According to a policy paper recently published in PLoS Medicine, drug companies control multiple steps in the research, analysis, writing and publication of a large proportion of medical literature, and they do so behind the scenes.

Sergio Sismondo, Queen's University, Kingston, Canada is an expert in the philosophy of science says that these articles are "ghostly" because signs of their actual production are largely invisible--academic authors whose names appear at the tops of ghost-managed articles give corporate research a veneer of independence and credibility."

Dr Sismondo says that drug companies hire medical education and communication companies (MECCs) to help produce and place company-funded articles in medical journals and that these articles are managed because those MECCs "shape the eventual message conveyed by the article or by a suite of articles." The doctor looked at one specific example - the published medical literature on the antidepressant drug sertraline. Dr. Sismondo's analysis suggested that between 18% and 40% of the literature on this drug published between 1998 and 2000 was ghost managed by a single MECC acting on behalf of the drug's manufacturer. He said that ghost managed studies affect medical opinion, practice and ultimately, patients. "I suspect that most researchers -- even those participating in the system -- don't have a good sense of the extent to which this happens," explained Dr. Sismondo.

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