Transparency and trust

Editor—If ghost writing is defined as what happens when the identity of a writer is concealed, then Abbasi's statement, “We know that ghost writing happens, and the identity and the motivations of the ghost writer are not revealed” is self evidently true, albeit not very informative.¹ However, many people understand medical ghost writing to mean that a professional medical writer, whose name does not appear on the author list, wrote the paper. When this happens, the identity of the writer is sometimes not revealed, but it often is, usually in the acknowledgments section. It is therefore misleading to state that the identity of the ghost writer is not revealed as though this were a universal truth.

Figure 1.

Kmietowicz's news article also misleads by saying that distinguished authors put their names to papers without ever seeing the raw data.² This may be true but is hardly the whole story. What exactly are you supposed to do with thousands upon thousands of laboratory results, for example? Data from clinical studies can be interpreted only once they have been processed into summary tables and graphs: a job that is more appropriately done by a statistician than a clinician. In my experience of writing papers on behalf of investigators, the named authors always have access to the summary tables and graphs, which is far more important than access to the raw data.

I agree, however, that high ethical standards must be maintained when professional medical writers draft papers on behalf of named authors, and that transparency is an essential part of this. One set of recently published guidelines seeks to ensure good practice in this context,³ and the European Medical Writers Association is currently preparing guidelines that will further define the ethical responsibilities of professional medical writers.