This New York Times article on the (apparently widespread) practice of drug companies drafting and ghostwriting scientific articles favorable to their products, and then arranging for academics to publish the articles under their own names, focuses, reasonably enough, on the potential for such practices to mislead doctors and other readers.

As an academic, though, I was particularly struck by the stress that the drug company Wyeth laid on the fact that the nominal authors of these articles were not being paid and endorsed the contents. In reality, having someone write articles for you amounts to not doing the job for which, as an academic, you are paid and, if the articles are sufficiently numerous and well-placed, promoted. It would be far more ethical (or less unethical) to pay academics for product endorsements, published as commercial advertisements.

Of course, in a world where a $50 billion (or maybe $17 billion, who can tell?) fraud barely makes the front page, and a $100 million rip-off is buried somewhere behind the shipping news, it seems a bit precious to worry about allegations of goldbricking academics passing off corporate propaganda as their own work. But at least I can understand how this scam works, as opposed to how a massive Ponzi scheme can be operated for decades under the noses of what are supposed to be the world’s most sophisticated fnancial markets and regulators.

36 thoughts on “Ghostwritten

  1. But at least I can understand how this scam works, as opposed to how a massive Ponzi scheme can be operated for decades under the noses of what are supposed to be the world’s most sophisticated fnancial markets and regulators.

    Are you losing respect for regulators as a class or just in this case. 😉

  2. p.s. There is no space on the front page of newspapers for $50 billion dollar rip offs when we are busy reading about trillion dollar rip offs.

  3. Actually, I don’t see what the problem is with ghost-writing — these articles are so easy to write (and it’s not like the stats are complicated) it’s really only the money that makes a difference, and given the pressure everyone has to get it in universities (and these companies have loads of it, and getting enough of it will get you promoted), this is obviously a much more likely and essentially unfixable bias. The other reason these companies will always win by giving grants to academics is due to a publishing bias in favour of finding effects. In this case, if a drug doesn’t work as claimed, it’s vastly harder to publish that compared to if you do find big effects, since no-one cares about null effects, and even if you did find a null effect, you could just be accused of running a sloppy experiment.

  4. “these articles are so easy to write”

    Having written quite a few of them, I don’t find it so. And I don’t get the impression my colleagues find it any easier.

  5. I have also never found academic writing easy – however my recollection is that the following information from JAMA (the Journal of the American Medical Association) is typical
    “All authors (ie, the corresponding author and each coauthor) must complete and submit an Authorship Form with signed statements on Authorship Responsibility, Criteria, and Contributions; Financial Disclosure and Funding/Support; and either Copyright Transfer/Publishing Agreement or Federal Employment.3(pp128-133) In addition, authors are required to identify their contributions to the work described in the manuscript”

    As long as this sort of procedure is held to I don’t see how having an external body assist on drafts is much different to having an Honours student draft up a paper, run the experiment, and so forth. However, contributions from a corporate source should be acknowledged as they would be for the student. Perhaps lack of full acknowledgment is more the problem.

  6. Am I alone in thinking that the entire scientific humanist enlightenment and all subsequent progress has been subverted by unregulated capitalism (greed) and advertising (lying)?

  7. “Having written quite a few of them”

    You’re confusing what you write with efficacy of drug X on Y studies. Many academics articles are very hard to write (I know myself). Alternatively, I have colleagues who apply for NH&MRC grants (quite legitimately so) and basically use the same template with the drug name switched across grants.

  8. Actually, if you want a non-controversial example of this, try searching for X and cognitive performance with Scopus or google scholar (I won’t write it for fear of hitting spam, but think of the types of things teenagers consume at dance parties). These are very useful outcome studies (if you take X, how does it effect your cognitive performance ?. Does it affect your memory? does it work on different groups differently ? etc.) What you’ll find is many short articles that follow a similar format (and the occasional big theoretical one which would be hard to write) — the difficulty associated with these short studies is not writing them up (and if people need help writing them, I don’t see what the big deal is), its getting the equipment to do them, running them properly, getting through ethics, organizing them etc .

