Rethinking the Whodunnit Approach to Assessing the Quality of Health Care Research -- A Call to Focus on the Evidence in Evidence-Based Practice

ipated that those working in the “trenches” of managed care pharmacy would appreciate an objective evaluation of the evidence about prescription drug cost-sharing. What we did not anticipate was a query we received from a consultant about our real reasons for writing the editorial. He asked about our business interest in the topic and why we had not disclosed the financial relationships that must have prompted our work. It was apparently inconceivable that 2 journal editors would closely examine the research evidence underlying a health care management tool for no reason other than an interest in determining the quality of the evidence. Apparently equally unthinkable was the fact that we had no conflicts of interest to disclose. We wonder if the cynical perspective evident in the question posed to us is unavoidable. We work in an industry in which most research is funded by parties with a commercial interest in the study outcomes. It is easy to conclude that a relationship between economic interest and research findings is inevitable. Adriane Fugh-Berman, author of numerous books and articles about complementary medicine, tells a similar tale: “When a university or medical society invites me to speak, I am often asked which company sponsors my talks. Not whether a company sponsors me, but which company.” 2