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REVIEW ARTICLE
Year : 2022 | Volume
: 17
| Issue : 6 | Page : 334-341
Publication ethics and misconducts
Anurag Sachan1, Sahil Khanna2, Vishal Sharma1
1 Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
2 Division of Gastroenterology, Mayo Clinic, Rochester, New York, USA
Correspondence Address:
Dr. Vishal Sharma
Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh
India
Source of Support: None, Conflict of Interest: None
CheckDOI: 10.4103/0973-3698.364678
A peer-reviewed publication is a culmination of the scientific process, which involves various stages, including planning and executing a research project. Publications, apart from being evidence of research productivity, have become the chief measure of assessment of a researcher for selection and promotion. This has increased the pressure on academicians to have more publications. Moreover, with advances in peer review and an increasing number of journals that want to publish “impactful research” with a bias toward positive results, the process of getting a publication has become more difficult and complex. There is a lack of awareness about ethical practices known as good publication practices (GPPs). Reporting any research in a standard manner, preregistration of clinical trials, obtaining a proper ethical clearance, maintaining patient anonymity, and getting proper consent are some of the components of GPP. Misconducts in the publication process at the author's front include data fraud, plagiarism, copyright violations, nondisclosure of conflicts of interest, and duplicate publications. The peer reviewers and editors are also prone to misconduct, either knowingly or unknowingly. Ethical misconduct should be handled appropriately at the institutional, editorial, or journal level. The custodians of these ethical pillars are largely the editors and peer reviewers who must base their decisions on suggestions and advice from the organizations standardizing the practices, such as the Committee on Publication Ethics and the International Committee of Medical Journal Editors.
Keywords: Data fraud, misconducts, plagiarism, publication ethics
To ensure the growth of scientific vigor and an unbiased publication of truth, the ethical principles related to practices must be followed in principle and practice. Historically, the formal publication in a journal can be traced back to the 17th century, when the first journal with peer review was established by Henry Oldenburg of the British Royal Society.[1] The aim of any researcher or academician is to pursue the scientific method with the utmost integrity in search of the truth. Any research, once done, only materializes when the work is peer-reviewed and published, and the scientific community/public becomes aware of it.[2],[3] Publication of the scientist's work is important for the recognition of the individual. However, this is not the reason why the edifice of peer-reviewed science and publication exists. The entire process of research and publication is to generate and disseminate new knowledge. The publications in the field of medicine are the bedrock of evidence-based medicine. Therefore, it is imperative that the published work in medicine is truthful, ethical, and free of possible biases.[2],[4] It is important for researchers and authors to understand that while publications bring some prestige and recognition, they come with a lot of responsibility. There are ethical issues involved in each step, from formulating the scientific query, designing the study to answer the query, choosing collaborators, dealing with difficulties in recruitment or follow-up, dealing with missing data, and decisions about authorship. Each of these small steps constituting the publishing process could potentially become a misstep if due diligence is not taken. The present review will review various types and levels of publication misconduct and suggest how to avoid, detect, and sanction such misconduct.
Challenges to Scholarly Publishing in the Modern EraThe scientific publishing process has evolved over the years with improvements in peer review and the emergence of new challenges. The major innovations include the introduction of open peer review, postpublication peer review, and open-access publishing.[2] There has been an increase in the number of journals, and as such, different methods of evaluation of manuscripts for publication are in vogue. As the number of articles is increasing exponentially, newer issues related to ethical misconduct are being recognized, leading to increased retractions of published works.
