0
Postgraduate Education Corner: MEDICAL WRITING TIP OF THE MONTH |

Goodbye Ghostwriters!*: How To Work Ethically and Efficiently With Professional Medical Writers FREE TO VIEW

Karen L. Woolley, PhD
Author and Funding Information

*From ProScribe Medical Communications, Noosaville, Australia.

Correspondence to: Karen L. Woolley, PhD, ProScribe Medical Communications, 18 Shipyard Circuit, Noosaville 4566, Australia; e-mail: kw@proscribe.com.au



Chest. 2006;130(3):921-923. doi:10.1378/chest.130.3.921
Text Size: A A A
Published online

If you recognize the ethical and scientific obligations to publish your research, but have not always been able to do so, you are not alone. Between one third to two thirds of medical research may remain unpublished.12 The main reason for nonpublication is lack of time, but limited manuscript preparation experience or English writing skills can also present challenges for authors.1,35 When limited by time, experience, or language, researchers may seek medical writing assistance.34 Although the legitimate role of professional medical writers has been recognized by journal editors, authors need to know how to work appropriately with writers.67 The purpose of this article is to describe how authors can work ethically and efficiently with professional medical writers—and, in so doing, say goodbye to ghostwriters!

Before describing how to work with writers, professional medical writers must be differentiated from ghostwriters.8 For the purpose of this article, professional medical writers are writers who abide by ethical guidelines for medical writing (Table 1 ). When a professional medical writer assists authors, the writer ensures that the authors control the content, and that the writer’s involvement and funding source are acknowledged in the publication. In contrast, due to ignorance or ill intent, ghostwriters may try to control the content and not disclose their involvement or funding source. Ghostwriters can expose authors, journals, and sponsors to justifiable, but undesirable, media attention.,11

There is no single “type” of author who works with professional medical writers. A survey12on author attitudes toward medical writing found that authors who reported that they would use medical writing services included junior and senior academics, men and women, and those with excellent medical writing skills and extensive medical writing experience and those without. Professional medical writers may help authors prepare manuscripts based on studies sponsored by not-for-profit (eg, academic institutions, patient advocacy groups) or for-profit (eg, pharmaceutical, biotechnology, device companies) organizations. The prevalence of medical writing assistance in publications from high-ranking, international, peer-reviewed journals was recently reported to be 6% for non–industry-sponsored research and 10% for industry-sponsored research.13 As the number of, and demand for, medical writers is increasing, more authors may have the opportunity to work with professional medical writers in the future.14

Authors elect to work with professional medical writers for various reasons. The most common reasons that have been cited by authors were that medical writers could help them prepare manuscripts that would: (1) be better written, (2) be of higher quality, (3) take less of their time to prepare, and (4) have a higher chance of being published.12Although more direct evidence is required, research indicates that medical writing assistance can reduce publication delays and enhance quality.13,15

Authors can work ethically with professional medical writers by following guidelines developed by journal editors and professional medical writers (Table 1). There is a high level of consensus among these guidelines, with each reinforcing the importance of transparency. Essentially, authors working with professional medical writers need to do the following: (1) acknowledge the medical writer, and (2) disclose the associated funding source. If no funding was used for the writer’s services, this should be stated explicitly. Before writing begins, authors need to confirm that their medical writer complies with these guidelines.

Fortunately, the process required for ethical manuscript preparation aligns well with the process used for efficient manuscript preparation. Professional medical writers will, ideally, follow a standard operating procedure (SOP) that facilitates ethical and efficient manuscript preparation. Manuscript SOPs may vary among writers, but every writer’s SOP should require that authors and writers work collaboratively throughout the process. The SOP should clarify that authors are responsible for identifying the key messages and data to be presented in the manuscript. The SOP may then recommend that the writer develop a comprehensive structural outline based on the author-identified messages and data. The outline should be reviewed, edited (as necessary), and agreed to by the authors. The SOP may then clarify that the writer prepares the first, full-text version of the manuscript only after the key messages, data, and the scope and sequence of content have been author approved. An experienced medical writer will be able to efficiently convert the approved outline into a submission-ready manuscript. The writer, rather than the authors, can perform many of the time-intensive tasks in manuscript preparation. These tasks include the following: drafting text that is clear, concise, credible, and grammatically correct; preparing figures and tables; tracking and incorporating author feedback; ensuring the manuscript meets the requirements of the journal (eg, word count, formatting); and finalizing the multiple text and graphics documents usually required for on-line submission. The SOP should mandate that authors retain responsibility for approving the final version of the manuscript and submitting it to the journal. A professional medical writer can help authors efficiently address the issues (eg, problems with writing style, graphics, formatting) that have been previously identified as persistent problems in manuscripts submitted to CHEST,16 and help ensure that manuscripts are prepared ethically.

