Sixth version of the "Uniform Requirements for Manuscripts Submitted to Biomedical Journals": lots of ethics, some new recommendations for manuscript preparation.

I n November 2003, the International Committee of Medical Journal Editors (ICMJE) published a revised version of their Uniform Requirements for manuscripts, first launched in 1979 by a small group of editors of general medical journals then simply named the Vancouver Group. This committee has produced six editions of the Uniform Requirements, the last one reviewing the whole document and including in the text a number of separate statements published independently by the ICMJE in the past years. The fifth edition was published in 1997. More than a half of the present document is devoted to ethical principles related to the process of evaluating and publishing manuscripts in biomedical journals and the relationships between editors, authors, peer reviewers, advertisers, and the media. A considered reading of the text is recommended mostly to editors, authors, and readers of biomedical literature; some main contents are commented on below. Ethical principles in science publication are as critical as ethical principles in research conduct. Publication is an ultimate stage of scientific research; in fact, as it has been stated, science does not exist until it is published. Scientists have a critical role in most of today’s societies, which are firm believers in science dictations. Health sciences, moreover, deal with very sensitive constituents of people’s happiness and welfare. Hence, it would be desirable that researchers strictly respect conduct principles to better serve the interests of the community and to causing no damage. Among the several ethical issues discussed by the ICJME, authorship is probably one of the major fields for misconduct in biomedical publication, and in which more discrepancies are to be found among researchers, and also among authors and editors. Also it should be said that most of the time misconducts regarding authorship will have no important consequences for the public’s health, but they have an effect on the public perception on the reliability on biomedical science. Perhaps most of the authors in biomedical sciences simply do not know authorship criteria. Perhaps only readers keen on publication theoretical aspects, the same people who are already familiar and reflective over issues such as authorship, are now reading this editorial. In a survey of 66 researchers from a university medical faculty in Britain— half of them with more than 30 published papers—only five respondents were able to quote all three criteria of the ICMJE for authorship, and only one knew that all three criteria were required to credit authorship. We believe that formal education on publication and on publication ethics is an important gap in health careers. But as most of the ‘‘authors’’ of biomedical articles ignore or directly flout common rules regarding authorship, it could make sense first to ask: Do we need any criteria for authorship? And if so, what kind of criteria do we need? We do think that we need some criteria. And that the criteria by the ICJME are good enough. The key issue is to guarantee public responsibility for the published information, if really not feasible for every author for the full manuscript, at least of every contributor to the parts in which he or she has participated. But it would be necessary too for at least the designation of a ‘‘guarantor’’ or main person responsible for the work as a whole, as it has been said emulating ‘‘ministerial responsibility’’. The ICJME criteria fit this approach: they no longer claim for ‘‘public responsibility for the content’’ to each author of a paper, as in the 1997 edition. They refer to ‘‘substantive intellectual contributions’’ for the authors and they recommend the identification of at least one person ‘‘responsible for the integrity of the work as a whole’’. The famous three criteria for authorship credit (‘‘1. Substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data; 2. Drafting the article or revising it critically for important intellectual content; and 3. Final approval of the version to be published. Authors should meet conditions 1, 2, and 3’’) are still in this version of the document with only minor variations: the words ‘‘or acquisition of data’’ were not in the fifth edition. This criterion was added by the ICMJE in 2000 as a separate statement after the experience of the Lancet in disclosing the contributions of their authors: it was noticed that the criteria for authorship outlined by the ICJME were not completely congruent with the self identified contributions of researchers. Although the claim to accomplish all the three conditions has been criticised by editors and authors, in fact criteria (2) and (3) are not strict nor ‘‘astonishing out of touch’’, as it has been stated, but rather attainable by any category of coauthor. The key issue is then accomplishing the first criterion; and to keep in mind the necessary public responsibility for the whole or appropriate contents of the work. It is worth remembering that the acknowledgements section is a wonderful place to recognise any kind of contribution to the work—for everybody participating in the study to feel that their work has been fairly and publicly acknowledged, as respectable as the byline under the title. Curiously, contributions in the acknowledgements section are commonly described in detail, but the same is the exception for contributions in the byline. Conflict of interest is another ethical issue profusely discussed in the ICMJE document as related to individual authors’ commitments, to project support, or to commitments of editors, journal staff, or reviewers. As defined by the ICMJE, conflict of interests exits when ‘‘an author (or the author’s institution), reviewer or editor has financial or personal relationships that inappropriately influence (bias) his or her actions (...). These relationships vary from those with negligible potential to those with great potential to influence judgement, and not all relationships represent true conflict of interest. The potential for conflict of interest can exist whether or not an individual believes that the relationship affects his or her scientific judgement’’. EDITORIALS 731