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Hopefully, this will also spur the federal and other medical research funding agencies to consider funding more clinical trials independent of the pharmaceutical industry. ... First, most of the published controlled clinical trials (level A evidence) are directly supported by the pharmaceutical industry. These are very expensive studies to do. ...doi:10.1155/2000/525071 pmid:18159301 pmcid:PMC2094789 fatcat:iilhoubf6rbypmeollwdfyjnue
We note that, in general, clinical guidelines may use evidence that has a number of biases, are subject to conflicts of interest at multiple levels, and often do not include unpublished research. ... This article examines the controversy surrounding these guidelines using the 2013 cholesterol guidelines as a case study of broader trends in clinical guidelines to use a narrow evidence base, expand the ... At the trial level, pharmaceutical companies fund approximately 75% of clinical drug trials published in top medical journals  . ...doi:10.1016/j.healthpol.2016.05.009 pmid:27256859 fatcat:5psarkhtercjfiyiijgk76ojfq
Mechanism and Causality in Biology and Economics
There is some evidence that deception in medical trials can fail. ... To understand randomisation in this way is perfectly appropriate from a methodological point of view but this is not how it was understood by those who introduced it into the regulatory system. ...doi:10.1007/978-94-007-2454-9_11 fatcat:v26awcx2zzf2tppgk7vcueeypm
randomised clinical trial has become the "gold standard" by which the choice of treatment and evidence to support its use is now judged. ... Very clear declarations of conflicts of interest are essential, especially for studies sponsored by the pharmaceutical industry. ...doi:10.1136/adc.82.4.275 pmid:10735828 pmcid:PMC1718285 fatcat:6q2cbv6ynze2vf757bv4eqjfdu
drugs are published while those that cast doubt on efficacy are suppressed. 140 The medical establishment has taken some steps to rein in the biasing effects of having trials funded by those who look ... Epstein, The Pharmaceutical Industry at Risk: How Excessive Government Regulation Stifles Innovation, 82 CLINICAL PHARMACOLOGY & THERAPEUTICS 131, 131-32 (2007). 112 See Barkun et al., supra note 111 ...doi:10.2139/ssrn.1937787 fatcat:of6rxmfi5fczpfecfvk3cut6nu
construction of the evidentiary process in clinical trials-how the evidence-making process is itself tainted. ... , clinical trial protocols or outcome measures. ...doi:10.1017/s1745855207005017 fatcat:tyu3yewnyvanfkb4d4pth2cmpy
Methods: We recruited 20 medical and pharma ceutical directors from national and regional plans who are involved in pharmaceutical and therapeutics committees to participate in the study. ... This study describes how US commercial payers use different types of CER to make reimbursement decisions in different disease states. ... The authors have received no external funding for this research. ...doi:10.1200/jop.2011.000526 pmid:22942820 pmcid:PMC3348603 fatcat:ztigq3b2arcyzpblswvpjwpedq
Evidence Based Medicine - Closer to Patients or Scientists?
in the group of patients for which the clinical trial was designed, those with rheumatoid arthritis. ... At any given clinical encounter, the physician does not have all the information needed to make an evidencebased decision. ...doi:10.5772/38844 fatcat:tfv43zg2f5bungman5gst27epi
Evidence-Based Medicine - A Paradigm Ready To Be Challenged?
A possible solution to prevent industrial bias would be to make it mandatory to outsource the trials to independent clinics in which they can be performed. ... RCTs sponsored and/or conducted by pharmaceutical companies, because of funding and publication bias, have consistently more favourable results than those from comparable but independent trials. ...doi:10.1007/978-3-476-05703-7_4 fatcat:r6ntxr23ebecdoeawsg74y4yti
It is accepted that randomised controlled trials are one of the best forms of evidence from a clinical trial and the "gold standard" in evidence.27 31. ... There needs to be a greater sense of urgency in the response to the plight of those children living with intractable epilepsy and to make sure that their families can all access clinical trials of CBPM ... Published written evidence The following written evidence was received and can be viewed on the inquiry publications page of the Committee's website. ...doi:10.1211/pj.2019.20207242 fatcat:chnrerxnrzd45l2fcmyn7svcby
One of the most prominent exponents of the use of RWE is the pharmaceutical industry. ... the RCT as being the 'gold standard' basis of decision-making. ...doi:10.1007/s40801-019-0155-3 pmid:31016548 pmcid:PMC6520412 fatcat:kyuheeis65gc3eid5dsopngpdq
The placement of the randomized controlled trial at the top of the hierarchy of methods as the gold standard of medical research is also demonstrative of epidemiological commitments. ... For example, pharmaceutical industry-funded trials are four times more likely than publicly funded trials to produce favorable results for their products, despite both sources scoring high for methodological ... Disclosure Statement The author has no conflicts of interest to report. ...doi:10.1089/jwh.2009.1680 pmid:20575678 fatcat:46felfiaibe7rckbaxbbg3mgmy
In spite of having the same evidence, the groups developed three different recommendations. The entire group then explored some of the reasons for this variability. ... The Advanced/Policy Track of the 2004 Kaiser Permanente Evidence-Based Medicine Symposium was an interactive session that focused on developing evidence-based clinical practice guidelines. ... Third, the KP team members are less likely to have significant conflicts of interest with industry compared to national experts who sit on other guideline teams. ...pmid:21660172 pmcid:PMC3104842 fatcat:cpajd35wsjehfddcimu5ma7v7y
For example, there are credible reservations about the validity of hierarchical levels of evidence, a core element of the EBM paradigm. ... In addition, potential and actual methodological and statistical deficiencies have been identified, not only in many published randomized controlled trials but also in systematic reviews, both rated highly ... has not made a contribution to the paper; often to add prestige), and "ghost authorship" (authors who have made significant contributions to the paper, are not included, often those writing for industry ...doi:10.1017/s0317167100014542 fatcat:woe7to4vrnc5bgyyva6fqezboi
Randomized clinical trials provide the most internally valid evidence for medical decision-making. ... This article reviews some ways in which the design and application of clinical trials could be improved so that the evidence produced would be more relevant to health-care providers and other decision ... Acknowledgments: This work was supported by Grant K-08 HS00004 from the Agency for Healthcare Research and Quality. I thank Drs. ...doi:10.1007/bf03206622 fatcat:i3kgodkfgzfubiemxipqfmzsra
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