  9. Wasn’t it Lord Byron who first said that easy writing makes damned hard reading? Nowhere is this more true than in scientific papers, particularly biomedical papers. Yes, it’s all too easy to write a turgid account in the passive voice of some experiments. When I read ‘and it’s not like the stats are complicated’, Conrad, I shudder to think of getting a half-written MS from you with a request to ‘get the P-values’. The sums are straightforward, yes, but inference is rarely simple, unless the data pass Joseph Berkson’s intra-ocular traumatic test.
    PrQ, don’t you understand that these plagiarists are too busy making money to write a straight sentence?

  10. andrew, it was a lot more than capitalism that made the enlightenment possible,

    partly it was chucking out the dogmatic fundamentalism that you so consistently espouse

    and even if it was a big part of the propulsion in that period, it is now, like Cronos, eating its children

  11. Andrew R., quite right, unregulated capitalism (greed) and advertising (lying)has made possible the huge financial rip-offs, partly indicated in JQ’s post. However, I don’t understand why you don’t agree with the Ikonoclast regarding the apparent incompatibility of unregulated financial capitalism and misleading advertisig with the ideals of the enlightenment.

  12. The trouble is, Ikonoclast @6, that historical narratives like the subversion of the enlightenment by capitalism – or, for that matter, AR’s inversion of capitalism enabling the enlightenment – are narratives, not science. You couldn’t establish them scientically: they’re falsified all over the place.

    Maybe it’s our human desire for narrative explanation that confounds science?

  13. O6,

    what we’re basically talking about a lot of the time is creating a taxonomy. Panadol works under conditions X, Y, & Z with groups A, B, & C. Useful to know, but not thrilling to most. That’s why its possible for some people to publish over 1000 articles, as the author questioned in the article has. I’ll just assume that not all of them are literary masterpieces or massively deep theoretical works. Alternatively, I’m sure where they work loves them for it, as do most universities in Australia where people get ARC linkage grants (and similar), which encourage these types of collaborations.

  14. EG,
    IMHO the ideals of the enlightenment were made possible by the wealth coming from the growth of capitalism and capitalism (in particular the free movement of goods and services) is at least partially enabled by the information that advertising provides.
    It is all very well to argue that capitalism, somehow, “pollutes” the enlightenment, however it is the leisure and specialisation that allowed those ideals to be formed, published, discussed and passed around.
    To put it another way, and for argument’s sake, I may believe that my parents somehow polluted my mind – but I should also recognise that without my parents I would not have a mind to pollute.

  15. look at the world economy during the time of the enlightenment and you’ll find that as much wealth is flowing into Europe as a result of the violent conquest of the rest of the world and the associated mass genocide and slavery as anything else.

  16. Why was it going to Europe and not, say, China, gerard? China had already explored most, if not all, of the places that you say the wealth was coming from. Any ideas on why?

  17. advertising – next time you watch an ad break on TV, try and pick up how much of what you are seeing and hearing actually involves straight information about the actual product. it is a very small part.

  18. gerard,
    Most advertising is designed to get you to try the product – or at least to give it a look on the shelves or shop floor. Whether you choose to spend your money or not is then up to you. It is therefore part of the buying process – trying to make you consider another product or service. It can do little more than that.
    You say wealth flowed from the other places. I asked why was it flowing to Europe. What could be clearer?

  19. I said the wealth was flowing to Europe because Europe violently conquered the rest of the world. China didn’t.

  20. andrew, some of your answers are elegant rebuttals

    but some really prostitute you,

    that bit you just wrote about advertising getting you to try the product is false and you know it,

    please do not try and defend the indefensible because it diminishes the good bits you offer

  21. smiths,
    When you buy bread, do you do it on the basis of the fact that your parents always bought the same bread or do you look around for the best at the price you can afford or want to pay?
    If it is the second then my statement on the reason for advertising is true. If the first, then you are the deepest conservative I know.
    Your answer?

  22. Galbraith noticed decades ago the ability of advertising to create demand for goods or services that people didnt even imagine they wanted or needed (not exact quote)

  23. #20 Andrew and interested others – this is an excellent and highly readable introduction to the literature on automaticity which is relevant to the limits of advertising.