In the present times, where the aphorism of “publish or perish” has gained currency globally, institutions and even peers set the benchmark of a researcher's value according to the quality and quantity of an individual's publications.[3],[5] The selection and assessment of medical educators/teachers, unfortunately, has become singularly focused on the number and quality of peer-reviewed publications. A possible reason is that other parameters such as teaching and clinical/laboratory work may be difficult to measure and assess. The need for having some published work to show during selection and promotion could result in authors and researchers digressing from the standard ethical practices in their pursuit of a publication. Further research grants are often contingent on previous publications. All these factors have led to a mad rat race to publish – with ethics often taking a backseat. Even a clinician who may not be a keen researcher is compelled to publish to advance his career; while a researcher, to improve their prospect of getting a research grant, may want quick publications.[1],[5] This has led to an increase in publication frauds – use of fraudulent/falsified data, plagiarism, expansion of predatory publications which do not have appropriate peer review and quickly publish whatever is submitted to them after paying for what is termed as an “open-access fee” or “article-processing charges.” These publications have increased the mistrust in the open-access publication movement as many “predatory journals” now label themselves as open-access publications. To avoid publication misconduct, multiple guiding principles and recommendations have been formulated by the scientific community as good publication practices (GPPs).[1],[6]
Standards of Ethical PublicationPre-registration
Currently, pre-registration is mostly done for clinical trials and systematic reviews. This ensures that the limited resources for doing research are utilized properly, avoiding duplication of efforts. It also ensures that negative studies are not lost because of publication bias, which favors studies with “positive” results. Preregistration for clinical trials is presently mandatory and should be done following the local regulatory bodies.[2] Ethically, all trials should be registered before patient enrollment or initiation. It acts as a dual beneficiary to science as well as the author. Preregistration prevents publication bias and enables transparency of the scientific method, thus preventing (or documenting) any deviation from protocol. It also serves the author's purpose by acting as an advertisement for patient recruitment and increasing the chances of publication in case of a “negative” trial. The trials can be registered in a clinical trial registry approved by the World Health Organization's International Clinical Trials Registry Platform.[7] Preregistration also ensures that the study's outcomes are predecided and cherry-picking positive outcomes are avoided during the publication process.
Systematic reviews and meta-analyses may also be registered before initiation with the International Prospective Register of Systematic Reviews or databases such as the Cochrane Collaboration. The preregistration is not mandatory for systematic reviews by most regulatory bodies and journals currently. There are pros and cons to the registration of systematic reviews – the original idea may be used by another group and published before the author group who registered. Furthermore, the registration process in itself is tedious and takes time. However, preregistration may help in decreasing redundant reviews.[2],[8]
Standards of reporting
Various committees and scientific groups have formulated reporting standards for providing guidance to authors for reporting the study to enhance the quality of the article. These guidelines are for author guidance, but many journals advise strict adherence to these guidelines. Reporting the study in a manner conforming to guidelines increases the chances of publication as well as decreases redundancy.[9] The main standards of reporting for major study types are summarized in [Table 1], and details can be further acquired on equator-network.org.[10]
Ethical clearance committee
It is necessary to get ethical clearance for all human and animal studies from an appropriate ethical committee (EC). Ideally, each institute has the responsibility to set up an EC which can work in an appropriate and sustainable manner. The Indian Council of Medical Research (ICMR) has laid down its guidelines on the role and constitution of an ethical clearance committee.[11],[12] The responsibility of providing the infrastructure, logistics, and human resource is the institution's responsibility. Large institutions may have multiple ECs to have a faster processing time for research proposals. However, each EC should be a stand-alone committee, and members should not have any prior record of ethical misconduct. Independent ECs also exist, which are not affiliated with any institution and can be utilized by researchers from institutions that do not have their own EC. However, these independent ECs should function as per the national guidelines, and they would work like an institutional EC to assess the submitted proposal with access to all records. It should also undertake a regular review of the project and ensure the protection and well-being of research participants.[12]
As per ICMR guidance, any EC should have a minimum of 7–15 members, and any decision can only be taken in the presence of at least five members at a time. EC has affiliated, and nonaffiliated members of the institution and ideally should have one lay person as a member. In any meeting, one nonaffiliated member is a must for its validity, and ICMR guidelines suggest preferably having a layperson in such meetings. EC should be independent under a chairperson who should not be the head of the institution so that the head can be the appellate authority to dissolve/reappoint EC or handle any disputes. The reviews are conducted by the EC as an exemption from review, expedited review, and full-committee review based on the risk involved to the participants in the research proposal. The EC gives decisions as approved, revision with minor modifications, revision with major modification/resubmission, and not approved. The decision should also state the monitoring of the work, whether quarterly or annually, by EC.[12],[13]
