Objectives Despite decades of research using animals to develop pharmaceutical treatments for patients who have had a stroke, few therapeutic options exist. The vast majority of interventions successful in preclinical animal studies have turned out to have no efficacy in humans or to be harmful to humans. In view of this, we explore whether there is evidence of a move away from animal models in this field.
Methods We used an innovative methodology, the analysis of opinion papers. Although we took a systematic approach to literature searching and data extraction, this is not a systematic review because the study involves the synthesis of opinions, not research evidence. Data were extracted from retrieved papers in chronological order and analysed qualitatively and descriptively.
Results Eighty eligible papers, published between 1979 and 2018, were identified. Most authors were from academic departments of neurology, neuroscience or stroke research. Authors agreed that translational stroke research was in crisis. They held diverse views about the causes of this crisis, most of which did not fundamentally challenge the use of animal models. Some, however, attributed the translational crisis to animal–human species differences and one to a lack of human in vitro models. Most of the proposed solutions involved fine-tuning animal models, but authors disagreed about whether such modifications would improve translation. A minority suggested using human in vitro methods alongside animal models. One proposed focusing only on human in vitro methods.
Conclusion Despite recognising that animal models have been unsuccessful in the field of stroke, most researchers exhibited a strong resistance to relinquishing them. Nevertheless, there is an emerging challenge to the use of animal models, in the form of human-focused in vitro approaches. For the sake of stroke patients there is an urgent need to revitalise translational stroke research and explore the evidence for these new approaches.
- animal models
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Contributors PP conceived the idea for the project, searched for the literature, analysed and interpreted the data. She wrote the first draft of the paper and revised several drafts before approving the final version. She agrees to be accountable for all aspects of the work. RR searched for the literature and contributed to data analysis. She reviewed and revised several drafts before approving the final version. She agrees to be accountable for all aspects of the work. Pound, Pandora Corresponding Author Conceptualization (Lead) Data curation (Lead) Formal analysis (Lead) Investigation (Lead) Methodology (Lead) Project administration (Lead) Validation (Equal) Writing-original draft (Lead) Writing-review & editing (Lead) Ram, Rebecca Formal analysis (Supporting) Investigation (Supporting) Validation (Equal) Writing-review & editing (Supporting).
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Ethics approval Not applicable
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available in Dryad data repository DOI https://doi.org/10.5061/dryad.xpnvx0kb9
Open data This article was not formally preregistered. The data are available at https://datadryad.org/stash/dataset/doi:10.5061/dryad.xpnvx0kb9. The materials used are widely available.
Open materials This article was not formally preregistered. The data are available at https://datadryad.org/stash/dataset/doi:10.5061/dryad.xpnvx0kb9. The materials used are widely available.
Open peer review Prepublication and Review History is available online at http://dx.doi.org/10.1136/bmjos-2019-100041.
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