    Click to access bargh_chartrand_1999.pdf

    It is important to see advertising as both discrete (individual ads) and continuous (repeated reinforcement of similar messages/ideas/values etc)

  24. The problem with advertising is not that it exists, but that it is predominantly a mix of dishonesty and bullshit. Isn’t there a theory that capitalism only works in a scenario of complete information? Current advertising seems to me to be inconsistent with this theory. Perhaps advertising content needs to be regulated for honesty.

  25. Andrew R., Among the things that were achieved by the enlightenment was the separation of wealth accumulation from royal absolutism, i.e., the creation of individualism as the dominant strand in western philosophy. Without the Enlightenment, which is the same as saying ‘without the rise of philosophical individualism’, capitalism would not have been possible.

  26. In the biosciences, specifically in the bio-pharma arena, ghostwriting happens. However, a more subtle corruption of the academic peer review process that happens is the marketing campaign’s pre-launch phase (for want of a better way of putting it). For some new drugs that are very niche, and for drugs reaching end-of-patent, a pre-launch phase starts well before FDA final approval.

    The idea is to create an article blitz based around short trials, *and* to promote the efficacy of the drug for off-label applications. An off-label application is any medical condition other than the one for which the drug is designed. As an example, anti-depressants are FDA approved for the medical condition of depression; a stringent set of clinical trials are required to get that approval. Recently, various anti-depressants have been promoted in the academic literature for off-label use in treating chronic pain. Off-label use is usually a much easier goal for FDA endorsement.

    Once a drug has solid support in the academic literature, media pages are passed onto the various professional magazines; the off-label applications are promoted widely, and the academic literature is conveniently cited. That part of the medical community who read these mags (sometimes they receive the magazine gratis, if the drug is promoted in the magazine) then talk with colleagues in the tearoom about the drug. This builds credibility for the drug.

    In some cases, the off-label uses are what make a drug a block-buster (ie a billion dollar or more earner). The treatment of the original medical condition might be too small a market, hence the rationale behind this marketing strategy.

    As an example of how the pharma guys get the article count up, go to the Pubmed site – where all USA grantees must submit a copy of their articles – then search on any drug that is known for off-label use. Then check how many of the articles have a pharma guy or a pharma affiliation among the authors. Also count the number of articles with negative conclusions.

    A few months back, I did just that. I looked up one of the anti-convulsants (these are for the treatment of epilepsy), as they are being promoted by doctors for the treatment of chronic pain. After reading through a lot of articles in Pubmed I realised that I hadn’t seen a single article that only involved unencumbered researchers. Many of the trials were very short; many of the trials allowed the subjects to use up to 4 grams of paracetamol per day, if they needed additional pain relief. Does that not seem bizarre in a chronic pain relief trial?

    Pharmaceutical drugs have been life-savers for many; off-label applications have turned out to be very important for many. Nevertheless, something about the current practices of a number of bio-pharma companies leaves a sour taste.

  27. #30
    I think melanie was making the opposite point that you were making – the Enlightenment made capitalism possible, not vice versa.

    don’t assume everything you write is worthy of an answer.

  28. gerard,
    I have always thought that you should at least be polite and answer a question if asked. Perhaps standards of manners are different in your universe.
    smiths point was (IMHO) that one polluted the other. Mine was that they enabled each other. While I disagree with melanie on the direction of causality, the difference is (IMHO) in the context of this discussion, irrelevant. One is (again, IMHO) freedom applied in the scientific and philosophicals areas, with capitalism being freedom applied in the economic context. Which caused the other is (in this context) irrelevant – one could hardly have polluted the other if they are the same thing applied in differing areas.

  29. Andrew R. One of the leading enlightenment figures is John Locke. I’m not sure if his brand of individualism counts as ‘capitalist’ since he came up with the notion that the product of one’s labour is one’s property. Capitalism on the other hand, says that one’s property can be the product of any number of people’s labour. Another aspect of enlightenment individualism was also, of course, that you shouldn’t own another person – though the treatment of humans as commodities to be traded seems perfectly compatible with “freedom applied to the economic context” or free trade.

  30. melanie,
    You always own your own labour. If you choose to sell it to another that is your decision on the use of your own (human) capital. Good capitalism. Government forces (or provides strong incentives for) you to work contrary to what you would choose to do – not capitalism.
    Which one would Locke recognise?

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