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September 11, 2009

Ghostwriting Is Called Rife in Medical Journals

"Six of the top medical journals published a significant number of articles in 2008 that were written by ghostwriters financed by drug companies, according to a study released Thursday by editors of The Journal of the American Medical Association. ...

In the scientific literature, ghostwriting usually refers to medical writers, often sponsored by a drug or medical device company, who make major research or writing contributions to articles published under the names of academic authors.

The concern, the researchers said, is that the work of industry-sponsored writers has the potential to introduce bias, affecting treatment decisions by doctors and, ultimately, patient care.

According to the study, responding authors reported a 10.9 percent rate of ghostwriting in The New England Journal of Medicine, the highest rate among the journals.

Editors of the Boston-based journal said Thursday that they were “puzzled” and “skeptical” of the findings.

The study also reported a ghostwriting rate of 7.9 percent in JAMA, 7.6 percent in The Lancet, 7.6 percent in PLoS Medicine, 4.9 percent in The Annals of Internal Medicine, and 2 percent in Nature Medicine. ...

“It was very compelling, and I find it quite shocking, to be honest,” Ginny Barbour, chief editor of PLoS Medicine, the journal of the Public Library of Science, said after the meeting. “We are a journal that has very tough policies, very explicit policies on ghostwriting and contributorship, and I feel that we’ve basically been lied to by authors."

Read more in New York Times, September10 , 2009.

Comment: It would be a mistake to go to far in reacting to this, and banning any help to researchers from writers. Many doctors and scientists are not also writers, and they have other things to do. Struggling with the writing or with finding time to do it will often delay publication of their results, sometimes by years. This process will cumulatively delay the whole multi-billion-dollar research enterprise, and reduce the quality of patients' care. Yet this serious mistake could easily be made, since people do not see what could have been, and therefore do not see the damage.

Our first thoughts about standards:

1. The process, including any role by pharmaceutical or device companies, must be properly disclosed;

2. The authors listed on the paper must know what's going on and be in control of the writing -- or exceptions must be disclosed (for example, if a leader of the study who has died should be listed among the authors);

3. Ideally, the original research budget should include a small percentage for publication (both for help from medical writers, and also to subsidize the publication process, so the paper will be available to all, not only to subscribers to some journal). Then industry money will not be needed for the writing or publication.