- Email: [email protected]
The signature of responsibility
THE LANCET
COMMENTARY
Complaints made to The Lancet’s ombudsman July, 1996, to June, 1997 Editorial (1) No radiological acknowledgment and poor evaluation of a magnetic resonance image in a letter. (2) Book review done by an author: refers to a multiauthor work reviewed 4 years ago. (3) Improper delay alleged over publication a dozen years ago of a paper from one of the laboratories involved in work on HIV. Relevant records no longer available. (4) Poor refereeing of a letter rejected for publication; letter was reconsidered. (5) Questions on editorial integrity in rejection of manuscript: did the journal shy away because the subject (a third world dilemma) was too difficult, unpleasant, or awesome? Decisions made found to be based on standard editorial criteria. (6) Undue delay (5 months) in handling a manuscripts: a whole string of unsatisfactory events involving dilatory and then new reviewers, resulting in unacceptable delay. (7) Rejection of letter about unfair academic preferment; suggestions made on presenting this objective. (8) Rejection of letter; straightforward plea on an editorial decisions about haematological work deemed to deserve a platform. Advertising (9) Improper conduct by a non-medical overseas Lancet advertiser: first complaint received after 3 years’ advertising, alleging failure to refund professional fees. Appropriate professional body overseas identified and complainant referred to it. (10) Unfair advertisements in overseas edition; relates to standards demanded of drug advertisements in copies printed for India. Subscriptions (11) Delay in honouring journal subscription: illustrating problem of the flood of last-minute or delayed subscriptions arriving at the end of the calendar year; mechanisms under review.
proper answers. The setting appears quite promising after the first year. The editorial staff have come to accept that the ombudsman is there as an independent, unpaid someone who snoops around, opening drawers and files. Not “one of us” but there by agreement—the only basis for authority. Authors have used the ombudsman sparingly so far, for a journal with a 93% rejection rate for papers.4 In the main, authors understand his brief. The complaints made have been considered ones, and often searching. As an example, that on editorial integrity led to meetings as well as much correspondence. The journal has made efforts to improve its procedures where appropriate. I have come to appreciate firemen: forever flexing muscles in readiness for the next blaze, yet most of the time facing no flames at all. I am in waiting for another year.
Thomas Sher wood c/o The Lancet, London, UK 1 2 3 4
Horton R. The Lancet’s ombudsman. Lancet 1996; 348: 6. Chalmers I. The Lancet’s ombudsman. Lancet 1996; 348: 410–11. Davey Smith G. The Lancet’s ombudsman. Lancet 1996; 348: 411. Sharp D, McConnell J, Horton R. The Lancet in figures in 1996. Lancet 1997; 349: 374.
Vol 350 • July 5, 1997
The signature of responsibility A research paper does not exist through wizardry alone. Some stern critics in rare cases might disagree, but the article comes out of a head (or heads), not a hat. One thinks of this writer as an author. But the scientific author is more than just a recorder of events. The scientist as author is, according to the definition of the International Committee of Medical Journal Editors (the Vancouver Group),1 someone who not only takes public responsibility for the work but who can also attest to “substantial contributions to (a) conception and design, or analysis and interpretation of data; and to (b) drafting the article or revising it critically for important intellectual content; and on (c) final approval of the version to be published”. Many researchers think this definition is out of touch with their own research practice.2,3 It leans towards being a senior authors’ charter,4 falling short of providing explicit credit for those who actually do research (eg, a skilled laboratory worker). And, in an era of highly technical, multidisciplinary research, how can all authors be expected “to take public responsibility for the content”?1 On balance, the definition seems to fail important tests of relevance and reliability. The Vancouver Group has translated some useful general guidance concerning authorship into rigid qualifications. This approach seems mistaken to me. It does not recognise the true spirit of the relationship between investigator and editor. The Vancouver Group definition defines this relationship in adversarial terms: if you wish to call yourself an author, it declaims, editors demand that you fulfill these criteria. The investigatoreditor relationship immediately gets off on the wrong footing. Editors assume the role of schoolteachers, applying arbitrary rules based on their power of authority rather than negotiating a decision based on collaboration with researchers. These problems are long standing. The apparently simple process of reporting scientific research has always been shrouded in controversy.5 However, that anxiety has intensified recently,6 and it became more focused still during a conference on authorship held in Nottingham, UK, in June, 1996. Since then, there has been a spate of further reflection and hand-wringing.7–9 Yet little serious change to our existing systems of authorship has been introduced. A better model might be to consider the investigatoreditor relationship as a contract, one sealed by their respective signatures on the letter of submission and the letter of acceptance. A contract is an agreement that binds the parties to it. The advantage of considering this relationship as a contractual one is that it implies an ethical obligation—a duty—on both sides. These duties do not merely extend into the past—for instance, that the investigators have honestly reported their findings. They also extend into the future, drawing the signatories (investigators and editor) back to the paper if and when the need arises, as it inevitably does in critical correspondence. What are the elements of this contract? First, the agreement of both parties, though obvious, is fundamental. Second, and more difficult for our purposes, is the idea that the contract must be enforceable. In the 5
