Research In Medicine And Healthcare - Lecture 4 And 5 Flashcards
Simulations with mathematics models/computer
- In silico
- used to generate massive data sets
In vitro and ex vivo models
- In glass cultures and out of the living organism
- examples in vitro: In Petri dish, glass, in test tubes or flask
- examples ex vivo: outside of body with small sample
Animal models - Nematodes
- 40% homology to human
- easy to study and cheap
- short life cycle, self-fertilizes
- can be frozen and thawed
- transparent
Animal Models - Fruit Flies
- 65% genetic homology
- life cycle and development
- sensitive to environmental conditions
Animal Models - Rats
- Social and intelligent
- effects on metabolism (not kids)
- genetically modified
- ex. Knockdown, knockout and amplify gene expression
Animal Models - Mice
- recombinant DNA technology
- importance of a single protein
-study lifestyle effects on metabolism
not a good model for obesity as humans secrete more leptin because of more adipose tissue
Animal Models - Swine
- human infant development and metabolism
- organ transplants
- can be cloned
Animal Models - Labratory Primates
- Closest model you will get to a human
- ex. human pathologies, transplantation, drug abuse, toxicology
Non-clinical Studies (Non-intervention)
No medical treatment given, can not produce cause and effect but can predict assosiations/ correlations (ex. epidemiological studies)
Clinical Studies (Intervention)
- Medical treatment or placebo is given
- can be used to predict cause and effect
- double-blind, placebo-controlled clinical trials are the best
Human Clinical Trials 5 steps
- Preclinical - animals
- Phase 1 Clinical Trial - 10s
- Phase 2 Clinical Trial - 100s
- Phase 3 Clinical Trial - 1000s
- After approval - long-term use
Cochrane Reviews
Database of systemic reviews and meta-analyses which summarize and interpret the results of medical research
How are Pre-Clinical Trials Performed
- In silico research
- Ex vivo
- In vitro
- Animal Model Research
Non-Intervention Trials
- Case-control survey studies
- Cohort survey studies
- Randomized controlled trials
Randomized Control Trials
- Double-blind studies
- Critically appraised papers
- Critically appraised topics
Evidence-Based Medicine
patient values is most important so optimal decisions are possible
Integrative Medicine
- Treats the whole person, not just the disease
- Healing-oriented medicine
- all aspects of lifestyle
- ex. family health teams, physio, chiropractor, therapist
Collective Medicine
- connection between the health of humans, animals and the environment
- human and animal mental health are linked
- promote, improve and defend the health and well-being of all species
Enhancement Medicine
- Cosmetics (ex. Botox and liposuction)
- Nootropics (omega-3 and fatty acids)
- Others (Laser vision enhancement, steroids, fertility drugs)
5 Human Clinical Trial Stages
- Preclinical
- Phase 1 clinical trial
- Phase 2 clinical trial
- Phase 3 clinical trial
- After approval
Preclinical
- Animal studies before testing on humans
- can take a long time
- ex. Exploratory phase with testing potential vaccines on animals
Phase 1 Clinical Trial
- Is it safe for humans
- what is a safe dosage
- are there any side effects
- Small test group (10 people)
Phase 2 Clinical Trial
- Does the drug work for its intended purpose
- check safety and efficacy
- larger test group (100s)
Phase 3 clinical trial
- How does it compare to other treatments
- Efficiency
- Larger test group (1000s)
After Approval
- Ongoing assessment of long-term use
- Benefits and risks
- Manufacturer submits application for health Canada for review
Review and approval of Vaccines Example
- Scientific Reviews
- Approval
- Distribution
- Vaccination
- Ongoing monitoring and review
Another Term for collective medicine
One Health
Systemic Reviews
Summarize and Interpreting data results
Evolutionary Medicine - Darwinian Medicine
- Application of modern evolutionary theory to understanding health and disease
- Body is shaped by evolutionary process
- ex. Our modern diet vs paleolithic diets
Collective Medicine CONCEPT - (One Health)
- Recognizing that human and animal health and mental health are inextricably linked
- connectons mont the health of humans, animal and the environement
Collective Medicine APPROACH - (One Health)
working together across all displaces to combat complex heath challenges that arise at the interconnnection of human, animal and environnemental health
