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Editorials   |    
Changing Ethical Standards in Scientific Publication
Richard A. Brand, MD1; James D. Heckman, MD2; James Scott, FRCS3
1 Clinical Orthopaedics and Related ResearchPhiladelphia, Pennsylvania
2 The Journal of Bone and Joint Surgery (American Volume)Boston, Massachusetts
3 The Journal of Bone and Joint Surgery (British Volume)London, United Kingdom
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The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2004 Sep 01;86(9):1855-1856
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Truth is the drive at the center of science; it must have the habit of truth, not as dogma but as a process1.—Jacob Bronowski, Science and Human Values
Truth is the drive at the center of science; it must have the habit of truth, not as dogma but as a process1.
—Jacob Bronowski, Science and Human Values
Scientific writing imposes upon the authors a grave responsibility to report truth and to do so in an ethical manner. Editors and publishers have long recognized the importance of ethical behavior. The Memoirs of the Literary Society of Manchester noted in 1785:
The sanction which the Society gives to the work, now published under its auspices, extend only to the novelty, ingenuity, or importance of the several memoirs which it contains. Responsibility concerning the truth of facts, the soundness of reason, in the accuracy of calculations is wholly disclaimed: and must rest alone, on the knowledge, judgement, or ability of the authors who have respectfully furnished such communications2.
The sanction which the Society gives to the work, now published under its auspices, extend only to the novelty, ingenuity, or importance of the several memoirs which it contains. Responsibility concerning the truth of facts, the soundness of reason, in the accuracy of calculations is wholly disclaimed: and must rest alone, on the knowledge, judgement, or ability of the authors who have respectfully furnished such communications2.
Despite certain universal concepts, the standards or requirements of publishing, as other human endeavors, undergo natural evolution, and standards acceptable even ten to twenty years ago are no longer acceptable. In recent years, a number of organizations, including the Council of Science Editors (CSE), the International Committee of Medical Journal Editors (ICMJE), and the Committee on Publication Ethics (COPE), have published contemporary ethical guidelines addressing a variety of issues3-5. These include research misconduct, redundant publication, fraud and plagiarism, conflicts of interest, authorship, privacy, and ethical approval of research. We, the editors of three major orthopaedic journals, wish to draw the attention of readers and contributors to several of these issues, namely, redundant publication, plagiarism, conflict of interest, and ethical approval of research.
No one would take exception to the explosion of information in recent years. Approximately 8% of the articles recently published in orthopaedic surgery appear to have some degree of redundancy6. It is incumbent upon contributors to avoid redundant publication and the more common practice of publishing multiple, closely related articles ("least publishable unit,"7 "meat extender,"8 or "salami slicing"9). These latter practices are often difficult to identify in a prospective manner because authors may change the order of authorship and particularly the corresponding author, submit to multiple journals, or submit at differing times. Material containing essentially similar aims or hypotheses, data sets, conclusions, and references will likely all fall within the framework of redundant publication. (Most editors make exception for material published in a second language when the first publication has appeared in print and can be noted and referenced.)
Plagiarism occurs when authors substantively report the work (unpublished or published) of others without properly crediting the original source. Such copying may take the form of presenting data or figures from other publications, copying paragraphs, or even verbatim reporting crucial original phrases. At the gray edges, individuals differ on what constitutes plagiarism10. At a minimum it may involve copying key phrases, concepts, or images without quotations or citations, but at worst it represents theft with legal ramifications11.
Each of our journals has explicit policies dealing with conflicts of interest, and each requires the authors to specify in essentially similar manners the type of conflict. Perhaps the most common relate to the involvement of an individual with a commercial product being reported12-17. While conflicts do not per se jeopardize the scientific validity, readers must be made aware of a potential bias in reporting.
Standards of ethical review of research have undergone rapid evolution over the past ten to fifteen years, and continue to do so. Institutional review of human and animal research is now required in many, if not most, industrialized countries. Accordingly, many journals require statements of approval. One of our journals now requires a copy of the institutional review board approval18. Each of our journals concurs with the requirement for such ethical approval.
We are committed to following contemporary ethical standards, and will cooperate in these cases when appropriate. When we encounter a case of any ethical violation, each of us will at a minimum write the author for an explanation. Possible duplicate submissions will be sent in a blinded fashion to an independent reviewer for an assessment. Authors who violate these ethical standards are subject to a variety of sanctions3,19. The particular sanction depends upon the violation. Minor violations (e.g., failing to cite a previous author) might result in a letter to the author noting the violation and the current ethical standard, but major violations (e.g., fraud or frank plagiarism) might involve a sanction against future publication in our particular journal or even notification of the authors' institutions for their own actions.
Ethical standards promote high quality research. We therefore believe it is crucial to draw attention to and follow such standards.
Bronowski J.Science and human values. New York: Harper and Row; 1965. p 60.60  1965 
 
