Merel Ritskes-Hoitinga

Dr. Merel Ritskes-Hoitinga

SYRCLE, Department for Health Evidence, Radboud university medical center
orcid

Research Focus & Metrics

Academic Career Length

18Years (2009-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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26 March 2014 in BMC Medical Research Methodology
Verified
Journal Article
Open access
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CHCarlijn R Hooijmans
Carlijn R Hooijmans
MRMaroeska M Rovers
Maroeska M Rovers
RVRob Bm de Vries
Rob Bm de Vries
MLMarlies Leenaars
Marlies Leenaars
Merel Ritskes-HoitingaMerel Ritskes-Hoitinga
Merel Ritskes-Hoitinga
MLMiranda W Langendam
Miranda W Langendam
Systematic Reviews (SRs) of experimental animal studies are not yet common practice, but awareness of the merits of conducting such SRs is steadily increasing. As animal intervention studies differ from randomized clinical trials (RCT) in many aspects, the methodology for SRs of clinical trials needs to be adapted and optimized for animal intervention studies. The Cochrane Collaboration developed a Risk of Bias (RoB) tool to establish consistency and avoid discrepancies in assessing the methodological quality of RCTs. A similar initiative is warranted in the field of animal experimentation.

7 November 2018 in Journal of Translational Medicine
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Journal Article
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PPPandora Pound
Pandora Pound
Merel Ritskes-HoitingaMerel Ritskes-Hoitinga
Merel Ritskes-Hoitinga
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. 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. 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.

15 July 2019 in Journal of Translational Medicine
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Journal Article
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CLCathalijn Leenaars
Cathalijn Leenaars
CKCarien Kouwenaar
Carien Kouwenaar
FSFrans R. Stafleu
Frans R. Stafleu
ABAndré Bleich
André Bleich
Merel Ritskes-HoitingaMerel Ritskes-Hoitinga
Merel Ritskes-Hoitinga
FMFranck Meijboom
Franck Meijboom
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. 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%. 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.

10 July 2020 in Systematic Reviews
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Journal Article
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DGDavid Gough
David Gough
PDPhil Davies
Phil Davies
GJGro Jamtvedt
Gro Jamtvedt
ELEtienne Langlois
Etienne Langlois
JLJulia Littell
Julia Littell
JGJeremy Grimshaw
Jeremy Grimshaw
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.

1 June 2021 in Journal of Clinical Epidemiology
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Journal Article
Closed access
JSJennifer C. Stone
Jennifer C. Stone
KGKathryn Glass
Kathryn Glass
JCJustin Clark
Justin Clark
Merel Ritskes-HoitingaMerel Ritskes-Hoitinga
Merel Ritskes-Hoitinga
ZMZachary Munn
Zachary Munn
SDSuhail A.R. Doi
Suhail A.R. Doi