Far from their portrayed role as neutral arbitrators of truth, scientific journals are one of the many covert means by which corporate interests bend reality to corroborate their bottom line. For instance, in 2014 it was found that out of the 73 studies of new drugs published in the New England Journal of Medicine, 60 were industry sponsored, 50 had drug maker employees among the authors and 37 had lead researchers that received financial incentives from the drug maker. That same year the industry paid for 6,550 clinical trials, while the NIH funded 1,048 clinical trials; several years later that disparity has only grown wider. A 2021 study combed through numerous databases, bibliographies, expert recommendations and web alerts and identified 19 industry strategies across 8 industries for influencing outcomes in science. The pharmaceutical industry uses 16 of them including controlling the design, analysis and funding of peer reviewed studies published in journals, publishing the same study multiple times under different authors to create the illusion of multiple studies, concealing industry involvement in studies, scientific messaging and policy reforms and even threatening litigation against researchers who attempt to publish results unfavorable to the pharmaceutical industry’s products. Even as far back as 1994 it was observed that industry trials rarely produced results unfavorable to their products. A review of 56 industry sponsored trials of non-steroidal anti-inflammatory drugs produced zero results unfavorable to the drugs. A decade later, a systematic review of 30 different studies which compared the difference in outcomes between industry sponsored trials and independently funded trials found that the former were 4x more likely to have outcomes favorable to the sponsor than independently funded studies. Of the 16 studies that were clinical trials or meta-analyses 13 produced outcomes favorable to the sponsor. This is possible not only by controlling the trial design but also the terms of reference i.e. asking the right questions but controlling the design is just as crucial. By controlling the design Pharma companies can trial their product against a known inferior treatment, trial their product against a below threshold dose of a competitor’s product, use multiple clinical endpoints and select the ones that create favorable results for publication, use multicenter trials and select favorable centers for publication and/or analyze results in a way that makes them appear more favorable to the product such as conflating absolute risk reduction and relative risk reduction.