This last week's NEJM contains a long-overdue expose on CROs (contract research organizations): http://content.nejm.org/cgi/content/short/357/14/1365 .
These organizations have one purpose: to carry out studies for the pharmaceutical industry in the most expeditious and efficient manner. The problem is that often, it is expeditious and efficient to compromise patient safety.
The article states the issue better than I could hope to. I will only comment that regardless of who is carrying out the actual clinical trial, that industry control of or involvement in the design of the trial is another MAJOR problem that must be addressed if we wish to search for the truth and protect study participant and subsequent patient safety in the study of novel pharmaceutical agents.
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