Readers of peer-reviewed publications need to know that authors, not medical writers, control the messages and data presented. Medical journals and professional medical writers need to work together to educate authors and readers about appropriate medical writer involvement. The monthly medical writing series in CHEST is a perfect example of how editors and writers can collaborate to benefit authors and, ultimately, readers.

Authors who are limited by time, writing expertise, or English writing skills may seek medical writing assistance. Medical journals have recognized the legitimate role of professional medical writers, but the onus is on authors to work with professional medical writers, not ghostwriters. A professional medical writer can help authors prepare manuscripts ethically and efficiently by following a well-defined manuscript preparation process.

Abbreviation: SOP = standard operating procedure

Professor Woolley is a paid university lecturer in medical writing and drug development and is also the Chief Executive Officer of ProScribe. ProScribe’s PhD-qualified professional medical writers are paid by academic, biotechnology, and pharmaceutical clients to provide medical writing services. ProScribe staff do not ghostwrite.

Table Graphic Jump Location
Table 1. Guidelines From Medical Journal Editors and Medical Writers on Acknowledging Medical Writer Involvement*
* 

Although additional guidelines and statements have been published on publication ethics, the guidelines listed in this Table provide practical advice for authors who want to work with professional medical writers.

I thank Jane McDonald and Drs. Yoonah Choi, Julie Ely, Leigh Findlay, Christine Wichems, and Mark Woolley from ProScribe Medical Communications for their critical review of this article.

Camacho, LH, Bacik, J, Cheung, A, et al (2005) Presentation and subsequent publication rates of phase I oncology clinical trials.Cancer104,1497-1504. [CrossRef] [PubMed]
 
Wise, P, Drury, M Pharmaceutical trials in general practice: the first 100 protocols; an audit by the clinical research ethics committee of the Royal College of General Practitioners.BMJ1996;313,1245-1248. [CrossRef] [PubMed]
 
Wager, E, Field, EA, Grossman, L Good publication practice for pharmaceutical companies.Curr Med Res Opin2003;19,149-154. [CrossRef] [PubMed]
 
Jacobs, A, Wager, E European Medical Writers Association (EMWA) guidelines on the role of medical writers in developing peer-reviewed publications.Curr Med Res Opin2005;21,317-322. [CrossRef] [PubMed]
 
Irwin, RS A new face of CHEST heralds a new era [editorial].Chest2006;129,1-3. [CrossRef]
 
International Committee of Medical Journal Editors. Uniform requirements for manuscripts submitted to biomedical journals: writing and editing for biomedical publication; ethical considerations in the conduct and reporting of research. Available at: www.icmje.org/index.html#ethic. Accessed June 25, 2006.
 
World Association of Medical Editors. Policy statement: ghost writing initiated by commercial companies. Available at: www.wame.org/wamestmt.htm#ghost. Accessed June 25, 2006.
 
Woolley, KL Letter to the editor. AMWA J. 2005;;20 ,.:184
 
CHEST editorial department. Instructions to authors. Available at: www.chestjournal.org/misc/authorInstructions.pdf. Accessed June 25, 2006.
 
