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To the Editor: Dr Als-Nielsen and colleagues¹ found that trials funded by for-profit organizations favored the active drug more commonly than placebo. The authors concluded that this may have been due to biased interpretation of trial results. However, an association between funding and study conclusions is not surprising.

A major reason for this, which the authors alluded to briefly, is the "violation of the uncertainty principle," an unfortunate phrase, as it implies error or some nefarious or underhanded activity. There really is no reason to expect that "half of all [published] trials should favor the control intervention." While equipoise may be present in at least some trials sponsored by nonprofit organizations, it is unrealistic to think that there is anything like equipoise in studies sponsored by industry. It is not the business of pharmaceutical companies to do such studies; they are in the business of confirming efficacy. No pharmaceutical company . . . [Full Text of this Article]

Robert H. Palmer, MD
Forest Research Institute
Jersey City, NJ

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