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December 17, 2003

Occupational Safety of Home Health Workers—Reply

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;290(23):3070. doi:10.1001/jama.290.23.3070-a

In Reply: Dr Palmer argues that trials sponsored by for-profit organizations have a much higher probability of producing a positive outcome, and that it is thus not surprising that they are more likely to draw positive conclusions than are trials sponsored by nonprofit organizations. Our study was designed to assess whether an association between funding and study conclusions reflected "more positive outcomes," which Palmer states would explain our findings. We found that this did not appear to be the case. Neither the treatment effect nor the occurrence of adverse events could explain the association between funding and conclusions. We found no significant difference in treatment effect between trials funded by different sources, but trials funded by for-profit organizations reported significantly more adverse events in the experimental group. Accordingly, our results do not support Palmer's suggestion that for-profit trials have a higher probability of favoring the experimental treatment. It was not possible to include the phase of a trial as a covariate in our analyses since very few trial reports stated the phase of the trial.

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