Table 1.

Toward a future state of metabolism‐based treatment for epilepsy

Challenges and opportunities
Challenge	Opportunity
Insufficient rigor in pre‐clinical and clinical studies	Adherence to principles of rigor, reproducibility, sex as a biological variable, and including appropriate representation in both preclinical and clinical studies Reporting adherence to published rigor guidelines
Animal models do not mirror the human condition	Studying species that more closely mimic human pathophysiology In silico modeling human physiology Basic science studies in humans
Incomplete understanding of network properties of metabolism	Build on existing knowledge, tools, and approaches (e.g., by the BRAIN Initiative) to investigate metabolic circuits
Missing or incomplete data sets	Adherence to data sharing guidelines
Clinical trial recruitment	Optimizing remote participation Use of monitoring devices Novel clinical trial designs (using appropriate statistics)
Poor relevance of measured clinical trial outcomes to patient wellbeing	Inclusion of advocacy organizations
Neglect of individual biological differences in clinical trials	Data‐intensive sub‐analysis methods to capitalize on potentially important biological information
Excessive proportion of negative trial results	Rigorous failure analysis
No validated biomarkers	Development of biomarkers (at various stages of investigation) within the BEST framework for future clinical studies