Authors published in the New England Journal of Medicine who responded to a survey presented at the sixth peer review congress reported a 10.9% rate of ghostwriting, according to the New York Times (www.nytimes.com/2009/09/11/business/11ghost.html?_r=4). Six of the top medical journals published many articles in 2008 that were written by ghostwriters. Among authors of 630 articles who responded anonymously, 7.8% acknowledged contributions to their articles by people whose work should have qualified them to be named as authors on the papers but who were not listed. Writers sponsored by industry may introduce bias, affecting treatment decisions by doctors and ultimately patient care.