 A final way in which our knowledge in medicine generated by research is potentially adversely affected by values is through the funding patterns connected with research. As implied above, pharmaceutical companies sponsor a considerable portion of drug trials and have a variety of interests at stake in these investments well beyond the gathering of evidence for the effectiveness (or lack thereof) of a particular product. There is consistent evidence that negative research results typically are suppressed when sponsored by industry (Lexchin 2012a), leading to a bias in what is reported and thus what evidence is available on which to make prescribing and treatment decisions. Bias also has been found in a number of other areas: within the study itself in the choice of research question or topic of investigation, in the choice of doses or drugs against which the drug under study is to be compared, in the control over trial design and various changes in protocols, and in decisions to terminate clinical trials early, and in the reinterpretation of data, as well as in the publication of data such as restrictions on publication rights, use of fake journals, favoring journal supplements and symposia rather than peer review venues, the use of ghostwriting, and in the details of the reporting of results and outcomes (Sismondo 2008; Reiss 2010b; Lexchin 2012b). All of these issues weaken the evidence base on which clinical care judgments are made, and also lead to potentially adverse effects for patients.