Enhancing Safety Evaluations: A Comprehensive Framework for Evidence-Based Safety Assessment Using the Bradford Hill Criteria
摘要
In drug development, safety assessments must integrate data from heterogeneous sources including clinical trials, non-clinical toxicology, mechanistic evidence, and real-world evidence. At any given timepoint—such as protocol development, dose escalation, interim reviews, or regulatory safety reports—data may be incomplete, or contextually ambiguous. Teams often struggle to summarize the totality of evidence for a given safety topic in a way that is both scientifically rigorous and operationally consistent. There is a lack of a structured, reusable framework that enables critical appraisal and consistent communication of causality reasoning. Consequently, evaluations of safety information are frequently fragmented, logic trails get lost, and key conclusions may become difficult to defend or reproduce, particularly with changes in cross-functional teams or loss of institutional memory. Our framework recognizes and addresses these real-life operational challenges. We propose a structured application of the Bradford Hill Criteria (BHC) [