How are hockey-playing goons the same as “puzzled” medical journal editors?

hockey calgary fightI’ve often said to my hockey-mad son Ben that we could end on-ice fighting in hockey (not, incidentally, our national sport, but arguably our Canadian obsession) if only the National Hockey League would put me in charge for just one week. But the folks who do run the NHL clearly have no appetite for banning hockey fighting, or they would have acted to end it by now.

Despite their feeble protests about the unacceptability of fighting and the known dangers of career-ending concussions, team owners tolerate cheap shots by beefy goons who spear, hit, and drop their gloves to fight. The League accepts it, the owners accept it, the players accept it, and the fans apparently love it.

There is, alas, no organizational will to ban violence on the ice.

And much like hockey goons, medical journal editors could end the appallingly unethical and dangerous practice of medical ghostwriting in one week, but these editors clearly have no appetite for banning ghostwriting in their journals, or they would have acted to end it by now.

There is, alas, no organizational will to ban medical ghostwriting. Continue reading

All bark, no bite: new Big Pharma trials/ghostwriting guidelines

pills purple mixLet’s not pop the champagne corks just yet to celebrate the recent announcement of new guidelines for Big Pharma from the trade group Pharmaceutical Research & Manufacturers of America (PhRMA).  The wordy guidelines are called Principles on Conduct of Clinical Trials and Communication of Clinical Trial Results. They went into effect last week, and are a response to mounting scandals and scrutiny about how clinical research trials are conducted and reported. These new principles also cover issues like authorship contributions and medical ghostwriting; disclosure of financial conflicts of interest; public registration of clinical trials; and publicly accessible summaries of all clinical trial results.

These last two are apparently a stab at addressing the current reality that negative clinical trial results either never see the light of day or are only selectively reported to favour the drugs being tested. The principles have been hailed by some as a step in the right direction, although many point out that they may have more bark than bite in addressing, for example, the chronic problem of medical ghostwriting. Continue reading

Merck paying off 3,100 families for heart attack/stroke deaths linked to Vioxx painkilling drug

vioxx blueDrug giant Merck & Co. is paying the families of more than 3,100 Vioxx painkiller users who died of heart attacks and strokes that were blamed on the drug. Merck introduced Vioxx in 1999 but withdrew it from the market in 2004 when a study showed the drug doubled the risk of heart attacks and strokes. By 2007, Merck had set up a fund of $4.85 billion (yes, that’s billion with a ‘B’)  to cover claims of death and lesser injuries, after reserving $1.9 billion to fight over 26,600 Vioxx lawsuits in court. Houston attorney Mark Lanier observed at the time:

“We don’t know any drug right now with this number of deaths associated with it. This is a very sad chapter in the tragedy of pharmaceutical companies gone wild.” 

And – quelle surprise! – Vioxx turns out to be one of countless prescription drugs that have been fraudulently promoted in industry-funded ghostwritten articles in medical journals.    Continue reading

Medical ghostwriting and ‘Guest Authorship’: twins separated at birth?

vancouver purpleParticipants at this month’s International Congress on Peer Review and Biomedical Publication in Vancouver heard an interesting medical journal survey report on ghostwriting vs. ‘guest authorship’ that has me scratching my head in confusion. Presented by the Journal of the American Medical Association, the report confirmed that the prevalence of both ‘honorary’ and ‘ghost authors’ in medical journal articles is “still a concern”. 

Here’s a dose of reality for JAMA editors: it’s not just a “concern”.  It’s global fraud being perpetrated upon the innocent patients of the world thanks in part to the lax (some more cynical than I might say ‘non-existent’) controls in place in many medical journal editors’ offices. For example:

  • only four of the journals surveyed ask and then publish information on who the actual article authors are (Annals of Internal Medicine, JAMA, Lancet,and PLoS Medicine)
  • New England Journal of Medicine claims that the journal “asks about author contributions but doesn’t publish them.” (Earth to NEJM: this is the same as not asking).
  • Nature Medicine has “no instructions to authors about disclosing author contributions.”

This sounds like a de facto stamp of approval for the common practice of ghostwriting and ‘guest writing’. But by now, you may be asking the question: “Carolyn, what is the difference between ‘guest writing’ and ‘ghostwriting’ in research published in medical journals”?  The answer, my fellow Nags, is:  not much.  But here’s JAMA’s official definition:  Continue reading

50-100% of medical journal articles paid for by Big Pharma?

Just when we thought things couldn’t get any more slimy in the wonderful world of Big Pharma-funded medical journal articles, along comes last week’s editorial in the Canadian Medical Association Journal.  Their September 9th editorial claims that somewhere between 50% and 100% of articles on drugs that appear in journals are ghostwritten, according to Dr. David Healy, a psychiatrist at the University of Cardiff in Wales and a critic of the drug industry’s influence on physicians’ drug prescribing habits. Dr. Healy further claims:

“Ghostwriting ‘crept up on’ the medical profession and became so common by the mid-90s that even senior researchers came to accept it as an ethical practice. Other critics of the practice agree, claiming that many researchers will put their name on a document as primary author even if they just edited it — or only read it and made no changes.

“If you have people like me who say they won’t do this, the pharmaceutical industry can easily go elsewhere and find a person who will.” Continue reading

Medical journal resorts to sleuthing to sniff out ghostwriters


magn glass3Here’s one possible solution to the fraudulent practice of medical ghostwriting that seems so easy, I’m wondering why all medical journal editors are not already doing it, given the current bad press garnered by the Wyeth Pharmaceuticals medical ghostwriting scandal, among many others. Editor-in-chief of the Journal of Managed Care Pharmacy Dr. Frederic Curtiss has told Reuters Health that data attached to documents created in Microsoft Word have allowed him to discover which articles submitted to his journal may have been written by ghostwriters hired by drug companies. 

When documents are saved in Word, the software attaches additional information, called metadata, which identifies who created the document. Subsequent edits or changes made by anybody else (like the medical school academics and researchers who fraudulently claim that they are the real authors) can also be identified. Curtiss estimates that every third manuscript he receives has metadata that does not match the article’s listed authors.  Continue reading