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Poor reporting quality may contribute to irreproducibility of results and failed 'bench-to-bedside' translation. Consequently, guidelines have been developed to improve the complete and transparent reporting of in vivo preclinical studies. To examine the impact of such guidelines on core methodological and analytical reporting items in the preclinical anesthesiology literature, we sampled a cohort of studies. Preclinical in vivo studies published in Anesthesiology, Anesthesia & Analgesia, Anaesthesia, and the British Journal of Anaesthesia (2008-2009, 2014-2016) were identified. Data was extracted independently and in duplicate. Reporting completeness was assessed using the National Institutes of Health Principles and Guidelines for Reporting Preclinical Research. Risk ratios were used for comparative analyses. Of 7615 screened articles, 604 met our inclusion criteria and included experiments reporting on 52 490 animals. The most common topic of investigation was pain and analgesia (30%), rodents were most frequently used (77%), and studies were most commonly conducted in the United States (36%). Use of preclinical reporting guidelines was listed in 10% of applicable articles. A minority of studies fully reported on replicates (0.3%), randomization (10%), blinding (12%), sample-size estimation (3%), and inclusion/exclusion criteria (5%). Statistics were well reported (81%). Comparative analysis demonstrated few differences in reporting rigor between journals, including those that endorsed reporting guidelines. Principal items of study design were infrequently reported, with few differences between journals. Methods to improve implementation and adherence to community-based reporting guidelines may be necessary to increase transparent and consistent reporting in the preclinical anesthesiology literature.

Dr. Anna Byszewski, MD, is a geriatrician at The Ottawa Hospital and Regional Geriatric Program of Eastern Ontario. She completed medical school and residency training in Internal Medicine and Geriatric Medicine at the University of Ottawa. She is currently a full- time professor at the Faculty of Medicine at the University of Ottawa, an investigator at the Ottawa Hospital Research Institute, and is actively involved in developing and teaching communication, collaboration skills, and professionalism in the medical curriculum. Her remarkable dedication to improve the quality of care for geriatric patients through her teaching and practice were recognized in 2011 by The Ottawa Hospital Compass Award. As chair of a task group for the Dementia Network of Ottawa, she also produced the Driving and Dementia Toolkit that aims to improve quality of care and safety of geriatric patients with dementia behind the wheel. Her work is now an internationally recognized resource manual for health care workers, patients, and caregivers. In this interview, Dr. Byszewski highlights the important issues in improving the quality of care and safety for geriatric patients. This topic is of special importance due to the aging Canadian population and the unique challenges faced by health care providers such as reducing the risks of falls, cognitive decline, and polypharmacy. RÉSUMÉ Dre Anna Byszewski, MD, est une des gériatres principales à l’Hôpital d’Ottawa et au Programme gériatrique régional de l’est de l’Ontario. Elle a complété sa résidence en médecine interne et en médecine gériatrique à l’Université d’Ottawa. À l’heure actuelle, elle est professeure à temps plein à la Faculté de Médecine de l’Université d’Ottawa, chercheuse à l’Institut de recherche de l’Hôpital d’Ottawa, et est activement impliquée dans le développement et l’enseignement de la communication, des compétences de collabora- tion et du professionnalisme au niveau du curriculum médical. Son remarquable dévouement à l’amélioration de la qualité des soins pour les patients gériatriques, à travers son enseignement et sa pratique médicale, a été récompensé en 2011 par le Prix Compass de l’Hôpital d’Ottawa. En tant que présidente d’un groupe de travail du Réseau de la démence d’Ottawa, elle a également mis au point la Trousse d’information sur la conduite automobile et la démence, qui cherche à améliorer la qualité des soins et la sécurité au volant des patients gériatriques avec la démence. Son travail constitue désormais un manuel de ressources reconnu au niveau international, pour aider les travailleurs de la santé, les patients et les soignants qui gèrent de tels défis. Dans cette entrevue, Dre Byszewski met en évidence les questions importantes dans le domaine de l’amélioration de la qualité des soins et de la sécurité des patients chez les pa- tients gériatriques. Ce sujet est d’une importance particulière en raison de la population canadienne vieillissante et des défis uniques qu’affrontent les gériatres, tels que la réduction du risque de chutes et la polypharmacie.

Objectives: Early phase cell therapy trials face many barriers to successful, timely completion. To optimise the conduct of a planned clinical trial of mesenchymal stem cell (MSC) therapy for chronic stroke, we sought patient and physician views on possible barriers and enablers that may influence their participation. Design: Semistructured interview study. Setting: Patients were recruited from three rehabilitation centres in Ontario, Canada; physicians were recruited from across Canada through snowball sampling. Participants: Thirteen chronic stroke patients (patients who had experienced a stroke at least 3 months prior; 10 male, 3 female) and 15 physicians (stroke physiatrists; 9 male, 6 female) participated in our interview study. Data adequacy was reached after 13 patient interviews and 13 physician interviews. Methods: Interview guides and directed content analysis were based on the Theoretical Domains Framework (TDF). Interviews were coded, and relevant themes were identified. Results: Most patients were optimistic about participating in an MSC therapy clinical trial, and many expressed interest in participating, even if it was a randomised controlled trial with the possibility of being allocated to a placebo group. However, the method of administration of cells (intravascular preferred to intracerebral) and goal of the trial (efficacy preferred to safety) may influence their intention to participate. All physicians expressed interest in screening for the trial, though many stated they were less motivated to contribute to a safety trial. Physicians also identified several time-related barriers and the need for resources to ensure feasibility. Conclusions: This novel application of the TDF helped identify key potential barriers and enablers prior to conducting a clinical trial of MSC therapy for stroke. This will be used to refine the design and conduct of our trial. A similar approach may be adopted by other investigators considering early phase cell therapy trials. [ABSTRACT FROM AUTHOR]

Objective This study aimed to conduct a systematic review of preclinical and clinical evidence to chart the successful trajectory of talimogene laherparepvec (T-VEC) from the bench to the clinic. Design This study was a systematic review. The primary outcome of interest was the efficacy of treatment, determined by complete response. Abstract and full-text selection as well as data extraction were done by two independent reviewers. The Cochrane risk of bias tool was used to assess the risk of bias in studies. Setting Embase, Embase Classic and OvidMedline were searched from inception until May 2016 to assess its development trajectory to approval in 2015. Participants Preclinical and clinical controlled comparison studies, as well as observational studies. Interventions T-VEC for the treatment of any malignancy. Results 8852 records were screened and five preclinical (n=150 animals) and seven clinical studies (n=589 patients) were included. We saw large decreases in T-VEC’s efficacy as studies moved from the laboratory to patients, and as studies became more methodologically rigorous. Preclinical studies reported complete regression rates up to 100% for injected tumours and 80% for contralateral tumours, while the highest degree of efficacy seen in the clinical setting was a 24% complete response rate, with one study experiencing a complete response rate of 0%. We were unable to reliably assess safety due to the lack of reporting, as well as the heterogeneity seen in adverse event definitions. All preclinical studies had high or unclear risk of bias, and all clinical studies were at a high risk of bias in at least one domain. Conclusions Our findings illustrate that even successful biotherapeutics may not demonstrate a clear translational road map. This emphasises the need to consider increasing rigour and transparency along the translational pathway. [ABSTRACT FROM AUTHOR]