Resources for Medical Editors in World Association of Medical Editors

POLICY STATEMENTS-PREPARED BY THE WAME EDITORIAL POLICY COMMITTEE

· Conflict of Interest in Peer-Reviewed Medical Journals

· Definition of a Peer-Reviewed Journal

· Authorship

· The Registration of Clinical Trials

· Ghost Writing Initiated by Commercial Companies

· Recommendations on Publication Ethics Policies for Medical Journals

· Impact Factor

· Geopolitical Intrusion on Editorial Decisions

· The Responsibilities of Medical Editors

· Regional Workshops for Medical Editors

· Free Journal Access for Poor Nations

· The Relationship Between Journal Editors-in-Chief and Owners (formerly titled Editorial Independence)

Conflict of Interest in Peer-Reviewed Medical Journals

Conflict of interest (COI) exists when there is a divergence between an individual’s private interests(competing interests) and his or her responsibilities to scientific and publishing activities such that a reasonable observer might wonder if the individual’s behavior or judgment was motivated by considerations of his or her competing interests.COI in medical publishing affects everyone with a stake in research integrity including journals, research/academic institutions, funding agencies, the popular media, and the public.Journals are interested in COI as it relates to a specific manuscript.

Everyone has COIs of some sort.Having a competing interest does not, in itself, imply wrongdoing.However,it constitutes a problem when competing interests could unduly influence (or be reasonably seen to do so) one’s responsibilities in the publication process.If COI is not managed effectively, it can cause authors, reviewers,and editors to make decisions that, consciously or unconsciously, tend to serve their competing interests at the expense of their responsibilities in the publication process, thereby distorting the scientific enterprise.This consequence of COI is especially dangerous when it is not immediately apparent to others.In addition, the appearance of COI, even where none actually exists, can also erode trust in a journal by damaging its reputation and credibility.

COI policies differ among journals and are evolving over time.Every peer-reviewed medical journal (herein“Journal”) should have its own COI policies for authors,reviewers, and editors.Journals should make these policies readily accessible to everyone involved in the publication process by publishing them with instructions for authors.The Editorial COI Policy that addresses editor COI should be published as well.This statement summarizes the main elements of COI policies with examples and options for disclosure and management.

Definition and Scope

Journals should publish their own definition of COI.In the context of medical publishing, COI exists when a participant in the publication process (author, peer reviewer, or editor) has a competing interest that could unduly influence (or be reasonably seen to do so) his or her responsibilities in the publication process.Among those responsibilities are academic honesty, unbiased conduct and reporting of research, and integrity of decisions or judgments.The publication process includes the submission of manuscripts, peer review,editorial decisions, and communication between authors,reviewers and editors.

Types of Competing Interests

Many kinds of competing interests are possible.Journals often have policies for managing financial COI, mostly based on the untested assumption that financial ties have an especially powerful influence over publication decisions and may not be apparent unless they are made explicit.However, other competing interests can be just as damaging, and just as hidden to most participants, and so must also be managed.The following are examples of competing interests; they do not include all possibilities and they may coexist.

Financial ties.This conflict is present when a participant in the publication process has received or expects to receive money (or other financial benefits such as patents or stocks), gifts, or services that may influence work related to a specific publication.Commercial sources of funding, by companies that sell drugs and medical devices, are generally seen as the most concerning, perhaps because of many well-publicized examples of bias related to ties to industry.Examples of financial ties to industry include payment for research, ownership of stock and stock options, as well as honoraria for advice or public speaking, consultation, service on advisory boards or medical education companies, and receipt of patents or patents pending.Also included are having a research or clinical position that is funded by companies that sell drugs or devices.Competing interests can be associated with other sources of research funding including government agencies, charities (not-for-profit organizations), and professional and civic organizations,which also have agendas that may be congruent or at odds with research findings.Clinicians have a financial competing interest if they are paid for clinical services related to their research —for example, if they write,review, or edit an article about the comparative advantage of a procedure that they themselves provide for income.Financial competing interests may exist not just on the basis of past activities but also on the expectation of future rewards, such as a pending grant or patent application.“Insider trading,” which is the use for one’s financial gain of information obtained through participation in research, review or editing before it is available to the general public, is a special kind of financial COI that has both legal and ethical implications.

Academic commitments.Participants in the publications process may have strong beliefs(“intellectual passion”) that commit them to a particular explanation, method, or idea.They may, as a result, be biased in conducting research that tests the commitment or in reviewing the work of others that is in favor or at odds with their beliefs.For example, if research challenging conventional wisdom is reviewed by someone who has made his or her reputation by establishing the existing paradigm, that person might judge the new research results harshly.Investigators in the same field might make extra-efforts to find fault with manuscripts from competing teams, to delay publication or relegate the work to a lesser journal.While such commitments are not generally part of author’s disclosures, editors should be aware of them and their potential influence on author(s), reviewer(s), and themselves.

Personal relationships.Personal relationships with family, friends, enemies, competitors, or colleagues can pose COIs.For example, a reviewer may have difficulty providing an unbiased review of articles by investigators who have been working colleagues.Similarly, he or she may find it difficult to be unbiased when reviewing the work of competitors.Bonds to family members may be strong enough that their competing interests should be treated as if they are also present for those directly involved with a manuscript.

Political or religious beliefs.Strong commitment to a particular political view (e.g., political position, agenda, or party) or having a strong religious conviction may pose a COI for a given publication if those political or religious issues are affirmed or challenged in the publication.

Institutional affiliations.A COI exists when a participant in the publication process is directly affiliated with an institution that on the face of it may have a position or an interest in a publication.An obvious concern is being affiliated with or employed by a company that manufactures the drug or device (or a competing one) described in the publication.However,apparently neutral institutions such as universities,hospitals, and research institutes (alone or in partnership with industry) may also have an interest (or the appearance of one) in the results of research.For example, investigators may have a COI when conducting research from a laboratory funded by private donors who could have (or appear to have) an interest in the results of the study, on a device for which the participant’s institution holds the patent, when the institution is the legal sponsor of the drug or device trial, or if the institution is in litigation in an area related to the study.Professional or civic organizations may also have competing interests because of their special interests or advocacy positions.

