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Full Disclosure: Rewrite Ghostwriting Rules to Focus on Origination

Full Disclosure: Rewrite Ghostwriting Rules to Focus on Origination

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In the war against ghostwriting in the medical literature, the rules can only get you so far.

Former Secretary of Defense Donald Rumsfeld famously said, "You go to war with the army you have, not the army you might want or wish to have at a later time."

He was explaining some of the early missteps in the United States' war against Iraq. Well, the army we have in the war against ghostwriting is ill-equipped and poorly deployed.

When I started this Full Disclosure series in August, I referred to a piece in PLoS Medicine about the way medical journal editors could help solve the problem.

In How Industry Uses the ICMJE Guidelines to Manipulate Authorship-And How They Should Be Revised, Alastair Matheson, a longtime pharma consultant, makes a strong case that the International Committee of Medical Journal Editors (ICMJE), in attempting to make plain the role of pharmaceutical companies in scientific research, has actually provided pharma a cloak that "boosts the credibility of industry publications and masks their commercial function."

"Alongside traditional 'guest authorship' and ghostwriting, industry may simply exaggerate the contribution of named academic authors and downplay that of commercial writers, who are excluded from authorship but listed as contributors in the small print," Matheson said.

Matheson says medical editors need to stop focusing entirely on who "wrote" the article and focus more on the thinking and framing behind the research or the review. In his view, if pharma or a medical communications company hired by pharma originates the idea for an article – examples of which are abundant in the Drug Industry Document Archive – the companies and the specific people involved should be listed as bylined authors. This is similar to what Dr. Mark Kramer, formerly of Merck Research Laboratories, proposed in Antidote last week. Matheson writes:

From industry's perspective, the most useful feature of the current ICMJE guidelines is the formula used to distinguish between authors and contributors. To qualify as an author, an individual must (1) contribute substantially to either conception and design, or acquisition of data, or analysis and interpretation of data; and (2) draft the article or revise it critically for important intellectual content; and (3) be responsible for final approval of the manuscript. This "triple-lock" formula has become a de facto license for misrepresentation. Provided academics make some contribution to design or data analysis, some revisions to a manuscript, and approve it, they are required to be named as authors. By contrast, industry may conduct most of the design, data collection and analysis, and all the writing, but if sign-off is ceded to the academic, it is disqualified from authorship. Unsurprisingly, the practice of ceding final sign-off to academic "authors" is widespread in commercially driven publications.

In Matheson's own disclosure statement, he provides a nice template for how authors should describe their various loyalties, both past and present. Right at the top of the article, it says:

For over 15 years AM has been partially dependent on the pharmaceutical and biotechnology industries for his income, providing consultancy and writing services as a freelance contractor. This experience has been both directly with corporations and, more frequently, with medical communications agencies. Currently he spends about 25% of his time on industry-related work and currently makes about 50% of his income from it. The rest of his time he spends working as an independent consultant with Fondation ARCAD, an academic organization for oncology research based in France, and in academic research, principally in cancer biology and science studies.

Have an idea for how to fix the problem of industry-sponsored ghostwriting? Send a note to or via Twitter @wheisel.

Photo credit: Kate Mereand-Sinha via Flickr

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