by Evangeline Leash
In 1985, the International Committee of Medical Journal Editors (ICMJE; also known as the Vancouver Group) drew up a set of criteria for authorship to be incorporated into their Uniform Requirements for Manuscripts Submitted to Biomedical Journals (ICMJE, 1985). They took this step partly to discourage the inflationary increase they had noticed in the number of authors listed on biomedical papers and partly to put an end, they hoped, to the practice of “gift” authorship (Anonymous, 1985; Smith, 1994). Bestowal of gift authorship on colleagues who had had little or no involvement in the reported research had facilitated the publication of many fraudulent papers by John Darsee (Relman, 1983; Huth, 1986a) and later by Robert Slutsky (Engler et al, 1987). Some of those “gifted” with authorship, though happy to accept credit for work they had not done, disowned the papers bearing their names when questions were raised about them (Relman, 1983; Huth, 1986a; Engler et al, 1987), much to the dismay of the unfortunate journal editors who had published those papers (Rennie and Flanagin, 1994). Not surprisingly, then, substantial scientific involvement and ability to take responsibility for the work were the main themes of the ICMJE’s authorship criteria, which, being based on previously published opinions and organizational guidelines (Huth, 1986b), reflect traditional concepts of scholarly authorship. Contributions not sufficient to justify authorship were to be mentioned in an acknowledgments section. The authorship criteria have been expanded since their introduction in 1985. In the most recently published version of the Uniform Requirements (ICMJE, 1993), the criteria are stated as follows:
— All persons designated as authors should qualify for authorship. The order of authorship should be a joint decision of the co-authors. Each author should have participated sufficiently in the work to take public responsibility for the content.
— Authorship credit should be based only on substantial contributions to a) conception and design, or analysis and interpretation of the 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. Conditions a), b), and c) must all be met. Participation solely in the acquisition of funding or the collection of data does not justify authorship. General supervision of the research group is not sufficient for authorship. Any part of an article critical to its main conclusions must be the responsibility of at least one author.
Almost 500 biomedical journals, including 21 dental journals, have agreed to accept manuscripts prepared according to the technical specifications of the Uniform Requirements (ICMJE, 1993). Because many of these journals either cite the Uniform Requirements for authors to obtain or incorporate the authorship criteria into their instructions to authors, the ICMJE’s criteria for authorship may be the most widely distributed definition of authorship in the biomedical field.
Two papers published in 1994 make it clear, however, that actual authorship practices in biomedical research often differ from what the ICMJE — and many other editors as well as many researchers — considers ideal. Shapiro et al (1994) surveyed first authors of 200 research papers with four or more authors that were published in 10 leading basic science and clinical journals. They asked these first authors to indicate to which of the following six major tasks of a research project they and their co-authors had made substantial contributions: a) initial conception, b) design of the study, c) provision of needed resources, d) collection of data, e) analysis and interpretation of data, and f) writing the first draft or revising drafts for important intellectual content. The results from the 184 first-author respondents indicated that, whereas about 30% of the total authors had contributed to two or three tasks and 43% to four, five, or six tasks, 18% had contributed to only one task, most frequently the provision of resources or collection of data. Six percent of the authors were said to have made no substantial contribution to any of the six major tasks. Overall, according to the first authors, 26% of the total authors had not contributed substantially to the intellectual tasks of conception, design, analysis, interpretation, writing, or revision. In a smaller study in the UK, Goodman (1994) similarly surveyed first authors of multi-authored papers in five consecutive issues of a peer-reviewed general medical journal, asking them about their contributions and those of their co-authors. He used an expanded list of contributions that included the ICMJE criteria, without so identifying them, and several others — such as “obtained grant”, “head of department”, “referred patients to study”, “gave statistical help” — that do not meet the ICMJE criteria. Goodman concluded that about one-third of the 84 authors of these papers had not made “substantial contributions”, as defined by the ICMJE, to the intellectual content of the papers.
