MAKING the right decisions on medical treatments depends on sound, unbiased scientific evidence on whether drugs work.

It is interesting then that in the past week two separate papers - in respected journals, the Lancet and BMJ - have highlighted shortfalls blighting the reliability of clinical trials and studies.

Neither attracted much coverage outside of the science press, which is a pity as this is an important and neglected issue. But sadly not a new phenomenon.

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The Lancet study - by Oxford University researchers - found that fewer than half of US clinical trials have complied with the law on reporting results, despite regulations brought in three years ago that stipulated a one-year deadline.

Non-reporting of clinical trial results has been well documented since the 1980s, especially in trials which found no evidence of effectiveness for the treatment being tested.

But failing to disclose disappointing trial results distorts the overall evidence base: evidence of ineffectiveness is equally important - it is just less potentially profitable.

The authors say that the high rates of non-compliance found in the new study likely reflect the lack of enforcement by regulators, despite laws allowing them to charge up to $12,000 a day in delay penalties.

Dr Ben Goldacre, who led the study, said: “Patients and clinicians cannot make informed choices about which treatments work best when trial results are routinely withheld...Our study has identified over 2,400 trials breaching the rules, but to our knowledge the FDA has never levied a single fine."

Meanwhile, the BMJ study - published yesterday - looked at the funding of patient groups by the pharmaceutical and medical device industries. Of the 26 studies (primarily in the US and Europe), funding of the patient groups involved ranged from an estimated 20-83 per cent.

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However, of the groups that received industry funding, only a quarter (27%) disclosed this information on their websites

Patient groups are pivotal: they fund medical research, influence public coverage of drugs and treatments, and contribute to decisions on approvals.

Yet this tells us, as the journal notes, that conflicts of interest between patient groups and industry "are extensive and run deep".

If voluntary disclosure is not working, mandatory disclosure is needed. In an era of 'fake news', spin and propaganda, medical science must be one area that the public can put its trust in because it is simply to important to get wrong.