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Ghosts, drugs, and blogs

In a recent essay in PLoS Medicine, Sergio Sismondo of Queen's University, Ontario, Canada, set out to answer the question: how much of the medical literature is shaped behind the scenes by the pharmaceutical industry?

By its hidden nature, it is obviously a challenge to determine the exact prevalence of "ghost management," defined by Sismondo as the phenomenon in which "pharmaceutical companies and their agents control or shape multiple steps in the research, analysis, writing, and publication of articles."

The most solid information, he says, comes from a lawsuit that allowed access to a document listing 85 manuscripts on the antidepressant drug sertraline that were being coordinated for the drug's manufacturer Pfizer by the medical education and communication company (MECC) Current Medical Directions.

Based on this information, Sismondo calculates that between 18% and 40% of articles about sertraline indexed in Medline from 1998 to 2000 were managed by Pfizer through this one MECC. These are "large enough percentages to have substantial effects on the overall shape of the medical literature on this drug," says Sismondo.

It is not surprising that his provocative essay caught the notice of the press and the blogosphere.

The Chronicle of Higher Education, for example, lead its story with: "Drug companies play a far bigger role than previously suspected in managing how academics publish articles in medical journals."

A psychiatric nurse practitioner, writing on her blog, put it rather more bluntly and personally: "Creepy to think that an unknown amount of information that we as clinicians rely on may have been secretly planted there by the drug companies."

Sismondo's article, said Roy Poses on the Health Care Renewal blog, "is an important contribution to our knowledge of how research on human beings is manipulated into marketing and propaganda, if not outright disinformation.”

Peter Suber, tireless author of the Open Access News Blog, thought that this essay had implications for the open access movement. "What’s the OA connection?" he wrote. "Some publishers worry out loud and groundlessly that OA will undermine peer review and quality control, but then work with pharma companies to undermine peer review and quality control themselves and profit handsomely from it."

Meanwhile, back at the PLoS Medicine website, we've published several electronic letters in response to Sismondo's essay. One of these is by the senior officers of the American Medical Writers Association, who take issue with Sismondo's suggestion that AMWA is “dominated” by MECCs. Sismondo himself responds, noting that several of the national officers listed on AMWA’s website appear to be affiliated with MECCs.

If you’re an AMWA member, we’d be interested in hearing your views.

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