All studies that enroll human or animal participants prospectively should have ethical clearance. That being said, studies where no direct intervention is being done or no proposed contact with the patient may be exempted from getting clearance from EC, such as narrative review, commentary, systematic review, and meta-analysis.[11] Approval of EC for case reports is not required by most journals and the scientific community. However, the practices may differ between journals or institutions as this gives a further layer of protection to the author in case of a dispute.[14]
Patient anonymity and consent
In pursuance of the scientific method, we should never lose the humanitarian aspect of research ethics and safeguard the individual identity and rights of each patient. Maintaining patient anonymity in all published research is an integral part that should always be kept in mind. Case reports, case series, or review articles may contain images of patients, which may make the patient identifiable. All efforts should be made for de-identification, but what constitutes appropriate de-identification is a debatable issue.[11] Explicit informed consent should be obtained from the patient, or if patients cannot give valid consent – their guardians or legally acceptable representative.[12] This is especially important in the present era of social media when journal articles and images are shared widely beyond the published paper through Tweets, Facebook posts, and group messages.[2] It is always advisable to show the images and manuscript to the concerned individual before submission. Deviation from this may lead to the retraction of the article as well as legal repercussions for the author(s). Even in large clinical trials, reviews, and retrospective studies, all efforts to de-identify individual participants should be made. Even while sharing the data with the journal or other researchers, individual patients' personal identifying parameters should not be disclosed as far as possible.
Informed consent is an integral part of all research where human participants are enrolled, but in specific places, a waiver of this consent may be applied where research is hampered without a waiver. A waiver is scientifically justified in retrospective studies with patients de-identified, research on anonymous data or samples, surveillance programs, research with data available in a public forum, and humanitarian disasters where the patient could not provide consent.[12]
Publication MisconductsMisconduct is a violation of scholarly and ethical conduct in scientific publications.[1] Although one tends to think that only the less impactful journals are likely to publish ethically flawed work, this is far from the truth. One of the most “impactful” articles published in the Lancet that was retracted due to ethical misconduct was the “Wakefield” article connecting the (MMR) Measles Mumps Rubella vaccine to autism. This article created a lot of skepticism about the vaccine in the general public, and finally, after much criticism and multiple reports, the study was probed. Multiple ethical misconducts came to light, including data fabrication, misrepresentation, improper consent, and nondeclaration of conflicts of interest leading to eventual retraction.[15]
Data frauds
Falsification of data is when data are modified to generate favorable results which are inaccurate. Data misrepresentation is a type of falsification where the data chosen may be selective and not represent the complete data set without a declaration of the same. Fabrication is when data are created where no data exists. These are serious forms of misconduct and should be dealt with appropriately, including debarring the authors and informing the institution about the concerns, and seeking investigation for the same.[16]
Plagiarism
Plagiarism is a grave scientific misconduct and has multiple definitions.[11] It can simply be the passing of someone else's words, ideas, images, or data as your own. It is also termed literary fraud, where the concept or used language is presented as original, whereas it is derived from the existing source without due credit. It can be as simple as borrowing a sentence or image without attributing the source. It can potentially lead to copyright violations and can have legal implications.[11],[17] Few examples may help in elucidating the presence of plagiarism in a medical student's or resident's work:
A medical resident, while making a presentation about reflux symptoms in rheumatological diseases, copies the tables and images from a few articles without proper acknowledgment.
A resident, while writing the thesis on responses to COVID vaccination in rheumatological diseases, finds an excellent review article and copies a table as he feels that it conveys the essence of the message he wants to give.
Plagiarism is commonly found in the scientific world and is sometimes very difficult to recognize. It has been increasing recently due to the ease of copying online available resources, lack of respect for others' work, unawareness about plagiarism, and lack of suitable training in the competitive field of academic research. A recent survey from 11 institutions in India conducted on over 783 residents and junior faculty showed that <3% had adequate knowledge about plagiarism practices.[18] Some common types of plagiarism are tabulated in [Table 2].[15],[16],[17],[18],[19],[20]
A researcher reports a new stool test to diagnose gastrointestinal involvement in rheumatological diseases but does not cite a previous paper that initially reported the use of the test.
