Medical ghostwriting is a well-documented phenomena, revealed repeatedly in scientific articles, reviews, abstracts, posters, CME units, and even entire journals.
You can now append clinical textbooks to this list.
The textbook, “Recognition and Treatment of Psychiatric Disorders: A Psychopharmacology Handbook for Primary Care,” by Charles Nemeroff and Alan Schatzberg (American Psychiatric Publishing, 1999), was in fact, ghostwritten, according to a public letter issued last week by the Project on Government Oversight (POGO), a non-profit organization dedicated to investigative journalism.
The real author of the textbook was Sally Laden, working for Scientific Therapeutics Information (STI), a medical communications company, who was contracted by GlaxoSmithKline (then SmithKline Beecham) for the work. In the preface of the book, STI is only credited only for “editorial assistance.”
For use of their names, Nemeroff and Schatzberg received about $18,000 in royalties on the book, which was largely purchased by SmithKline Beecham and given away to family doctors. Commenting for the New York Times, David Kessler, former commissioner of the Food and Drug Administration, was astonished:
To ghostwrite an entire textbook is a new level of chutzpah. . . . I’ve never heard of that before. It takes your breath away.
While the most common target of blame for ghostwriting has been the pharmaceutical industry, POGO has directed its ire on those who have been funding academics like Nemeroff and Schatzberg with public monies. In their letter, addressed directly to Francis Collins, Director of the NIH, POGO claims that both researchers have collected more than $23 million in NIH funds since 2006, with another $2 million awarded just this year.
Likewise, others have pointed their finger at academia.
According to a 2005 study published in NEJM, a full 50% of medical school administrators responsible for negotiating clinical trial arrangements with industry reported that they would allow the sponsor to draft the manuscript. A further 11% were unsure.
And in a study published this year in PLoS Medicine, only 20% of academic medical centers in the United States have policies explicitly prohibiting ghostwriting. The authors, Jeffrey Lacasse and Jonathan Leo, argue that the lack of explicit authorship guidelines permits academics to engage in complicit and mutually beneficial relationships with industry sponsors, relationships that may be ultimately harmful to public health.
Academic medical centers enable the pharmaceutical industry to covertly shape the medical literature in favor of commercial interests.
It is time for more disclosure of external interests in academic writing, and some of this responsibility clearly rests with academics and the institutions that house and support them.
Physician, it’s time to heal thyself.
Correction: December 9, 2010
On December 8, 2010, The New York Times posted a correction on the story. Below is the fulltext:
A headline on Nov. 30 with an article about SmithKline Beecham’s role in the publication of a book about treating psychiatric disorders overstated SmithKline’s actions. While documents show that SmithKline (now known as GlaxoSmithKline) hired a writing company for the book, they do not indicate that the company wrote the book for the authors, Dr. Charles B. Nemeroff and Dr. Alan F. Schatzberg. The article also described incorrectly, in some editions, events outlined in a letter from the writing company to Dr. Nemeroff. The correspondence proposed a timeline for the writing company to furnish the doctors and SmithKline with draft text and final page proofs for approval; the letter did not say that the company had already provided those materials for final approval. And the article misstated the context under which Dr. David A. Kessler, the former commissioner of the Food and Drug Administration, commented about the book’s production. The letter and other documents were described to him; he did not personally review the documents.
- Drug Company Used Ghostwriters to Write Work Bylined by Academics, Documents Show (propublica.org)
- Interview with a Ghost (Writer) (schoarlykitchen)
- Ghosts in the Machine — The Industry of Medical Authorship (scholarlykitchen)