Evidence-based practice within nutrition: what are the barriers for improving the evidence and how can they be dealt with?

Martine Laville; Berenice Segrestin; Maud Alligier; Cristina Ruano-Rodríguez; Lluis Serra-Majem; Michael Hiesmayr; Annemie Schols; Carlo La Vecchia; Yves Boirie; Ana Rath; Edmund Neugebauer; Silvio Garattini; Vittorio Bertele; Christine Kubiak; Jacques Demotes-Mainard; Janus Jakobsen; Snezana Djurisic; Christian Gluud

doi:10.1186/s13063-017-2160-8

Evidence-based practice within nutrition: what are the barriers for improving the evidence and how can they be dealt with?

Martine Laville ¹ Berenice Segrestin ¹ Maud Alligier ¹ Cristina Ruano-Rodríguez ^{2, 3} Lluis Serra-Majem ^{3, 2} Michael Hiesmayr ⁴ Annemie Schols ⁵ Carlo La Vecchia ⁶ Yves Boirie ⁷ Ana Rath ⁸ Edmund Neugebauer ⁹ Silvio Garattini ¹⁰ Vittorio Bertele ¹⁰ Christine Kubiak ¹¹ Jacques Demotes-Mainard ¹¹ Janus Jakobsen ^{12, 13} Snezana Djurisic ^{12, *} Christian Gluud ^{12, *}

* Auteur correspondant

1 FCRIN INI-CRCT - Coordination Nationale Réseau FORCE - French-Clinical Research Infrastructure Network [Lyon]

2 (CIBEROBN) - CIBER Fisiopatología de la Obesidad y Nutrición [Madrid, Spain]

3 Research Institute of Biomedical and Health Sciences - Nutrition Research Group [Las Palmas, Spain]

4 Division of Cardiac, Thoracic, Vascular Anaesthesia and Intensive Care [Vienna, Austria]

5 Department of Respiratory Medicine [Maastricht, The Netherlands]

6 Department of Clinical Sciences and Community Health [Milan, Italy]

7 Service de nutrition clinique [CHU Gabriel Montpied, Clermont-Ferrand]

8 Orphanet - Plateforme d'information et de services pour les maladies rares et les médicaments orphelins

9 Brandenburg Medical School [Witten, Germany]

10 IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri" [Milan, Italy]

11 ECRIN - European Clinical Research Infrastructures Network [Paris]

12 Centre for Clinical Intervention Research - Copenhagen Trial Unit -CTU [Copenhagen, Denmark]

13 Department of Cardiology [Holbaek, Denmark]

Abstract : BackgroundEvidence-based clinical research poses special barriers in the field of nutrition. The present review summarises the main barriers to research in the field of nutrition that are not common to all randomised clinical trials or trials on rare diseases and highlights opportunities for improvements.MethodsSystematic academic literature searches and internal European Clinical Research Infrastructure Network (ECRIN) communications during face-to-face meetings and telephone conferences from 2013 to 2017 within the context of the ECRIN Integrating Activity (ECRIN-IA) project.ResultsMany nutrients occur in multiple forms that differ in biological activity, and several factors can alter their bioavailability which raises barriers to their assessment. These include specific difficulties with blinding procedures, with assessments of dietary intake, and with selecting appropriate outcomes as patient-centred outcomes may occur decennia into the future. The methodologies and regulations for drug trials are, however, applicable to nutrition trials.ConclusionsResearch on clinical nutrition should start by collecting clinical data systematically in databases and registries. Measurable patient-centred outcomes and appropriate study designs are needed. International cooperation and multistakeholder engagement are key for success.

Keywords : European Clinical Infrastructure Network Specific barriers Nutrition ECRIN Randomised clinical trials Evidence-based clinical practice Evidence-based medicine Assessment

Type de document :

Article dans une revue

Trials, BioMed Central, 2016, 18 (1), pp.425. 〈10.1186/s13063-017-2160-8〉

Domaine :

Sciences du Vivant [q-bio]

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