Re: Ghostwriting: the importance of definition and its place in contemporary drug marketing
Defenses of ghostwriting, as exemplified in two of the responses to Matheson’s paper, are endlessly creative (1-2). It is always interesting to see industry try and defend the idea that the authors of papers do not need to be listed on the byline. My colleague Jeff Lacasse and I have addressed this topic in several publications (3-5). Thanking writers for providing “editorial assistance” in the acknowledgments section of the paper instead of the authorship byline, essentially changes the rule of authorship attribution so that ghostwriting is acceptable. Listing ghost authors as editorial assistants allows pharmaceutical companies to publish articles with conflicts-of interest that are not transparently reported. Editorial assistants are not mentioned in the abstract, are not indexed in publication databases, are not mentioned in subsequent citations, and are never mentioned in news media accounts of the article. In other words, the fact that a pharmaceutical company directly co-authored the paper is concealed from view. That this is seen as acceptable in an era of increased disclosure of conflicts-of-interest is puzzling.
As Senator Charles Grassley stated, in a report from the Senate Committee on Finance titled, “Ghostwriting in the Medical Literature”: “Despite its acknowledgement of medical writers for ‘editorial assistance,’ the role of pharmaceutical companies in medical publications remains veiled or undisclosed.” (4)
Even medical writers acknowledge the reality. In communications with Forest Pharmaceuticals about the byline of a clinical trial of Citalopram in children, Mary Prescott of the Weber Shandwick states: “I don’t know that any decision has been made about who is going to write the manuscript (not to be confused with who is going to be the author[s] of the manuscript, which also isn’t decided, as far as I know) (6).”
To be honest I am not sure that trade groups should have a place at the table when it comes to deciding the proper definition of ghostwriting. This is an academic decision best left to the Journal Editors. It is unfortunate that the two responses that defend the practice of not listing corporate authors on the byline use ICMJE guidelines as support for their views. To improve the credibility of biomedical research eroded by ghostwriting, the ICMJE should revise their approach to regulating authorship. As authors submit manuscripts to medical journals, each author should be required to sign a statement guaranteeing that no ghost authors participated in authorship or co-authorship of the submitted article, and that all medical writers are listed as authors on the byline. This simple move forward could have profound consequences for the medical literature as a whole. Much progress has been made relatively quickly in identifying ghostwriting as a problem, and we are now on the verge of largely solving this problem—if those with editorial influence in academic medicine will insist on policies to ensure that there are no undisclosed conflicts of interest haunting the contemporary medical literature.
6. Jureidini, J. Amsterdam, J.D., and Leemon, M. The Citalopram CIT-MD-18 pediatric depression trial: Deconstruction of medical ghostwriting, data mischaracterization, and academic malfeasance. International Journal of Risk and Safety. 2016;28 (1):33-43. Accessed at: http://content.iospress.com/articles/international-journal-of-risk-and-s... 15 September 2016.
Rapid Response:
Re: Ghostwriting: the importance of definition and its place in contemporary drug marketing
Defenses of ghostwriting, as exemplified in two of the responses to Matheson’s paper, are endlessly creative (1-2). It is always interesting to see industry try and defend the idea that the authors of papers do not need to be listed on the byline. My colleague Jeff Lacasse and I have addressed this topic in several publications (3-5). Thanking writers for providing “editorial assistance” in the acknowledgments section of the paper instead of the authorship byline, essentially changes the rule of authorship attribution so that ghostwriting is acceptable. Listing ghost authors as editorial assistants allows pharmaceutical companies to publish articles with conflicts-of interest that are not transparently reported. Editorial assistants are not mentioned in the abstract, are not indexed in publication databases, are not mentioned in subsequent citations, and are never mentioned in news media accounts of the article. In other words, the fact that a pharmaceutical company directly co-authored the paper is concealed from view. That this is seen as acceptable in an era of increased disclosure of conflicts-of-interest is puzzling.
As Senator Charles Grassley stated, in a report from the Senate Committee on Finance titled, “Ghostwriting in the Medical Literature”: “Despite its acknowledgement of medical writers for ‘editorial assistance,’ the role of pharmaceutical companies in medical publications remains veiled or undisclosed.” (4)
Even medical writers acknowledge the reality. In communications with Forest Pharmaceuticals about the byline of a clinical trial of Citalopram in children, Mary Prescott of the Weber Shandwick states: “I don’t know that any decision has been made about who is going to write the manuscript (not to be confused with who is going to be the author[s] of the manuscript, which also isn’t decided, as far as I know) (6).”
To be honest I am not sure that trade groups should have a place at the table when it comes to deciding the proper definition of ghostwriting. This is an academic decision best left to the Journal Editors. It is unfortunate that the two responses that defend the practice of not listing corporate authors on the byline use ICMJE guidelines as support for their views. To improve the credibility of biomedical research eroded by ghostwriting, the ICMJE should revise their approach to regulating authorship. As authors submit manuscripts to medical journals, each author should be required to sign a statement guaranteeing that no ghost authors participated in authorship or co-authorship of the submitted article, and that all medical writers are listed as authors on the byline. This simple move forward could have profound consequences for the medical literature as a whole. Much progress has been made relatively quickly in identifying ghostwriting as a problem, and we are now on the verge of largely solving this problem—if those with editorial influence in academic medicine will insist on policies to ensure that there are no undisclosed conflicts of interest haunting the contemporary medical literature.
1. Stretton, S. Rapid Response BMJ 2016;354:i4578. Accessed at: http://www.bmj.com/content/354/bmj.i4578/rr-0 15 September 2016
2. Weigel, A. Rapid Response. BMJ 2016;354:i4578 Accessed at: http://www.bmj.com/content/354/bmj.i4578/rr 15 September 2016.
3. Leo, J, Lacasse, J.R., and Cimino, A.N. Why Does Academic Medicine Allow Ghostwriting? A Prescription for Reform. Society 2011. Accessed at: http://diginole.lib.fsu.edu/islandora/object/fsu:252737/datastream/PDF/view on 15 September 2016.
4. Leo, J, Lacasse JR. (2012), Medical Ghostwriting: A University-Sanctioned sleight of hand. Society 2012. Accessed at http://diginole.lib.fsu.edu/islandora/object/fsu:252736/datastream/PDF/view on 15 September 2016.
5. Leo, J and Lacasse, J. Ghostwriting and Academic Medicine. Chronicle of Higher Education. July 19, 2010. Accessed at: http://www.chronicle.com/article/ghostwritingacademic/123613 15 September 2016.
6. Jureidini, J. Amsterdam, J.D., and Leemon, M. The Citalopram CIT-MD-18 pediatric depression trial: Deconstruction of medical ghostwriting, data mischaracterization, and academic malfeasance. International Journal of Risk and Safety. 2016;28 (1):33-43. Accessed at: http://content.iospress.com/articles/international-journal-of-risk-and-s... 15 September 2016.
Competing interests: No competing interests