Guests and Ghosts Begone–Guest Authorship and Ghostwriting and the Journal of Clinical Sleep Medicine

Publication in peer-reviewed journals is the “coin” of the academic realm. Faculty who publish extensively are more quickly and easily promoted. They also establish reputations in their area of expertise resulting in national and international recognition. This leads to speaking engagements and better credentials for research grant applications. For physicians, patient care volume may increase as a consequence of being perceived as an expert in their field of practice. All of these outcomes are considered benefits of publication in medical journals. However, with authorship comes accountability for the contents of the publication. Authorship accountability cannot occur if the author has contributed little or nothing to the intellectual content of the paper. In a recent disturbing case study of industry documents from the rofecoxib litigation, Ross et al¹ highlight a systematic practice in a large pharamaceutical firm whereby manuscripts were prepared by or for the sponsor, and lead authorship attributed to an academic physician who had little or no input into the intellectual content of the document. Compelling evidence was presented that manuscripts were prepared by the sponsor or a 3^rd party hired by the sponsor, and then authors were recruited to “headline” the paper to increase its credibility. Such a practice has been termed “guest authorship.”² It is difficult to conceive that recruited authors can fulfill accepted criteria for authorship, and be responsible for the intellectual content of the publication. The personal ethics of lending ones name and reputation to such a paper are certainly questionable.

Just as troubling as the practice of recruiting “guest authors” may be, “ghostwriting” or the non disclosure of individuals who made substantial contributions to a manuscript is an equally significant concern. If readers are to accept the veracity of the contents of a publication, then it is essential that all persons who made important contributions be identified especially if such individuals potentially represent the interests of industry sponsors. In the case study by Ross et al,¹ there was disclosure in most cases that a study was financed by the pharmaceutical sponsor or that one or more of the authors was employed by the sponsor. However, in others, there was no disclosure of any relationships between the sponsor and the author(s). Although many papers reporting the results of industry sponsored research are balanced presentations, there is a general tendency for such studies to have a bias towards the perspective of the sponsor.³ In order for the reader to make his own evaluation of the data, it is essential that the relationship between the sponsor and the authors be disclosed.

If “guest authorship” and “ghostwriting” were infrequent occurrences, there would be some mild concern on the part of editors and the general academic community. However, it appears that these practices are not isolated to one large pharmaceutical company and are widespread.⁴ In the absence of any central submission process for manuscripts, it is thus the responsibility of each journal to try to extinguish these practices.

In response to growing concern and the prevalence of “guesting” and “ghosting”, the Journal is immediately instituting a new submission policy. Upon submission of a manuscript, all authors must submit to the editorial office the Conflict of Interest Disclosure and Attestation of Authorship Form. All authors will be required to attest that they fulfill the following criterion of authorship, substantive intellectual contribution in one of these areas: study design, data collection, data analysis, interpretation of results or manuscript preparation. In addition, each author will be required to certify that they have read and approved the submitted manuscript draft. Finally, the corresponding author will be asked whether any other individuals contributed to the writing of the manuscript, and if so to either add them as authors or cite them in the acknowledgment section of the paper. No manuscripts will be processed without receipt of these forms from all authors. Although I recognize that completion of this form will not end “guesting” and “ghosting,” it will place the Journal on the record of not condoning these practices. It is my hope that neither unwanted “guests” nor “ghosts” are in the Journal’s future.