Medical ghostwriting paid for by pharmaceutical company & endorsed by medical doctors
Larry Brownstein
Thursday, 06 August 2009 12:09 UTC
A recent report in the New York Times contends that court documents show that a pharmaceutical company hired ghostwriters to provide research reports about certain medical therapies. Elsevier has said it will investigate the issue since some of the articles, primarily review articles, appeared in their journals. Some doctors have allowed their names to be affixed to papers written by ghostwriting firms, the justification being that they lent their expertise. The case in question is without doubt only the tip of this particular iceberg, and this iceberg hopefully small.
While some ghostwriters may well be trained in the science they are ghosting, this is a corrupt, and corrupting, practice.
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I’m always surprised when such stories emerge about pharmaceutical companies using ghostwriters to write-up clinical studies on behalf of the clinicians that conducted the trials. However, I’m not surprised about the ghostwriting. I’m surprised that people don’t realise that this is a multi-million pound/dollar industry. Medical communications companies get contractually employed to provide such services. Elsevier isn’t alone if it has published articles that have been ghostwritten. One argument that companies make for providing ghostwriter help is that clinicians often don’t have enough time to ensure timely dissemination of the results. The clinical statisticians will do the official calculations for the results section, but they may have ‘help’ with the introduction and discussion sections. A good agency will ensure that the integrity of the clinicians are not compromised by the ghostwriting – and the clinicians have the opportunity to edit the final draft that would be submitted to the journal. However, in the past, this has been open to interpretation. When I worked in the medical communications field (overlapping the time mentioned in the NYTimes article), rules were emerging that meant that a company could help sketch out the outline of an article but then had to be completely ‘hands-off’ with the writing process taking place between the ghost writer and the clinicians alone. The peer review process then should, in theory, ensure that no-one is making any medical claims that cannot be corroborrated. However – full clinical trials are often not reported in medical journals, due to limitations on article length, which means that some not so positive results (which were not primary endpoints of the trial) may not be discussed (but not actively hidden). It could be that the NYT article highlights a time when this system could be more abused but, on the whole, journals now have very strict rules that only those that participated in the clinical studies can appear as authors. The rules about who wrote the articles are not so clear. I have personally worked with clinicians who are grateful for the support and feel, in no way, that their clinical integrity has been compromised by this process.
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I have seen this practised in that informal ghost writers were hired and when errors emerged such as the paper was submitted to and accepted by multiple journals simultaneously no one challenged this until it came up in IRBS. It is likely widespread. The danger is that the writers may be excellent and convincing but not appropriately trained for the research at hand. The IRB was told this was none of their concern as they were there to monitor patient safety.
I personally feel that this was an ethical concern and ultimately does effect patient safety…When the people involved were confronted they all blamed it on other members of their team. The other area is multiple names are added to the paper but some authors said their name was used without permission so this is all not just big pharma so to speak….If the article was well written how would Elsevier or the pharma company for that matter even know…other than they have signed agreements from pharma and researchers to discourage this behavior.
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It is hard to see why “this is a corrupt, and corrupting, practice”.
Is it better to have medics and researchers writing incomprehensible and turgid prose that only three colleagues would understand, or to bring in a communications expert to help in this work?
A “ghost writer” does not exist to create their own messages, but to convey those of the solid bodies whose names appear on the articles.
If the written words that emerge from the ghostly pen are full of lies, then how come the researchers put their names to it?
Of course, there would be no need for ghosts if the journals themselves put in the copy editing needed to turn impenetrable jargon into readable papers. But that isn’t going to happen.
I suspect that the reason why this upsets people is that pharmaceuticals companies hire the ghosts. Would they feel quite so hot under the collar were university researchers to indulge in the same practice?
The original message is full of humbug, with no evidence to support its wild assertions. Not the sort of thing that would survive peer review.
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Yes, I agree with Martin. If the researchers are willing to have their names attached to a piece I would think that means they endorse what it says, and that it conveys the results of their research. Presumably ghost writing makes research work accessible to a wider audience. If this is conveyed accurately then that is all to the good.
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Sorry, I meant Michael (rather than Martin)!
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I don’t buy it. As a victim of the pharmaceutical business, I am shocked by the ignorance I’ve experienced with the psychiatric medical profession. There is no accountabilty in this profession and the psychiatric drug business. Having ghostwriters only deepens the tangled web of lies, ignorance, and harm. We have become a medical business of fragmented individuals. Each having a particular role in this haunting charade called psychiatric “medicine”. The closest it comes to is psychiatric technology. They have taken wholeness out of medicine and created a human technology field. This practice of having ghostwriters is another aspect of this smoke and mirrors horror show called medicine!!
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I agree with Michael in that to have readable papers and decent copy writers is a huge bonus…and that the responsibility is ultimately up to the people that put their names on the paper. And yes being the one with the ghost writer on hand is likely to lead to a more open mind
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The notion that “This practice of having ghostwriters is another aspect of this smoke and mirrors horror show called medicine!!” is one of many non sequiturs in this confused rant.
How on earth can a clarifying hand make it easier for the “psychiatric medical profession” to mistreat patients?
You may have a beef with how medics treat mental conditions, but to suggest that ghost writers worsen things stretches logic beyond its limits.
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Micheal, as a writer I imagine you can appreciate that writing is a psycho-intellectual experience. My logic behind my rant is that when a researcher dispenses his information to the public through a ghostwriter he or she is not learning what that information will mean to the public by not taking part in the psycho-intellectual writing process. I believe that information he or she would learn by writing the article is critical in creating an organic human healthcare system. To me this is quite simply about taking full responsibility for one’s actions!
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I wonder whether any science communication people are interested in commenting in the BMJ
There have been comments on my blog, and a lot of comments on PZ Myers’ Pharyngula blog, but none on the original review in the BMJ. Are we seeing the slow death of print journals?
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