Similarly, review articles related to ro-fecoxib were frequently prepared by un-acknowledged authors employed by medical publishing companies and at-tributed authorship to investigators who often did not disclose financial sup-port from Merck. The limited nature of our source ma-terial for this case-study review pre-vented an exact determination of the contributions of recruited authors to the overall design and conduct of the clini-cal trial and/or the preparation of manu-scripts. Although we reviewed in ex-cess of 20 000 documents produced during the consolidated rofecoxib liti-gation, we were frequently unable to identify versions of manuscript drafts dated before and after external, aca-demically affiliated authors had been re-cruited. In addition, we cannot ex-clude contributions by authors made by telephone or in person that would not be identified by reviewing documents obtained through litigation. However, the instances for which we did iden-tify before and after manuscript drafts, such as for protocol 078, we found scant documentary evidence that the re-cruited authors were involved in the de-sign or conduct of the study or made substantive contributions to the manu-script beyond minor editing. Partici-pating only in minor editing does not meet authorship criteria of the Inter-national Committee of Medical Jour-nal Editors (ICMJE). 129 In addition, we could not determine how often ghost-writing and guest authorship actually occurred, whether the contracted manuscript drafts from medical pub-lishing companies were used, or if the proposed payments (honoraria) were provided. Nevertheless, although we
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