Is society losing control of the medical research agenda?

conflicts of interest. [2]3][4][5] Clinical research is dictated by the need to promote products of industry.In this sense, academics may have indeed lost control of the clinical research agenda.Many important questions in clinical research have no connections with specific products and thus would not be supported by industry. 8Such questions may never be funded or may not be cited frequently once published.The recent increase in funding for profit may not be solely due to the need of industry to advertise.Recent cuts in government research budgets, together with the steady increase of applications for funding, provide an opening for the private sector. 9 10 Trials sponsored by industry are more likely to show favourable outcomes, 11 and be published in prestigious journals.Randomised controlled trials usually receive many citations, 12 especially if they show "positive" results.Citations strengthen the prestige of the journal, and journals may wish to publish only those papers that are likely to be cited often, thereby creating a vicious circle. The future of academic medicineOur findings are in line with the scenario of "Academic Inc," with academic medicine evolving into an efficient enterprise that is directed by profit with strong ties to other profit making corporate structures. 13 Our findings do not agree with a scenario where academic medicine disappears.Most influential research originates from the US and other wealthy countries, a situation that is dissonant with a global view of health needs.Government and the public sector still make major contributions to academic research, despite the rapid increase in industry sponsorship.Medical research should reflect public needs more closely.NAP and AAA thank A Germenis for his encouragement.This work was conducted under the