BMJ: Pathways to independence: towards producing and using trustworthy evidence

14 December, 2019

'A global team of influential researchers, clinicians, regulators, and citizen advocates suggest how we can start to build an evidence base for healthcare that is free of commercial influences...'

CITATION: Pathways to independence: towards producing and using trustworthy evidence

BMJ 2019; 367 doi: (Published 03 December 2019)

Cite this as: BMJ 2019;367:l6576


- Trustworthy evidence is required to enable well informed decisions about healthcare

- Widespread financial dependence on industry brings commercial bias in research evidence, medical education and clinical practice

- Such bias tends to overstate healthcare benefits and play down harms

- Greater financial independence from industry is desirable and possible, with examples of reform across research, education, and practice

- The proposed steps towards financial independence from commercial interests will involve major culture change.


We all want to base our healthcare decisions on trustworthy evidence. Yet the landmark 2009 Institute of Medicine report identified widespread financial conflicts of interest across medical research, education, and practice.1 It highlighted that extensive industry influence may be jeopardising “the integrity of scientific investigations, the objectivity of medical education, the quality of patient care, and the public’s trust in medicine.”...

To deepen understanding of the problems and help develop solutions, we encourage you to respond to this article through The BMJ’s rapid responses, including your positive or negative experiences of reforms. We also encourage you to sign a short statement of support available here ( and suggest strategies and priorities.


Best wishes, Neil

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