To conduct research ethically and report honestly is an obligation-Prof.Douglas Altman


Publication Ethics Congress proceedings-III

To conduct research ethically and report honestly
is an obligation - Prof.Douglas Altman

Fourth criteria was added to ICMJE guidelines on Authorship to ensure that
all authors must be responsible for integrity of the work-Dr.Trish Groves

Various countries have different credit system for authors hence Editors
should not get involved in authorship listing-Prof.Farhad Handjani

SHIRAZ (IRAN): Making the best use of information technology organizers of the Second conference on Publication Ethics held here on December 4-5th arranged presentations through Video Conferencing from London and Oxford in the second session on December 4th 2014. This session was chaired by Dr. Charlotte Haug, Dr. Fatema Jawad and Dr. Ehsan Shamsi. Dr. Trish Groves Head of Research at BMJ and Editor-in-Chief of BMJ Open made a presentation on Authorship Criteria: Why the fourth criterion was needed?

She pointed out that research when completed must be fully reported. ICMJE is a small working group and we meet every year. Authorship matters because it confers credit important for academics but one is also responsible for the published work. It means responsibility and accountability. Fourth criteria was added to the ICMJE guidelines on authorship to ensure that all authors must be responsible for integrity of the work. If any problem arises, all the authors are responsible to investigate it and solve those problems. All authors should identify co-authors who are responsible for specific parts of the work. Study group can have many authors but those should be listed who are involved in most of the work. It should clearly state the contributorship as to who did what. Others also contributed to the study but they did not qualify for authorship but they all must be acknowledged. In transparency declaration the lead author confirms that no important aspects have been omitted and everything has been explained.


Dr. M. Irfan Editor JPMI ,Dr. Fatema Jawad Chief Editor JPMA, Mr. Shaukat Ali Jawaid
Chief Editor Pakistan Journal of Medical Sciences photographed during the
Congress on Publication Ethics held at Shiraz recently.

During the discussion it was pointed out that while including the fourth criteria in ICMJE guidelines, the title of the guidelines was also changed. These are now recommendations and it is expected that every journal and every institution follows it and gets it implemented.

The next presentation through video conferencing was by Prof. Douglas Altman from Centre for Statistics and medicine from Oxford University. His topic was adhering to CONSORT statement in reporting RCTs. He was of the view that research has validity if methods have validity and research findings are published in usable form. Speaking about the RCTs as to what has happened he referred to the WMA as well as Helsinki declaration. It is the obligation to conduct research ethically and report honestly. It is important that all trials are registered and trial results are made publicly available within reasonable time of completion of the study.

Speaking about taxonomy of poor reporting he said it relates to non-publication or selective reporting or incomplete reporting. It is misleading reporting to make the results simply positive. These practices, he opined, are very common. Referring to the harm of poor reporting he said that it leads to over estimation of advantages and the given treatment. In one of the studies in 164 trials, 31% had bias in reporting while in another non-pharmacological intervention study 39% out of 137 had reporting bias. In many systematic reviews the readers complain that they cannot extract from the publication what does it mean? Poor reporting is a serious problem in systematic reviews. Speaking as to what can be done to improve this situation, Prof. Douglas said that there is a responsibility of every one involved to ensure that published research is an unbiased. All trials are registered and all results are reported. In reality many trials are never published. He further stated that authors should sign a declaration of transparency and conflict of interest. CONSORT has a 25-item check list stating what should be reported in a paper. It should also contain a flow diagram describing patient progress which should be included in trial report. Many journals, he said, has adopted this Consort statement. He concluded his presentation by stating that not all trials are registered and not all trials are published. Journal articles are seriously inadequate and improvement overtime is slow. UK research system requires that researchers will adhere to Helsinki declaration. Many journals have included this in their instructions to authors but authors are not reading and following these guidelines. He emphasized the need to strengthening the reporting culture. It is essential that Ethics Committees, scientists, organizations, editors all adhere to it and work together. He recommended that completeness, accuracy was need of the society at large. We must make authors to follow the reporting systems, look at the manuscript carefully, and support registration for publication besides training peer reviewers. Trial reporting should be completely transparent and all parties need to remedy this unacceptable situation, he remarked.