THE LANCET
COMMENTARY world of medical journals, there seems no-one to take on this task. Except perhaps one person: this journal’s ombudsman (see p 4), who is responsible for seeing that the processes of The Lancet are fair and proper. The agreement is proposed by the offer of a paper from the investigator(s). The editor decides whether to accept this offer. The journal’s instructions describe how the contract is to be negotiated—eg, peer review based on criteria such as originality and statistical validity. If negotiations are successful, the offer is accepted. The effect of this contractual approach is to dispense with the concept of authorship altogether, replacing it with the notion of signatories. But this change tackles only part of the problem of authorship. The second piece of a possible solution to our authorship puzzle was first explored by Drummond Rennie at the Nottingham meeting.10 His proposal aims to resolve the central problem of authorship—namely, the specific part played by each “author” cited on a paper. He invited editors to list in their journals the contribution of each “author” to the article concerned. This policy would heal the schism that has grown between publication credit and accountability. The Vancouver Group responded by making one small concession to the reality it otherwise chose to ignore—namely, that “Editors may ask authors to describe what each contributed; this information may be published”.1 In their forthcoming paper,10 Rennie, Yank, and Emanuel add a further authorial function—that of a guarantor. One or more contributors should guarantee the integrity of the entire work. In The Lancet this week, we adopt Rennie et al’s proposal by publishing at the end of each article and early report a list of “Contributors” and their respective roles. An obvious difficulty remains, as Rennie has pointed out to me. Contributors may hide behind their job titles, which could lead to further obfuscation. We shall try to be vigilant in preventing this manoeuvre. While I am enthusiastic about this new method, there is one aspect of it which seems to reproduce the old difficulty of the Vancouver definition. A guarantor is supposed to accept accountability for all parts of a completed research paper. This guarantee can only ever be theoretical, since no one or two investigators can oversee every episode of trial data entry or sample pipetteing. Is it realistic to identify one or more people as theoretical guarantors? In extreme circumstances, such as fraud, it may help to clarify further where final responsibility lies, but this matter requires some further thought. It is time to abandon authorship. Or, at the very least, it is time to face up to the fatal flaws of imprecision that surround our existing definitions of what it is to be a scientific “author”. In place of “authors”, a combination of signatories to the paper and contributors to the research, based on the the model of an explicitly stated investigator-editor contract, offers one way forward.
Richard Horton The Lancet, London, UK 1
2
3
6
International Committee of Medical Journal Editors. Uniform requirements for manuscripts submitted to biomedical journals. Ann Intern Med 1997; 126: 36-47. Eastwood S, Derish P, Leash E, Ordway S. Ethical issues in biomedical research: perceptions and practices of postdoctoral research fellows responding to a survey. Sci Eng Ethics 1996; 2: 89-114. Bhopal R, Rankin J, McColl E, et al. The vexed question of authorship:
views of researchers in a British medical faculty. BMJ 1997; 314: 100912. 4 Pinching AJ. On authorship and acknowledgements. N Engl J Med 1992; 326: 1084-85. 5 Medawar P. Is the scientific paper a fraud? In: The strange case of the spotted mice. Oxford: Oxford University Press, 1996:33-39. 6 Horton R, Smith R. Signing up for authorship. The Lancet 1996; 347: 780. 7 Parmley WW. Authorship: taking the high road. JACC 1997; 29: 702. 8 Smith R. Authorship: time for a paradigm shift? BMJ 1997; 314: 992. 9 Editorial. Games people play with authors’ names. Nature 1997; 387: 831. 10 Rennie D,Yank V, Emanuel L. When authorship fails: a proposal to make contributors accountable. JAMA 1997 (in press).
Protocol reviews at The Lancet Since the start of the year, The Lancet has been selecting and sending for peer review protocols from clinical trials and meta-analyses. For those that passed scrutiny, the journal has made a provisional commitment to publish the primary clinical manuscript. Four protocols have so far been accepted. An advertisement in this issue gives brief details of these four, with a cross-reference to a fuller, 500word summary on the journal’s website (http://www.thelancet.com), which includes contact details for the investigators and the expected submission date for the manuscript.
These four were selected from 15 submitted in the first 6 months of 1997. The Lancet is providing this new service for authors and readers to highlight good-quality studies at an early stage, to compile a register of selected trials, and to reduce publication bias against negative or neutral findings. Investigators will benefit by easier recruitment of cooperating centres and trial participants, and in their funding applications.