Kronick DA. Peer review in 18th-century scientific journalism. JAMA.1990; 263: 1321-2.2631321  1990  [PubMed][CrossRef]
 
Committee on Publication Ethics. The COPE Report 1999. London: Committee on Publication Ethics; July 1999. . 
www.publicationethics.org.uk/cope1999/pages/contents1999.phtml

 
Council of Science Editors. Editorial policy statements. Reston, VA: Council of Science Editors; 2000. . 
www.councilscienceeditors.org

 
International Committee of Medical Journal Editors. Uniform requirements for manuscripts submitted to biomedical journals: writing and editing for biomedical publication. November 2003. . 
www.icmje.org

 
Gwilym SE, Swan MC, Giele H. One in 13 `original' articles in the Journal of Bone and Joint Surgery are duplicate or fragmented publications. J Bone Joint Surg Br.2004;86: 743-5.86743  2004  [CrossRef]
 
Refinetti R. In defense of the least publishable unit. FASEB J.1990;4: 128-9.4128  1990  [PubMed]
 
Williamson A, White C, editors. The COPE Report 1998: annual report of the Committee on Publication Ethics. London: BMJ; 1998.  1998 
 
Rogers LF. Salami slicing, shotgunning, and the ethics of authorship. AJR Am J Roentgenol.1999;173: 265.173265  1999 
 
Julliard K. Perceptions of plagiarism in the use of other authors' language. Fam Med.1994;26: 356-60.26356  1994 
 
Vogelsang J. Plagiarism—an act of stealing. J Perianesth Nurs.1997;12: 422-5.12422  1997  [PubMed][CrossRef]
 
Brand RA, Buckwalter JA, Talman CL, Happe DG. Industrial support of orthopaedic research in the academic setting. Clin Orthop.2003;412: 45-53.41245  2003  [PubMed][CrossRef]
 
Crowninshield R. The orthopaedic profession and industry: conflict or convergence of interests. Clin Orthop.2003;412: 8-13.4128  2003  [CrossRef]
 
DelSignore JL. Current guidelines regarding industry-sponsored continuing medical education. Clin Orthop.2003;412: 21-7.41221  2003  [CrossRef]
 
Epps CH Jr. Ethical guidelines for orthopaedists and industry. Clin Orthop.2003;412: 14-20.41214  2003  [PubMed][CrossRef]
 
Lubahn JD, Mankin CJ, Mankin HJ, Kuhn PJ. Orthopaedics, ethics, and industry. Appropriateness of gifts, grants, and awards. Clin Orthop.2000; 371: 256-63.371256  2000  [PubMed][CrossRef]
 
Zuckerman JD, Prasarn M, Kubiak EN, Koval KJ. Conflict of interest in orthopaedic research. J Bone Joint Surg Am.2004;86: 423-8.86423  2004 
 
The Journal of Bone and Joint Surgery. Instructions to authors. J Bone Joint Surg Am.2004;86:(follows Table of Contents).86  2004 
 
Wenger NS, Korenman SG, Berk R, Liu H. Punishment for unethical behavior in the conduct of research. Acad Med.1998;73: 1187-94.731187  1998  [PubMed][CrossRef]
 

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References

Bronowski J.Science and human values. New York: Harper and Row; 1965. p 60.60  1965 
 
