As editors of general medical journals, we recognize that the publication
of clinical research findings in respected peer-reviewed journals is the ultimate
basis for most treatment decisions. Public discourse about this published
evidence of efficacy and safety rests on the assumption that clinical trials
data have been gathered and are presented in an objective and dispassionate
manner. This discourse is vital to the scientific practice of medicine because
it shapes treatment decisions made by physicians and drives public and private
health care policy. We are concerned that the current intellectual environment
in which some clinical research is conceived, study subjects are recruited,
and the data analyzed and reported (or not reported) may threaten this precious
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