At a time when concern about the practice has hit a fever pitch, a new study reveals that only 13 of the country's top 50 academic medical centers have policies that prohibit medical ghostwriting – when medical writers, who are often sponsored by pharmaceutical companies, secretly author journal articles under the bylines of academic researchers.
A closer look at the study results shows that among the seven Calfornia institutions examined, only Stanford University bans ghostwriting.
The study was authored by Jeffrey R. Lacasse, an assistant professor at Arizona State University's School of Social Work, and Jonathan Leo, an associate professor at Lincoln Memorial University's DeBusk College of Osteopathic Medicine in Harrogate, Tenn. The study was published yesterday in PLoS Medicine, a journal produced by the Public Library of Science.
Its findings help shed more light on a battery of recent investigative reports and academic studies showing that ghostwriting is not only alive and well in American medical schools, but is also harmful to our collective health.
The New York Times reported last August that ghostwriters paid by a pharmaceutical company played a major role in producing 26 scientific papers backing the use of hormone replacement therapy in women, suggesting that the level of hidden industry influence on medical literature was broader than previously known.
The journal articles examined by the Times emphasized the benefits of hormone therapies such as Wyeth's Prempro and Premarin to protect against aging skin, dementia and heart disease. But a major study revealed in 2002 that menopausal women who took certain hormones had an increased risk of invasive breast cancer, heart disease and stroke. Guess who paid medical writers to draft the scientific papers? Wyeth.
'It's almost like steroids and baseball,' said Dr. Joseph S. Ross, an assistant professor of geriatrics at Mount Sinai School of Medicine in New York, who has conducted research on ghostwriting. 'You don't know who was using and who wasn't; you don't know which articles are tainted and which aren't.'
In September, a study by editors of the Journal of the American Medical Association found that six of the top medical journals published a significant number of articles in 2008 that were written by ghostwriters.
The New York Times has been all over the issue, but the blogosphere sizzles with ghostwriting tales, too. William Heisel's blog, Antidote, has used documents from UC San Francisco's Drug Industry Document Archive to detail how one researcher promoted Wyeth’s products on article after article.
Dr. Daniel Archer, of Eastern Virginia Medical School's Jones Institute for Reproductive Medicine, didn't disclose, however, that DesignWrite, a medical communications company hired by Wyeth, had conceived of the articles, wrote them and then asked Archer to sign his name.
California universities that shy away from bans on ghostwriting are bound to face growing pressure to step up to the plate. Last fall, Sen. Charles E. Grassley, R-Iowa, wrote to 10 of the top medical schools to ask what they were doing about professors who put their names on ghostwritten articles in medical journals, and why that practice was any different from plagiarism by students, the New York Times reported.
'Students are disciplined for not acknowledging that a paper they turned in was written by somebody else,' Grassley wrote. 'But what happens when researchers at the same university publish medical studies without acknowledging that they were written by somebody else?'