Declaring and Managing COIs

COIs are ubiquitous and cannot be eliminated altogether.However, they can be managed constructively so that they make the least possible intrusion on journal content and credibility.

Journals’ policies for disclosure and management of COI must take the following into consideration:

What COI must be declared, how, to whom and when? Journals need to be as specific as possible about their definition of COI for authors and reviewers,including the kinds of competing interests they wish to have declared by those individuals, with the understanding that any operational definition will be imperfect.They should provide clear instructions about how to make declarations.It should also be clear that a journal may ask additional questions or seek clarification about declarations.For example, the journal may ask for details about future monetary gains or ask an author who works in a laboratory funded by a particular organization for written details about how their independence and research integrity was maintained.

All declarations about COI should be requested in writing as a condition of reviewing a manuscript and asked in such a way that authors will have a high likelihood of reporting their COIs related to the manuscript.

No generally accepted standard, nor evidence-based consensus, exists for precisely defining the degree of financial COI or the timeframe that creates a substantial risk of bias or damage to the journal’s reputation.Judgments may be affected by many factors including, in the case of financial COI, the amount of money, goods,or services exchanged, how recently they were received and whether they are expected in the future, as well as the services provided in return.To guide authors in this decision, journals should publish their own standards for financial COI, including its standards on expiry on COI(e.g., only declare COI within last five years), as precisely as possible.

Managing COI depends on disclosure because it is not possible to routinely monitor or investigate whether competing interests are present.Disclosure is about the facts that might bear on COI; assertions of integrity are not, in themselves, helpful.

The consequences for failing to declare COI: The journal should state the steps editors will take if competing interests surface from other sources after a manuscript is submitted or published.For example, the journal may investigate allegations of COI and action may be taken if found to be true.Such investigations should be completed as quickly as reasonably possible.If a manuscript has been published and COI surfaces later, the journal may publish the results of the investigation as a correction to the article and ask the author to explain, in a published letter, why the COI was not revealed earlier.

Which COIs will result in a manuscript not being considered further? Journals must be transparent about COI situations that, if present, will result in a manuscript not being considered further.Some journals have made it explicit that they will exclude authors from writing narrative (not systematic) reviews of topics in which they have a competing financial interest, on the grounds that it is more difficult for readers to detect bias in reviews than reports of original research, where methods are made more explicit.Some journals may apply internal editorial rules about which COI situations are not acceptable but these may not be explicit to those involved in the publication process; a journal COI policy needs to articulate the journal’s position.

How COI will be dealt with by the journal? Journals should publish all relevant COI disclosures with the publication.Other additional management strategies include for example:

· Not considering a manuscript further

· Exclusion of those with COI from the process (e.g.,reviewer or editor)

· Abstaining from decisions where COI might arise (e.g.,editors)

· Investigation by impartial observers

Some research institutions provide information about their employees’ COI on their Web sites.Journals should routinely ask authors to disclose such e-links as part of their COI disclosure.

Journals have a responsibility to raise awareness and educate the research community about COI.One option to increase understanding of the concept is to ask investigators and reviewers “if my competing interest becomes known to others later, would I feel defensive or would others in the publication process, readers or the public think I was hiding my other interests or could they feel I misled or deceived them?”

Responsibilities of Participants

Authors.All authors should be asked to report their financial COI related to the research and written presentation of their work and any other relevant competing interests.Journals should publish all COI (or their absence) reported by authors that are relevant to the manuscript being considered.In additional to financial COI, policies for authors should be extended to other types of competing interests that might affect (or be seen to affect) the conduct or reporting of the work.Journals should disclose all COIs that they themselves thought were important during the review process.Declarations should require authors to explicitly state funding sources and whether the organization that funded the research participated in the collection and analyses of data and interpretation and reporting of results.

Reviewers.Reviewers should be asked if they have a COI with the content or authors of a manuscript.If they do, they should be removed from the review process.In general, it is best to avoid reviewers from the same institution as the authors, unless the institution is so large that authors and reviewers are not working colleagues.

Editors.Editors should not make any editorial decisions or be involved in the editorial process if they have or a close family member has a COI (financial or otherwise) in a particular manuscript submitted to their journal.For example, if editors have political/religious COI or personal COI with respect to the authors or their work, the editors should remove themselves from the decision-making process.An editor may also be in a COI if a manuscript is submitted from their own academic department or from their institution (if it is small); in such situations, they should have explicit policies, made in advance, for how to manage it.When editors submit their own work to their journal, a colleague in the editorial office should manage the manuscript and the editor/author should recuse himself or herself from discussion and decisions about it.Some journals list editors’ competing interests on their website but this is not a standard practice.Readers should refer to the WAME Policy on the Relationship Between Journal Editors-in-chief and Owners for additional comment about COI as it relates to editors.

Definition of a Peer-Reviewed Journal

A peer-reviewed biomedical journal is one that regularly obtains advice on individual manuscripts from reviewers who are not part of the journal’s editorial staff.Peer review is intended to improve the accuracy, clarity, and completeness of published manuscripts and to help editors decide which manuscripts to publish.Peer review does not guarantee manuscript quality and does not reliably detect scientific misconduct.

Peer reviewers should be experts in the manuscript’s content area, research methods, or both; a critique of writing style alone is not sufficient.Peer reviewers should be selected based on their expertise and ability to provide high quality, constructive, and fair reviews.For research manuscripts, editors may, in addition, seek the opinion of a statistical reviewer.

Peer reviewers advise editors on how a manuscript might be improved and on its priority for publication in that journal.Editors decide whether and under which conditions manuscripts are accepted for publication,assisted by reviewers’ advice.

