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To advance healthcare and promote public trust, the integrity of medical research must be a high priority.1 Guest authorship (here encompassing gift, honorary, courtesy and coercive authorship) lists as ‘authors’ people who have not made substantial contributions to the work. It can occur: as fealty to supervisors, such as department chairs, laboratory directors or grant coordinators, who become authors on articles without making substantive contributions; as a means to enhance the esteem a paper receives by adding a preeminent name to the author list; or as a means to hide the publication’s origin in industry, as when a drug/device company designs, executes and writes a study’s report—without identifying its employees as authors in the resulting journal publication—then invites prominent physician(s) to serve as lead ‘author(s).’2 3 Here, the physicians are guest authors while company employees are ghost authors.
Although both guest and ghost authorship are roundly decried,3–8 previous publications have deemed them detrimental research practices that nevertheless are not quite research misconduct. Here, we focus on guest authorship, arguing that it falls squarely within the definition of ‘research misconduct.’ We then present options for academic institutions and medical journals to discourage guest authorship, thereby reinforcing integrity in medical science.
Scope of the problem
Among major, peer-reviewed medical journals, guest and ghost authorship are disturbingly common. Across multiple studies, approximately one in every five articles had evidence of guest authorship and one in nine articles indicated ghost authorship.3–9 Studies of guest authorship show, for example, an average 44% across five high-impact surgery journals, and 60% of articles in one prominent general medical journal.10 Finally, a survey of Cochrane review articles showed 39% with evidence of guest authorship, 9% with ghost authors, and 2% with evidence of both.11 Whereas ghost authorship is denounced as a largely corporate phenomenon,2 12 …
Contributors EHM is professor in the College of Medicine (University of Tennessee), focusing on health law and bioethics. Her recent article (J Law & Biosciences 2021; 8(1): 1-30) arguing, for the first time anywhere, that organisations such as corporations are capable of directly committing research misconduct—by the definition—set the stage for this article. JCW has served as Academic Clinical Quality Director, directly overseeing multiple collaborative scholarly projects. EHM and JCW contributed to the conceptualisation, investigation, original draft writing, and review and editing the draft. EHM is the named guarantor of the article, both authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.