What can editors do to prevent ghostwriting?

1. What can editors do to prevent ghostwriting? Elizabeth Wager PhD Publications Consultant Chair, Committee on Publication Ethics

2. What is ghostwriting?

3. What is ghostwriting in academic publishing? • Unacknowledged involvement of a writer on a publication • Usually relates to professional medical writers working at/for drug companies

4. Ghostwriting is NOT the same as ghost authorship • Ghost author = person who meets authorship criteria but is not included on list of authors • Ghost writer = may not fulfil authorship criteria ...

5. World Association of Medical Editors (WAME) policy statement: Ghost authorship exists when someone has made substantial contributions to writing a manuscript and this role is not mentioned in the manuscript itself WAME considers ghost authorship dishonest and unacceptable http://www.wame.org/resources/policies#ghost

6. But WAME goes on to say … To prevent some instances of ghost authorship, editors should make clear in their journal's information for authors that medical writers can be legitimate contributors and that their roles and affiliations should be described in the manuscript

7. ICMJE authorship criteria All persons designated as authors should qualify for authorship, and all those who qualify should be listed. Each author should have participated sufficiently in the work to take public responsibility for appropriate portions of the content. http://www.icmje.org

8. ICMJE authorship criteria Authorship credit should be based on substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; drafting the article or revising it critically for important intellectual content; and final approval of the version to be published. Conditions 1, 2, and 3 must all be met. Acquisition of funding, the collection of data, or general supervision of the research group, by themselves, do not justify authorship.

9. European Medical Writers Association (EMWA) guidelines To qualify as an author … the writer would need to have made a substantial contribution to the analysis or interpretation of the data and feel able to take public responsibility for the research. In practice this means that professional writers are unlikely to be named as authors on primary research publications. However, they may qualify for authorship of review articles …. Jacobs A, Wager E. Curr Med Res Opin. 2005;21:317-21.

10. Who’s an author? Design study Write protocol Perform study Analyse study Write report • Recruit patients • Record data • Coordinate study Interpret findings Draft article Approve article Revise article

11. ICMJE says authors must do 3 things: Design study Write protocol Perform study Analyse study Write report • Recruit patients • Record data • Coordinate study Interpret findings 1 2 3 Draft article Approve article Revise article

12. Medical writers are usually only involved in stage 2: Design study Write protocol Perform study Analyse study Write report • Recruit patients • Record data • Coordinate study Interpret findings 1 2 3 Draft article Approve article Revise article

13. For primary papers • Ghostwriting is more about conflict of interest / transparency than authorship

14. For review articles • Ghostwriting may be about conflict of interest / transparency AND authorship!

15. What can editors do to prevent ghostwriting? • Publish / explain authorship criteria • Distinguish ghost writing from ghost authorship • Explain that professional writers ‘can be legitimate contributors’ but must be acknowledged

16. What can editors do to prevent ghostwriting? • Adopt a contributorship policy • identifying roles may prevent guestsand ghosts • Use the anti-ghostwriting checklist

17. Anti-Ghostwriting Checklist What Should Be Done To Tackle Ghostwriting in the Medical Literature? Gøtzsche PC et al. PLoS Medicine. 2009;6(2):e1000023. doi:10.1371/journal.pmed.1000023

18. Anti-Ghostwriting Checklist • (a) Did the medical writer meet the 3 criteria for authorship, as specified by the ICMJE?(b) If not, has the writer been identified in the acknowledgements or as directed by the journal? • Has the source of funding for the medical writer’s services been identified in the acknowledgement or as directed by the journal? • Did the author(s) make the final decision on the main points to be communicated in the manuscript, particularly in the conclusion? • Did the author(s) make the final decision on the primary and secondary outcomes and relevant data to be reported in the manuscript? • If requested by the journal, can the medical writer provide evidence that the manuscript was prepared in accordance with international guidelines for ethical medical writing (e.g. ICMJE URM, GPP, EMWA, AMWA, ISMPP)?

19. should: educate question seek declarations should not: investigate adjudicate Editors

20. The questioning method may affect the answers: • Croatian Medical Journal study • Randomized 1462 authors to receive 3 types of declaration form: • ‘instructional’ -- guidance on ICMJE • ‘categorical’ – checklist with 11 possible activities • ‘open ended’ -- free text response Marusic et al. CMRO 2006;22:1035-44

21. CMJ study findings

22. COPE guidance on spotting authorship problems • Author unable to respond to reviewer comments • Changes made by somebody not listed • Impossibly prolific author (especially of reviews / opinions) • Role missing from contributor list • Unfeasibly long or short author list • Industry-funded study with no company authors

23. COPE flowchart

24. What can editors do to prevent ghostwriting? • Publish / explain authorship criteria • Distinguish ghost writing from ghost authorship • Explain that professional writers ‘can be legitimate contributors’ but must be acknowledged • Adopt a contributorship policy • Use the anti-ghostwriting checklist • Follow the COPE flowchart / guidance