1 authorship bernard lo, m.d. august 27, 2009. 2 questions looked self up in pub med? omitted as...
TRANSCRIPT
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Authorship
Bernard Lo, M.D.
August 27, 2009
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Questions
Looked self up in Pub Med?
Omitted as author?
Co-author didn’t deserve it?
Asked to add author who didn’t
deserve it?
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Survey of UCSF fellows
Omitted as author 20%
Co-author didn’t deserve it 38%
Asked to make someone author who
didn’t deserve it 37%
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Case 1: Prior agreements fail
You are second author
First author not analyzing data or
writing paper
You want to take lead, get paper out
What would you do?
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Case 1: Prior agreements fail
Participants enrolled, data collected
and entered into statistical program
First author not analyzing data or
writing paper
You want to take lead, get paper out
What would you do?
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Case 1: Prior agreements fail
What would you do? Send an ultimatum to your colleague Get your mentor to pressure him Forget about the project and move on Not sure
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Case 2: Added author
Division chief asks to be author
Comments in seminars and on abstract
Not participate in design or analysis
What would you do?
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Case 2: Added author
What would you do? Hold your nose and do it Refuse and stand up for your principles Ask your department chair to intervene Forget about the project and move on Not sure
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Question
How did you feel about this authorship
experience?
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Outline of session
Criteria for authorship
Problems with authorship
Practical dilemmas
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Why have authorship?
Recognition Job, grants, promotions
Accountability Prevent fabrication, fraud, plagiarism
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Criteria for authorship
Conception and design or data
analysis and interpretation, AND
Drafting or substantially revising
article, AND
Approving final manuscript
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Criteria for authorship
Not merely
Funding or equipment
Collection of data
Supervision of research group
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Questions?
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Problems with authorship
1. Publish articles that shouldn’t be
published False, fabricated data Duplicate publications
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Problems with authorship
2. Fail to publish articles that should be Negative results
3. Too many authors = honorary authors People listed who shouldn’t be
4. Too few authors = ghost authors People omitted who should be authors
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Advantage study (2003)
Randomized trial of 5557 patients
Refecoxib vs. naproxen
Discontinue Rx for GI reasons: 5.9%
vs. 8.1%
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Advantage study
MIs: 5 on rofecoxib vs. 1 on naproxen 3 additional rofecoxib deaths not reported
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Statement by lead author
“Merck designed the trial, paid for the trial, ran
the trial. . . Merck came to me after the study
was completed and said, ‘We want your help
to work on the paper.’ The initial paper was
written at Merck, and then was sent to me for
editing”
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Ghostwriting
Asked by medical education company
to write a review paper on interactions
between warfarin and dietary
supplements sponsored by drug
company
JGIM 2005; 20: 546
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Ghostwriting
Received draft article, with name on
title page
Company developing oral
anticoagulant No mention of product Biased against warfarin
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Ghostwriting
Later asked to review same paper No mention of ghost author No mention of drug company sponsorship
Are these isolated cases?
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Problematic authorship
Honorary authors 21%
Ghost authors 13%
Ghosts acknowledged 0%
JAMA 1998; 280:222
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Problematic authorship
No substantial contributions26%
Provided subjects, materials,
lab, technical assistance 58%
Collected data 25%
JAMA 1994; 271: 438
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Preventing ghost authorship
All persons who had input into writing
must be author or acknowledged
All persons named as authors or
acknowledged must complete financial
disclosure
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Journal requirements for industry-sponsored research
Full responsibility for trial Access to data Data analysis
Control over publication Including data detrimental to product
Disclose financial relationships Including payment for writing
Questions?
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Duplicate publication
Articles in systematic reviews 1234
Duplicate 103 (8%)
No cross reference 63%
Translations 12%
JAMA 2004; 291: 974
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Types of duplication
Identical sample and outcomes
Combine several articles
Report different outcomes on sample
New data added to preliminary article
Part of larger trial, same outcomes
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What is wrong with multiple publications?
Inefficient transfer of information
Bias in evidence base
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Problems with authorship
5. Authors in wrong positions
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Who’s on second?
Less prestige than first
Middle authors contribute even less
Last author often senior
Not cited after 6th
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Who understands order?
Not journal editors
Not deans
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Survey of department chairs
Fictitious article and authors
Infer author’s contributions
Epidemiology 2004; 15; 125
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Contributions of authors
“Little idea of roles of any author”
If corresponding author, more credit
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Documentation of authorship
Describe specific contributions In manuscript In promotion packet
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Concussions in NFL players
Retrospective review of data from team
physicians
Return to play not associated with
increased risk of second concussion
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Conclusion
“Might be safe for college/high school
football players to be cleared to return
to play on the same day as the injury”
“Keep an open mind to possibility that
present analysis of professional
football players may have relevance to
college and high school players.”
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Dispute among 5 authors
Two disagreed
One said passage added without her
knowledge
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Lead author
Proofs were sent to each author No need to point out new passage
“If people who are not scientists or
physicians are misinterpreting it, that
is not the responsibility of those who
wrote it.”
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Reactions?
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Case 1: Prior agreements fail
What would you do? Send an ultimatum to your colleague Get your mentor to pressure him Forget about the project and move on Not sure
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Excuses
It’s in the pipeline
It’s next in the pipeline
BMJ 1994; 309: 1739
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Excuses
I’m reanalyzing the data
The data are on a Windows computer
I can’t find the right statistical test to
prove it worked
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Pragmatic concerns
Power differences
Future repercussions
Is it worth the hassle?
Can you live with yourself?
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Just do it, diplomatically
“I know you’re very busy. I’m willing to
take over as 1st author and write a
draft.”
“If I haven’t heard in 3 weeks, I’ll
assume you’re too busy to be first
author.”
Questions?
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Case 2: Added author
What would you do? Hold your nose and do it Refuse and stand up for your principles Ask your department chair to intervene
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Just say no, diplomatically
“The journal insists that all authors
sign that they have met a list of
requirements. I would feel very
awkward signing this. I’d like your
permission to give you a big thank you
in the acknowledgments.”
Questions?
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Emotional impact of authorship disputes
After disputes commonly feel:
Angry
Hurt
Taken advantage of
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Take home points
Be explicit about authorship positions
and responsibilities
Spell out arrangements in advance