From October, 15 to 18, the First international forum toward evidence-based toxicology was held at Cernobbio/Como, Italy. The forum was organised by the European Commission in close collaboration with scientists active in toxicology, life sciences, biostatistics, modeling and medicine.

About 170 scientists from more than 25 European, American and Asian countries followed the organisers’ invitation to discuss the strengths and weaknesses of methodologies currently used by toxicological safety assessment, to explore the available concepts of evidence-based toxicology (EBT) and to launch an initiative to formally implement evidence-based assessment methods.

Summary of the 1st International Forum Towards Evidence-Based Toxicology

After getting together on October, 15, the forum was opened on October 16 with a welcome address by Thomas Hartung, (European Commission, ECVAM). To highlight the need for an EBT, several members of the scientific steering group gave short presentations expressing their views of why there is room for improvement within toxicological practice. This first session ended with the presentation of Christopher Portier giving an overview of current concepts and schemes of science-driven toxicological decision-making.

In the following session Roberta Scherer and Edmund Neugebauer presented the history, the objectives and essential building blocks of evidence-based medicine/health care (EBM/EBHC) focusing on the Cochrane Collaboration and EBM guideline development.

After an overview on how toxicology relates to medicine in terms of knowledge creation and decision making by Claudius Griesinger and a talk on the concept of evidence-based evaluation of causation regarding individual patients by Phillip Guzelian, the rest of the first day was dedicated to break-out group work. While a smaller group started to work toward a definition and declaration of EBT, most of the participants were tackling in small interactive groups the three issues

• What is the process of science-based decision-making in toxicology today?
• Strength/weakness analysis of the current information sources and methods used in toxicology
• How can we improve the toxicological toolbox?

The morning of the second day was divided into two plenary sessions aiming to give the participants ideas of possible approaches to EBT. In the first part current concepts of EBT and the topic of uncertainty in cancer risk assessment were addressed by the three speakers Lutz Edler, Sebastian Hoffmann and Phil Guzelian. The second session was focusing on ‘EBT: case studies and examples’, in which Ellen Silbergeld, Lutz Müller, Hugh Barton, Denis Sarigiannis and Jürgen Borlak presented some of their work indicating some possible directions towards EBT.

The afternoon of the second day was focusing on the way forward. Break-out groups were examining the applicability of EBM tools to basic research, hazard identification and decision-making in toxicological practice. In addition, the group working toward a definition and declaration of EBT continued their work after having collected feed-back from all participants at the beginning of this group work session.

At the end of the second day all participants were rewarded for their hard work with a gala dinner in the antique Villa Erba at the shore of Lake Como.

The final forum day started with presentation of the results of all break-out groups, followed by a plenary session to reach a common understanding in terms of a definition of EBT, the objective of an EBT and to discuss possible follow-up work. Most importantly, a list of ten characteristics of EBT was agreed upon by all participants.

The forum was closed with a plenary session giving not only the scientific steering group, but all participants to give feed-back and their personal impressions.

More information about the declaration of Como, the ten defining characteristics and a possible mission statement of EBT will follow in the near future.