David McNamee The Lancet, London, UK
Vol 350 • July 5, 1997
COMMENTARY
Complaints made to The Lancet’s ombudsman July, 1996, to June, 1997 Editorial (1) No radiological acknowledgment and poor evaluation of a magnetic resonance image in a letter. (2) Book review done by an author: refers to a multiauthor work reviewed 4 years ago. (3) Improper delay alleged over publication a dozen years ago of a paper from one of the laboratories involved in work on HIV. Relevant records no longer available. (4) Poor refereeing of a letter rejected for publication; letter was reconsidered. (5) Questions on editorial integrity in rejection of manuscript: did the journal shy away because the subject (a third world dilemma) was too difficult, unpleasant, or awesome? Decisions made found to be based on standard editorial criteria. (6) Undue delay (5 months) in handling a manuscripts: a whole string of unsatisfactory events involving dilatory and then new reviewers, resulting in unacceptable delay. (7) Rejection of letter about unfair academic preferment; suggestions made on presenting this objective. (8) Rejection of letter; straightforward plea on an editorial decisions about haematological work deemed to deserve a platform. Advertising (9) Improper conduct by a non-medical overseas Lancet advertiser: first complaint received after 3 years’ advertising, alleging failure to refund professional fees. Appropriate professional body overseas identified and complainant referred to it. (10) Unfair advertisements in overseas edition; relates to standards demanded of drug advertisements in copies printed for India. Subscriptions (11) Delay in honouring journal subscription: illustrating problem of the flood of last-minute or delayed subscriptions arriving at the end of the calendar year; mechanisms under review.
proper answers. The setting appears quite promising after the first year. The editorial staff have come to accept that the ombudsman is there as an independent, unpaid someone who snoops around, opening drawers and files. Not “one of us” but there by agreement—the only basis for authority. Authors have used the ombudsman sparingly so far, for a journal with a 93% rejection rate for papers.4 In the main, authors understand his brief. The complaints made have been considered ones, and often searching. As an example, that on editorial integrity led to meetings as well as much correspondence. The journal has made efforts to improve its procedures where appropriate. I have come to appreciate firemen: forever flexing muscles in readiness for the next blaze, yet most of the time facing no flames at all. I am in waiting for another year.
Thomas Sher wood c/o The Lancet, London, UK 1 2 3 4
Horton R. The Lancet’s ombudsman. Lancet 1996; 348: 6. Chalmers I. The Lancet’s ombudsman. Lancet 1996; 348: 410–11. Davey Smith G. The Lancet’s ombudsman. Lancet 1996; 348: 411. Sharp D, McConnell J, Horton R. The Lancet in figures in 1996. Lancet 1997; 349: 374.
Vol 350 • July 5, 1997
The signature of responsibility A research paper does not exist through wizardry alone. Some stern critics in rare cases might disagree, but the article comes out of a head (or heads), not a hat. One thinks of this writer as an author. But the scientific author is more than just a recorder of events. The scientist as author is, according to the definition of the International Committee of Medical Journal Editors (the Vancouver Group),1 someone who not only takes public responsibility for the work but who can also attest to “substantial contributions to (a) conception and design, or analysis and interpretation of data; and to (b) drafting the article or revising it critically for important intellectual content; and on (c) final approval of the version to be published”. Many researchers think this definition is out of touch with their own research practice.2,3 It leans towards being a senior authors’ charter,4 falling short of providing explicit credit for those who actually do research (eg, a skilled laboratory worker). And, in an era of highly technical, multidisciplinary research, how can all authors be expected “to take public responsibility for the content”?1 On balance, the definition seems to fail important tests of relevance and reliability. The Vancouver Group has translated some useful general guidance concerning authorship into rigid qualifications. This approach seems mistaken to me. It does not recognise the true spirit of the relationship between investigator and editor. The Vancouver Group definition defines this relationship in adversarial terms: if you wish to call yourself an author, it declaims, editors demand that you fulfill these criteria. The investigatoreditor relationship immediately gets off on the wrong footing. Editors assume the role of schoolteachers, applying arbitrary rules based on their power of authority rather than negotiating a decision based on collaboration with researchers. These problems are long standing. The apparently simple process of reporting scientific research has always been shrouded in controversy.5 However, that anxiety has intensified recently,6 and it became more focused still during a conference on authorship held in Nottingham, UK, in June, 1996. Since then, there has been a spate of further reflection and hand-wringing.7–9 Yet little serious change to our existing systems of authorship has been introduced. A better model might be to consider the investigatoreditor relationship as a contract, one sealed by their respective signatures on the letter of submission and the letter of acceptance. A contract is an agreement that binds the parties to it. The advantage of considering this relationship as a contractual one is that it implies an ethical obligation—a duty—on both sides. These duties do not merely extend into the past—for instance, that the investigators have honestly reported their findings. They also extend into the future, drawing the signatories (investigators and editor) back to the paper if and when the need arises, as it inevitably does in critical correspondence. What are the elements of this contract? First, the agreement of both parties, though obvious, is fundamental. Second, and more difficult for our purposes, is the idea that the contract must be enforceable. In the 5
