Ghostwriting at Elite Academic Medical Centers in US

Jeffrey R.Lacasse, Jonathan Leo

PLOS Medicine; e1000230

Background:

Medical ghostwriting, the practice of pharmaceutical companies secretly authoring journal articles published under the byline of academic researchers, is a troubling phenomenon because it is dangerous to public health. For example, ghostwritten articles on rofecoxib probably contributed to “..lasting injury and even deaths as a result of prescribers and patients being misinformed about risks”. Study 329, a randomized controlled trial of paroxetine in adolescents was ghostwritten to claim that paroxetine is “generally well tolerated and effective for major depression in adolescents”, although data made available through legal proceedings show that “Study 329 was negative for efficacy on all 8 protocol specified outcomes and positive for harm”. Even beyond frank misrepresentation of data, commercially driven ghostwritten articles shape the medical literature in subtler but important ways, affecting how health conditions and treatments are perceived by clinicians. The ability of industry to exercise clandestine influence over the peer- reviewed medical literatures is thus a serious threat to public health.

In 2009, the institute of Medicine recommended that US-based academic medical centers enact policies that prohibit ghostwriting by their faculties. However, to date, there has been no systematic assessment of ghostwriting policies at academic medical centers. Since US based academic medical centers generate biomedical  research for a worldwide audience, we chose to conduct the first such investigation on elite US based academic medical centers generate biomedical research for a worldwide audience, we chose to conduct the first such investigation on elite US based academic medical centers.

Finding of Our Survey:

Of the 50 academic medical centers that we examined, ten(20%) explicitly prohibit ghostwriting. Of these ten, seven (14%) include some definition of ghostwriting in their policy, while three (6%) prohibit ghostwriting without defining the term. Many schools have an authorship policy that does not clearly ban all aspects of ghostwriting; the most common reason is a failure to require that all qualified authors be listed. Three academic medical  centers have stringent authorship policies that prohibit it in practice (by requiring both a substantive  contribution to qualify for authorship and that all who qualify for authorship  and that all who qualify for authorship be listed) but do not mention ghostwriting by name.