To the Editor: In their study of reported outcomes in major cardiovascular trials, Dr Ridker and Mr Torres1 found that clinical trials funded by for-profit organizations were more likely to report positive findings than those funded by not-for-profit organizations, which were more likely to report results that were negative. One explanation not considered in their discussion is the possibility that the private sector is better able to predict a positive outcome.
The National Institutes of Health funds projects based on the decisions of review committees made up of academic researchers. Such groups may promote studies of public health issues that are neglected by industry because of unprofitable treatments or populations, or test scientifically viable hypotheses without patent-protected sponsors. However, committees of investigators may not safeguard taxpayer dollars in order to maximize a return on investment with the same alacrity as a project officer in a drug or device company who must answer to a board of directors and, ultimately, shareholders. A case in point was the decision by the National Heart, Lung, and Blood Institute to fund the Magnesium in Coronaries (MAGIC) trial for acute myocardial infarction, despite the prior publication of a major trial with 58 000 participants that had negative results.2 The MAGIC trial subsequently had negative results.3
Rather than indict private industry for not funding trials that prove to be negative, decision makers in the public sector should recognize that not every hypothesis merits a major trial. Funding, particularly with public dollars, should be based on picking winners.
Financial Disclosures: None reported.
This letter was shown to Dr Ridker, who declined to reply.—ED.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
Instructions
Comments are moderated and will appear on the site at the discretion of the Journal of American Medical Association editors. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest* Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more
Subscribe for full-text access to content from 1998 forward and a host of useful features
Activate your current subscription (AMA members and current subscribers)
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Customize your page view by dragging & repositioning the boxes below.
and access these and other features:
Register Now
Enter your username and email address. We'll send you a reminder to the email address on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.