THE LANCET
COMMENTARY world of medical journals, there seems no-one to take on this task. Except perhaps one person: this journal’s ombudsman (see p 4), who is responsible for seeing that the processes of The Lancet are fair and proper. The agreement is proposed by the offer of a paper from the investigator(s). The editor decides whether to accept this offer. The journal’s instructions describe how the contract is to be negotiated—eg, peer review based on criteria such as originality and statistical validity. If negotiations are successful, the offer is accepted. The effect of this contractual approach is to dispense with the concept of authorship altogether, replacing it with the notion of signatories. But this change tackles only part of the problem of authorship. The second piece of a possible solution to our authorship puzzle was first explored by Drummond Rennie at the Nottingham meeting.10 His proposal aims to resolve the central problem of authorship—namely, the specific part played by each “author” cited on a paper. He invited editors to list in their journals the contribution of each “author” to the article concerned. This policy would heal the schism that has grown between publication credit and accountability. The Vancouver Group responded by making one small concession to the reality it otherwise chose to ignore—namely, that “Editors may ask authors to describe what each contributed; this information may be published”.1 In their forthcoming paper,10 Rennie, Yank, and Emanuel add a further authorial function—that of a guarantor. One or more contributors should guarantee the integrity of the entire work. In The Lancet this week, we adopt Rennie et al’s proposal by publishing at the end of each article and early report a list of “Contributors” and their respective roles. An obvious difficulty remains, as Rennie has pointed out to me. Contributors may hide behind their job titles, which could lead to further obfuscation. We shall try to be vigilant in preventing this manoeuvre. While I am enthusiastic about this new method, there is one aspect of it which seems to reproduce the old difficulty of the Vancouver definition. A guarantor is supposed to accept accountability for all parts of a completed research paper. This guarantee can only ever be theoretical, since no one or two investigators can oversee every episode of trial data entry or sample pipetteing. Is it realistic to identify one or more people as theoretical guarantors? In extreme circumstances, such as fraud, it may help to clarify further where final responsibility lies, but this matter requires some further thought. It is time to abandon authorship. Or, at the very least, it is time to face up to the fatal flaws of imprecision that surround our existing definitions of what it is to be a scientific “author”. In place of “authors”, a combination of signatories to the paper and contributors to the research, based on the the model of an explicitly stated investigator-editor contract, offers one way forward.
Richard Horton The Lancet, London, UK 1
2
3
6
International Committee of Medical Journal Editors. Uniform requirements for manuscripts submitted to biomedical journals. Ann Intern Med 1997; 126: 36-47. Eastwood S, Derish P, Leash E, Ordway S. Ethical issues in biomedical research: perceptions and practices of postdoctoral research fellows responding to a survey. Sci Eng Ethics 1996; 2: 89-114. Bhopal R, Rankin J, McColl E, et al. The vexed question of authorship:
views of researchers in a British medical faculty. BMJ 1997; 314: 100912. 4 Pinching AJ. On authorship and acknowledgements. N Engl J Med 1992; 326: 1084-85. 5 Medawar P. Is the scientific paper a fraud? In: The strange case of the spotted mice. Oxford: Oxford University Press, 1996:33-39. 6 Horton R, Smith R. Signing up for authorship. The Lancet 1996; 347: 780. 7 Parmley WW. Authorship: taking the high road. JACC 1997; 29: 702. 8 Smith R. Authorship: time for a paradigm shift? BMJ 1997; 314: 992. 9 Editorial. Games people play with authors’ names. Nature 1997; 387: 831. 10 Rennie D,Yank V, Emanuel L. When authorship fails: a proposal to make contributors accountable. JAMA 1997 (in press).
Protocol reviews at The Lancet Since the start of the year, The Lancet has been selecting and sending for peer review protocols from clinical trials and meta-analyses. For those that passed scrutiny, the journal has made a provisional commitment to publish the primary clinical manuscript. Four protocols have so far been accepted. An advertisement in this issue gives brief details of these four, with a cross-reference to a fuller, 500word summary on the journal’s website (http://www.thelancet.com), which includes contact details for the investigators and the expected submission date for the manuscript.
These four were selected from 15 submitted in the first 6 months of 1997. The Lancet is providing this new service for authors and readers to highlight good-quality studies at an early stage, to compile a register of selected trials, and to reduce publication bias against negative or neutral findings. Investigators will benefit by easier recruitment of cooperating centres and trial participants, and in their funding applications.
David McNamee The Lancet, London, UK
Vol 350 • July 5, 1997