Dr. Ponneh Sarveravan from Iran gave details about adhering to CONSORT statement in RCTs with pharmaceutical interventions. They included 492 pharmacological RCTs which met the inclusion criteria. Of these 280 were published in Persian language and 230 in English language and less then 50% adhered to CONSORT statement. Three hundred seventy six had identified RCTs in the title, 445 completely defined the pre-specified secondary outcome measures, 326 gave details regarding the methods used to generate or random allocation. 429 gave details regarding mechanism used to implement the random allocation, 480 mentioned who generated the random allocation, 489 listed as to who assigned participants to interventions. Registration number and name of the trial registry was mentioned by 297 and 339 RCTs respectively while 493 gave information as to where the full trial protocol can be accessed. Their conclusions were that RCTs published in Iranian medical journals do not adhere well to CONSORT statement. The editors, authors and reviewers all need to be trained to consider CONSORT statement in reporting clinical trials well.

Mr. Shaukat Ali Jawaid from Pakistan in his presentation pointed out that authors are the most dangerous pressure groups which the Editors of biomedical journals have to face. The situation is worse in developing Third world countries where the authors, academicians are under tremendous pressure to publish for academic advancements and promotions. He supported his statements by referring to the various e mails received from the authors. He advised his editor colleagues to be careful when they receive too much submission from the same e mail, do not entertain manuscripts from professional groups, business groups but deal with the authors directly. Always ensure that the submitted manuscripts are accompanied by Ethics Committee/IRB approval. In case of submissions from overseas if you suspect the signatures on letter of undertaking to be suspicious, ask the authors to resubmit the LOU with proper signatures. Check the ménace of gift authorship, in case of too many authors, ask the submitters to reduce the number of authors, have a good peer review system. He further suggested that one should maintain record of correspondence with authors and reviewers for at least two years, always screen manuscripts for plagiarism, create awareness about scientific misconduct, go for CME and Continuous Professional Development which is the key to success and learn from colleagues how to face certain difficult situations. Presentation by Prof. Aminul Haque from Bangladesh was based on the ICMJE criteria for authorship which is available on the net on ICMJE website.

What constitutes authorship was discussed by Dr. Zoe Mullan, Editor of Lancet Global Health. She described in detail the common problems encountered and the current definition of authorship, advantages of authorship. She also disclosed that there are 877 cases related to authorship on the COPE website. COPE has also developed six flow charts related to authorship. ICMJE as well as American Physiological Society all give importance to concept, design of the study, significant contribution. Execution of study or interpretation is open to question but ICMJE guidelines are stricter in this regard. She further stated that it is not for the Editors to decide whether someone is or is not eligible to be an author. Every journal, she opined, should define authorship policy and all authors must sign authorship statement. Editors should ask for details regarding contributorship besides a declaration that the authors take the responsibility for integrity of the research work. She also talked about acknowledgment and said that those who meet some criteria but not all the four can be listed in acknowledgement. COPE recommends that individuals so named should also sign a declaration of agreement. The editors should also consider sending correspondence about a submitted paper to all named authors to reduce the possibility that some individuals may have been included without their consent. At times problems do arise and it is the responsibility of the editors to get it resolved. Do not feel that you must make the judgment yourself instead always refer to the authors instructions and COPE is there to help, she added.

