Ghost and Honorary Authorship in Cancer Research

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Despite stigma and efforts to limit prevalence, ghost and honorary authorship remain widespread in clinical trials.
Despite stigma and efforts to limit prevalence, ghost and honorary authorship remain widespread in clinical trials.

Concerns about the degree to which inappropriate authorship in journal articles affects transparency and accountability are widespread in the academic community.1 Inappropriate authorship is either honorary authorship, in which a named author did not substantially contribute to a work, or ghost authorship, in which an individual substantially contributes but is not credited as an author.

The International Committee of Medical Journal Editors (ICMJE) established criteria for determining authorship.2 These include contributing to the design or data acquisition and analysis of the work, drafting or revising the work, final approval of the published version, and agreeing to be accountable for the work's accuracy and integrity, the last of which was only recently added. Designated authors should meet all of these criteria, and those who do should be credited. 

A handful of studies assessed the frequency of inappropriate authorship. The results are often widely disparate, from as low as 21% in 1 study to as high as 75% in another.3,4 This may be attributed to different study methods, sampling frames, or definitions of what constitutes inappropriate authorship. The studies concluded, however, that inappropriate authorship is still prevalent, and recommended that journals take steps to address the problem.

Ian Tannock, MD, PhD, of the Ontario Cancer Institute in Toronto, and colleagues investigated the frequency of honorary and ghost authorship in systemic cancer therapy clinical trials published in 6 “high-impact” journals between July 2010 and December 2012.5 The results, published in the European Journal of Cancer, found that 66% of articles met their definition for ghost authorship, defined as “any scenario where investigators or statisticians listed in the protocol were not included as authors and not acknowledged in the report of the trial.” Thirty-three percent met the definition for honorary authorship, defined as any contributor listed who did not meet all 3 of the original ICMJE criteria, established in 1985. 

“I think ghost authorship is particularly prevalent for large, randomized trials that are published in major journals,” said Dr Tannock in an interview with Cancer Therapy Advisor. “Honorary authorship is a bit different. One of the things that you notice when you look at major trials is that you see the same names often occurring as the first author of the papers. And you sort of know that they aren't the people that were intimately involved with each of these protocols. There's a tendency of pharma to invite somebody with name recognition to lead the paper.”

A journal's impact factor—the frequency at which an article in a journal has been cited in a given time period—was positively associated with honorary authorship, but not with ghost authorship. Funding source did not predict for either honorary or ghost authorship.

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