Analysis of studies that compare the dose accuracy of prefilled insulin pens.

Multiple industry-sponsored studies have been published about the accuracy of insulin delivery using prefilled insulin pens. Although the study by Weise and colleagues in this issue of Journal of Diabetes Science and Technology found that the Novo Nordisk device was slightly more accurate than the Sanofi-Aventis device, one can anticipate a Sanofi-Aventis-funded study that may find the opposite, because no internationally acceptable, publicly funded, unbiased scientific organization exists to perform head-to-head comparisons of drugs and devices in an evidence-based manner. Currently, clinicians are left on their own to determine whether a study on this topic was conducted in an accurate, unbiased manner. A fundamental redesign of clinical research could reinvigorate and revolutionize the process by which innovations travel from the bench to the bedside. As we anticipate changes in healthcare in the future, it is imperative that the approval and postmarketing surveillance process is revised to support the practice of true evidence-based medicine.