Dr. Mohammad Irfan from Pakistan discussed regional view on authorship. He started his presentation with a case from Pakistan being discussed on the PAME List serve wherein the authorship was in dispute due to differences between the principal investigator and his supervisor. He pointed out that Supervisors are supposed to be mentors but in such a scenario, one can only feel pity for the young researchers/trainees. Even our religion says that one must have a mentor in life but if we consider the ground realities about mentorship, the situation is not promising. Referring to a survey in 2002 conducted among 4160 earlier career and 3,600 mid-career biomedical and social science researchers, he said that early career researches who received mentoring related to ethics and research decreased the odds of engaging in research misconduct but mentoring on professional survival increased these odds. About 2% of scientists admitted that they fabricated, falsified or modified the data, 77% admitted misconduct. Mentoring, Dr. Irfan said is important in the training and grooming of successive generation of scientists. A study among 92 Nobel laureates showed that more than half of them had worked under older Nobel laureates. What was transmitted to them was not just knowledge or skills but a style of thinking, he remarked. Talking about as to what constitutes inadequate mentoring he mentioned failure to review trainee raw data at regular intervals, failure to establish clear standards and failure to adequately support the trainee in career development. Talking about characteristics of successful mentoring relationship Dr. Irfan mentioned reciprocity, mutual respect and clear expectations.

Continuing Dr. Irfan said that mentoring fails because of poor communication, lack of commitment, personality differences, conflict of interest and lack of experience. Toxic mentors are destroyers or criticizers. The Dumpers are mentors who force novices into new roles and let them sink or swim while Blocker mentors are those who continually refuse requests, withhold information, take over projects or supervise too closely whereas the Avoiders are the mentors who are neither available nor accessible.

As regards regional mentorship, research culture, Dr. Irfan stated, has not yet developed , RCTs are not so frequently carried out, publications are essential for promotion and improving the CVs, training is inadequate an the time available is short. Sometimes the authors are forced to put the name of seniors in byline of their manuscripts though they have had no contribution at all. Sometimes reviewers deliberately ignore some shortcomings in a manuscript from his friend or former professor/boss. All these are the harsh facts which must be considered while proposing any guidelines for acceptable ethical behaviour. He was of the view that the situation can be improved by creating awareness about authorship guidelines, Ethical Approval certificates, acknowledgement of submission being sent to all authors and enhancing the role of the regulatory authorities like HEC in Pakistan through the respective institutions. Institutions can play a role if trainees have identified mentors, they are provided training on mentoring skills, provide resources and support for mentoring the faculty, have guidelines on best practices in mentoring besides recognizing and rewarding the excellence in mentoring, Dr. Irfan concluded.

Replying to a question during the discussion, Dr. Behrooz Astaneh said that there is a suggestion from the Iranian MOH that try not to publish studies in your own university journal and it was not being followed by some. Change in authorship should be decided in the beginning as the project starts. It should also be decided who will be the first, second and third author etc. One of the participants from Mashad University opined that PhD students will have problems if it is decided in the beginning. Prof. Handjani remarked that different countries have different credit system for first, second, third and other authors. Usually it is the first author who is expected to do most of the work. Some journals mention name of authors in alphabetical order and it is also specified in the instructions to authors. As such the Editors should not get involved in authorship listing. Dr. Behrooz Astaneh opined that all those authors who fulfill all the four ICMJE criteria for authorship should get equal credit. It was also emphasized that Journals should have an Appeal process for the authors whose manuscripts are rejected. Shaukat Ali Jawaid remarked that in their experience two authors appealed against the decisions of the Reviewers and when the authors challenged the decision with documentary evidence of latest research supporting their findings, their appeal was upheld and the reviewers also thanked them for the feedback and updating them. It shows that the authors who have done the study and prepared the manuscripts are most of the time much better informed than the reviewers. That is why to be a reviewer offers many advantages.

Workshop on Plagiarism & Journal Flow

In the afternoon Dr. Charlotte Haug along with Dr. Mohammad Irfan conducted a workshop on Plagiarism while Dr. Behrooz Astaneh along with Dr. Zoe Mullan conducted the workshop on Journal Flow: the International standards.

In the plagiarism workshop Dr. Charlotte summing up the discussion after detailed deliberations on two cases felt that plagiarism cases are complicated. Not everything is good. It also leads to some difference among senior editors. There can be a difference of opinion. It is always better to be careful, think of consequences and onus of the responsibility is always on the Editorial Board.