The CME enterprise has reached a crossroads. The purpose of this paper is to examine the available evidence, provide clarification of the analysis, criticism, research, and policy proposals regarding CME. An analysis of developments during the past five years will allow stakeholders to appropriately assess and project future direction. In a survey of more than 100 published articles, studies, consensus statements, and reports addressing the state of CME between 2005 and 2010, a set of four important "CME policy and scrutiny trends" emerged and is identified below. A collec- tive analysis of these comments and findings produces a set of recommendations that will assist in shaping the CME debate and developments for the next five years.