Peer reviewers are sometimes paid for their efforts but usually provide their opinions free of charge, as a service to their profession.Editors should require all peer reviewers to disclose any conflicts of interest, financial or otherwise, related to a particular manuscript and should take this information into account when deciding how to use their review.Generally speaking, people with a direct financial interest in the results of the manuscripts should not be reviewers.

To be considered peer reviewed, a journal should have obtained external reviews for the majority of manuscripts it publishes, including all original research and review articles.Some editors request peer review for other kinds of articles, such as opinion pieces (commentaries/editorials) and correspondence.To have been peer reviewed, a manuscript should have been reviewed by at least one external reviewer; it is typical to have two reviewers and sometimes more opinions are sought.Editors of peer-reviewed journals need not send all submitted manuscripts out for review.Manuscripts that seem unlikely to be published in that journal may be returned to authors without external review, to allow authors to submit the manuscript to another journal without delay and to make efficient use of reviewers’ and editors’ time.

Editors should state their journal’s peer review policies,including which kinds of article are peer reviewed and by how many reviewers, in the instructions for authors.Editors should also periodically publish statistics describing their journal’s review process, such as number of manuscripts submitted, acceptance rate, and average times from manuscript submission to rejection letter to authors and, for accepted manuscripts, time to publication.

Authorship

Authorship is a way of making explicit both credit and responsibility for the contents of published articles.Credit and responsibility are inseparable.The guiding principle for authorship decisions is to present an honest account of what took place.Criteria for authorship apply to all intellectual products, including print and electronic publications of words, data, and images.Journals should make their own policies on authorship transparent and accessible.

Criteria for Authorship

Everyone who has made substantial intellectual contributions to the study on which the article is based(for example, to the research question, design, analysis,interpretation, and written description) should be an author.It is dishonest to omit mention of someone who has participated in writing the manuscript (“ghost authorship”) and unfair to omit investigator who have had important engagement with other aspects of the work.(See the WAME policy statement, “Ghost Writing Initiated by Commercial Companies”)

Only an individual who has made substantial intellectual contributions should be an author.Performing technical services, translating text, identifying patients for study,supplying materials, and providing funding or administrative oversight over facilities where the work was done are not, in themselves, sufficient for authorship,although these contributions may be acknowledged in the manuscript, as described below.It is dishonest to include authors only because of their reputation, position of authority, or friendship (“guest authorship”).

Many journals publish the names and contributions of everyone who has participated in the work(“contributors”).Not all contributors necessarily qualify for authorship.The nature of each contributors’participation can be made transparent by a statement,published with the article, of their names and contributions and WAME encourages this practice.

One author (a “guarantor”) should take responsibility for the integrity of the work as a whole.Often this is the corresponding author, the one who sends in the manuscript and receives reviews, but other authors can have this role.All authors should approve the final version of the manuscript.

It is preferable that all authors be familiar with all aspects of the work.However, modern research is often done in teams with complementary expertise so that every author may not be equally familiar with all aspects of the work.For example, a biostatistician may have greater mastery of statistical aspects of the manuscript than other authors, but have somewhat less understanding of clinical variables or laboratory measurements.Therefore,some authors’ contributions may be limited to specific aspects of the work as a whole.

All authors should comply with the journals’ policies on conflict of interest.

Number of Authors

Editors should not arbitrarily limit the number of authors.There are legitimate reasons for multiple authors in some kinds of research, such as multi-center, randomized controlled trials.In these situations, a subset of authors may be listed with the title, with the notation that they have prepared the manuscript on behalf of all contributors, who are then listed in an appendix to the published article.Alternatively, a “corporate” author (e.g.,a “Group” name) representing all authors in a named study may be listed, as long as one investigator takes responsibility for the work as a whole.In either case, all individuals listed as authors should meet criteria for authorship whether or not they are listed explicitly on the byline.If editors believe the number of authors is unusually large, relative to the scope and complexity of the work, they can ask for a detailed description of each author’s contributions to the work.If some do not meet criteria for authorship, editors can require that their names be removed as a condition of publication.

Order of Authorship

The authors themselves should decide the order in which authors are listed in an article.No one else knows as well as they do their respective contributions and the agreements they have made among themselves.Many different criteria are used to decide order of authorship.Among these are relative contributions to the work and,in situations where all authors have contributed equally,alphabetical or random order.Readers cannot know, and should not assume, the meaning of order of authorship unless the approach to assigning order has been described by the authors.Authors may want to include with their manuscript a description of how order was decided.If so, editors should welcome this information and publish it with the manuscript.

Authorship Disputes

Disputes about authorship are best settled at the local level, before journals review the manuscript.However, at their discretion editors may become involved in resolving authorship disputes.Changes in authorship at any stage of manuscript review, revision, or acceptance should be accompanied by a written request and explanation from all of the original authors.

The Registration of Clinical Trials

The effectiveness of medical interventions should be based on the results of all properly conducted clinical trials, whether or not the trials have been published.The results of unpublished trials are systematically different from those that are published; they tend to be "negative"(find no effect or harm) or fail to support the interests of the funding agency.Therefore, relying on published trials alone can provide a biased view of effectiveness and safety.

Registration of clinical trials at their inception, in widely available registries, makes it possible for all stakeholders to take unpublished trials into account when summarizing the evidence for an intervention's effects.Information in registries can also prompt efforts to discover the original objectives and results of unpublished trials and the reasons why they were not published.

For these reasons, the World Association of Medical Editors supports efforts to register all clinical trials at their inception.Because registration is useful only to the extent that it includes all trials, it should be required of the research community as a whole and not voluntary according to the source of funding or preferences of the investigators.The contents of registries should be freely accessible and searchable to anyone in the world who wants to examine them.