Hamilton, CW, Royer, MG, for the AMWA 2002 Task Force on the Contributions of Medical Writers to Scientific Publications.. AMWA position statement on the contributions of medical writers to scientific publications.AMWA J2003;18,13-16
 
Wilde Matthews, A Ghost story: at medical journals, writers paid by industry play big role. The Wall Street Journal,. 13 Dec 2005;; ,.:A1
 
Phillips, SG, Carey, LA, Biedermann, G Attitudes toward writing and writing assistance in peer-reviewed articles.AMWA J2001;16,10-16
 
Woolley KL, Ely J, Woolley M, et al. Declaration of medical writing assistance in international, peer-reviewed publications and effect of pharmaceutical sponsorship [abstract]. Paper presented at the International Congress on Peer Review and Biomedical Publication; September 16, 2005; Chicago, IL.
 
Koreith, K Medical writing market appreciation.Centerwatch Monthly2004;11,1-5
 
Wager, E, Middleton, P Effects of technical editing in biomedical journals: a systematic review.JAMA2002;287,2821-2824. [CrossRef] [PubMed]
 
Block, AJ The results are not perfect [editorial]. Chest. 1999;;115 ,.:1223. [CrossRef] [PubMed]
 

Figures

Tables

Table Graphic Jump Location
Table 1. Guidelines From Medical Journal Editors and Medical Writers on Acknowledging Medical Writer Involvement*
* 

Although additional guidelines and statements have been published on publication ethics, the guidelines listed in this Table provide practical advice for authors who want to work with professional medical writers.

References

Camacho, LH, Bacik, J, Cheung, A, et al (2005) Presentation and subsequent publication rates of phase I oncology clinical trials.Cancer104,1497-1504. [CrossRef] [PubMed]
 
Wise, P, Drury, M Pharmaceutical trials in general practice: the first 100 protocols; an audit by the clinical research ethics committee of the Royal College of General Practitioners.BMJ1996;313,1245-1248. [CrossRef] [PubMed]
 
Wager, E, Field, EA, Grossman, L Good publication practice for pharmaceutical companies.Curr Med Res Opin2003;19,149-154. [CrossRef] [PubMed]
 
Jacobs, A, Wager, E European Medical Writers Association (EMWA) guidelines on the role of medical writers in developing peer-reviewed publications.Curr Med Res Opin2005;21,317-322. [CrossRef] [PubMed]
 
Irwin, RS A new face of CHEST heralds a new era [editorial].Chest2006;129,1-3. [CrossRef]
 
International Committee of Medical Journal Editors. Uniform requirements for manuscripts submitted to biomedical journals: writing and editing for biomedical publication; ethical considerations in the conduct and reporting of research. Available at: www.icmje.org/index.html#ethic. Accessed June 25, 2006.
 
World Association of Medical Editors. Policy statement: ghost writing initiated by commercial companies. Available at: www.wame.org/wamestmt.htm#ghost. Accessed June 25, 2006.
 
Woolley, KL Letter to the editor. AMWA J. 2005;;20 ,.:184
 
CHEST editorial department. Instructions to authors. Available at: www.chestjournal.org/misc/authorInstructions.pdf. Accessed June 25, 2006.
 
Hamilton, CW, Royer, MG, for the AMWA 2002 Task Force on the Contributions of Medical Writers to Scientific Publications.. AMWA position statement on the contributions of medical writers to scientific publications.AMWA J2003;18,13-16
 
Wilde Matthews, A Ghost story: at medical journals, writers paid by industry play big role. The Wall Street Journal,. 13 Dec 2005;; ,.:A1
 
Phillips, SG, Carey, LA, Biedermann, G Attitudes toward writing and writing assistance in peer-reviewed articles.AMWA J2001;16,10-16
 
Woolley KL, Ely J, Woolley M, et al. Declaration of medical writing assistance in international, peer-reviewed publications and effect of pharmaceutical sponsorship [abstract]. Paper presented at the International Congress on Peer Review and Biomedical Publication; September 16, 2005; Chicago, IL.
 
Koreith, K Medical writing market appreciation.Centerwatch Monthly2004;11,1-5
 
Wager, E, Middleton, P Effects of technical editing in biomedical journals: a systematic review.JAMA2002;287,2821-2824. [CrossRef] [PubMed]
 
Block, AJ The results are not perfect [editorial]. Chest. 1999;;115 ,.:1223. [CrossRef] [PubMed]
 
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543