Search

The significant morbidity and mortality of coronavirus disease 19 (COVID-19) prompted a global race to develop new therapies. These include interventions using cell- or cell-derived products, several of which are being tested in well-designed, properly controlled clinical trials. Yet, the search for cell-based COVID-19 treatments has also been fraught with hyperbolic claims; flouting of crucial regulatory, scientific, and ethical norms; and distorted communication of research findings. In this paper, we critically examine ethical issues and public communication challenges related to the development of cell-based therapeutics for COVID-19. Drawing on the lessons learned from this ongoing process, we argue against the rushed development of cell-based interventions. We conclude by outlining ways to improve the ethical conduct of cell-based clinical investigations and public communication of therapeutic claims.

The International Society for Stem Cell Research has updated its Guidelines for Stem Cell Research and Clinical Translation in order to address advances in stem cell science and other relevant fields, together with the associated ethical, social, and policy issues that have arisen since the last update in 2016. While growing to encompass the evolving science, clinical applications of stem cells, and the increasingly complex implications of stem cell research for society, the basic principles underlying the Guidelines remain unchanged, and they will continue to serve as the standard for the field and as a resource for scientists, regulators, funders, physicians, and members of the public, including patients. A summary of the key updates and issues is presented here.

Clinical relevance: Findings from this study examining Australian optometrists' insights into ocular stem cell (SC) therapies have capacity to inform continuing professional development (CPD) about these interventions. Background: This study investigated Australian optometrists' knowledge, views, experiences, and preferred education sources regarding ocular SC therapies. Methods: An online survey was distributed to optometrists via Optometry Australia, Mivision magazine, professional groups, and social media from August 2020 to March 2021. Data were collected on demographics, and SC knowledge, awareness and experience. Results: Of 81 optometrists who completed the survey, many were metropolitan-based (85%), worked in independent practice (47%), female (56%) and >46 years of age (45%). Approximately one-fifth indicated awareness of ocular SC therapies used in standard practice; one-third had knowledge of SC clinical trials. The most noted SC therapies were for corneal disease in the United States [US] (72%) and Australia (44%). Respondents identified the availability of SC therapies for dry eye disease in Australia and the US (39% and 44% respectively), despite no regulatory-approved treatments for this indication. Clinical trials investigating inherited retinal and corneal diseases in Australia were the most commonly identified (44% and 36%, respectively). Half the respondents felt 'unsure' about the quality of evidence for treating eye conditions using SCs. One-fifth indicated concerns with these therapies; of these, most mentioned efficacy (82%), safety (76%) and/or cost (71%). About one-fifth reported being asked for advice about SCs by patients. Two-thirds felt neutral, uncomfortable, or very uncomfortable providing this advice, due to lack of knowledge or the topic being beyond their expertise. Over half (57%) were unsure if clinical management should change if patients received SC therapies. Respondents were receptive to face-to-face education. Conclusion: Some optometrists responding to this survey were aware of ocular SC therapies and/or clinical trials. CPD programs may assist with maintaining currency in this evolving field. [ABSTRACT FROM AUTHOR]

