Research Article

Ghost Authorship in Industry-Initiated Randomised Trials

  • Peter C Gøtzsche mail,

    To whom correspondence should be addressed. E-mail:

    Affiliation: Nordic Cochrane Centre, Copenhagen, Denmark

  • Asbjørn Hróbjartsson,

    Affiliation: Nordic Cochrane Centre, Copenhagen, Denmark

  • Helle Krogh Johansen,

    Affiliation: Nordic Cochrane Centre, Copenhagen, Denmark

  • Mette T Haahr,

    Affiliation: Nordic Cochrane Centre, Copenhagen, Denmark

  • Douglas G Altman,

    Affiliation: Centre for Statistics in Medicine, Oxford, United Kingdom

  • An-Wen Chan

    Affiliation: Department of Medicine, University of Toronto, Canada

  • Published: January 16, 2007
  • DOI: 10.1371/journal.pmed.0040019
  • Published in PLOS Medicine

Reader Comments (2)

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Ghostwriting Study Needs Clearer Justification of Criterion for Authorship

Posted by plosmedicine on 31 Mar 2009 at 00:12 GMT

Author: Barton Moffatt
Position: Research Assistant
Institution: University of Minnesota, Twin Cities
Submitted Date: August 12, 2007
Published Date: August 13, 2007
This comment was originally posted as a “Reader Response” on the publication date indicated above. All Reader Responses are now available as comments.

Gøtzsche et al. (2007) employs an innovative methodology to reveal ghostwriting in the biomedical literature, but is hampered by a narrow focus, an idiosyncratic definition of authorship and a misapplication of the ICMJE’s authorship criterion.

A comparative study that contrasts industry and non-industry funded papers would be more illuminating. The primary defense of scientific ghostwriters and those who employ ghostwriters is that the practice of ghostwriting is indistinguishable from standard scientific authorship practices (Lagnado 2002). This analogy does not actually hold (Moffatt and Elliott 2007), but studies identifying ghostwriters should demonstrate how these practices diverge from standard authorship practices.

In addition, Gøtzsche et al. (2007) presents an idiosyncratic definition of ghostwriting without substantial justification. The authors state "We defined ghost authorship as present if individuals who wrote the trial protocol, performed the statistical analyses, or wrote the manuscript, were not listed as authors of the publication, or as members of a study group or writing committee, or in an acknowledgment" (Gøtzsche et al. 2007, p. 0048).

This definition is problematic because there is no scientific consensus that these activities by themselves establish authorship. It is not clear, for example, why writing a trial protocol should make someone an author on an article reporting the results of a trial but produced by someone else. Since most of the ghostwriters uncovered in this study are statisticians, the authors need to explain why doing a statistical analysis makes someone an author of a scientific paper. At a minimum, the authors need to justify this definition in terms of a common criterion for scientific authorship.

This study does not, despite its explicit claim, apply the ICMJE authorship criterion in its analysis. The ICMJE criterion requires a putative author to meet each of three conditions to qualify as an author. The guidelines state "authorship credit should be based on 1) substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data; 2) drafting the article or revising it critically for important intellectual content; and 3) final approval of the version to be published. Authors should meet conditions 1, 2, and 3" (ICMJE 2007).

The authors of this study dismiss the final approval criterion, failing to grasp that all three conditions are necessary to qualify under the ICMJE criterion. To apply the ICMJE criterion correctly, the authors would also need to retroactively identify participants who had final approval over a paper. Unfortunately, there is little evidence of this kind of decision making available from trial protocols. As a result, this methodology cannot conclusively identify ghostwriters according to the ICMJE definition of authorship.

Finally, the claim that mandatory contributor lists will clean up industry sponsored ghostwriting is suspect. Anyone willing to mislead the public about the real authors of a paper for financial gain is undoubtedly also willing to deceive people about who contributed to the paper. The ‘named author’ on industry funded ghostwritten papers is often a well respected academic, chosen to enhance the scientific respectability of a paper’s marketing message. What is to stop companies from paying sham contributors to do the same?


Gøtzsche et al. (2007) Ghost Authorship in Industry-Initiated Randomised Trials. PLoS Medicine Vol. 4, No. 1, e19 doi:10.1371/journal.pmed.0040019.

ICMJE (2007) Uniform Requirements for Manuscripts Submitted to Biomedical Journals: Writing and Editing for Biomedical Publication. Accessed July 1, 2007.

Lagnado M (2002) Haunted papers. Lancet 359: 902.

Moffatt B, Elliott C (2007) Ghost marketing: pharmaceutical companies and ghostwritten journal articles. Perspectives in Biology and Medicine 50: 18-31.

No competing interests declared.