Further evidence of divergent thinking between journal editors and many biomedical researchers about authorship comes from a survey of post-doctoral biomedical research fellows at the University of California, San Francisco, conducted in 1992 (Eastwood et al, 1996). Asked to select from a list the criteria they believed warranted authorship of a research paper, large majorities of respondents checked “designed or collaborated substantially in the design of the study” (92%) and “analyzed and interpreted the data reported in the paper” (85%); 69% checked “wrote first draft of the paper” and 65% “developed or collaborated in developing a testable hypothesis for the study”, all of which are consistent with the ICMJE criteria. However, 85% checked “performed the experiments or collected the data reported in the paper”, 47% checked “was head of the lab in which the research was done”, and 44% checked “obtained funding for the research project” — all three of which are excluded by the ICMJE as authorship criteria. More disturbing was the effect on some of these postdocs of having observed or experienced what they regarded as authorship abuses. Thirty-eight percent said they had been listed as an author on a paper for which another author did not deserve authorship by the criteria they had selected; 37% said they had been asked to list an undeserving author on a paper; and 20% said they had been excluded as an author when they thought they deserved authorship by their selected criteria. Overall, 32% of the total 324 survey respondents said they would be willing to list an undeserving author if it would make publication of their work more likely or benefit their research career; but of those who had had any of the three unfavorable experiences with authorship described above, 75% said they would be willing to list an undeserving author (P<0.001). Thus, their perception of the actual practice of authorship assignment in the research environment had apparently made them willing to compromise their own principles.
Taken together, these findings reflect that, while many biomedical researchers do adhere to the ICMJE criteria, or something very similar, many others have not adopted them as the standard for authorship — indeed, many may never have heard of them (Huth, 1990). In reality, what is considered a contribution deserving of authorship varies from department to department, institution to institution, field to field, country to country. In some areas, custom dictates that the head of the department or laboratory be listed as an author of every paper issuing from that group — despite the attendant risks demonstrated in the Darsee, Slutsky, and several more recent cases (e.g., see Court and Dillner, 1994). For other researchers, pragmatism prevails: Authorship becomes “a trading chip in an economic game” (Conrad, 1990), bartered for material, information, research subjects, technological expertise, or whatever is required to get the research done. Still others frankly think that those who obtain the necessary funding or who carry out clinical trials, conduct experiments, collect data, or perform statistical analysis — “the people who actually do the work ” (Pinching, 1992) — fully qualify as co-authors, and they view the ICMJE criteria as a “senior authors’ charter” (Pinching, 1992).
What accounts for these widely diverging views of biomedical authorship? One possible factor is that those with an interest in biomedical authorship have different reasons underlying their interest. Academic researchers want first and foremost to make their research results known to the scientific community. But they know they need publications to get the resources to carry out their research (Angell, 1986). They are also aware that the credit derived from authorship opens the door to jobs, promotion, tenure, referrals, and prestige (Angell, 1986; Engler et al, 1987; Rennie and Flanagin, 1994; Shapiro et al, 1994; Smith, 1994). These considerations may inspire some to seek, or to confer, authorship for contributions that fall short of the ICMJE ideal. Journal editors, however, are concerned about the integrity of the research they publish and have legal as well as ethical stakes in publication. For these reasons, they want the list of authors to include only those involved closely enough in the work as a whole to be able to defend its design, execution, findings, and conclusions (Huth, 1986c; Kassirer and Angell, 1991; Rennie and Flanagin, 1994). Finally, promotion committees and granting agencies are interested in what they can glean from a publications list about an individual’s creativity and productivity. Often their judgments are based on guesses as to what the position of a name in the list of authors indicates about the nature and extent of that person’s contribution to the work — a highly unreliable method (Moulopoulos et al, 1983; Rennie and Flanagin, 1994; Shapiro et al, 1994).
