Do you know any ghosts? There are numerous programs on television and movies about ghosts. My favorite is still Casper the Friendly Ghost. I know I should have outgrown him, but I am not a fan of the scary ghost stories and movies currently in vogue. Do you know any ghosts? Sounds like a silly question, but you may have a ghost for a colleague or friend—at least a ghostwriter. In my opinion, ghostwriting in medical literature can take at least three forms—1) when someone claims to have written an article and there is no evidence it exists, 2) when someone is listed on a published article and actually contributed very little to it, and 3) when someone has written a substantial portion of the manuscript yet is not listed as a contributing author. Unfortunately, all three circumstances are more frequent than you might imagine.

A recent review shows that honesty in publishing is not what one would think when it comes to claiming scientific publications. The findings were that fully one-third of the publications claimed by general surgery residency applicants were “ghosts” meaning they could not be confirmed in any publication’s database.1 This is truly sad when the medical leaders of tomorrow think nothing of providing false information on their applications. It makes one wonder; will they be honest in other facets of their careers?

The last two problems are intertwined to the point that it is of great concern. How many times have professors’ names appeared on publications when they knew little if anything about the paper? This used to be a common occurrence (used to be?) when the name of the department chairman appeared on every paper published by the department members whether or not he provided any input. For the most part this has changed, but names of non-contributors still appear on published articles. Many times it occurs when a medical company sponsors a research project and hires a professional writer to produce the manuscript. Many times this is done completely without the input of the investigators. After the paper is finished, everyone’s name is put on the paper, yet the one who actually wrote it is not listed. This misconduct should be addressed sternly. If someone who has a vested interest in the outcome of a research project writes the manuscript for publication, do you truly think the outcome will be negative? Many times data that do not meet expected outcomes are conveniently lost or marginalized. If products, treatments, and medications are adopted based on false outcomes data, the patient will be the one to suffer or even be injured.2 When it is discovered that distinguished professors and others prominent in their fields put their names on publications for financial compensation or even to bolster their reputations, harsh penalties should be imposed. Unfortunately, this happens all too often in today’s world where money and power seem to triumph even in science.3, 4 I highly recommend reading the articles referenced below. They make for unbelievable reading.

So, do you know any ghosts? If you do, I hope it is only Casper or the like. If not, I would suggest you call Ghost Busters!

1) Kuo PC, Schroeder RA, Shah A, Shah J, Jacobs DO, Pietrobon R. “Ghost” publications among applicants to a general surgery residency program. J Am Coll Surg. 2008;207(4):485-489.
2) http://www.scholarlykitchen.sspnet.org/2009/06/10/nonsense-for-dollars.
3) Gøtzsche PC, Kassirer JP, Woolley KL, Wager E, et.al. What should be done to tackle ghostwriting in the medical literature? PLoS Med. 2009;6(2):e23.
4) PLoS Medicine Editors. Ghostwriting: the dirty little secret of medical publishing that just got bigger. PLoS Med. 2009;6(9):e1000156.