The power of clinical trials and guidelines,and the challenge of conflicts of interest

The pace of medical discovery accelerated rapidly after World War II as America and a few other countries endowed biomedical research and as pharmaceutical companies collaborated with clinical investigators and statisticians to conduct controlled trials (5). In the U.S., in 1951, the newly organized National Heart Institute, now the National Heart, Lung, and Blood Institute (NHLBI), funded the world's first international, multi-center cardiovascular clinical trial.