"Some of it is just naïveté on the physicians' part," she says. "But there's also the fact that this is so common that it's not considered unusual. There's no shame attached to it." -- Adriane Fugh-Berman

"This wasn't the first time a manuscript had been rejected because it wasn't written by the putative author. But the event helped bring to light the role that ghostwriters, and the medical-education companies (MECs) that employ them, have played -- and continue to play -- in shaping the medical-science literature. The event initiated a dialogue on the topic in the community of peer-reviewed journal editors and led to guidelines on dealing with ghostwritten articles that are now embraced by many -- though not all -- scientific journals." ...

"Ghost authorship occurs when an unacknowledged author writes, or makes substantial contributions to, an article published in the peer-reviewed science literature. Typically, the author is a professional writer with scientific expertise, hired by medical-education and communications companies. These articles are destined to appear under the names of scientists who contribute little to their writing. They are backed by for-profit companies -- often pharmaceutical companies -- which, like most scientific authors but for different reasons, hope to influence scientific opinion. Such activities skew the medical literature by injecting a marketing spin that benefits the sponsor, Fugh-Berman says."

"People tend to think of marketing messages as 'buy drug A,' but that's never the message imbedded in such articles," Fugh-Berman says. "The message may be, disease A is underdiagnosed or far more serious than previously believed, and currently used drugs for this disease are highly problematic." Most academics know that it's unethical to sign their names to work they didn't do, but it's just as important not to hide contributions from others, says Fugh-Berman, who currently writes about how drug companies inject marketing messages into the medical literature on her Web site, Pharmed Out."

"The cynical injection of marketing messages into the scientific literature sounds outrageous, but abuses common in academic publishing set the stage. When a lab chief insists on being an author for every article emerging from his lab, or when a prominent scientist is invited to be an "honorary author" on a paper to boost prestige, lines that should be bright become fuzzy, Fugh-Berman says. "It's such a mixed message because we throw students out of school for plagiarizing. And then we, as scientists, plagiarize their work, and then that's supposed to be acceptable."

"Some academic medical centers, such as the one at Yale University, are cracking down on ghostwriting by barring faculty members from being listed as authors unless they make a substantive contribution. And top-tier medical journals, such as The Journal of the American Medical Association, PLoS Medicine, the British Medical Journal, and the Journal of General Internal Medicine, have developed stringent authorship guidelines to ascertain the contributions of each author and obtain full disclosure of authors' funding sources and financial ties."

"Fugh-Berman highlights the conflict-of-interest requirements of the journal American Family Physician. Instead of just asking if there is a conflict of interest, the new guidelines include a checklist of questions with scenarios spelled out. Faced with such specific language, authors would have to "actively lie" to cover up the involvement of an unacknowledged author, Fugh-Berman says. "You can lie, but you can't say that you didn't understand the question. And I think that that's important. ... You don't want people deciding for themselves what are relevant conflicts of interest because nobody thinks their conflicts of interest are relevant."

"But not all medical journals have taken such measures, and many still publish ghostwritten works, Gerrity says. Last year, it came to light that Merck had paid the publishing company Elsevier to produce a journal, Australasian Journal of Bone & Joint Medicine, which looked like a peer-reviewed medical journal but was filled with articles and reviews from MECs, including articles favorable to Merck products for osteoporosis."... Excerpts from the article

Karen Weaver, MLS, Electronic Resources Statistician, Duquesne University, Gumberg Library, Pittsburgh PA email: [log in to unmask] / Gmail: [log in to unmask]