New authorship requirements

In August 2013, an important revision of the ICMJE recommendations included a fourth criterion for authorship to emphasize each author’s responsibility to stand by the integrity of the entire work^1,10,11. Classically, the ICMJE requirements for authorship included (1) substantial contributions to the conception or design of the work or the acquisition, analysis, or interpretation of data for the work; (2) drafting the work or revising it critically for important intellectual content; and (3) final approval of the version to be published. In the updated ICMJE requirements, a new (fourth) criterion also should be met¹. This novel requirement for authorship includes an agreement to be accountable for all aspects of the work and ensures that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved¹. The essence of this new requirement is that it helps to balance credit with responsibility¹⁰. With this revision, the ICMJE emphasizes that authorship is a serious commitment to accountability. Now all four conditions must be met by each individual author¹. The addition of a fourth criterion was motivated by situations in which some authors were unable to, or refused to, respond to inquiries on potential scientific misconduct regarding certain aspects of the study or by denying any responsibility^1,10-14. Editors occasionally face reluctant authors who try to distance themselves from a conflictive publication and shift responsibilities elsewhere¹¹. The main novel idea is to emphasize the responsibility of each author to stand for the integrity of the entire work. Each author of a scientific paper needs to understand the full scope of the work, know which coauthors are responsible for specific contributions and have confidence in coauthors’ ability and integrity^1,10-14. Should questions arise regarding any aspect of a study, the onus is on all authors to investigate and ensure resolution of the issue, which is then to be presented to the corresponding editor^1,10-14.

To better appraise this fourth criterion, the precise meaning of responsibility and accountability should be revisited. Responsibility is defined as the moral obligation to ensure that a particular task is adequately performed^15,16. Accordingly, responsibility relates to tasks that have been assigned to an individual^15,16. By contrast, accountability denotes the duty to justify a given action to others and to respond for the results of that action^15,16. Therefore, accountability mainly relates to the awareness and assumption of the role of being the one to blame if things go wrong^15,16. Nevertheless, oftentimes, responsibility is used interchangeably with accountability^15,16.

Claiming that each individual author is held morally responsible in every case that misconduct is detected would appear unreasonable considering the complexity of current research. Rather, the fourth criterion suggests that each author must cooperate to clarify misconduct-related issues if the paper is called into question^1,16.

Research credits

Acceptance and publication of a scientific paper are always a cause of major celebration among authors¹¹. Authorship provides prestige, credit, and scientific recognition. Authorship has important academic, social, and financial implications^1,11. Currently, authorship remains a major criterion for promotion and career advancement among scholars. Publication records are revised in depth for university tenures and job appointments. A total number of publications and citations remain currencies widely used to ascertain the academic value of individual investigators. In this regard, the ICMJE recommendations on authorship are intended to ensure that anybody who has made a “substantive” intellectual contribution to a paper is given credit as an author¹.

Potential problems derived from publication of research

Publication of a scientific paper usually marks the end of a research project and opens a time for discussion and criticism or acceptance by the scientific community¹¹. Occasionally, the healthy scientific debate fuelled by the publication of the paper raises serious concerns. In rare cases, even the integrity of the research or published paper is brought into question¹¹. In these situations, authors may try to escape from the embarrassment of publishing a scientifically flawed study. This explains why the new fourth criterion is so pertinent to address issues related to scientific misconduct. Should irregularities be confirmed, editors must report to the authors’ academic institution and, eventually, to the readers, with expressions of concern, or in the worst case scenario, with a retraction of the published paper¹.

Byline location and hierarchy

There is no adequate guidance for author sequence in the byline. In fact, practices to clarify the relative merit of the different coauthors in a manuscript vary significantly among scientific disciplines^18-22. For biomedical journals, the first author is the most important position, followed by the last author and then the second author. The first author is reserved for the person who made the largest contribution (investing most time in the project) usually the author who wrote the first draft of the paper. Then, the sequence of authors tends to represent progressively lesser contributions¹⁸. Following this approach, where the sequence determines credit, the last author receives the least. Accordingly, the last position might be considered as a rather generous option. Actually, the last position is currently considered as very important in biomedical research, and in fact, it is frequently associated with the corresponding author or the guarantor of the entire work¹⁸. However, many argue that senior scientists should grab the pen (keyboard) more often as writing remains essential for advancement in knowledge¹⁹. Senior authors have the responsibility to promote the academic career of new generation scientists.