Many practical issues will need to be resolved before universal trial registration is a reality.A single, worldwide registry would be ideal but multiple registries are more feasible in the short term because trials are conducted in many regions of the world and in many clinical research areas and there is currently no single body that oversees the world's research.To ensure the integrity of registries,they should be managed by groups without potential conflict of interest in the results of the trials they include.Journal editors should support the development of registries by participating in efforts to develop a consensus on requirements for registry contents,responsibility, access, search ability, and comprehensiveness and by promoting their implementation.When suitable registries are available,editors should require prior registration of all trials published in their journals.Editors of small journals with limited resources should be engaged in this process to ensure that their role in registries is feasible in their setting.

Ghost Writing Initiated by Commercial Companies

The integrity of the published record of scientific research depends not only on the validity of the science but also on honesty in authorship.Editors and readers need to be confident that authors have undertaken the work described and have ensured that the manuscript accurately reflects their work, irrespective of whether they took the lead in writing or sought assistance from a medical writer.The scientific record is distorted if the primary purpose of an article is to persuade readers in favor of a special interest, rather than to inform and educate, and this purpose is concealed.

Ghost authorship exists when someone has made substantial contributions to writing a manuscript and this role is not mentioned in the manuscript itself.WAME considers ghost authorship dishonest and unacceptable.Ghost authors generally work on behalf of companies, or agents acting for those companies, with a commercial interest in the topic, and this compounds the problem.For example, a writer employed by a commercial company may prepare an article, then invite an expert in the field to submit the work, perhaps with minor revisions,under his or her own name.The submitting author may be paid, directly or indirectly, for this service.In other circumstances, investigators may pay a professional writer to help them prepare their article but not mention this assistance, gaining credit for writing they have not done.Although editors seek to avoid publication of ghost written articles, these articles are often very difficult to detect.

Submitting authors bear primary responsibility for naming all contributors to manuscripts and describing their contributions.Ghost authorship would be avoided if corresponding authors listed everyone else who participated in the work, including those who contributed only to the writing, along with their individual contributions and institutional affiliations; stated explicitly how the work was paid for; and fully disclosed any further potential competing interests.

However, responsibility for ghost written manuscripts goes beyond individual authors.Other parties, including companies—such as marketing, communications, and medical education companies who are paid to assist pharmaceutical and medical device companies in disseminating favorable messages about their products—may initiate the sequence of events for which the author is the final and most easily identified participant.These other participants are also responsible for ghost written manuscripts and addressing their roles should be part of the solution.

To prevent some instances of ghost authorship, editors should make clear in their journal's information for authors that medical writers can be legitimate contributors and that their roles and affiliations should be described in the manuscript.When editors detect ghost written manuscripts, their actions should involve both the submitting authors and commercial participants if they are involved.Several actions are possible:

1.publish a notice that a manuscript has been ghost written, along with the names of the responsible companies and the submitting author;

2.alert the authors' academic institutions, identifying the commercial companies;

3.provide specific names if contacted by the popular media or government organizations; and

4.share their experiences on the WAME Listserve and within other forums.

Together, these actions would increase transparency and public accountability about ghost writing and its manipulation of the scientific record and deter others from this practice.

Impact Factor

Impact factor is widely regarded by authors and academic programs to be a measure of a journal's prestige and value and can be important for authors'career advancement in academic medicine.However,impact factor can be affected by a number of aspects unrelated to journal quality, including self-citation by a journal, publication timing, and types of articles published.As a result, impact factor has become a highly discussed issue among journal authors and editors.WAME list-serve discussions have addressed its benefits and fallacies.On the basis of this discussion, the WAME Board makes the following recommendations to WAME members:

1.More research is needed to evaluate the impact factor and other measures of journal and article quality.We urge fellow editors to consider important research questions and conduct research in this field.WAME offers its virtual discussion room for contacts and plans.

2.Journal editors should look beyond impact factor as a summary statistics and present other indicators of journal visibility, such as circulation, number of published articles,and the distribution of the citations.Such demographics of a journal should be regularly published to inform journal readers and authors.

3.Journal editors have the responsibility to educate their readers, authors, administrators, and their scientific community in general about impact factor and its relevance, as well as about other measures of journal and article quality.

Geopolitical Intrusion on Editorial Decisions

Decisions to edit and publish manuscripts submitted to biomedical journals should be based on characteristics of the manuscripts themselves and how they relate to the journal's purposes and readers.Among these characteristics are importance of the topic, originality,scientific strength, clarity and completeness of written expression, and potential interest to readers.Editors should also take into account whether studies are ethical and whether their publication might cause harm to readers or to the public interest.Editorial decisions should not be affected by the origins of the manuscript, including the nationality, ethnicity,political beliefs, race, or religion of the authors.Decisions to edit and publish should not be determined by the policies of governments or other agencies outside of the journal itself.

Editors should defend this principle, as they do other principles of sound editorial practice, and enlist their colleagues' support in this effort if necessary.Geopolitical Intrusion on Editorial Decisions (Spanish)Organizations and Journals Supporting the Statement on Geopolitical Intrusion on Editorial Decisions

The Responsibilities of Medical Editors

Editors should:

1.Respect their journal’s constituents (readers,authors, reviewers, and the human subjects of research)by:

· Making the journal’s processes (e.g., governance,editorial staff members, number of reviewers, review times, acceptance rate) transparent;

· Thanking reviewers for their work;

· Protecting the confidentiality of human subjects.

2.Promote self-correction in science and participate in efforts to improve the practice of scientific investigation by:

· Publishing corrections, retractions, and critiques of published articles;

· Take responsibility for improving the level of scientific investigation and medical writing in the larger community of potential authors and readers.

3.Assure honesty and integrity of the content of their journal and minimize bias by:

· Managing conflicts of interest;

· Maintaining confidentiality of information;

· Separating the editorial and business functions of the journal.

4.Improve the quality of their journal by:

· Becoming familiar with the best practice in editing,peer review, research ethics, methods of investigation,and the rationale and evidence base supporting them;

· Establishing appropriate programs to monitor journals’performance;

· Soliciting external evaluations of the journal’s effectiveness.

