Medical Journal Article Ghost Writing
Implications of Pharmaceutical Company Involvement
Sep 28, 2009
The most basic definition of ghost writing is the payment of a professional writer to write something that is credited to someone else. For this reason, ghost writing generally is seen as having dubious ethics – one person taking credit for the work of another person. But can it have wider implications? The press would like us to believe that it does when applied in the context of medical research.
Several reports have highlighted a number of articles recently published that have since been discovered to be written by employees or representatives of pharmaceutical companies. These articles were written by third parties, and attributed to well-known names in the field in return for payment from the company developing the drug being tested.
But does it matter who writes the article? And does it affect how the study is perceived?
Who Can Author a Piece of Medical Research?
To be an attributed named author on a scientific or medical research article, the individual must have made a significant contribution to the actual content of the paper, including generation of the data included. The reason for this is that authors are responsible for the accuracy of the data presented and for the interpretation of the data.
Moreover, the reputation of the researcher (author) is at stake when a paper is published under their name. Because of these reasons, the ghost writer, or medical writer, is not left to write a paper by themselves – they must work closely with the named authors to ensure that data are interpreted correctly, and the messages of the article are presented as intended.
Usually, the writer will review the data, and sketch an outline of what should be included, and which results should be emphasised. Then the main named author of the paper will review and approve it, or make amends as necessary. The writer will then work up a full draft, ready for another round of approval by the named author. This process continues until the copy accurately represents what the named author wants to say.
Why Use a Medical Writer?
Using a medical writer has a number of advantages:
- Correct use of language and grammar. Most research is published in English, but many researchers do not have English as their first language. Use of a ghost writer ensures that copy is written in fluent English.
- Use of time. Clinicians involved in medical research or clinical trials are very busy people, and left to their own devices, much of their research would just not get published. Use of a ghost writer relieves time pressure, while continued review ensures they maintain control of the content.
- Compliance with the Association of the British Pharmaceutical Industry's (ABPI) Code of Practice. Clinicians may not fully understand the nuances or implications of the Code, while medical writers are usually fully trained in these requirements.
Pharmaceutical Company Involvement
Concerns have been raised about the involvement of pharmaceutical companies in the authorship of scientific articles, with popular opinion assuming that they introduce bias and misinterpretation of results to favour their product. However, rules are in place to ensure this is almost impossible to achieve.
The ABPI Code of Practice aims to ensure that all written materials are unbiased, fair and do not mislead. Nothing can be published that cannot be substanstiated with scientific evidence. Furthermore, companies are obligated to publish the results of clinical trials according to the endpoints that were set out when the trial was commenced. This means that the emphasis of results cannot be changed in order to make them look more favourable.
However, it is true is that clinicians involved in a clinical trial of a product are likely to be generally in favour of that product, and may have positive opinions about that drug based on their experiences with it. They may believe that it is in the interest of the medical community as a whole that the trial results are published. This means that these clinicians are generally happy to publish positive data about their drug. Moreover, many physicians work in the same way with multiple pharmaceutical companies, often on competing drugs, so the question of commercially favourable bias towards one drug is often irrelevant.
The reporting of data from medical research is necessary, but expensive, and therefore only likely to be funded by organisation who have a commercial interest in the product. While physicians taking part in clinical trials, who put their names to the published results, are often in favour of the drug in the interest of the advancement of medical science, the use of a medical writer can help to ensure that any physician bias is removed, that the rules of the ABPI Code of Conduct are abided by, and that papers are written well and in a timely fashion.
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