Canadian Medical Association Journal 1996; 154: 751
On the one hand, a group of investigators may have carried out the first three activities and then assigned the writing up of the project to someone who, by agreement, acts as scribe, showing each and every draft to the authors who have final say on what is submitted to a medical journal. Traditionally, "ghosts" have seldom been identified. Should they be?
On the other hand, listed authors may have had almost no involvement in the conception or design of the study, analysis of the results or preparation of the manuscript but were responsible for recruiting patients for the study and carrying out the study protocol. Indeed, in some cases the position of the author in the byline may be directly related to the number of patients he or she recruited. Who are the real authors? Too frequently they are part of the study team of the firm who wanted and paid for the study to be done, but seldom are they identified.
Concealment of the real authors of a paper does the sponsoring body little good and, perhaps, a great deal of harm. Which should we trust more, a report in which the firm clearly discloses its involvement in all aspects of a clinical study, or one in which it hides behind a group of pseudoauthors whose sole activity was to follow rigidly a protocol prescribed by the sponsors?
To be fair, most clinical investigators know the realities of participating in clinical trials sponsored by commercial firms. But it seems somewhat less than forthright to list authors who were not and to conceal authors who were.