Regional Workshops for Medical Editors

WAME strongly encourages regional or local initiatives to provide workshops or conferences, etc, for editors of peer-reviewed medical journals, to encourage the highest standards of reporting medical science.Although funds are not available, WAME is prepared to assist in the planning of workshops or conferences, to help in finding appropriate faculty, and to help negotiate some assistance to facilitate clearly planned projects that rely primarily on local or regional resources.Inquiries should be directed the WAME President or Secretary.

Free Journal Access for Poor Nations

In response to the World Health Organization Health InterNetwork Access to Research Initiative (HINARI) (1),an increasing number of the world's leading medical publishers are allowing free Web-based access to scientific journals in those countries that cannot afford to pay for them.Since we as medical editors view disseminating medical knowledge as among our greatest honors and responsibilities, we heartily endorse this practice, and encourage all medical editors and publishers around the world to adopt it.

The Relationship Between Journal Editors-in-Chief and Owners (formerly titled Editorial Independence)

1.The conditions of the editors-in-chief's employment,including authority, responsibilities, term of appointment,reporting relationships, and mechanisms for resolving conflict, should be explicitly stated in writing and approved by both editor and owner before the editor is appointed.Those conditions bearing on editorial freedom should be shared with readers by publication in the journal or on its website.

2.Editors-in-chief should have full authority over the editorial content of the journal, generally referred to as“editorial independence.” Editorial content includes original research, opinion articles and news reports, both in print or electronic format, and how and when information is published.Owners should not interfere in the evaluation, selection or editing of individual articles,either directly or by creating an environment in which editorial decisions are strongly influenced.

3.Editorial decisions should be based mainly on the validity of the work and its importance to readers, not the policies or commercial success of the owner.Editors should be free to publish critical but responsible views about all aspects of medicine without fear of retribution,even if these views might conflict with the policies or commercial goals of the owner.To maintain this position, editors should seek input from a broad array of advisors such as reviewers, editorial staff, an editorial board, and readers.

4.Editors-in-chief should establish procedures that guard against the influence of commercial, organizational,and personal self-interest on editorial decisions and should make these procedures clear and transparent to all interested parties.They should be compensated for their work on the journal in a manner that does not create a conflict of interest for the manuscripts they consider(see Conflict of Interest Policy Statement).

5.Owners have the right to hire and fire editors-in-chief but they should dismiss them only for substantial reasons such as a pattern of bad editorial decisions,disagreement with the long-term editorial direction of the journal, or personal behavior (such as criminal acts) that are incompatible with a position of trust.It may also be appropriate to end the editor’s service if, for whatever reason, owners and editors find they are unable to work together in a spirit of mutual trust and collaboration.Termination of an editor’s appointment should be a deliberate process, involving open discussion at the highest level of the organization, and should not be precipitous, except for egregious wrongdoing.

6.The limits of editorial freedom are difficult to define in the general case.Editors should be receptive to articles representing all legitimate points of view and should be free to publish any responsible positions.However, owners cannot be expected to retain editors who take strong, consistent, one-sided positions against the core values and policies of their parent organization.

7.Editors-in-chief should report to the highest governing body of the owning organization, not its administrative officers.Major decisions regarding the editor’s employment should be made by this body with open discussion and time to hear from all interested parties.Some organizations have found it useful to establish an independent oversight committee to advise them on major decisions regarding their editor and journal.Both owners and editors should have a meaningful role in appointment of members, since both are stake-holders in the committee’s effectiveness.The work of such committees should be transparent and publicly available.

8.Editors should resist any actions that might compromise these principles in their journals, even if it places their own position at risk.If major transgressions do occur, all editors should participate in drawing them to the attention of the international medical, academic, and lay communities.

RESOURCES FOR EDITORS FROM SOURCES OTHER THAN WAME

BOOKS

—Iverson C, Christiansen S, Flanagin A, et al.American Medical Association Manual of Style: A Guide for Authors and Editors.10th ed.Oxford, UK: Oxford University Press; 2007.

—Bailar JC, Angell M, Boots S, et al.Ethics and Policy in Scientific Publication.Bethesda, Md: Council of Biology Editors; 1990.

—Style Manual Committee.Scientific Style and Format:The CSE Manual for Authors, Editors, and Publishers.7th ed.Reston, VA: The Council; 2006.

—Godlee F, Jefferson T, eds.Peer Review in Health Sciences.London, England: BMJ Publishing Group;1999.

—Hudson Jones A, McLellan F.Ethical issues in biomedical publication.Baltimore, Md: Johns Hopkins University Press; 2000.

—Huth EJ.Writing and Publishing in Medicine.3rd ed.Baltimore, Md: Williams and Wilkins; 1999.

—Lock S.The future of medical journals.London,England: British Medical Journal; 1991.

—Lock S, Wells F, eds.Fraud and Misconduct in Medical Research.London, England: BMJ Publishing Group;1993.

—National Academy of Science.Responsible Science:Ensuring the Integrity of the Research Process.Washington, DC: National Academy Press; 1992.

WEB SITES

—EQUATOR Network: Guidelines for reporting medical research and other resources.http://www.equator-network.org

—Journal Instructions for Authors: Links to the Instructions for Authors of many journals, compiled by the University of Toledo's Mulford Library.http://mulford.meduohio.edu/instr/

—Peer Review Congresses:Peer Review in Scientific Publishing.Papers from the First International Congress on Peer Review in Biomedical Publication.Chicago, Ill: Council of Biology Editors Inc; 1991.

Guarding the guardians: research on editorial peer review.In: Selected proceedings from the First International Congress on Peer Review in Biomedical Publication.JAMA.1990;263:1309-1456.

The Second International Congress on Peer Review in Biomedical Publication.JAMA.1994;272:91-170.

The Third International Congress on Peer Review in Biomedical Publication.JAMA.1998;280:213-302.

The Fourth International Congress on Peer Review in Biomedical Publication.JAMA.2002;287:2745-2898.

