New England Journal of Medicine

Research Bias: Be Careful Where You Place Your Trust

Industry funding is a major impediment to unbiased results when it comes to testing new methodologies and pharmaceutical drug interventions, as analyses have shown that industry-sponsored trials report positive outcomes significantly more often than trials financially backed by the government, nonprofits, or nonfederal organizations.1 In a publication, bias known as the “file drawer” phenomenon, negative and null trials, or results that are unfavorable to drugs are more likely to be suppressed.2 There is also widespread rigging of data—deliberate manipulation of outcomes and use of statistical sleight-of-hand—wherein the outcomes of trials are being corrupted by commercial interests.3 And then there is the issue of industry bribery of journal editors. One retrospective observational study revealed that 50.6 percent of journal editors accept payments from industry sources, with an average payment of $28,136 and some payments approaching half a million dollars, meaning that the editors of the most influential journals in the world, who steer the scientific dialogue, are effectively on the take.4 In addition, a 2007 national survey published in the New England Journal of Medicine found that 94 percent of physicians had ties to the pharmaceutical industry, with physicians receiving free meals, reimbursement for medical education or professional meetings, consulting, lecturing, and enrolling patients in clinical trials.5

  1. Florence T. Bourgeois, Srinivas Murthy, and Kenneth D. Mandl, “Outcome Reporting among Drug Trials Registered in ClinicalTrials.gov,” Annals of Internal Medicine 153, no. 3 (2010): 158–66, https://doi.org/10.7326/0003-4819-153-3-201008030-00006.

  2. Erick H. Turner et al., “Selective Publication of Antidepressant Trials and Its Influence on Apparent Efficacy,” New England Journal of Medicine 358, no. 3 (2008): 252–60, https://doi.org/10.1056/NEJMsa065779.

  3. John P. A. Ioannidis, “Why Most Published Research Findings Are False,” PLoS Medicine 2, no. 8 (2005): e124, https://doi.org/10.1371/journal.pmed.0020124; and Alex Hern and Pamela Duncan, “Predatory Publishers: The Journals That Churn Out Fake Science,” The Guardian, August 10, 2018, www.theguardian.com/technology/2018/aug/10/predatory-publishers-the-journals-who-churn-out-fake-science.

  4. Jessica J. Liu et al., “Payments by US Pharmaceutical and Medical Device Manufacturers to US Medical Journal Editors: Retrospective Observational Study,” BMJ 359 (October 26, 2017): j4619, https://doi.org/10.1136/bmj.j4619.

  5. Eric G. Campbell et al., “A National Survey of Physician-Industry Relationships,” New England Journal of Medicine 356, no. 17 (2007):1742–50, https://doi.org/10.1056/NEJMsa064508.)