Authors: Andi L. Shane, Michael D. Cabana, Collin L. Ellis, James T. Heimbach, Susanne Hempel, Ruben Hummelen, Susan Lynch, Daniel J. Merenstein, Mary Ellen Sanders, Daniel J. Tancredi and Stephane Vidry
Corresponding author: ashane@emory.edu
Emory University; Atlanta, GA USA
Michael D. Cabana
University of California, San Francisco; San Francisco, CA USA
Collin L. Ellis
University of California, Davis; Davis, CA USA
James T. Heimbach
JHEIMBACH, LLC; Port Royal, VA USA
Susanne Hempel
RAND Corporation; Santa Monica, CA USA
Ruben Hummelen
Lawson Health Research Institute Probiotics; London, ON Canada
Susan Lynch
University of California, San Francisco; San Francisco, CA USA
Daniel J. Merenstein
Georgetown University; Washington, DC USA
Mary Ellen Sanders
ISAPP
Daniel J. Tancredi
University of California, Davis; Davis, CA USA
Stephane Vidry
ILSI Europe a.i.s.b.l.; Brussels, Belgium
Abstract:
The heterogeneity of human clinical trials to assess the effectiveness of probiotics presents challenges regarding interpretation and comparison. Evidence obtained from clinical trials among a population with disease or specific risk factors may not be generalizable to healthy individuals. The evaluation of interventions in healthy persons requires careful selection of outcomes due to the absence of health indicators and the low incidence of preventable conditions. Given the tremendous resources invested in such trials, development of consistent approaches to assessing the effectiveness of probiotics would be beneficial. Furthermore, the reporting, presentation, and communication of results may also affect the validity of the scientific evidence obtained from a trial. This review outlines the challenges associated with the design, implementation, data analysis, and interpretation of clinical trials in humans involving probiotics. Best practices related to their design are offered along with recommendations for enhanced collaboration to advance research in this emerging field.