To determine the prevalence of ghostwritten manuscripts among AMWA and EMWA members before, during, and after implementation of educational initiatives, we initiated a series of surveys in 2005.
All AMWA and EMWA members were invited by email to participate in the survey; one or two email reminders were sent.
Consistent with the relative sizes of the organizations, more participants were members of AMWA than EMWA.
Disclosure was associated with familiarity with guidelines from AMWA, EMWA, GPP, ICMJE, and PhRMA.
Our findings should not be generalized to the overall prevalence of ghostwriting in the medical literature because survey participation was restricted to AMWA and EMWA members who had made substantial contributions to manuscripts.
Although respectable for an email survey without incentives, our response rate was low enough that participants might not be representative of all AMWA and EMWA members, who in turn might not be representative of all medical writers.
It is possible that AMWA and EMWA members are more likely to follow guidelines than medical writers who are not members of these organizations and that those who devote time to survey participation are also more likely to devote time to learning ethical guidelines and complying with them.
These survey findings suggest that the prevalence of ghostwriting remains unacceptable despite extensive efforts by AMWA, EMWA, and other organizations to educate medical writers about ethical practices.