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The Latest Medical Research Scandal and the Question of Journal Authorship Rules

Walter Reed Army Medical Center“Ghostwriting” is the ethically fraught practice of intentionally excluding major contributors of an article from its byline or acknowledgements, and instead hiring respected experts in the field as named authors to give the appearance of credibility and neutrality. The problem has been around in scientific journals for decades, and industries may use it as a tactic to promote products with favorable research results (the issue made headlines last spring). The tobacco industry was accused of some early examples of ghostwriting. And just last week, New York Times writers Barry Meier and Duff Wilson reported a related problem involving forged authorship of a study at the nation’s premiere military research hospital, the Walter Reed Medical Center.

Dr. Timothly R. Kuklo, a former Army orthopedic surgeon, is accused of falsifying research on a bone-growth product called Infuse, sold by Medtronic. The journal article in question concluded that Medtronic’s Infuse was significantly more effective in healing soldiers’ severe leg injuries than traditional bone-graft treatment. The Times obtained a full report of the Army investigation on Dr. Kuklo’s supposed medical research fraud. The investigation found that Dr. Kuklo forged the signatures of four Army doctors as authors of the study while naming himself the lead author. None of these doctors, including Dr. Romney C. Anderson, a Walter Reed surgeon, saw the article before it was published in the British Journal of Bone and Joint Surgery.

Dr. Anderson notified Army officials and the publication’s editor after reviewing the article. He was convinced that some of the data were invented after he checked the Walter Reed records Dr. Kuklo supposedly used, Meier and Wilson reported. The journal retracted the study in March and banned Dr. Kuklo from future contributions.

Dr. Kuklo also failed to disclose a financial relationship with Medtronic in the journal article. Medtronic hired him as a consultant in 2006 and financed some of his research at Walter Reed, Meier and Wilson wrote.

The International Committee of Medical Journal Editors has journal authorship guidelines designed to prevent ghostwriting. The Pharmaceutical Research and Manufacturers of America, an industry trade group, recommends these guidelines, and scientists who study ghostwriting believe better adherence to such rules is imperative to preventing research fraud. However, the ICMJE does not specifically address ghostwriting and many authors disregard or disagree with the guidelines.

Meier and Wilson reported that the New England Journal of Medicine’s peer review process prevented Dr. Kuklo’s controversial study from being published in the popular general medicine journal, but more comprehensive rules may be necessary to eliminate ghostwriting.

Image: AP/Charles Dharapak

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