Ghostwriting can haunt medical journals

Two University of Pennsylvania psychiatry professors have been accused by a colleague of academic misconduct. They are accused of attaching their names to a journal article allegedly ghost-written by GlaxoSmithKline employees 10 years ago.

Dr. Jay D. Amsterdam filed a complaint Friday with the federal Office of Research Integrity. It alleges that a study published in the American Journal of Psychiatry in 2001 skewed the results of a study on the depression drug Paxil.

Drug companies often have a hand in the research that ends up on the pages of medical journals. They pay for the research and often hire medical writers to help draft the stories. Company employees are often listed among the authors. All that, said Dr. John Abramson, a lecturer at Harvard Medical School and a frequent expert witness who testifies against drug companies in trials, is kosher. As long as there is disclosure and transparency, he adds.

“A medical writer might create a shell of the article that says this is the primary outcome measure, this is the population measure that’s going to be included in the study, and then create dummy tables for the results,” Abramson said. “That is perfectly legitimate.”

The problem is when that veers into ghostwriting. Medical writers paid by drug companies have control over the data analysis and writing, not the academic whose name adds legitimacy at the top of the study, Abramson said.

“Then there’s a serious problem, because then what’s happening is that the commercial sponsor of the study is using a facade of science,” Abramson said.

Massachusetts psychiatrist Dr. Danny Carlat said ghostwriting might hold a special allure for companies marketing drugs to psychiatrists because there is a vast array of drugs that are of similar effectiveness.

“In a field like that, where there’s so much competition, ghostwriting becomes a very important part of the marketing machinery of any company,” Carlat said. “You want to convince psychiatrists who are reading these studies that your drug has some kind of advantage, however slight, over the competitor’s drug.”

A University of Pennsylvania representative said it is investigating the claims of academic misconduct, though the professors involved believe the allegations to be “unfounded”. It has also added an explicit “no ghostwriting” clause to its ethical code in 2010.

A GlaxoSmithKline representative said the company no longer has details on the writing process for the decade-old study, but it has always been its policy to give primary authors final approval over study manuscripts. Three Glaxo employees were named among the authors of the study in question, but their affiliation was not printed alongside their names.