National efforts are under way to link together large administrative databases to permit hypotheses concerning adverse associations to be tested more rigorously. To enable medical sleuths to detect the initial scent that leads them to track a lowfrequency adverse drug effect, more open and better reporting is needed. But fuller reporting of all adverse experiences without filtering on the basis of statistical significance or perceived causality would result in the publication of more tedious supplemental tables that primarily contribute to information overload. Similarly, Justice Sotomayor noted that such unfiltered information “could bury the shareholder in an avalanche of trivial information.”

However, in cases in which data showing initially seemingly unimportant imbalances eventually add up to a clear signal of an adverse action of a drug, transparent early reports could reduce the likelihood of litigious arguments concerning who knew what and when. Individual manufacturers should not be in the position of determining what information is considered material for public dissemination. Physicians are also well aware that our noninfallible but important recommendations are based on our best assessments of incomplete data, with levels of evidence ranging from firm to anecdotal. With the finality afforded by the Supreme Court decision in Matrixx, investors can be assured of increased access to statistically nonsignificant information regarding reports of adverse drug experiences. Although the medical establishment lacks legal authority, it could use its standards- setting powers to improve access to the same level of information. The resulting flood of data, though likely to represent biologic noise rather than evidence sufficient to establish even “probable cause,” would contribute to the total mix of available information and might, under some circumstances, influence reasonable prescribers and patients to alter their treatment plans: a sommelier, for example, might consider any report of anosmia to be material.

Dr. Pfeffer is a physician in the Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital, and a professor at Harvard Medical School; and Ms. Bowler is a U.S. magistrate judge, U.S. District Court — all in Boston.