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Ghost Authorship in Industry-Initiated Randomised Trials
Open accessAbstract
BACKGROUND: Ghost authorship, the failure to name, as an author, an individual who has made substantial contributions to an article, may result in lack of accountability. The prevalence and nature of ghost authorship in industry-initiated randomised trials is not known. METHODS AND FINDINGS: We conducted a cohort study comparing protocols and corresponding publications for industry-initiated trials approved by the Scientific-Ethical Committees for Copenhagen and Frederiksberg in 1994-1995. We defined ghost authorship as present if individuals who wrote the trial protocol, performed the statistical analyses, or wrote the manuscript, were not listed as authors of the publication, or as members of a study group or writing committee, or in an acknowledgment. We identified 44 industry-initiated trials. We did not find any trial protocol or publication that stated explicitly that the clinical study report or the manuscript was to be written or was written by the clinical investigators, and none of the protocols stated that clinical investigators were to be involved with data analysis. We found evidence of ghost authorship for 33 trials (75%; 95% confidence interval 60%-87%). The prevalence of ghost authorship was increased to 91% (40 of 44 articles; 95% confidence interval 78%-98%) when we included cases where a person qualifying for authorship was acknowledged rather than appearing as an author. In 31 trials, the ghost authors we identified were statisticians. It is likely that we have overlooked some ghost authors, as we had very limited information to identify the possible omission of other individuals who would have qualified as authors. CONCLUSIONS: Ghost authorship in industry-initiated trials is very common. Its prevalence could be considerably reduced, and transparency improved, if existing guidelines were followed, and if protocols were publicly available.
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“Naming of authors can also help to identify conflicts of interest (item 7b) and reduce ghost and gift authorship.38 39 40 41”
From SPIRIT 2025 explanation and elaboration: updated guideline for protocols of randomised trials (2025) · cites this paper as [39]
In the citing paper
“Only a minority of reviews (2%) reported being funded by for-profit sources, but the true proportion may be higher [171].”
From The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration (2009) · cites this paper as [171]
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Pallotti, V., Caroselli, V. A., Esandi, M. E., & Esandi, M. D. C. (2025) · Journal of Academic Ethics · doi:10.1007/s10805-025-09656-6 · Cited by 2
Evaluating Authorship Guidelines of Top Medical Schools and Plastic Surgery Journals
Mirsky, N. A., Munkwitz, S. E., Kassira, W. M., Pathagamage, P., Coelho, P. G., & Thaller, S. R. (2025) · Annals of Plastic Surgery · doi:10.1097/sap.0000000000004435 · Cited by 2
Dragon Kill Points: applying a transparent working template to relieve authorship stress
Martinig, A. R., Burk, S. L. P., Drobniak, S. M., Perry, I., Morrison, K., Petersohn, M., Pottier, P., Nakagawa, S., Pollo, P., Ricolfi, L., et al. (2026) · BMC Biology · doi:10.1186/s12915-026-02521-x · Cited by 4
“Unsur-prisingly, ghost authorship disproportionately affects early career researchers and those with less social capital [1, 79–81].”
Ética de la comunicación científica
Elli, J. R. (2015) · Neurología Argentina · doi:10.1016/j.neuarg.2014.07.004 · Cited by 2
Writing the Roadmap for Medical Practice
Norman, G. A. V. (2024) · Anesthesiology Clinics · doi:10.1016/j.anclin.2024.02.006 · Cited by 2
Ghost-writing in oral and maxillofacial literature: facilitator of progress or ethical erosion?
Jain, A., & Merchant, Y. P. (2025) · British Journal of Oral and Maxillofacial Surgery · doi:10.1016/j.bjoms.2025.07.011 · Cited by 2
Ioannidis, J. P. A. (2018) · Circulation Cardiovascular Quality and Outcomes · doi:10.1161/circoutcomes.118.005205 · Cited by 2
Clinical Research Authorships: Ethics and Problem-Solving
Katib, A. A. (2020) · Canadian Journal of Bioethics · doi:10.7202/1073787ar · Cited by 4
“The ghost authorship industry could even have marketed several drugs (29,30).”
Reporting and Interpreting of Results
Friedman, L. M., Furberg, C. D., DeMets, D. L., Reboussin, D. M., & Granger, C. B. (2015) · Springer eBooks · doi:10.1007/978-3-319-18539-2_20 · Cited by 2
Tharyan, P. (2012) · Mens Sana monographs · doi:10.4103/0973-1229.91426 · Cited by 2
Simone, D. (2019) · Cambridge University Press eBooks · doi:10.1017/9781108186070.003 · Cited by 2
Bioethics, Politics and Business
Lötjönen, S., & von Troil, H. (2008) · TemaNord · doi:10.6027/tn2008-570 · Cited by 2
Gao, L., Sha, T., Chen, B., Li, M., Pan, X., Guo, Y., Chen, Z., Lim, H. C., & Guo, Y. (2016) · European Journal of Integrative Medicine · doi:10.1016/j.eujim.2016.10.003 · Cited by 2
COPE Flowcharts and infographics – How to recognise potential authorship problems
Editorial, A. (2022) · Science Editor and Publisher · doi:10.24069/sep-21-06 · Cited by 2
Authorship of Scientific Articles
Riancho, J. A. (2007) · Acta Otorrinolaringologica (English Edition) · doi:10.1016/s2173-5735(07)70351-4 · Cited by 2
Metadata
- Authors
- Gøtzsche, P. C., Hróbjartsson, A., Johansen, H. K., Haahr, M. T., Altman, D. G., & Chan, A.-W.
- Affiliations
- Cochrane (DK)
- University of Oxford (GB)
- University of Toronto (CA)
- Corresponding author
- Gøtzsche, Peter C
- Venue
- PLoS Medicine
- Publisher
- Public Library of Science (PLoS)
- Published
- 2007-01-16
- Volume
- 4
- Issue
- 1
- Pages
- e19
- ISSN
- 1549-1277 (ISSN-L)
- 1549-1676
- PMC
- PMC1769411
- OpenAlex
- W2095312096
- Cited by
- 289
- References
- 20
- Citations by year
- 2026: 7 · 2025: 15 · 2024: 5 · 2023: 11 · 2022: 8 · 2021: 9 · 2020: 12 · 2019: 19 · 2018: 20 · 2017: 7 · 2016: 19 · 2015: 14 · 2014: 14 · 2013: 19 · 2012: 9
- FWCI
- 25.09
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Funders
- Cancer Research UK
- Topics
- Health Sciences › Nursing › Issues, ethics and legal aspects › Pharmaceutical industry and healthcare
- Social Sciences › Education › Academic integrity and plagiarism
- Social Sciences › Library and Information Sciences › Academic Publishing and Open Access
- Keywords
- ghost authorship, authorship criteria, pharmaceutical industry, acknowledgment of contributors, research transparency
- MeSH terms
- Authorship, Humans, Publishing, Scientific Misconduct, Randomized Controlled Trials as Topic, Biomedical Research
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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