Kronick DA. Peer review in 18th-century scientific journalism. JAMA.1990; 263: 1321-2.2631321  1990  [PubMed][CrossRef]
 
Committee on Publication Ethics. The COPE Report 1999. London: Committee on Publication Ethics; July 1999. . 
www.publicationethics.org.uk/cope1999/pages/contents1999.phtml

 
Council of Science Editors. Editorial policy statements. Reston, VA: Council of Science Editors; 2000. . 
www.councilscienceeditors.org

 
International Committee of Medical Journal Editors. Uniform requirements for manuscripts submitted to biomedical journals: writing and editing for biomedical publication. November 2003. . 
www.icmje.org

 
Gwilym SE, Swan MC, Giele H. One in 13 `original' articles in the Journal of Bone and Joint Surgery are duplicate or fragmented publications. J Bone Joint Surg Br.2004;86: 743-5.86743  2004  [CrossRef]
 
Refinetti R. In defense of the least publishable unit. FASEB J.1990;4: 128-9.4128  1990  [PubMed]
 
Williamson A, White C, editors. The COPE Report 1998: annual report of the Committee on Publication Ethics. London: BMJ; 1998.  1998 
 
Rogers LF. Salami slicing, shotgunning, and the ethics of authorship. AJR Am J Roentgenol.1999;173: 265.173265  1999 
 
Julliard K. Perceptions of plagiarism in the use of other authors' language. Fam Med.1994;26: 356-60.26356  1994 
 
Vogelsang J. Plagiarism—an act of stealing. J Perianesth Nurs.1997;12: 422-5.12422  1997  [PubMed][CrossRef]
 
Brand RA, Buckwalter JA, Talman CL, Happe DG. Industrial support of orthopaedic research in the academic setting. Clin Orthop.2003;412: 45-53.41245  2003  [PubMed][CrossRef]
 
Crowninshield R. The orthopaedic profession and industry: conflict or convergence of interests. Clin Orthop.2003;412: 8-13.4128  2003  [CrossRef]
 
DelSignore JL. Current guidelines regarding industry-sponsored continuing medical education. Clin Orthop.2003;412: 21-7.41221  2003  [CrossRef]
 
Epps CH Jr. Ethical guidelines for orthopaedists and industry. Clin Orthop.2003;412: 14-20.41214  2003  [PubMed][CrossRef]
 
Lubahn JD, Mankin CJ, Mankin HJ, Kuhn PJ. Orthopaedics, ethics, and industry. Appropriateness of gifts, grants, and awards. Clin Orthop.2000; 371: 256-63.371256  2000  [PubMed][CrossRef]
 
Zuckerman JD, Prasarn M, Kubiak EN, Koval KJ. Conflict of interest in orthopaedic research. J Bone Joint Surg Am.2004;86: 423-8.86423  2004 
 
The Journal of Bone and Joint Surgery. Instructions to authors. J Bone Joint Surg Am.2004;86:(follows Table of Contents).86  2004 
 
Wenger NS, Korenman SG, Berk R, Liu H. Punishment for unethical behavior in the conduct of research. Acad Med.1998;73: 1187-94.731187  1998  [PubMed][CrossRef]
 
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These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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Richard A. Brand
Posted on October 13, 2004
Response to Sayana
Clinical Orthopaedics & Related Resarch

RE: Letter-to-the-Editor from Murali Krishna Sayana

We thank Mr. Sayana for his kind comments regarding our editorial. He raises a difficult question: “How do you decide what is a Least Publishable Unit?” In our editorial we wrote: “Material containing essentially similar aims or hypotheses, datasets, conclusions, and references will likely all fall within the framework of redundant publication.”2-4 All readers of scientific articles recognize there are times when one of these is identical in two or more articles, but there are differences in the others. We consider these to reflect least publishable units. As we noted, the problem is that these can be identified only in retrospect since the articles are usually published in different journals. The prospective identification of such articles is not easy in a large editorial office which may process large numbers of manuscripts per year.

