title: Reported outcomes in major cardiovascular clinical trials funded by for-profit and not-for-profit organizations: 2000-2005.
abstract: BACKGROUND
  In surveys based on data available prior to 2000, clinical trials funded by for-profit organizations appeared more likely to report positive findings than those funded by not-for-profit organizations. Whether this situation has changed over the past 5 years or whether similar effects are present among jointly funded trials is unknown.
  
  
  OBJECTIVE
  To determine in contemporary randomized cardiovascular trials the association between funding source and the likelihood of reporting positive findings.
  
  
  METHODS
  We reviewed 324 consecutive superiority trials of cardiovascular medicine published between January 1, 2000, and July 30, 2005, in JAMA, The Lancet, and the New England Journal of Medicine.
  
  
  METHODS
  The proportion of trials favoring newer treatments over the standard of care was evaluated by funding source.
  
  
  RESULTS
  Of the 324 superiority trials, 21 cited no funding source. Of the 104 trials funded solely by not-for-profit organizations, 51 (49%) reported evidence significantly favoring newer treatments over the standard of care, whereas 53 (51%) did not (P = .80). By contrast, 92 (67.2%) of 137 trials funded solely by for-profit organizations favored newer treatments over standard of care (P<.001). Among 62 jointly funded trials, 35 (56.5%), an intermediate proportion, favored newer treatments. For 205 randomized trials evaluating drugs, the proportions favoring newer treatments were 39.5%, not-for-profit; 54.4%, jointly funded; and 65.5%, for-profit trials (P for trend across groups = .002). For the 39 randomized trials evaluating cardiovascular devices, the proportions favoring newer treatments were 50.0%, not-for-profit; 69.2%, jointly funded; and 82.4%, for-profit trials (P for trend across groups = .07). Regardless of funding source, trials using surrogate end points, such as quantitative angiography, intravascular ultrasound, plasma biomarkers, and functional measures were more likely to report positive findings (67%) than trials using clinical end points (54.1%; P = .02).
  
  
  CONCLUSIONS
  Recent cardiovascular trials funded by for-profit organizations are more likely to report positive findings than trials funded by not-for-profit organizations, as are trials using surrogate rather than clinical end points. Trials jointly funded by not-for-profit and for-profit organizations appear to report positive findings at a rate approximately midway between rates observed in trials supported solely by one or the other of these entities.
authors.affiliation: Center for Cardiovascular Disease Prevention and the Division of Preventive Medicine, Brigham and Women's Hospital, Boston, Mass 02215, USA. pridker@partners.org
authors.forename: Paul M
authors.initials: PM
authors.lastname: Ridker
authors.forename: Jose
authors.initials: J
authors.lastname: Torres
mesh_terms: D015706:Bibliometrics; D002318:Cardiovascular Diseases / Q000628:therapy*; D023381:Endpoint Determination / Q000191:economics; D005381:Financing, Organized / Q000145:classification*; D006801:Humans; D007449:Investments; D009939:Organizations, Nonprofit / Q000706:statistics & numerical data*; D010043:Outcome and Process Assessment, Health Care; D017149:Private Sector / Q000706:statistics & numerical data*; D016032:Randomized Controlled Trials as Topic / Q000191:economics*; D012109:Research Support as Topic / Q000145:classification*; D016896:Treatment Outcome