Self-plagiarism is a special type of plagiarism where the author copies text or images from his own work. In addition, once published, the copyright is transferred to the journal, and self-plagiarism is an infringement of this copyright. Another type of self-plagiarism is text recycling, where the author uses text from his previous article multiple times.[20] The first publication from a research project is known as the primary publication. Any subsequent publication from the initial data should be clearly mentioned to be derived from the initial paper as a post hoc or subgroup analysis of initial work. Although self-plagiarism may not appear to be ethically incorrect, it has multiple concerns – artificially inflating one's work, copyright infringements, and wastage of reviewers' time and publication space.[11],[19],[20]
Duplicate or redundant publications are those where two publications have similar results and have been derived from the same data, especially when the absence of either of them would not lead to a loss in the knowledge of the scientific community.[19],[20] Duplicate publications represent an exact replication of previous work, while redundant publications are slightly modified versions of previous work without any new information or knowledge.
Salami slicing is another type of publication misconduct where a single research work is unreasonably divided into multiple publications which could have been covered in a single manuscript with an intention to increase the number of publications.[21] This is ethically unacceptable as it adds to the journal and reviewer work burden. Dividing work into separate publications may be acceptable when multiple papers from a large database are created or when there are clearly different aspects, such as clinical or laboratory data. In these scenarios, proper attribution to previous publications is imperative.[2] In areas of confusion (which will happen quite often), transparency and upfront declaration of any areas of concern are the best safeguards against any allegations of self-plagiarism or salami publication.[2],[20]
A researcher published a randomized trial on the use of antibiotics in the setting of acute severe ulcerative colitis. The researcher now wants to publish findings regarding using serum procalcitonin as a prognostic marker in acute severe colitis from the same cohort. He ensures that the previous work is cited and contextualizes clearly that the new paper utilizes the same patient set.[22],[23]
The University Grants Commission in India provides detailed guidelines on plagiarism knowledge, increasing awareness, detecting plagiarism, and penalties in case of violations.[24]
Copyright violation
Being an author and a proprietor, be aware of the “©” or the copyright of the content. The copyright may lie with the author, journal, or third party. This information is generally provided with the original publication/journal, and any usage of that content is under legal protection. Proper permission or payment for the content needs to be sought before its use to avoid any legal trouble. Usually, the author or editor-in-chief may be able to give permission for the usage of some content for academic purposes with proper acknowledgment or citation. However, permission needs to be sought from the publisher for any re-use of images, tables, or text. This may require payments for copyright directly or via a third party for acquiring the rights of usage.[21]
Author X has published a review article on gastroenterology manifestations of rheumatoid arthritis with an image he created. He wants to re-use the image he created for another work for a different journal. He takes permission from the previous publisher and then re-uses the image with proper attribution to the original publication to avoid any copyright issues.
Conflict of interest
''A conflict of interest (COI) exists when an author, reviewer, or editor has financial or personal relationships that may inappropriately influence his or her actions (dual commitments, competing interests, and competing loyalties).”[17] The potential of having a COI may always be present even if the author believes his views are unbiased. Hence, it is better to disclose any probable COI whenever in doubt. Chiefly COI can be divided into two types: financial and nonfinancial or personal. The financial COI is easier to identify as well as easy to disclose such as bonds, shares, sponsorship, paid lectures, or honorariums.[25] It is the personal or nonfinancial COI that is difficult to disclose and identify. These can occur due to individual relationships, prepublication agreements/restrictions, and academic competitions of authors.[2] Any strong views about a particular contentious field of work may constitute a COI when reviewing others' work. [Table 3] shows some examples of COI at various levels.
