Sunday, October 31, 2010

Advertising and Peer-Review in Medical Journals

The German online news site Telepolis reports in October 2010 about the pharmaceutical company Wyeth, which belongs to the Pfizer concern, hiring a public relations company (DesignWrite) to inject ghostwritten advertising into peer-reviewed articles that appear in closed-access medical journals.

The PR company carefully wrote articles that in diction and appearance seemed to be scientific articles that surveyed the literature on the topic of hormone replacement studies for menopausal women. The surveys downplayed the negative side effects, which include a higher risk of breast cancer, and praised the positive side effects, such as lowering the probability of dementia, of the substances. Later studies have shown that these hormone replacement medicines actually increase the probability of dementia. These surveys were given to researchers, who "edited" the articles and submitted them for publication to peer-reviewed journals.
This blog noted the article published in 2009 in the New York Times. Adriane J. Fugh-Berman, an associate professor for Complementary and Alternative Medicine at Georgetown University, has now published her study of the incident in the open-access journal PLoS: The Haunting of Medical Journals: How Ghostwriting Sold “HRT”.
Fugh-Berman has published a meticulously linked and documented article that demonstrates the depths of this relationship between the ghostwriters. One sample:
One co-author seemed puzzled by the concept that she was to author, but not write, an article [34]: “From what you have written, I would be more of an ‘editor’ rather than the major writer—that is, you guys would be writing the versions—with me ‘altering, editing, etc.? Is that correct?’” 1This query was in response to an e-mail from Karen Mittleman (a DesignWrite employee who supervised medical writers) that stated: “The beauty of this process is that we become your postdocs! … We provide you with an outline that you review and suggest changes to. We then develop a draft from the final outline. You have complete editorial control of the paper, but we provide you with the materials to review/critique” [34].
This would also suggest that the "normal" way of writing is to have the postdocs do the work and the PI publish the paper. And even when a peer review tried to question a paper, documents show that DesignWrite responded to the reviews (and not the supposed authors), at times scolding the reviewers for misusing the peer-review process! 

Fugh-Bermann summarizes:
Acceptance of ghostwriting, euphemistically termed “editorial assistance,” may be so widespread that it is considered normal. This could explain why several authors of ghostwritten articles have defended their involvement.
As a researcher for complementary and alternative medicine, it is of course to her advantage to demonstrate that what we have considered to be "hard science" in the area of medicine up until now has degenerated into an advertising circus. But her results are not based on just a single case - the list goes on and one. Fugh-Bermann: "Medicine, as a profession, must take responsibility for this situation. Naïveté is no longer an excuse."

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