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Where are clinical trials going? Society and clinical trials
Author(s) -
Sleight P.
Publication year - 2004
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1046/j.1365-2796.2003.01294.x
Subject(s) - clinical trial , medicine , confusion , conflict of interest , government (linguistics) , public relations , politics , profit motive , pharmaceutical industry , finance , political science , business , law , economics , pathology , psychology , linguistics , philosophy , psychoanalysis , pharmacology , microeconomics
. Clinical trials now increasingly impinge on society at large. First there is growing emphasis from health organizations on the need for unbiased evidence about the effectiveness of promoted remedies. Second, as most novel treatments accrue increased costs to society, these need to be evaluated in terms of value for money. Third, there has been confusion and concern about the resolution of conflicting evidence, especially the role of advertising and commercial pressures from a powerful pharmaceutical industry motivated by profit. Fourth, there is concern about research fraud and the ethics of clinical trials. Fifth, there is increasing suspicion of political advice, which sometimes has sought to reassure an anxious public on the basis of complex and possibly inadequate scientific information. Some of these issues are addressed by truly independent and properly constituted data and safety monitoring committees, which are of particular importance when academic investigators or universities have a large financial conflict of interest. This is now more problematic with the current encouragement of investigator‐led spin‐off companies. These issues are best resolved by independent financial support (from government or other institutions) rather than relying on the commercial sponsor.