Misconduct in Peer review ProcessPeer review is when a person, usually working in a similar field, opines on work for its appropriateness for the scientific community and to improve it.[17] Peer review may be single-blinded (reviewer's identity unknown to author), double-blinded (authors and reviewers blinded to each other), or open (both are aware), respectively. With an increasing number of peer review journals, there are multiple ethical issues being identified.[26]
Fake peer review
Fake review occurs in multiple situations where either the author has provided a fake E-mail address while suggesting a reviewer and provides a review impersonating another person, or the reviewer gives a fake review for financial gain from author/third party.[2]
Adversarial peer review
The use of derogatory words or harsh language in reviews is not supported by the scientific community. Knowingly, rejecting an article not on merits but due to academic competition or skepticism. Reviewers may reject an article in order to publish their own related work and delay the publication of competing work.[26]
Replicating manuscript
The reviewer may replicate the manuscript or use the idea after rejecting or delaying the manuscript.[26]
Soliciting authorship
The reviewer may contact authors and solicit financial benefit/authorship in the next paper for giving a positive review.
“Positive study” bias
In general, the reviewers may be biased toward a study showing positive results rather than a negative study causing the rejection even if the study design is appropriate. This is, perhaps, a common but unidentifiable bias in the peer review and editorial process.[2],[26]
Conflicts of interest in peer review
COI in peer review is when the reviewer has a personal, financial, or academic relationship with the authors or the submitted work. It should be disclosed to the handling editor, and review should usually not be accepted in the presence of COIs.[25]
Ghost peer review
This is another type of peer review misconduct where a researcher hands over a peer review assigned to him to his junior colleague or student. Eventually, he/she submits the comments in his name without acknowledging the help received, and the junior colleagues get no contribution for the efforts. Apart from the ethical concerns, these may result in poorly done peer reviews by individuals not trained to peer review. Many journals now have mentored reviews which allow junior colleagues to help and participate in reviews under supervision of senior colleagues and get acknowledgment for their efforts.
Ethics in Editorial StandardsEditors and the editorial board are not immune to ethical misconduct, and journals should have a proper policy of ensuring disclosures of COI.[17],[27] As explained earlier, the editors, apart from financial conflicts, may have conflicts of interest with the author or his work, so each journal should routinely specify the conflicts of interest of each editorial member publicly for a fair process.
In an ideal world scenario, there should be a provision of queries and appeals by the author against the review process or editorial decisions in all journals. A lack of appeals processes or clarity has been demonstrated even among major journals, including top gastroenterology journals.[28] Whenever a correction/corrigendum is supplied to any prior published article, it should be published separately, and the reasons should be specified and linked to the actual paper. Withdrawal and retractions should again be specified by the author/editor in the journal with reasons. Records of retractions should be maintained by the journal and be accessible to the public.[11]
Authorship CriteriaThe International Committee of Medical Journal Editors (ICMJE) has a four-criteria approach – contribution in the original proposal, data collection, processing, or analysis.[2],[11] This includes participation in conceiving, designing, collecting, or analyzing data; writing or revising the manuscript; and final approval of the final version. In addition to the above, an author in a publication also accepts the responsibility of vouching for the credibility and authenticity of the work and giving proper replies to questions arising from it.[2],[11] This is important as in the prior “Wakefield” example, where 10 out of the 12 authors backed out from confirming the authenticity of the published data.[18] Often, the authors take the help of colleagues or students in doing the work who may not satisfy the criteria for authorship but remain a contributor and should be properly declared in the manuscript.
