Monday, November 26, 2007

Ghostwriting: Some Updates

Ghostwriting, as I discuss in HOOKED, is one of the hardest practices at the medicine-Pharma interface to get a grip on. All parties to the transaction--the academic physician whose name appears as the author of the article; the medical writer who actually wrote the article; and the drug company that funded everything--either are paying good money, or are paid good money, not to talk about any of it. Yet if anything at all in the medicine-Pharma relationship ought to be an ethical no-brainer, this is it. It can never be right for people to lie, in print, in the pages of medical journals, about who did or did not write something. And for the academic physician, accepting money to put your name on an article you did not write, and henceforward listing that article in your curriculum vitae as if you had written it, has to be the slimiest of unprofessional behaviors.

For all these reasons, even brief anecdotes about ghostwriting are worth taking note of. Here are a couple (one thanks to Roy Poses' excellent Health Care Renewal blog-- see Links).

Most recently, Jean E. Sealey, professor emerita of physiology and biophysics at Weill Cornell Medical College, went public with an approach she had received to "write" a review on the new anti-hypertensive drug nebivolol (Forest Laboratories):

http://blogs.wsj.com/health/2007/11/21/odd-ghostwriting-offer-raises-researchers-blood-pressure/

One of the commentators astutely asked why the Wall Street Journal placed this news item on its blog instead of doing an in-depth story in its print edition.

Going back a little ways, Danny Carlat, in his own excellent blog on psychiatry issues (http://carlatpsychiatry.blogspot.com/), reported on a paper for which one of the listed co-authors is Dr. C. Lindsay DeVane, Professor of Psychiatry and Vice Chair for research at the Medical University of South Carolina. The paper is a summary of a discussion that occurred as part of an "Expert Roundtable," and was published in the May 2007 issue of CNS Spectrums, where it was listed as eligible for CME credit:

http://carlatpsychiatry.blogspot.com/2007/09/author-calls-his-own-cns-spectrums.html

Dr. DeVane told Dr. Carlat that this paper is a "piece of commercial crap" and that the views expressed there are not his. He had not read the final version before it was published. The article was written after the discussion by a medical writer hired by i3 CME and funded by Bristol-Myers-Squibb. Dr. DeVane told Dr. Carlat that he found the draft text, which he was shown, "inaccurate, simplistic." He did not say whether he requested or demanded the right to edit "his" article. Neither Dr. DeVane nor Dr. Carlat addressed the question of 1) why Dr. DeVane allowed his name to appear on this article if it is untrue with regard to his views on the subject; and 2) whether any money changed hands at any point in the process. (One would assume that Dr. DeVane was paid expenses plus an honorarium to speak at the symposium, at the very least).

Just by way of further illustration of how hard it is to get a handle on the ghostwriting issue, I recently told a colleague of mine, who spends a lot more time than I do hanging out with journal editors, that the highest amount that I had ever been able to find in print, for the sum paid to the academic "author" of a ghostwritten paper for the privilege of using his name, was $1000. My colleague merely snorted.

2 comments:

MarilynMann said...

Actually, the Wall Street Journal published a front page article on ghostwriting in 2005.
http://online.wsj.com/article/SB113443606745420770.html
"Ghost story: At Medical Journals, Writers Paid by Industry Play Big Role"

Anonymous said...

The practice of ghostwriting may be acceptable if one is implementing this method for writing in the media, perhaps. But with clinical studies, there is a much higher level of importance that authorship of these studies is completely authentic and not constructed for commercial purposes, as the study, once published, can affect the well being if not the improved health of others. Ghostwriting in medical journals overtly states deception and dishonesty, which reflects poorly on the entire medical establishment.