Independent medical research.

Concerns about undue influence of sponsors on research have already been heard for decades. Efforts to change this situation have had insufficient impact. Here we draw attention to an innovative proposal by the Royal Netherlands Academy of Sciences on how to prevent sponsor-induced bias. Is the problem still urgent? Several studies suggest that it is. In a recent survey of the 289 most-cited clinical trials published between 1994 and 2003, Ioannidis’ group analysed the origin of authors (academic or nonacademic) and the source of finance of these trials. 1 This study was done within the context of the International Campaign to Revitalise Academic Medicine (ICRAM). 2 During the period of observation, the proportion of investigations financed by pharmaceutical industries increased significantly: no less than 65 of the 77 most-cited clinical trials were (co-)financed with money from industry. Obviously the increasing influence of industry is a reason for concern, especially when the boundaries of influence are unclear. Industrial involvement, particularly in drug trials, usually starts with the design of the study, the choice of the comparator drugs, and the selection of the clinical investigators. Often industry has a major involvement in the collection and control of the data, as well as in data analysis. Even the (ghost)writing of the article may be done by the sponsor. It is of quite some concern, as Kjaergard and Als-Nielsen have pointed out, that authors of trials with competing interests, i.e., those funded by for-profit organisations, are significantly more positive towards the results of their investigation than those without. 3 This observation fits in with the results of the systematic review by Lexchin et al., 4 which demonstrates that studies sponsored