Inappropriate authorship is where authorship is granted either for financial, personal, or academic gain. This becomes even more relevant in large multicenter studies with multiple collaborators. It is also routine to give authorship to institutional heads and departmental leads and is labeled honorary authorship.[30] Such authorship should be discouraged as a matter of principle.[30] Departmental heads should be authors only when they qualify the ICMJE criteria and not for providing overall supervision or allowing the departmental facilities to conduct the research work. Ghost authorship is when an individual has helped in the manuscript and qualifies as an author or needs to be acknowledged. This is usually a junior colleague or, sometimes, a pharmaceutical company or medical writer who writes the initial draft. Gift authorship is the putting a name on the author byline of an individual who has not done work to qualify as an author. This is usually done in the hope of the reciprocal benefit of being an author on others' work. Another common practice is that of guest authorship in which some senior persons of (KOL) Key opinion leader are provided authorship in hope of increasing chances of publication.[31]
Handling Ethical MisconductsWhenever an issue regarding ethical misconduct in a study is raised or suspected, the editor should ask for clarification from the author. If there is a delay in a reply or a lack of reply, the editor can declare an “expression of concern” regarding the study in the journal and start an investigation.[32] Further, if the allegations regarding the misconduct are accepted by the author or proven in the investigation, various measures need to be initiated. The first and foremost is the correction of the scientific record – this may be in way of a corrigendum/erratum to correct any errors. It is pertinent to point out the reason for the error – an honest error also needs correction.[33] Serious errors or misconducts such as image duplication, data fabrication or falsification, and duplicate publication would usually warrant retraction of the paper with clear reasoning for the action.[34] The editor should warn the author and may forbid any future publications from the offending author (s). The institution where the particular accused author/researcher is affiliated should be notified, and often the decisions regarding fabrication or fraudulent data are made after an investigation by institutions. In case the authors/institutions do not respond, the editors should conduct their own investigation and may publish an expression of concern or retraction as appropriate. Issues related to authorship may be dealt with at the level of authors or institutions. Sometimes, it may be notified after publication by co-authors or nonincluded individuals and may often be responsible for paper retraction or withdrawal.[2],[11] The best time to ensure that authorship is not an issue is during the planning and the deliberations may be documented in writing. Further, the corresponding author should take a guarantee of authorship and should circulate the version with co-authors for comments and clarifications. All suggested changes should be either incorporated or addressed. Nowadays, journals routinely E-mail an acknowledgment regarding manuscript receipt to all authors and ask them to agree to their being named as co-authors.
Retraction is usually a matter of shame as it implies misconduct, whereas withdrawal may be due to other reasons and may not dent the author's reputation. It is important that the reasons for the retraction or any corrective action are mentioned clearly so that transparency regarding the origin of errors in the publication is maintained.[34] If a COI is identified later, the journal/editor may take action on the accused or state a declaration/addendum publicly to acknowledge the COI. Editors, reviewers, and authors should take responsibility for the appropriate declaration of COI.[25] Any major peer review misconduct should be handled by the editor/journal, and the reviewer should be given a warning. The editors can make an editorial decision for the article when there is suspicion of adversarial review.
Custodians of Ethical PublishingThe guiding principles followed in medical research are from the Declaration of Helsinki from the World Medical Association, which initially laid these guidelines in 1964 and continues to update them. The onus of following the ethical issues related to scientific publication lies with each individual author. Still, there needs to be an overarching body to scrutinize and guide the individual authors and editors in ensuring ethical standards for published work.[1] The main organizations involved in overlooking the ethical issues with publishing across the world are:
Committee on Publication Ethics (COPEs)ICMJEWorld Committee of Medical Editors (WAME)The COPEs were founded with the premise to find practical solutions to prevent and deal with ethical misconduct.[35] ICMJE and WAME were formed by a group of editors of peer-reviewed medical journals, with WAME branching from ICMJE. The ICMJE laid down the roles and responsibilities of authors, contributors, reviewers, and editors. It also has guidance for manuscript preparation and editorial issues.[36]
The ICMR, which is a central organization, has taken up the task of laying down the framework for ethical issues in research with recent guidelines in 2017.[12] To ensure the adherence to ethical principles in the conduct of research, each research proposal goes through an individual independent research ethics committee for approval of the methodology and scientific principle. However, following the GPP is the authors, contributors, reviewers, and editors' responsibility.
ConclusionWith the advent of the era where “publish or perish” is the mantra among the medical fraternity and assessors, there is an increasing need to be aware of publication ethics and related misconduct. With publication misconduct, awareness is the first step in avoiding such issues. In this review, we have attempted to summarize various plausible publication misconducts at the author, reviewer, or editorial level. We have also suggested approaches to avoid and detect such misconduct [[Table 4]]. The reporting standards for various study types are available freely and are now required in most journals. Plagiarism, data frauds, fabrication, duplicate publications, and salami publishing are all misconducts that need to be avoided. Conflicts of interest should be declared, and more so if in doubt. Authorship has clearly laid down criteria that should be adhered to. Awareness about copyright and its violation should be known in the current era as it can cause legal and financial troubles.
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Conflicts of interest
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References
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