Abstract
Stem cell therapy for heart disease: truly beneficial?
Highlights
What did the BMJ study address in depth? Nowbar from the group of Francis (Imperial College, London, UK) investigated whether discrepancies in trials of use of bone marrow stem cells in patients with heart disease account for the variations in reported effect size in improvement of left ventricular function [8]
The final possibility is that in the reports with the fewest discrepancies, the LVEF effect might have been measured with least error
The authors strongly suggest that the following useful information can be drawn for the design of future trials of bone marrow stem cells: 1) prior registration on a public clinical trial registry should become universal and will be helpful in distinguishing unambiguously between trials that were multiply published or merely identical by coincidence; 2) reports should include a spreadsheet of all the data used for construction of the tables, so that incorrect values could be more identified; 3) it is important for studies, when solely relying on changes in LVEF as an endpoint, to be properly designed to resist error and to have adequate sample size to ‘beat’ the effects of biological variability
Summary
Bone marrow stem cell therapy might be less effective when it is carried out in a rigidly standardised way. Institutions with less attention to detail might incorporate an unnoticed contaminant that enhances the effect of treatment, producing reports with more discrepancies.
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