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Even Loftiest Medical Journals Haunted by Ghostwriting

by Brendon Nafziger, DOTmed News Associate Editor | September 21, 2009
Ghostwriting persists as a
blot on the reputation
of medical journals
Scholars claim almost one in ten articles in prestigious peer-reviewed journals fail to disclose real authors.

In a paper presented at the sixth annual International Congress on Peer Review Congress and Biomedical Publication in Vancouver, Canada, researchers from the New England Journal of Medicine found that 8 percent of articles from major medical journals covered in their study had authors who were ghostwriters not named in the papers -- a practice frowned upon in the medical community as the anonymity of the writer could conceal conflicts of interest.

About 26 percent of articles in these journals also had so-called honorary authors: These are writers credited with authorship who actually contributed very little to the articles.

The study included some of the most respected journals in medicine, such as JAMA, Nature Medicine, Lancet, PloS Medicine and even NEJM, where the researchers work.

The findings from the study are almost the same as those from the last survey, done in 1996, indicating ghostwriting is still an issue of real concern to the medical community.

"We believe that it would help if all journals required authors to disclose their contributions and published those disclosures," Joseph Wislar, lead author of the study, told DOTmed News.

Ghostwriters are controversial, because they can have ties to the drug industry that won't get disclosed if they aren't named.

"Of course, industry experts are capable of performing state-of-the-art studies conducted to very high standards," Larry Peiperl, M.D., an editor at PLoS Medicine, explained to DOTmed News. But he added, "There is considerable data showing that industry-sponsored studies that are published tend to favor the sponsor's product."

Last month, a Canadian doctor came under fire when an investigation by the Toronto Star revealed that an article on hormone therapy she was credited with writing was partly penned by DesignWrite, a New Jersey-based medical communications company hired by pharmaceutical giant Wyeth to promote its hormone replacement drugs.

And this July, following a suit joined by PloS Medicine and the New York Times, a U.S. federal court released over 1,500 documents indicating what a PloS Medicine editorial called Wyeth's "coordinated and carefully monitored campaign of ghostwriting" in support of the hormone replacement drug Prempro.

But Dr. Peiperl believes honorary authorship represents an equally serious problem. "Having honorary authors violates widely accepted standards...that require substantial participation in the work in order to merit authorship," he explained. "Guest authorship therefore creates confusion when authorship counts for promotion and future grant funding; those who take advantage of such patronage may be at an unfair advantage over those who play by the rules."

To discourage non-disclosure of authorship, Dr. Peiperl believes universities should punish faculty members who lend their names to ghostwritten articles using policies already in place for academic misconduct. He also thinks journal editors should retract articles found later to have used ghostwriting.

"Professors and researchers need to teach the new generation of doctors and scientists that allowing one's name to be used on ghostwritten papers is unprofessional and unacceptable," he stated.