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Objective To investigate whether funding of drug studies by the pharmaceutical industry is associated with outcomes that are favourable to the funder and whether the methods of trials funded by pharmaceutical companies differ from the methods in trials with other sources of support. Methods Medline (January 1966 to December 2002 and Embase (January 1980 to December 2002) searches were supplemented with material identified in the references and in the authors' personal files. Data were independently abstracted by three of the authors and disagreements were resolved by consensus. Results 30 studies were included. Research funded by drug companies was less likely to be published than research funded by other sources. Studies sponsored by pharmaceutical companies were more likely to have outcomes favouring the sponsor than were studies with other sponsors (odds ratio 4.05; 95% confidence interval 2.98 to 5.51; 18 comparisons). None of the 13 studies that analysed methods reported that studies funded by industry was of poorer quality. Conclusion Systematic bias favours products which are made by the company funding the research. Explanations include the selection of an inappropriate comparator to the product being investigated and publication bias.

Sponsorship of drug and device studies by the manufacturing company leads to more favorable results and conclusions than sponsorship by other sources. Our analyses suggest the existence of an industry bias that cannot be explained by standard 'Risk of bias' assessments.

Analysis 2.1. Comparison 2 Results: Industry sponsorship by test treatment company versus sponsorship by comparator treatment company, Outcome 1 Number of studies with favorable test treatment efficacy results.. .. .. Analysis 3.1. Comparison 3 Conclusions: industry sponsored versus non-industry sponsored studies, Outcome

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Our results across all reviews (pooled ROR 1.08) are very similar to results reported by similarly conducted reviews. As such, we have reached similar conclusions; on average, there is little evidence for significant effect estimate differences between observational studies and RCTs, regardless of specific observational study design, heterogeneity, or inclusion of studies of pharmacological interventions. Factors other than study design per se need to be considered when exploring reasons for a lack of agreement between results of RCTs and observational studies. Our results underscore that it is important for review authors to consider not only study design, but the level of heterogeneity in meta-analyses of RCTs or observational studies. A better understanding of how these factors influence study effects might yield estimates reflective of true effectiveness.

Analysis 2.1. Comparison 2 Results: Industry sponsorship by test treatment company versus sponsorship by comparator treatment company, Outcome 1 Number of studies with favorable test treatment efficacy results.. .. .. Analysis 3.1. Comparison 3 Conclusions: industry sponsored versus non-industry sponsored studies, Outcome

BackgroundThe roles of pharmacists in patient care have expanded from the traditional tasks of dispensing medications and providing basic medication counseling to working with other health professionals and the public. Multiple reviews have evaluated the impact of pharmacist-provided patient care on health-related outcomes. Prior reviews have primarily focused on in-patient settings. This systematic review focuses on services provided by outpatient pharmacists in community or ambulatory care settings. This is an update of the Cochrane review published in 2000. ObjectivesTo examine the e ect of outpatient pharmacists' non-dispensing roles on patient and health professional outcomes. Search methodsThis review has been split into two phases. For Phase I, we searched the Cochrane E ective Practice and Organisation of Care (EPOC) Group