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Mice and men should have more in common in clinical trials
March 31, 2009
Just as no two humans are the same, a Purdue University scientist has shown treating mice more as individuals in laboratory testing cuts down on erroneous results and could significantly reduce the cost of drug development. Mice have long been used as test subjects for treatments and drugs before those products are approved for human testing. But new research shows that the customary practice of standardizing mice by trying to limit environmental variation in laboratories actually increases the chance of getting an incorrect result.
The study, done by Joseph Garner, a Purdue assistant professor of animal sciences, and professor Hanno Würbel of the Justus-Liebig University of Giessen in Germany, was published in the early online edition of Nature Methods on Monday (March 30). It suggests scientists should change their methods and test mice in deliberately varying environmental conditions. Garner said that will decrease the number of false positive test results and eliminate further costly testing of drugs or treatments destined to fail.
"In lab animals, we have this bizarre idea that we can control everything that happens," Garner said. "But we would never be able to do that with humans, and we wouldn't want to. You want to know if a drug is going to work in all people, so you test it on a wide range of different people. We should do the same thing with mice."
Garner said human testing uses a broad range of subjects, giving scientists an idea of how a drug or treatment might affect different types of people. But scientists often use mice that are basically genetically identical and try to limit internal and external environmental factors such as stress, diet and age to eliminate variables affecting the outcome.
Garner said there is no practical way to ensure that all environmental conditions are the same with mice, however, because they respond to cues humans cannot detect. For example, a researcher's odor in one lab might cause more stress for a mouse than another researcher's odor in a second lab with different mice, giving different results. But scientists, unaware of the odor difference, may believe a treatment worked when the mice were actually responding to an environmental cue, giving a false positive.
The study used three different strains of mice from previously published data and compared their behavioral characteristics against each other. The observations were done in three different labs, two different types of cages and at three different times to make 18 different replicates of the same experiment. Traditional testing theories say the results should have been the same in all those experiments.
Once the results were compared, however, the researchers found many false positives, or instances when one strain appeared to act differently from another when it actually should not.
"There were nearly 10 times more false positives than we would expect by chance," Garner said. "There had to be a gremlin causing these false positives."
The researchers suspected the problem was in the traditional lab experiment design. So they reevaluated the data, picking a mouse of each strain from each environment - similar to matching pairs in human clinical trials - and found only the same number of false positives as would be expected by chance.
When mouse testing creates a false positive, leading a researcher to believe a drug has worked, the drug could be sent to further animal testing and human clinical trials at a cost of millions of dollars. Drugs that fail in clinical trials cannot be marketed, and the money is wasted. To recoup those losses, drug companies must increase the costs of marketable drugs.
"Drugs aren't expensive because they're costly to make," Garner said. "They're expensive because the company has to recoup the costs of the other drugs that have failed in human clinical trials. Numbers are hard to estimate, but for every drug that reaches the marketplace, well over 100 have been abandoned at some point in their development."
Garner said giving mice varying environments also could be better for the animals because fewer could be used. Weeding out an unsuccessful drug would eliminate an unnecessary second round of animal testing.
"The really exciting message is that we have shown how the false positives in early drug discovery can be drastically reduced without costing anything more than a change in experimental design," Garner said. "These are positive results for pharmaceutical research, patients and for mice."
Garner and Würbel, along with Würbel's doctoral student Helene Richter, received research funding from the German Research Foundation. Their research will now focus on which environmental factors have the most impact on results.
Purdue University
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Clinical Trials - A Practical Guide to Design, Analysis, and Reporting
by Duolao Wang (Author), Ameet Bakhai (Author)
Clinical trials form the backbone of evidence-based medicine, and appreciating clinical trial methods allows readers to critique, design and report clinical trials. This book is a friendly 'jargon buster' which aims to demystify the subject. It is divided into five sections: fundamentals of trial design, alternative trial designs, basics of statistical analysis, special trial issues in data analysis, and reporting of trials. Using simple language, the book explains - with illustrations of numerous trial examples - the conceptual and methodological issues that occur at all stages of clinical trial covering trial design, conduct, analysis and reporting. The book is an educational and approachable reference in a difficult area of medicine where clinicians often...
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Fundamentals of Clinical Trials
by Lawrence M. Friedman (Author), Curt D. Furberg (Author), David L. DeMets (Author)
This text is intended for the clinical researcher who is interested in designing a clinical trial and developing a protocol. It is also of value to researchers and practitioners who must critically evaluate the literature of published clinical trials and assess the merits of each trial and the implications for the care and treatment of patients. The text uses numerous examples of published clinical trials from a variety of medical disciplines to meaningfully illustrate the fundamentals. Technical design issues such as sample size are considered, but the technical details have been suppressed as much as possible through the use of graphs and tables. While the technical material has been kept to a minimum, the statistician may still find the principles and fundamentals presented in this...
