Evidence-Based Medicine (EBM)

Industry has an obligation to its shareholders to make a profit, which creates significant incentives for introducing bias into the research process. . . . Recent investigations have demonstrated a clear association between funding source and trial outcome, with commercially funded research three to four times more likely to have findings favorable to the sponsor than non-industry-funded research (Rogers & Ballantyne, 191). . . . Three related factors were responsible for the under-representation in clinical research of women, ethnic minorities, and other groups perceived to be ‘vulnerable,’ such as children and prisoners: explicit protectionist policies of exclusion; practical considerations of research efficiency and cost; and false assumptions about the relevance of sex, gender, and racial differences. . . . These justifications reflect what we call the ‘distortion paradigm,’ which defines the white adult male body as normal and considers female biological processes as distortions of this norm” (192). . . . Given that environmental and behavioral factors are estimated to cause up to 70% of premature death in the United States, a narrow focus on drug development can never maximize population health outcomes” (195).