COPE: The committee on publication ethics

Authorship 

In recent years, I have accepted articles for publication with only 1 author to as many as 41 authors. Many journals—including this one—try to limit the number of authors to a maximum of 6, but that approach sometimes fails to resolve all concerns. Most guidelines on this issue make it clear that the award of authorship should balance the intellectual contributions to the conception, design, analysis, and writing of a study.4 If no task can reasonably be attributed to a particular person, then he or she should not be credited with authorship. To avoid disputes, it is helpful to decide early in the planning of the research who will be credited as authors and who will be acknowledged. Once an article is submitted, we require all authors to agree to any authorship changes, such as the addition or deletion of an author, or a promotion or demotion.

Conflicts of interest 

Conflicts of interest are sometimes obvious but can include relationships that might not be fully apparent that could influence the judgment of authors, reviewers, and editors. Conflicts of interest are relationships that, when revealed later, would make a reasonable reader feel misled or deceived. They can be personal, commercial, political, academic, or financial. Such interests, when relevant, must be declared to editors by researchers, authors, and reviewers. We receive such notifications nearly every day, and, on receipt of this information, we have an obligation to disclose these conflicts of interest to our readers. Even when in doubt and the perception of conflict is present, notes COPE, it is better to disclose.

Medicine has already suffered from being too lax in enforcing the responsibilities of authorship combined with commercial conflicts of interest; it is now paying a heavy price. An article, “Medical papers by ghostwriters pushed therapy,” by Natasha Singer,5 which was recently published in the New York Times, details the harm that can result from this type of negligence. A total of 26 scientific articles, published in medical journals between 1998 and 2005, emphasized the benefits and deemphasized the risks of taking hormones to protect against maladies such as aging skin, heart disease, and dementia. Wyeth, a pharmaceutical company whose products include the hormone drugs Premarin and Prempro, paid a medical communications firm to draft the articles. The supposed medical consensus benefited Wyeth, since sales of those drugs soared to nearly $2 billion in 2001. But things fell apart in 2002, when a huge federal study on hormone therapy was stopped after researchers found that women who took certain hormones for relief of menopausal symptoms had increased risks of invasive breast cancer, heart disease, and stroke. It was then shown that well-known scientists were coaxed into signing on as authors to the review articles written by Wyeth employees to gain acceptance and publication in respected medical journals. These ghostwritten articles were typically reviews in which an author weighed a large body of medical research and offered a bottom-line judgment about how to treat a particular ailment. The AJO-DO has had a policy since 2002 against publishing any review article submitted by authors with a financial conflict of interest.

Peer review 

Peer reviewers are external experts chosen by editors to provide opinions, with the aim of improving the study as submitted for publication.3 Authors must make certain that they do not inadvertently disclose their schools or their identities when submitting a manuscript. What is guarded even more carefully is the identity of each reviewer selected by the editor. This is why we never ask authors to suggest reviewers who might be available to review a newly submitted article for publication. Overall, reviewers provide speedy, accurate, and unbiased reports that determine which articles are published. When reviewers suspect misconduct in the methods used in a scientific study, they are encouraged to report this to the editor in strict confidence. It is also the responsibility of journal editors to provide regular audits of their acceptance rates and publication times.

Advertising 

Because most scientific journals derive significant income from advertising, editorial decisions must not be influenced by advertising revenue. To accomplish this task, the editorial and advertising administrations of a journal must be clearly separated. Advertisements that mislead must be refused, and editors should be willing to support scientific findings that are critical of products whose companies purchase advertising in the profession's publications.3 In the American Association of Orthodontists, a high-level committee of the board is responsible for screening all advertising in its publications, which include the AJO-DO. This committee frequently requires companies to change the wording in their ads to reflect the latest evidence as published in the Journal. Ninety percent of the time, the advertising agencies representing these companies willingly comply with these requests, and the advertising is published.

The fact that COPE has grown rapidly in its influence since its foundation in 1997 speaks to the need for finding practical ways to deal with the many ethical issues that encompass good practice. As the guidelines on good publication practice note, “We thought it essential to attempt to define best practice in the ethics of scientific publishing. These guidelines should be useful for authors, editors, editorial board members, readers, owners of journals, and publishers.”3 I can certainly add that your AJO-DO editors, staff, and editorial board adopt and strive to enforce in a practical way these guidelines of publication as stated so well by COPE.