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Clinical Trials: A Methodologic Perspective Second Edition(Wiley Series in Probability and Statistics)
by Steven Piantadosi (Author)
Learn rigorous statistical methods to ensure valid clinical trials This Second Edition of the critically hailed Clinical Trials builds on the text's reputation as a straightforward and authoritative presentation of statistical methods for clinical trials. Readers are introduced to the fundamentals of design for various types of clinical trials and then skillfully guided through the complete process of planning the experiment, assembling a study cohort, assessing data, and reporting results. Throughout the process, the author alerts readers to problems that may arise during the course of the trial and provides commonsense solutions. The author bases the revisions and updates on his own classroom experience, as well as feedback from students, instructors, and...
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A Concise Guide to Clinical Trials
by Allan Hackshaw (Author)
Clinical trials have revolutionized the way disease is prevented, detected and treated, and early death avoided, and they continue to be an expanding area of research. They are central to the work of pharmaceutical companies, and there are many academic and public sector organizations that conduct trials on a wide variety of interventions, including drugs, devices, surgical techniques, and changes in behaviour and lifestyle. A Concise Guide to Clinical Trials provides a comprehensive yet easy-to-read overview of the design, conduct and analysis of trials. It requires no prior knowledge on the subject as the important concepts are introduced throughout. There are chapters that distinguish between the different types of trials, and an introduction to systematic reviews,...
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A Manager's Guide to the Design and Conduct of Clinical Trials (Manager's Guide Series)
by Phillip I. Good (Author)
This newly updated edition of the benchmark guide to computer-assisted clinical trials provides a comprehensive primer for prospective managers. It covers every critical issue of the design and conduct of clinical trials, including study design, organization, regulatory agency liaison, data collection and analysis, as well as recruitment, software, monitoring, and reporting. Keeping the same user-friendly format as the original, this Second Edition features new examples and the latest developments in regulatory guidelines, such as e-submission procedures and computerized direct data acquisition. The new edition also reflects the increasing globalization of clinical trial activities, and includes new information about international standards and procedures, including the...
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Introduction to Statistical Methods for Clinical Trials (Texts in Statistical Science)
by Thomas D. Cook (Author), David L DeMets (Author)
Clinical trials have taken a prominent role in the research and approval of new drugs. To conduct rigorous clinical studies, present and future biostatisticians need a good background in the design and analysis of data gleaned from those studies. This text provides a summary of statistical design, including cross-over designs, sample size estimation, sequential methods for interim analyses, survival analysis, and repeated measures. The authors also discuss a number of topics not addressed in other books on the subject, including the use of surrogate variables, meta-analysis, and longitudinal designs. Each chapter includes examples and exercises, and data sets are available for download from the Internet.
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Conducting Clinical Research: A Practical Guide for Physicians, Nurses, Study Coordinators, and Investigators
by Judy Stone (Author)
In Conducting Clinical Research: A Practical Guide for Physicians, Nurses, Study Coordinators, and Investigators, you will discover how to Attract drug companies to your site Land a study on good terms Recruit patient volunteers --- and keep them happy! Implement easy strategies for coordinating studies Organize your clinical trial activities Demystify regulatory requirements
Conducting Clinical Research is a practical, user-friendly how-to manual for medical professionals, physicians, nurses, study coordinators and investigators who are interested in learning what it takes to carry out clinical trials. Everything is covered from how drugs are developed to how to attract drug companies to a site, land a study, recruit volunteers, coordinate studies, organize...
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Principles and Practice of Clinical Trial Medicine
by Richard Chin (Author), Bruce Y Lee (Author)
Clinical trials are an important part of medicine and healthcare today, deciding which treatments we use to treat patients. Anyone involved in healthcare today must know the basics of running and interpreting clinical trial data. Written in an easy-to-understand style by authors who have considerable expertise and experience in both academia and industry, this book covers all of the basics of clinical trials, from legal and ethical issues to statistics, to patient recruitment and reporting results.
*Jargon-free writing style enables those with less experience to run their own clinical trials and interpret data.
*Book contains an ideal mix of theory and practice so researchers will understand both the rationale and logistics to...
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A Step-By-Step Guide to Clinical Trials
by Marilyn Mulay (Author)
Provides a practical approach to understanding the components of a clinical research trial as well as the tools to conduct a well- organized study. Designed for those interested in developing or enhancing skills to coordinate all aspects of clinical trials such as regulatory requirements, budgeting, contracts, patient recruitments and participation, and gathering and recording clear, invaluable data.
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Textbook of Clinical Trials
by David Machin (Editor), Simon Day (Editor), Sylvan Green (Editor)
Now published in its Second Edition, the Textbook of Clinical Trials offers detailed coverage of trial methodology in diverse areas of medicine in a single comprehensive volume. Praise for the First Edition: "... very useful as an introduction to clinical research, or for those planning specific studies within therapeutic or disease areas." BRITISH JOURNAL OF SURGERY, Vol. 92, No. 2, February 2005 The book’s main concept is to describe the impact of clinical trials on the practice of medicine. It separates the information by therapeutic area because the impact of clinical trials, the problems encountered, and the numbers of trials in existence vary tremendously from specialty to specialty. The sections provide a background to the disease area and...
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