Mr. Sayana raises a second question: “Do JBJS and CORR have a policy on ‘Least Publishable Unit’, or is the designation at the discretion of the editors and reviewers?” The Journal of Bone and Joint Surgery (Am) and Clinical Orthopaedics and Related Research do have policies in place. The editors initially contact each other and editors of other journals when relevant to discuss such cases. When only a limited amount of material is identical or similar, but much is not, we judge these to be cases of least publishable units. When either editor raises a question of closer similarity of the articles, we send blinded copies to expert independent reviewers for their opinion. Based upon whether those reviewers believe the articles redundant publication, we take what we believe is appropriate action. We write authors asking for an explanation, remind them of potential misconduct,1 and request the explanatory letter be signed by all authors. Further action is based upon their response, but at a minimum includes sending identical letters from both (or all) editors to the authors reminding them of the unethical nature of redundant or similar publication. The Committee on Publication Ethics1 has outlined a variety of additional actions, depending upon the nature of misconduct and we adhere to those guidelines.

Finally, Mr. Sayana raises a question of “clear policy on Least Publishable Unit.“ All three of our Journals require authors to sign a cover letter stating the contents have not been submitted or published elsewhere. We believe our statements to be quite clear and we are always available to discuss uncertain areas with the authors prior to submission.

Journals have very limited ability to police unethical submissions. Authors on the other hand have a responsibility to adhere to ethical standards. Each of our journals institutes appropriate enquiries and actions when the ethical standards are challenged.

Richard A. Brand, MD Editor-in-Chief Clinical Orthopaedics & Related Research Philadelphia, PA

James D. Heckman, MD Editor-in-Chief The Journal of Bone and Joint Surgery – American Boston, MA

James Scott, FRCS Editor The Journal of Bone and Joint Surgery - British London, UK

References:

1. The COPE Report 1999. Committee on Publication Ethics, http://www.publicationethics.org.uk/, 2003. 2. Brand RA, Heckman JD, Scott J: Changing ethical standards in scientific publication. Clin Orthop:1-2, 2004. 3. Brand RA, Heckman JD, Scott J: Changing ethical standards in scientific publication. J Bone Joint Surg Am 86-A:1855-1856, 2004. 4. Brand RA, Heckman JD, Scott J: Changing ethical standards in scientific publication. J Bone Joint Surg Br 86B, 2004.

Murali Krishna Sayana
Posted on September 20, 2004
The Least Publishable Unit
University Hospital of North Staffordshire

Dear Sir,

It was heartening to read the editorial this month by the BIG THREE. This editorial is a step in right direction, but leaves other questions unanswered. How do you decide what is a Least Publishable Unit? Do the JBJS and CORR have a policy on "Least Publishable Unit", or is the designation at the discretion of the editors and reviewers?

The editorial also discusses "meat extenders" and it could be argued that the article by Beaule, et al (1) is a meat extender of a recent article, "Risk Factors Affecting Outcome of Metal-on-Metal Surface Arthroplasty of the Hip" by Beaule, et al,(CORR: 418, Jan 2004, 87-93). The data are based on 94 hips in 83 patients. Compare Table 4 on page 90 of the CORR article to Table 1 of the JBJS article. There are discrepancies and similarities in these two tables probably based on the same data. The conclusions are the same - valgus positioning is better than varus.

One wonders why the calculations were done exclusively in the patients who were 40 years and younger? Why was the radiographic and biomechanical analysis not done on the whole sample of 400 patients on whom the 2-6 year follow up was published in January this year?

The counter-argument could be that it would be too extensive for all of the information to be included in one article. This is the reason why we need a clear policy on Least Publishable Unit by the BIG THREE that should be included in the instructions to the authors (2).

References:

1. Beaule,P.E., et al, Orientation of the Femoral Component in Surface Arthroplasty of the Hip. A Biomechanical and Clinical Analysis. JBJS, 86-A, 2015-2021, 2004

2. Doherty M. The Misconduct of Redundant Publication. The COPE Report 1998. www.publicationethics.org.uk/cope1998/pages1998/contents.phtml

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