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The Ghost in the Management

A Canadian academic was puzzled:

I  recently looked at the c.v. of a distinguished professor of medicine and saw that he had authored (most usually had co-authored) about 800 articles in peer-reviewed journals, an average of nearly 30 per year over his career. His publication rate has accelerated over the years, reaching 40 articles per year in the past decade. How can a scientist author and publish 40 articles in a year? Year after year? In my fields (Science and Technology Studies, Philosophy, Sociology), five peer-reviewed articles in a year is a lot, and most researchers would be happy to write one truly good article each year.

Rather than conclude the obvious — these guys are fucking geniuses — and go back to his low-paid slow-lane job, Sergio Sismondo decided to investigate.

Turns out they’re not writing the articles!

…[D]rug companies and their agents produce a significant percentage of the manuscripts on major current drugs. These manuscripts are then “authored” by academic researchers, whose contribution ranges from having supplied some of the patients for a clinical trial, to editing the manuscript, to simply signing off on the final draft. The companies then submit these manuscripts to medical journals, where they fare quite well and are published. The published articles contribute to accepted scientific opinions, but the circumstances of their production remain largely invisible. When the articles are useful, the marketing departments of the drug companies involved will buy thousands of reprints, which sales representatives (reps) can give to physicians. I call this whole process the “ghost management” of pharmaceutical research and publication.

[Ghost authors] are unlikely to make major contributions to the analysis or writing of an article. They are shown well-crafted manuscripts that have been reviewed by many scientists, writers, and marketers. They are not given access to the data. They are asked their views on very specific points. They are given short deadlines. Thus, authors of industry manuscripts are largely sidelined from the process of analyzing, writing, and publishing research.

About half of what you read about the drug you’re thinking of taking was written by a public relations firm.

[I]t appears that roughly 40 per cent of medical journal articles on major in-patent drugs are parts of individual publication plans on the drugs… [P]harmaceutical companies have complete control over roughly half of all clinical trial data…

A philosopher, Sismundo grapples with the ethics of simulacral science:

The pharmaceutical industry … has developed a [new] form of plagiarism, involving only willing participants. Moreover, it has created new reasons for concern: the hiding of interests that drive research and publication and the possible harm to patients that this may create. When sales reps bring reprints of articles to the offices of physicians, prescribing nurses, hospital staff in charge of formularies, and other drug gatekeepers, those articles may look like independent confirmation of the reps’ pitches. Plagiarizing [ghost authors] lend their good names to the pitches.

On the up side, there’s the rich abundance of scientific output with which, as modern consumers, we are blessed:

Another much-discussed issue in the ethics of publishing is over-publication. We are buried in masses of literature, making it difficult to find what is valuable. Publication hides as much as it reveals. Every year, library budgets increase at well above the overall rate of inflation. This is caused in part by publishers increasing the prices of journals, and in part by the increasing number of journals. The ghost management of pharmaceutical research and publication plays a role within the medical sciences, as industry planners calculate how many new articles bearing key messages they need to affect perceptions and sway those who prescribe drugs.

Margaret Soltan, June 15, 2009 7:23AM
Posted in: conflict of interest

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5 Responses to “The Ghost in the Management”

  1. Bill Gleason Says:

    Ghost papers are not just the product of the pharmaceutical industry.

    Some senior so-called authors have contributed little or nothing to papers bearing their names, not even having read them.

    Junior people write the paper and send it in but add the senior author’s name in tribute – rendering to Caesar and so on. This practice is rationalized by the senior author because (s)he obtained the money (via grants or ?) that made the research possible. Often the only contribution is to sign a copyright release form. As we’ve seen, sometimes not even this happens.

    Unfortunately this practice seems most wide-spread in medical research fields.

  2. Adam Says:

    This exposé by Sismondo tells us what it has come down to nowadays. Since when do leading academics rely on nonprofessionals to draft scientific reports or major review articles? What kind of example is that for junior investigators and trainees?

    I call it the Executive Author syndrome: set up the corporate relationship as consultant or grant recipient or key opinion leader; schmooze with the marketing managers; sign on for a proposed article; get other people to do the heavy lifting; place the article in a captive journal edited by oneself or a reliable crony; coordinate a slick public relations campaign with the corporation; forget (ahem) to disclose conflicts of interest; wave through a final text marked by slipshod tradecraft; then shill for the corporation in its press releases that do not disclose the author’s consultant relationship.

    No prizes for guessing who is the current Executive Author maestro.

  3. University Diaries » “Universities cracking down on student plagiarism need to pay closer attention to faculty.” Says:

    […] You do begin to wonder… I mean, what are universities afraid of? The medical faculty will poison their sherry? You’ve got all these really highly paid professors, quite a number of whom do a raft of illegal, unethical, embarrassing things… The whole conflict of interest, ghost-writing, Continuing Medical Vacation shebang… […]

  4. University Diaries » Ghosts Everywhere. Says:

    […] thanks Corey, a reader, for sending her this important article from a writer we’ve already seen at University Diaries — Sergio Sismondo. With Mathieu Doucet, Sismondo broadens his attack on the repellent and […]

  5. Professors Of Academic Medicine Are Different From You And Me*: Blowing The Lid Off Publishing In The Sciences - Tenured Radical - The Chronicle of Higher Education Says:

    […] about the publishing pace of a colleague in the humanities or social sciences, tell them to read this post from Margaret Soltan, our university ethicist on call over at University Diaries. Then tell them to […]

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