Are ghost authors vanishing from medical journals? A new study published last week in the BMJ suggests that ghost authorship may be in decline.
Ghost authorship is the lack of acknowledgement for individuals who may have contributed substantially to the production of an article, such as a paid medical writer or statistician. Honorary authorship, in comparison, is granting authorship status to individuals who may have had little (if any) involvement in a study, such as a dean or department head. Both ghost and honorary authors create problems for establishing credit and accountability in research.
The authors of the study, Joseph Wislar, a survey researcher at the American Medical Association, along with three editors from JAMA (Annette Flanagin, Phil Fontanarosa, and Catherine DeAngelis), updated an earlier study of inappropriate authorship from 1996. Surveying corresponding authors of papers published in 2008 in the top six medical journals, as measured by their impact factors (Annals of Internal Medicine, JAMA, Lancet, PLoS Medicine, NEJM, and Nature Medicine), the researchers report on the frequency of ghost and honorary authorship by journal and article type.
In 2008, self-reports of ghost authorship was 7.9%, down from 11.5% in 1996. In comparison, rates of honorary authorship remained statistically similar over time (17.6% in 2008 versus 19.3% in 1996). Prevalence of honorary authorship in research articles was higher in 2008 than in 1996, but lower for review articles and editorials.
Surprisingly, journals that require authors to detail their contributions showed no difference from journals without such author requirements.
While this study was beautifully and rigorously executed — with a response rate of over 70% — the researchers acknowledge that respondents may not be forthright with reporting inappropriate authorship practices, especially considering the social stigma against ghost authorship. Indeed, a study of members of the American Medical Writers Association and European Medical Writers Association put the incidence of ghostwriting at 42% for 2008, down from 62% in 2005. If the incidence of ghost writing is truly declining, it still has a long way to go.
Commenting on the study in an editorial, Patricia Baskin and Robert Gross, editors of the journal Neurology, question the very definition of scientific authorship and wonder whether the definition of authorship established by the International Committee of Medical Journal Editors (ICMJE) contributes to the problem of inappropriate authorship. They write:
The ICMJE criteria leave “substantial contributions” incompletely defined and, moreover, require three conditions to be met. However, in practice as the numbers of contributing specialists increase author groups tend to ignore the ICMJE criteria, adding “honorary authors” when contributors do not fulfil all three criteria. Thus the author byline may not have accurate information about individual contributions to a study or may not reflect important contributions from people who were not named.
Baskin and Gross’ solution for the journal Neurology was to make authorship as inclusive as possible and require that any medical writer who wrote the first draft of the article or responded to reviewer comments to be listed as an author with full disclosure.
It is unknown whether alternate policies will change the prevalence of inappropriate authorship. With hope, they will make it more difficult for ghost authors to hide.