Aim: Over the last two decades, numerous experimental studies have examined the feasibility of delivering stem cells into the cochlea to restore hearing. While these studies have spawned new cell therapy companies, there is little information on what patients understand or expect from these emerging therapies. Methods: This study sought to understand the awareness and perspectives of Australian audiologists and their adult patients toward stem cell therapies for treating hearing loss. Results: An anonymous survey indicated 91% of patients and 39% of audiologists were unaware of these therapies being developed. Thirty percent of audiologists reported being asked about stem cell therapies for hearing loss, but 70% were not confident answering patient queries about this and were unsure where to gather information. Primary concerns reported by patients were cost (45%) and safety of treatment (42%). Interestingly, 58% of patients were unsure of how this therapy would improve their hearing, yet 25% of these patients expected that their hearing would return to normal. Conclusion: There was strong support for development of educational materials for both patient and clinician. The increasingly important role of audiologists in providing patient counselling was reflected in overwhelming support (from both patient and clinician) for audiologists providing such information. Plain Language Summary In recent years, scientific studies have investigated the possibility of using stem cells to improve or restore hearing. Although some companies claim to be able use stem cell therapies to treat hearing loss now, there is currently not enough evidence to show these treatments are safe or effective. This study aimed to understand the awareness and perspectives of Australian audiologists and their adult patients toward stem cell therapies for hearing restoration. The study was conducted as a survey at an audiology clinic in Melbourne, Australia. The study found 91% of patients and 39% of audiologists were not aware of stem cell therapies for hearing loss. Although 30% of audiologists said they had been asked by a patient about stem cell therapies, 70% said they would not feel confident responding to a question from a patient. Primary patient concerns about stem cell therapies for hearing loss were cost (45%) and safety (42%). Most patients (57%) were unsure what stem cell therapies would do, but 25% expected that this treatment would return their hearing to normal. This study demonstrates the increasingly important role of audiologists in providing support to patients about future potential therapies for hearing loss, as reflected in overwhelming support (from both patient and clinician) for audiologists providing such information. Article highlights Australian audiologists & their patients report a lack of awareness around current & emerging stem cell therapies for hearing loss Almost all patients surveyed in this study (92%) reported being unaware of any current or potential therapeutic use of stem cells for hearing loss, and only a third of participating audiologists noted awareness of the use of stem cells in otology. Patients show a willingness to receive stem cell therapies for hearing loss Of patients who had self-perceived hearing loss, 75% indicated that they were open to the use of stem cells for the treatment of their hearing loss, should such treatments become available in the future. Audiologists have a key role in providing accurate & relevant information to patients All audiologists within this study agreed that they should have a role in educating patients in stem cell therapies for hearing loss, but few were comfortable in replying to patient enquiries. Audiology as a profession has shifted from a biomedical perspective, where clinicians primarily focus on managing the hearing loss with available treatment options, to a more patient-centered model of practice, which emphasizes joint decision-making and consideration of the biological, psychological and social needs of the patient. Consultation with a healthcare professional & reliable online platforms were identified as preferred ways to receive new information on stem cell therapies For most patients surveyed (91.1%), consultation with a health professional was the most preferable choice. Unsurprisingly, a strong preference for online materials was noted given the ease with which this material can be accessed. Notably, unverified information online can be dangerous for patients as it can be biased toward public opinion over empirical data and exaggerate positive aspects of experimental stem cell therapies without fully disclosing the burdens that come with such treatment. Opportunities for improved patient care through open discussion & informed, evidence-based decision making The findings of this study highlight the opportunity for discussion among audiologists, patients, researchers, audiology governing bodies, stem cell peak bodies and other important stakeholders on the role of audiologists in educating patients about potential future stem cell therapies for hearing loss. This dialogue could facilitate the establishment and integration of educational material and professional guidelines that could assist audiologists with their knowledge and confidence in advising patients, as well as managing their expectations in matters relating to stem cell therapies. In turn, this could enhance patient-centered care as patients are equipped with accurate information relating to the risks, benefits and limitations of stem cell therapies. With this information, patients could be better positioned to make informed decisions about their hearing health. [ABSTRACT FROM AUTHOR]

The International Society for Stem Cell Research (ISSCR) presents its 2016 Guidelines for Stem Cell Research and Clinical Translation (ISSCR, 2016). The 2016 guidelines reflect the revision and extension of two past sets of guidelines (ISSCR, 2006; ISSCR, 2008) to address new and emerging areas of stem cell discovery and application and evolving ethical, social, and policy challenges. These guidelines provide an integrated set of principles and best practices to drive progress in basic, translational, and clinical research. The guidelines demand rigor, oversight, and transparency in all aspects of practice, providing confidence to practitioners and public alike that stem cell science can proceed efficiently and remain responsive to public and patient interests. Here, we highlight key elements and recommendations in the guidelines and summarize the recommendations and deliberations behind them.

People are increasingly seeking complex health information online. However, how they access this information and how influential it is on their health choices remains poorly understood. Google Analytics (GA) is a widely used web analytics tool and it has been used in academic research to study health information-seeking behaviors. Nevertheless, it is rarely used to study the navigation flows of health websites. To demonstrate the usefulness of GA data, we adopted both top-down and bottom-up approaches to study how web visitors navigate within a website delivering complex health information about stem cell research using GA's device, traffic and path data. Custom Treemap and Sankey visualizations were used to illustrate the navigation flows extracted from these data in a more understandable manner. Our methodology reveals that different device and traffic types expose dissimilar search approaches. Through the visualizations, popular web pages and content categories frequently browsed together can be identified. Information on a website that is often overlooked but needed by many users can also be discovered. Our proposed method can identify content requiring improvements, enhance usability and guide a design for better addressing the needs of different audiences. This paper has implications for how web designers can use GA to help them determine users' priorities and behaviors when navigating complex information. It highlights that even where there is complex health information, users may still want more direct and easy-to-understand navigations to retrieve such information. [ABSTRACT FROM AUTHOR]

Health information websites can be useful for information seekers, and their design is crucial for the success of accessing the needed information. While web analytical tools (e.g. Google Analytics) used by such websites can provide descriptive measures of users, there is a disconnection between this data and the current understanding of health information-seeking behaviour. In this work, we leverage a theoretical model to interpret the Google Analytics data. Drawn on the visualisation of user behaviours based on this model, our research shows that better website design can be informed, and the evaluation of health websites can be performed on the basis of different user profiles. [ABSTRACT FROM AUTHOR]