Can these differing viewpoints and interests be reconciled? One approach the ICMJE and other journal editors may decide to take is to try harder to bring the research community around to their way of thinking, perhaps by publicizing their authorship criteria more widely or enforcing them more strictly (Godlee, 1996). It is unlikely, however, that a set of guidelines promulgated by editors will significantly influence the behavior of authors (Huth, 1986c; Smith, 1994) or could be effectively enforced. As another approach, scientific disciplines and organizations (e.g., the AADR [Bebeau and Davis, 1996]) could define authorship standards for their fields (Huth, 1986c), as could universities for their faculties (Institute of Medicine, 1989). Such actions would be worthwhile but, again, probably unenforceable. Another possibility is for editors and researchers to open a dialogue and perhaps come to an accommodation both groups could accept. This was the idea behind a recent conference to consider redefining biomedical authorship, held in Nottingham in June, 1996, and jointly sponsored by the Lancet, the British Medical Journal, the University of Nottingham, and Locknet, the international peer review research network (Horton and Smith, 1996a,b). Faced with evidence that their authorship definition is commonly ignored or incompletely applied (Horton and Smith, 1996a,b; Lundberg and Glass, 1996), members of the ICMJE met in plenary session and in small groups with about 90 biomedical researchers to discuss whether, and how, the ICMJE criteria should be modified (Godlee, 1996; Leash, 1996).
Still another possibility, one that could be viewed as satisfying the main interests of each party, would be simply to include in every paper a footnote in which each person credited with authorship defines the specific contribution(s) he or she made to the work — an idea that many have suggested (e.g., Moulopoulos et al, 1983; Huth, 1986c; Engler et al, 1988; Goodman, 1994; Shapiro et al, 1994). Thus, although authorship standards would probably still vary, whatever standards the authors had applied would be open to scrutiny by colleagues, institutions, editors, and the public (Engler et al, 1988). It would be clear to all readers which part of the research was the responsibility of which author(s) (Shapiro et al, 1994; an example of such a footnote is supplied in their paper). Journal editors could identify those authors whose involvement was sufficient to enable them to take responsibility for the work as a whole. If they chose, editors could ask authors to indicate their specific roles on a checklist of contributions the editors considered sufficient to warrant authorship, and so continue their efforts to raise awareness that authorship carries responsibility as well as credit (Huth, 1986c). Finally, committees or agencies attempting to evaluate someone for advancement or funding would have clear information regarding that person’s contributions to a research project (Shapiro et al, 1994).
A variant of this approach was offered by Drummond Rennie, Deputy Editor (West) of the Journal of the American Medical Association, at the conference in Nottingham. Noting that in much multidisciplinary research, not all authors of a paper can realistically take responsibility for the entire work, Rennie proposed that the term “author” be scrapped in favor of the term “contributor”; that all those considered by the research group to have contributed significantly to the work be listed in the byline and their exact contribution(s) defined in a footnote; and that one or more of the contributors, who are deeply familiar with the entire work and can defend it, be named as “guarantors,” who agree to be answerable in the event questions arise about the work (Godlee, 1996; Leash, 1996). (He stressed, however, that all contributors, not just the guarantors, should strive to verify the accuracy and validity of the entire work.) This full disclosure, he argued, would discourage gift authorship by exposing it; eliminate guesswork about what the first, middle, and last authors did; and allow recognition of some whose contributions may be substantial, valuable, and deserving of credit, but fall short of the full ICMJE criteria.
Debate on this proposal and on other possible modifications of the authorship criteria is continuing within the ICMJE, but after the meeting, the committee did agree to add the following sentence to the Uniform Requirements statement on authorship: “Editors may ask authors to describe what each contributed; this information may be published” (Lundberg and Glass, 1996).
Given the unlikelihood that biomedical researchers in all fields, institutions, and countries will soon come to full agreement with each other, let alone with journal editors, on detailed standards for biomedical authorship, it seems at present that explicit disclosure of each person’s role in the reported research is the most sensible way to discourage abuses of authorship, permit credit for all substantial contributions, and inform editors and readers of who stands behind each key portion of the work and who is prepared to vouch for the work as a whole.
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The author thanks S. Eastwood, H. Pritchard, and M. Zeiger for helpful suggestions in the preparation of this article.
Published in the Journal of Dental Research, 76(3):724-7, 1997.
Reprinted with permission.