Competing interests: JR has received research support through Yale University from Medtronic, the FDA, the Centers of Medicare and Medicaid Services, and the Blue Cross Blue Shield Association in the past three years. He receives research support through Yale University from Johnson and Johnson to develop methods to share clinical trial data and from the Agency for Healthcare Research and Quality, the National Heart, Lung and Blood Institute, and the Laura and John Arnold Foundation to establish the Good Pharma Scorecard at Bioethics International and to establish the Collaboration for Research Integrity and Transparency at Yale.