Many journals allow authors to declare that two or more individuals have made “equal contribution” to the research^21,25-28. In the last decade, the percentage of articles with equal contribution statements has increased dramatically both in basic and medical scientific journals²⁵. Notably, the designation of “joint first-authors” should be based on the quality and quantity of the work^21,25-28. Thus, the “contributed equally” designation should be reserved to honestly reflect similar scientific contributions and not to inflate a curriculum vitae^21,25-28. Interestingly, the practice of listing two individuals as “joint last author” is used less frequent but steadily increasing. These publications should include a footnote, clearly indicating that both authors equally contributed to the work^21,25-28.

The corresponding author takes primary responsibility for communication with the journal during the submission, peer-review, publication, and post-publication periods¹. Currently, most journals require contact e-mail addresses from all listed authors who then will be contacted to inform that the corresponding author submitted the paper. This ensures that they are aware that the paper has been submitted in their name. The systematic implementation of this electronic warning system paves the way to guarantee that the third authorship criterion has been met. Therefore, the policy now may be considered as a mere administrative requirement similar to the signing of a copyright transfer.

The “guarantor” of the study may be different from the first or corresponding author and frequently is the principal investigator or more senior person in the group. The guarantor takes full responsibility for the integrity of the work as a whole from inception to the published paper. Accordingly, the guarantor must be fully prepared to defend all parts of the research project and the final manuscript. Guarantors vouching for the integrity of the entire work are of special value for multiauthor articles particularly when many institutions are involved. All authors should also disclose potential conflicts of interest^1,5. The ICMJE uniform conflict of interest disclosure has been recently updated and all authors should complete the corresponding standardized individual electronic document^1,5. In particular, authors of sponsored studies should indicate that they had full access to the data and take complete responsibility for the accuracy and integrity of the analysis. This is important as roles and interests of different stakeholders may remain elusive or misleading in this type of the study¹.

The subjectivity and emotionality of authorship may explain why disputes among investigators are not uncommon. Authorship disputes among research teams should be avoided by deciding roles and responsibilities beforehand. Ideally, the order of authors should be collectively decided by the research team at the onset of the project²⁹. Then, the definitive author order should be revised when the work is completed, taking into account the actual level of individual contributions¹⁷. Editors are unable to judge whether authors have met the authorship criteria. The Committee on Publication Ethics (www.publicationethics.org) guidelines are useful to solve publication disputes⁹. Editors should seek explanations and signed agreement of all authors in case of a request for a change in the author list¹.

Multiauthored articles

Scientific collaboration has become increasingly important because the complexity of modern research involves different competencies¹⁶. Moreover, a large number of patients and centers may be required to adequately address clinically relevant questions¹⁶. In addition, multidisciplinary research groups offer the opportunity of cross-pollination¹⁶. Therefore, teamwork is currently commonplace in biomedical research. Coauthorship is the most tangible result of multilateral scientific collaboration. Group (corporate) authorship has become increasingly common with variations in how individual authors and research group names are listed in the byline. Notably, citation impact is greater in papers with multiple authors coming from international cooperation. The problem of inflating publication and citation records of authors participating in multicenter studies has been a cause of concern¹⁸. This is due, at least in part, to collaboration-induced self-citation³⁰. Salami publications, or least publishable unit strategies, are initiatives that inflate the number of publications on the same research project by dividing the work (that could have been presented in a single main paper) into smaller component parts and then publishing them as several different articles. Such strategies may be detected in some multicenter studies³⁰. The use of coauthor-adjusted citation indexes has been suggested to account for this phenomenon³⁰.

There is evidence that the number of coauthors per paper in medical literature has increased exponentially over time^22,31. The reason for this increase is probably multifactorial and includes, increasing complexity of research, as discussed, but also author inflation. Inappropriate authorship is not ethical and eventually leads to diminish the value of authorship, generating a situation where undeserved coauthors cannot take responsibility for the research^22,31. Interestingly, the correlation between research quality and number of authors is poor, suggesting that the component of author inflation plays a greater role than that of research complexity³¹.