Journal-Based Resources

Authorship

➢Opinion

—Rennie D, Yank V, Emanual L.When authorship fails:a proposal to make contributors accountable.JAMA.1997;278:579-585.

Wilcox LJ.Authorship: the coin of the realm, the source of complaints.JAMA.1998;280:216-217.

➢Research

—Bates T, Anic A, Marusic M, Marusic A.Authorship criteria and disclosure of contributions: comparison of 3 general medical journals with different author contribution forms.JAMA.2004;292:86-88.

—Bhopal RS, Rankin JM, McColl E, et al.The vexed question of authorship: views of researchers in a British medical faculty.BMJ.1997;314:1009-1012.

—Drenth JPH.Multiple authorship: the contribution of senior authors.JAMA.1998;280:219-221.

—Eastwood S, Derish P, Leash E, Ordway.Ethical issues in biomedical research: Perceptions and practices of postdoctoral research fellows responding to a survey.Sci Eng Ethics.1996;2:89-114.

—Flanagin A, Carey LA, Fontanarosa PB, et al.Prevalence of articles with honorary authors and ghost authors in peer-reviewed medical journals.JAMA 1998;280:222-224.

—Hoen WP, Walvoort HC, Overbeke AJPM.What are the factors determining authorship and the order of the authors' names: a study among authors of the Nederlands Tijdschrift voor Geneeskunde (Dutch Journal of Medicine).JAMA.1998;280:217-218.

—Yank V, Rennie D.Disclosure of researcher contributions: a study of original research articles in the Lancet.Ann Intern Med.1999;130:661-670.

Media

➢Opinion

—Deary IJ, Whiteman MC, Fowkes FGR.Medical research and the popular media.Lancet.1998;351:1726-1727.

—Johnson T.Medicine and the Media.N Engl J Med.1998;339:87-92.

—Nelkin D.An uneasy relationship: the tensions between medicine and the media.Lancet.1996;347:1600-1603.

➢Research

—Berland GK, Elliott MN, Morales LS, et al.Health information on the Internet: accessibility, quality, and readability in English and Spanish.JAMA.2001;285:2612-2621.

—Moynihan R, Bero L, Ross-Degnan R, et al.Coverage by the news media of the benefits and risks of medications.N Engl J Med.2000;342:1645-1650.

Peer Review and Editing

➢Opinion

—Laine C, Mulrow C.Peer review: integral to science and indispensable to Annals.Ann Intern Med.2003;139:1038-1040.

—Ray JG.Judging the judges: The role of journal editors.QJM.2002;95:769-774.

—Rennie D.Editors and Owners: stretching reputation too far.JAMA.1999;282:783-784.

—Schroter S, Black N, Evans N, Carpenter J, Godlee F,Smith R.Effects of training on quality of peer review:randomized controlled trial.BMJ.2004;328:673.

➢Research

—Berlin JA, on behalf of the University of Pennsylvania Meta-analysis Blinding Study Group.Does blinding of readers affect the results of meta-analyses? Lancet.1997;350:185-186.

—Bingham CM, Higgins G, Coleman R, Van Der Weyden M.The Medical Journal of Australia Internet peer review study.Lancet.1998;352:441-445.

—Black N, van Rooyen S, Godlee F, Smith R, Evans S.What makes a good reviewer and a good review for a general medical journal? JAMA.1998;280:231-233.

—Callaham ML, Baxt WG, Waeckerle JF, Wears RL.Reliability of editors' subjective quality ratings of peer reviews of manuscripts.JAMA.1998;280:229-231.

—Callaham ML, Knopp RK, Gallagher EJ.Effect of written feedback by editors on quality of reviews: two randomized trials.JAMA.2002;287:2781-2783.

—Callaham ML, Schriger DL.Effect of structured workshop training on subsequent performance of journal peer reviews.Ann Emerg Med.2002;40:323-328.

—Callaham ML, Wears RL, Waeckerle JF.Effect of attendance at a training session on peer review quality and performance.Ann Emerg Med.1998;32:318-322.

—Cho MK, Justice AC, Winker MA, et al.Masking author identity in peer review: what factors influence masking success? JAMA.1998;280:243-245.

—Das Sinha S, Sahni P, Nundy S.Does exchanging comments of Indian and non-Indian reviewers improve the quality of manuscript reviews? Natl Med J India.1999;12:210-213.

—Davis RM, Mullner M.Editorial independence at medical journals owned by professional associations.Sci Eng Ethics.2002;8:513-528.

—Day FC, Schriger DL, Todd C, Wears RL.The use of dedicated methodology and statistical reviewers for peer review: a content analysis of comments to authors made by methodology and regular reviewers.Ann Emerg Med.2002;40:329-333.

—Evans AT, McNutt RA, Fletcher SW, Fletcher RH.The characteristics of peer reviewers who produce good quality reviews.J Gen Intern Med.1993;8:422-428.

—Godlee F, Gale CR, Martyn CN.Effect on the quality of peer review of blinding reviewers and asking them to sign their reports: a randomized controlled trial.JAMA.1998;280:237-240.

—Good CD, Parente ST, Rennie D, Fletcher SW.A worldwide assessment of medical journal editors'practices and needs: results of a survey by the World Association of Medical Editors.S Afr Med J.1999;89:397-401.

—Goodman SN, Berlin J, Fletcher SW, Fletcher RH.Manuscript quality before and after peer review and editing at Annals of Internal Medicine.Ann Intern Med.1994;121:11-21.

—Justice AC, Cho MK, Winker MA, Berlin JA, Rennie D.Does masking author identity improve peer review quality? a randomized controlled trial.JAMA.1998;280:240-242.

—Marusic A, Mestrovic T, Petrovecki M, Marusic M.Peer review in the Croatian Medical Journal from 1992 to 1996.Croatian Med J.1998;39:3-9.

—Nylenna M, Riis P, Karlsson I.Multiple blinded reviews of the same manuscripts: effects of referee characteristics and publication language.JAMA.1994;272:149-151.

