Welch Vivian A, Wells George A, Hibbert Benjamin
From the Division of Cardiology (F.D.R., P.M., R.G.J., P.D.S., T.S., J.J.R., B.H.), CAPITAL Research Group (F.D.R., P.M., R.G.J., P.D.S., Z.D.M.D., R.M., T.S., J.J.R., B.H.), Vascular Biology and Experimental Medicine Laboratory (R.G.J., T.S., B.H.), and Cardiovascular Research Methods Centre (G.A.W.), University of Ottawa Heart Institute, Ontario, Canada; and School of Epidemiology, Public Health and Preventive Medicine (F.D.R., V.A.W., G.A.W.), Department of Cellular and Molecular Medicine (R.G.J., T.S., B.H.), Department of Radiology (R.M.), Department of Obstetrics and Gynecology (A.A.C.), Bruyère Research Institute (V.A.W.), and Centre for Global Health (V.A.W.), University of Ottawa, Ontario, Canada.
Circ Res. 2017 Jun 9;120(12):1916-1926. doi: 10.1161/CIRCRESAHA.117.310628. Epub 2017 Apr 3.
Methodological sources of bias and suboptimal reporting contribute to irreproducibility in preclinical science and may negatively affect research translation. Randomization, blinding, sample size estimation, and considering sex as a biological variable are deemed crucial study design elements to maximize the quality and predictive value of preclinical experiments.
To examine the prevalence and temporal patterns of recommended study design element implementation in preclinical cardiovascular research.
All articles published over a 10-year period in 5 leading cardiovascular journals were reviewed. Reports of in vivo experiments in nonhuman mammals describing pathophysiology, genetics, or therapeutic interventions relevant to specific cardiovascular disorders were identified. Data on study design and animal model use were collected. Citations at 60 months were additionally examined as a surrogate measure of research impact in a prespecified subset of studies, stratified by individual and cumulative study design elements. Of 28 636 articles screened, 3396 met inclusion criteria. Randomization was reported in 21.8%, blinding in 32.7%, and sample size estimation in 2.3%. Temporal and disease-specific analyses show that the implementation of these study design elements has overall not appreciably increased over the past decade, except in preclinical stroke research, which has uniquely demonstrated significant improvements in methodological rigor. In a subset of 1681 preclinical studies, randomization, blinding, sample size estimation, and inclusion of both sexes were not associated with increased citations at 60 months.
Methodological shortcomings are prevalent in preclinical cardiovascular research, have not substantially improved over the past 10 years, and may be overlooked when basing subsequent studies. Resultant risks of bias and threats to study validity have the potential to hinder progress in cardiovascular medicine as preclinical research often precedes and informs clinical trials. Stroke research quality has uniquely improved in recent years, warranting a closer examination for interventions to model in other cardiovascular fields.
方法学上的偏倚来源和报告不充分导致临床前科学研究结果不可重复,可能对研究成果转化产生负面影响。随机化、盲法、样本量估计以及将性别视为生物学变量被认为是至关重要的研究设计要素,可最大限度地提高临床前实验的质量和预测价值。
研究临床前心血管研究中推荐的研究设计要素实施情况的普遍性和时间模式。
对5种主要心血管杂志在10年期间发表的所有文章进行了回顾。确定了关于非人类哺乳动物体内实验的报告,这些实验描述了与特定心血管疾病相关的病理生理学、遗传学或治疗干预措施。收集了关于研究设计和动物模型使用的数据。在预先指定的研究子集中,将60个月时的引用次数作为研究影响力的替代指标进行了额外检查,该子集按个体和累积研究设计要素进行分层。在筛选的28636篇文章中,3396篇符合纳入标准。报告随机化的文章占21.8%,报告盲法的占32.7%,报告样本量估计的占2.3%。时间和疾病特异性分析表明,在过去十年中,除了临床前中风研究在方法学严谨性方面有显著改善外,这些研究设计要素的实施总体上没有明显增加。在1681项临床前研究的子集中,随机化、盲法、样本量估计以及纳入两性与60个月时引用次数的增加无关。
方法学缺陷在临床前心血管研究中普遍存在,在过去10年中没有实质性改善,并且在后续研究中可能被忽视。由此产生的偏倚风险和对研究有效性的威胁有可能阻碍心血管医学的进展,因为临床前研究通常先于临床试验并为其提供信息。近年来中风研究质量有独特的提高,值得仔细研究以便在其他心血管领域进行效仿干预。