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When drug and device studies are conducted, results that are unfavorable to the sponsor can pose great financial risks to the sponsor companies. Several factors can explain the relationship between sponsorship and favorable outcomes, including a variety of biasing choices in the design, conduct, and reporting of studies.<ref>Lundh A, Lexchin J, Mintzes B, et al. Industry sponsorship and research outcome. ''Cochrane Database Syst Rev'' 2017;2: MR000033.</ref> Inferior competing treatment alternatives may be chosen as well as less clinically relevant primary outcomes that have a better chance of achieving a significant effect. <ref>Djulbegovic B, Kumar A, Miladinovic B, et al. Treatment success in cancer: industry compared to publicly sponsored randomized controlled trials. ''PLoS One'' 2013;8: e58711.</ref> Of course, there is also another perspective, meaning that the observed success rates seen in industry-sponsored trials are also rooted in the way commercial sponsors invest in product development meaning that only proposals with promising data and a high likelihood of success progress to RCT testing.<ref>Fries JF, Krishnan E. Equipoise, design bias, and randomized controlled trials: the elusive ethics of new drug development. ''Arthritis Res Ther'' 2004;6: R250-5.</ref>

The higher success rates seen in industry-sponsored research are expected and can be explained by extensive research, development efforts, and multimillion dollars investments.<ref>DiMasi JA, Hansen RW, Grabowski HG. The price of innovation: new estimates of drug development costs. ''J Health Econ'' 2003;22: 151–185.</ref>

To manage conflict of interests, which is inevitable and must always be declared, it is important to maximize transparency in industry-funded research. Some of the proposed approaches include a carefully constructed advisory board with specific responsibilities as well as strict guidelines to protect research quality.<ref>Plottel GS, Adler R, Jenter C, et al. Managing conflicts and maximizing transparency in industry-funded research. ''AJOB Empir Bioeth'' 2020;11: 223–232.</ref> It is important to fully disclose financial, personal, and professional interests. Oversight by an independent third party is recommended as well as pre-registration of the study. The role of commercial partners must be defined and the relationship has to be continuously monitored. <ref>Cullerton K, Adams J, Forouhi N, et al. What principles should guide interactions between population health researchers and the food industry? Systematic scoping review of peer-reviewed and grey literature. ''Obes Rev'' 2019;20: 1073–1084.</ref> The scientific community has improved recently in regards to some of the key indicators of research reproducibility and transparency. This includes information on funding, conflict of interests statements, and an increase in protocol and data sharing. There is also a growing number of fully available texts, although the majority of texts are still not fully available. Nevertheless, confusion about research transparency still exists, and even though there has been some improvement, the scientific community is far from perfect in terms of research transparency and reproducibility.<ref>Wallach JD, Boyack KW, Ioannidis JPA. Reproducible research practices, transparency, and open access data in the biomedical literature, 2015-2017. ''PLoS Biol'' 2018;16: e2006930.</ref>
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