—Pitkin RM, Branagan MA, Burmeister LF.Accuracy of data in abstracts of published research articles.JAMA.1999;281:1110-1111.

—Pitkin RM, Branagan MA.Can the accuracy of abstracts be improved by providing specific instructions?a randomized controlled trial.JAMA.1998;280:267-269.

—Pitkin RM, Burmeister LF.Identifying manuscript reviewers: randomized comparison of asking first or just sending.JAMA.2002;287:2795-2796.

—Resch KI, Ernst E, Garrow J.A randomized controlled study of reviewer bias against unconventional therapy.J Royal Society Med.2000;93:164-167.

—Roberts JC, Fletcher RH, Fletcher SW.Effects of peer review and editing on the readability of articles published in Annals of Internal Medicine.JAMA.1994;272:119-121.

—Schroter S, Black N, Evans S, Carpenter J, Godlee F,Smith R.Effects of training on quality of peer rreview:Randomized controlled trial.BMJ.2004;328:673-675.

—Sweitzer BJ, Cullen DJ.How well does a journal's peer review process function? a survey of authors' opinions.JAMA.1994;272:152-153.

—Van Rooyen S, Godlee F, Evans S, Smith R, Black N.Effect of blinding and unmasking on the quality of peer review: a randomized trial.JAMA.1998;280:234-237.

—Wang G, Zhang B.Research design and statistical methods in Chinese medical journals.JAMA.1998;280:283-285.

—Walsh E, Rooney M, Appleby L, Wilkinson G.Open peer review: a randomized controlled trial.Br J Psychiatry.2000;176:47-51.

Publication

➢Opinion

—Edelson AM.On the future of scholarly journals.Science.1998:359.

➢Research

—Callaham ML, Wears RL, Weber EJ, Barton C, Young G.Positive-outcome bias and other limitations in the outcome of research abstracts submitted to a scientific meeting.JAMA.1998;280:254-257.

—Ray J, Berkwits M, Davidoff F.The fate of manuscripts rejected by a general medical journal.Am J Med.2000;109:131-135.

—Rochon PA, Bero LA, Bay AM, Gold JL, Dergal JM,Binnis MA, Streiner DL, Gurwitz JH.Comparison of review articles publiched in peer-reviewed and throwaway journals.JAMA.2002;287:2853-2856.

—Von Elm E, Poglia G, Walder B, Tramer MR.Different patterns of duplicate publication: an analysis of articles used in systematic reviews.JAMA.2004;291:974-980.

—Weber EJ, Callaham ML, Wears RL, Barton C, Young G.Unpublished research from a medical specialty meeting: why investigators fail to publish.JAMA.1998;280:257-259.

Publication Ethics

➢Policy

—Managing Allegations of Scientific Misconduct: A Guidance Document for Editors.Available at http://ori.dhhs.gov/multimedia/acrobat/masm.pdf

—Pharmaceutical Company Good Publication Practices Guidelines.Available at http://www.gpp-guidelines.org

➢Opinion

—Barrie JM, Presti DE.Digital plagiarism: the web giveth and the web shall taketh.JMIR.Available at:http://www.jmir.org/2000/1/e6/index.htm

—Callaham ML.Journal policy on ethics in scientific publications.Ann Emerg Med.2003;41:82-89.

—Eysenbach G.Report of a case of cyberplagiarism:and reflections on detecting and preventing academic misconduct using the Internet.JMIR.Available at:http://www.jmir.org/2000/1/e4/index.htm

—Franken EA Jr.Duplicate publication: crime and punishment.Acad Radiol.1998;5:407-408.

—Horton R.Revising the research record.Lancet.1995;346:1610-1611

—Huston P, Moher D.Redundancy, disaggregation, and the integrity of medical research.Lancet.1996;347:1024-1026.

—Smith R.Draft code of conduct for medical editors.BMJ.2003;327:1010.

➢Research

—Botkin JR, McMahon WM, Smith KR, Nash JE.Privacy and confidentiality in the publication of pedigrees: a survey of investigators and biomedical journals.JAMA.1998;279:1808-1812.

—Budd JM, Sievert ME, Schultz TR.Phenomena of retraction: reasons for retraction and citations to the publications.JAMA.1998;280:296-297.

—Friedman LS, Richter ED.Relationship between conflicts of interest and research results.J Gen Intern Med.2004;19:51-56.

—Jefferson TO, Alderson P, Davidoff F, Wager E.Editorial peer-review for improving the quality of reports of biomedical studies.Abstract available at http://cochranelibrary.com/.Full text available for fee at http://cochranelibrary.com/

—Krimsky S, Rothenberg LS.Conflict of interest policies in science and medical journals: editorial practices and author disclosures.Sci Eng Ethics.2001;7:205-218.

—Nylenna M, Andersen D, Dahlquist G, et al.Handling of scientific dishonesty in the Nordic countries.Lancet.1999;354:57-61.

Relations with Industry/Advertising

➢Opinion

—Deyo RA, Psaty BM, Simon G, Wagner, Omenn GS.The messenger under attack — intimidation of researchers by special interest groups.N Engl J Med.1997;336:1176-1179.

—Wager L et al.Good publication practice for pharmaceutical companies.Curr Med Res Opin.2003;19:149-154.

➢Research

—Bekelman JE, Li Y, Gross CP.Scope and impact of financial conflicts of interest in biomedical research.A systematic review.JAMA.2003;289:454-465.

—Chaudhry S, Schroter S, Smith R, Morris J.Does declaration of competing interests affect readers'perceptions? A randomised trial.BMJ.2002;325:1391-1392.

—Cho MK, Bero LA.The quality of drug studies published in symposium proceedings.Ann Intern Med.1996;124:485-489.

—Wilkes MS, Doblin B, Shapiro M.Pharmaceutical advertisements in leading medical journals: experts'assessments.Ann Intern Med.1992;116:912-919.