Until now, the number of authors in the byline was not considered in the evaluation of the relative academic merit of individual authors³. However, as a research project involves a defined amount of work, the larger the number of authors in a paper, the smaller the merit that deserves any given author. Major efforts are made by some individuals, whereas others contribute significantly less. The credit received by people doing the work becomes diluted by the inclusion of many authors with little, if any, contributions. Eventually, this “free lunch” strategy undermines the value of being named on a scientific paper³².

Authorship guidelines should be updated to adapt to the growing trend of collaborative research. The larger the number of authors, the more opportunities for contentious arguments and disputes. Every author of a “group authorship” work must meet the four criteria for authorship. Otherwise, they should be identified just as investigators or collaborators rather than authors¹. Given the complexity and multiple tasks involved in current research, it is clear that most authors cannot participate in every aspect of the work. Accordingly, specific responsibilities should be tied to different research roles. Authors should refrain from collaborating with colleagues whose quality or integrity may inspire concerns¹. Last but not least, with a growing number of authors, it is increasingly difficult to identify those who may be held morally responsible should scientific misconduct be detected^22,31. Holding everybody responsible is unfair to the researchers that are not guilty of misconduct.

Breaches in authorship: from ghost to guest authors

Breaches in authorship are a form of deception. Guest or gift (honorary) and ghost (hidden) authors represent a form of authorship abuse that should not be permitted^33-37. Ghost authorship is omitting authors who have made relevant contributions to a paper. Ghost authors provide contributions to a manuscript who do merit authorship but, for different reasons, are not included in the author byline. Some ghost authors may have major conflicts of interest or are paid by a commercial sponsor. This should be differentiated from ghostwriting. Ghostwriters are writing contributors to a manuscript that do not fulfill authorship criteria, but their contributions are not disclosed in the acknowledgments^17,36. Ghostwriting is also an unethical practice as it keeps hidden the involvement in the manuscript. The concern is that writers hired by the industry might influence the content of the publication or hide unwelcome results, which introduces potential bias that is obscured when relevant academic guest authors are accredited with authorship¹⁷. Professional medical writers should follow ethical publication practices and should openly disclose their involvement in the acknowledgment section³⁶.

The inclusion of individuals with minimal or no input reflects “loose authorship” practices^33-37. Guest, gift, or honorary authorship is defined as coauthorship awarded to people who do not meet the authorship criteria and have not contributed substantially to take public responsibility for the work¹. This may be offered in the belief that the prestige of a scientifically respected person will increase the likelihood of publication or the impact of the work²⁹. Oftentimes, a well-known academic senior name is used to conceal ghost authors with industry-related conflicts of interest²⁹. Both, the gift author and the remaining coauthors may benefit from this practice (a win–win situation) that, nevertheless, remains unethical. The increased pressure for publishing among scholars seeking promotion and career advancement (the “publish or perish” culture) may also help to explain these practices. This pressure explains why some researchers accept the “gift” authorship in papers to which they have not contributed intellectually. This abuse in authorship devalues the merit of being named as an author in a scientific paper. As previously discussed, quantitative contribution helps to prevent granting undeserved credits to guest authors who take away well-deserved credits from the authors who actually did the work^37-40.

Studies suggest that breaches of authorship guidelines are frequent. In a recent survey, one-third of authors believed that they had been excluded from deserved authorship and a similar number declared that they had experienced pressures to include undeserved authors in their papers²⁰. Another recent study of journals included in the Journal Citation Report database suggested that 85% of them included in their policy guidance the requirement that authors should be accountable for the research as a whole, 32% explicitly prohibited guest or ghost authorship but only 5% required authors to describe their individual contributions²⁵.

Final remarks

Authorship not only confers credit but also involves responsibility. Authors should be accountable and vouch for the integrity of the entire work. The Editors’ Network of the ESC endorses the ICMJE recommendations on authorship and encourages individual NSCJ to adapt their editorial policies accordingly.