The open access journal PLoS Medicine has been at the forefront of a closely related issue: full disclosure. In 2009, it was on the winning side of a suit that helped reveal the extent of ghostwriting in the biomedical literature. The practice, in which pharmaceutical companies pay for the production of a medical research article without the activity being disclosed, can distort the scientific record. Now, the journal has published a new study that indicates few of the top medical schools have any policy in place to govern ghostwriting among their faculty.
Most medical journals recognize that industry-sponsored studies can suffer from conflicts of interest, and may selectively promote positive results or underplay the significance of negative ones. As a result, they generally demand that all authors of a paper disclose potential conflicts. This specific form of ghostwriting undercuts that process: since the writers aren't credited, their conflicts never get listed. The new article cites specific instances where misleading results were ghostwritten in a way that minimized the issues with Vioxx and Paxil.
So, how are medical institutions responding to this problem? For the most part, they're not. The authors searched for policies regarding authorship and ghostwriting at the top 50 medical research centers and, in over half the cases, failed to find any, even after consulting research librarians at those institutions. Only 10 specifically prohibit ghostwriting, while another three have stringent authorship policies that effectively block its use.
The authors make an impassioned argument that this must change, as they view ghostwriting as a public health threat, and one that violates academic norms. They call on deans of academic medical centers to explicitly ban the practice by the end of this academic year, and call on the National Institutes of Health to refuse to fund any research at institutions that refuse. It would be a radical measure, but the institutions are apparently not responding to repeated discoveries of unethical behavior, suggesting something radical might be needed.
PLoS Medicine, 2010. DOI: 10.1371/journal.pmed.1000230