Publication ethics Professor Magne Nylenna, M.D., PhD

Stepwise developments in medical publishing From clinician to clinician From researcher to clinician From researcher to researcher  From information to qualification

Trends Internationalization Specialization Multiautorship Digital media Bibliometric evaluation Increased ”production”

Authorship Patients’ rights Publication bias Plagiarism Conflicts of interest

Authorship Who is an author? ”Author” vs. ”writer” Developments: Increasing multiauthorship (1,5 in 1950 – 4,5 in 2005) Undeserved authorship

Problems with undeserved authorship Credits, merits, unfairness Responsibility, trust

Undeserved authorship ”Gift authorship” ”Guest authorship” ”Ghost authorship” Ca 25% Ca 10%

Another way of looking at it: ”If authorship was a crime, are there enough evidence to sentence you?”

Authorship credit should be based on 1)substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; 2)drafting the article or revising it critically for important intellectual content; and 3)final approval of the version to be published. Authors should meet conditions 1, 2, and 3.

All persons designated as authors should qualify for authorship, and all those who qualify should be listed. Each author should have participated sufficiently in the work to take public responsibility for appropriate portions of the content. Some journals now also request that one or more authors, referred to as “guarantors,” be identified as the persons who take responsibility for the integrity of the work as a whole, from inception to published article, and publish that information. Increasingly, authorship of multicenter trials is attributed to a group. All members of the group who are named as authors should fully meet the above criteria for authorship/contributorship.

No one would like to be number 7……..

The order of authors The order of authors is decided by the authors themselves The first author has normally contributed most to the paper The contribution of each author can and should be specified The corresponding author has a particular responsibility and status

Acknowledgments All contributors who do not meet the criteria for authorship should be listed in an acknowledgments section. Examples of those who might be acknowledged include a person who provided purely technical help, writing assistance, or a department chair who provided only general support. Editors should ask corresponding authors to declare whether they had assistance with study design, data collection, data analysis, or manuscript preparation. If such assistance was available, the authors should disclose the identity of the individuals who provided this assistance and the entity that supported it in the published article. Financial and material support should also be acknowledged.

Some advice Authorship and the order of authors should be decided as early as possible The contribution of each author should be specified

What characterizes medical research? It involves human beings …who are vulnerable ….with their own free will (and self- determination)... and ethical and legal rights

Participants’ rights The consciousness about patients’ rights is increasing In clinical research it should always be stated whether the Declaration of Helsinki has been followed and whether the study has been approved by an ethics committee The distiction between public and professional reading is diminishing – patients are reading medical journals!

How to ensure patients’ anonymity Nonessential identifying details should be omitted. Informed consent should be obtained if there is any doubt that anonymity can be maintained. If identifying characteristics are altered to protect anonymity, such as in genetic pedigrees, authors should provide assurance, and editors should so note, that such alterations do not distort scientific meaning Masking the eye region in photographs of patients is inadequate protection of anonymity..

Publication bias Are ”negative studies” published? Where (and when) are ”negative studies” published? How are results presented?

Source: Scherer and Langenberg Systematic review of 46 reports. Cochrane Library Half of all studies reported in abstracts reach full publication N= 8,832 abstracts

Plagiarism The "use or close imitation of the language and thoughts of another author and the representation of them as one's own original work” Random House Compact Unabridged Dictionary

Be careful! Use quotemarks Give full references Give credit

Conflicts of interest Commercial and other conflicts of interest should be declared when a manuscript is submitted The funding of the project should be declared The editor decides which information to publish

Researchers’ independence and integrity sponsoring scepticism among patients and the public ”the dark room”

Authors must sign this: ”I had full access to all of the data in this study and I take complete responsibility for the integrity of the data and the data analysis”