Big Pharma shaping medical literature behind the scenes ? Med. Journal articl
Date: Wednesday, September 26 2007
"Ghost Management: How Much of the Medical Literature Is Shaped Behind the Scenes by the Pharmaceutical Industry? " by Sergio
EXCERPTS from a lengthy medical journal article
"There are many reports of medical journal articles being researched and written by or on behalf of pharmaceutical companies, and then published under the name of academics who had played little role earlier in the research and writing process [2-14]. In extreme cases, drug companies pay for trials by contract research organizations (CROs), analyze the data in-house, have professionals write manuscripts, ask academics to serve as authors of those manuscripts, and pay communication companies to shepherd them through publication in the best journals. The resulting articles affect the conclusions
found in the medical literature, and are used in promoting drugs to
"Articles in medical journals have real effects upon physician prescribing behavior, which is why pharmaceutical companies invest so much in their publication. Journal articles are heavily used in detailing, to validate claims and rebut worries. Even independent of
detailers, responsible physicians and medical researchers search the literature to gather evidence about the best treatments. Published scientific articles are the sources of medical information with the highest authority. Systematic reviews and meta-analyses almost all start with the published literature-so even fully independent reviews are influenced by ghostly activities. Therefore, the ghost management of journal articles is a step in the intervention into medical
"There are no straightforward solutions, short of large changes to the nature of medical publishing and/or research, changes that would effectively sequester pharmaceutical company funding from research and publishing  or from marketing . Until such changes come
about, at least we can hope for more awareness of and responsiveness
to the issue......
"Universities and academic health centers should prohibit contracts that allow sponsors to draft, edit, or suppress articles, or that allow sponsors to keep data from authors; they should even prohibit sponsors from facilitating publication. Universities should also take
disciplinary action against investigators who serve as authors on ghost-managed articles. Meanwhile, investigators need to be aware of the mechanisms of ghost management of work that goes under their
names, and to refuse to participate. Perhaps they need to be more modest about how many articles they can publish, and more realistic about the amount of effort, legwork, and/or creativity it takes to
publish an article....
Ghost Management: How Much of the Medical Literature Is Shaped Behind the Scenes by the Pharmaceutical Industry?
Funding: Research for this article was supported in part by a grant from the Social Sciences and Humanities Research Council of Canada. The funder played no role in the decision to submit the article or in its preparation.
Competing Interests: The author has d eclared that no competing interests exist.
Citation: Sismondo S (2007) Ghost Management: How Much of the Medical
Literature Is Shaped Behind the Scenes by the Pharmaceutical Industry? PLoS Med 4(9): e286 doi:10.1371/journal.pmed.0040286
Published: September 25, 2007
Copyright: © 2007 Sergio Sismondo. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and
reproduction in any medium, provided the original author and source are credited.
Abbreviations: CHC, Complete Healthcare Communications; CMD, Current Medical Directions; CRO, contract research organization; MECC, medical education and communication company
Sergio Sismondo is at Queen's University, Kingston, Ontario, Canada.
See URL above for remainder of lenghty paper with its following subheadings:
 From Ghost Writing to Ghost Management
 How Common Is Ghost Management?
 A Benchmark Study
"The most solid information available on ghost management comes from the work of David Healy and Dinah Cattell"
 MECCs (medical education and communication company)and Ghost Management: A Supply-Side Analysis
 References 51
[Proofreader’s note: this article was edited for spelling and typos on September 27, 2007]