Research Design and Statistics for Editors

➢General

—Lang T.Twenty statistical errors even YOU can find in biomedical research articles.CMJ.2004;45:361-370.

—Lee N, Millman A.ABC of medical computing:manipulating and analyzing data.BMJ.1995;311:614-617.

—Swinscow TDV.Statistics at Square One.9th Ed.BMJ Publishing Group Ltd; 1997.

—Whitley E, Ball J.Statistics review 1: presenting and summarising data.Crit Care.2002;6:66-71.

—Whitley E, Ball J.Statistics review 2: samples and populations.Crit Care.2002;6:143-148.

—Whitley E, Ball J.Statistics review 3: hypothesis testing and P values.Crit Care.2002;6:222-225.

—Whitley E, Ball J.Statistics review 4: sample size calculations.Crit Care.2002;6:335-341.

—Whitley E, Ball J.Statistics review 5: comparison of means.Crit Care.2002;6:424-428.

—Whitley E, Ball J.Statistics review 6: nonparametric methods.Crit Care.2002;6:509-513.

➢Clinical Trials

—Beller EM, Gebski V, Keech AC.Randomisation in clinical trials.Med J Aust.2002;177:565-567.

—Brighton JK, Gebski VJ, Keech AC.Specifying interventions in a clinical trial.Med J Aust.2002;176:281-282.

—Burgess DC, Gebski VJ, Keech AC.Baseline data in clinical trials.Med J Aust.2003;179:105-107.

—Cakir B, Gebski VJ, Keech AC.Flow of participants in randomised studies.Med J Aust.2003;178:347-349.

—Cook DI, Gebski VJ, Keech AC.Subgroup analysis in clinical trials.Med J Aust.2004;180:289-291.

—Gebski VJ, Keech AC.Statistical methods in clinical trials.Med J Aust.2003;178:182-184.

—Gebski V, Marschner I, Keech AC.Specifying objectives and outcomes for clinical trials.Med J Aust.2002;176:491-492.

—Hague WE, Gebski VJ, Keech AC.Recruitment to randomised studies.Med J Aust.2003;178:579-581.

—Heritier SR, Gebski VJ, Keech AC.Inclusion of patients in clinical trial analysis: the intention-to-treat principle.Med J Aust.2003;179:438-440.

—Keech AC, Gebski V.Managing the resource demands of a large sample size in clinical trials: can you succeed with fewer subjects? Med J Aust.2002;177:445-447.

—Keech AC, Wonders SM, Cook DI, Gebski VJ.Balancing the outcomes: reporting adverse events.Med J Aust.2004;181:215-218.

—Kirby A, Gebski V, Keech AC.Determining the sample size in a clinical trial.Med J Aust.2002;177:256-257.

—Lord SJ, Gebski VJ, Keech AC.Multiple analyses in clinical trials: sound science or data dredging? Med J Aust.2004;181:452-454.

—O'Connell RL, Gebski VJ, Keech AC.Making sense of trial results: outcomes and estimation.Med J Aust.2004;180:128-130.

—Pike R, Keech AC, Simes RJ.Clinical trials research in the new millennium: the International Clinical Trials Symposium, Sydney, 21-23 October 2002.Med J Aust.2003;178:316-317.

—Seale JP, Gebski VJ, Keech AC.Generalising the results of trials to clinical practice.Med J Aust.2004;181:558-560.

—Simes RJ, Gebski VJ, Keech AC.Subgroup analysis:application to individual patient decisions.Med J Aust.2004;180:467-469.

➢Cohort Studies

—Zhang J, Yu KF.What's the Relative Risk?: A method of correcting the odds ratio in cohort studies of common outcomes.JAMA.1998;280:1690-1691.

➢Qualitative Research

—Pope C, Ziebland S, Mays N.Qualitative research in health care: analysing qualitative data.BMJ.2000;320:114-116.

Style and Format

➢Opinion

—Altman DG, Schulz KF, Moher D, for the CONSORT Group.The revised CONSORT statement for reporting randomized trials: explanation and elaboration.Ann Intern Med.2001;134:663-694.

—Begg C, Cho M, Eastwood S, et al.Improving the quality of reporting of randomized controlled trials: the CONSORT Statement.JAMA.1996;276:637-639.(available at consort-statement.org)

—Bossuyt PM, Reitsma JB, Bruns DE, et al.Towards complete and accurate reporting of studies of diagnostic accuracy: the STARD Initiative.Clin Chem.2003;49:1-6.10.1373/49.1.1

—Bossuyt PM, Reitsma JB, Bruns DE, et al.The STARD Statement for Reporting Studies of Diagnostic Accuracy:explanation and elaboration.Clin Chem.2003;49:7-18.10.1373/49.1.7

—Haynes RB, Mulrow CD, Huth EJ, Altman DG, Gardner MJ.More informative abstracts revisited: a progress report.Ann Intern Med.1990;113:69-76.

—Kaplan JB, Bennett T.Use of race and ethnicity in biomedical publication.JAMA.2003;289:2709-2716.

—Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D,Stroup DF for the QUOROM Group.Improving the quality or reports of meta-analyses of randomised controlled trials: the QUOROM statement.Lancet.1999;354:1896-1900.

—Moher D, Schulz KF, Altman DG, for the CONSORT Group.The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomized trials.JAMA.2001;285:1987-1991 (also in Ann Intern Med.2001;134:657-662).

—Mulrow CD, Thacker SB, Pugh JA.A proposal for more informative abstracts of review articles.Ann Intern Med.1988;108:613-5.

—Skelton JR, Edwards SJL.The function of the discussion section in academic medical writing.BMJ.2000;320:1269-1270.

—Stroup DF, Berlin JA, Morton SC, Olkin I, et al, for the Meta-analysis of Observational Studies in Epidemiology(MOOSE) Group.Meta-analysis of observational studies in epidemiology: a proposal for reporting.JAMA.2000;283:2002-2012.

➢Research

—Devereaux PJ, Manns BJ, Ghali WA, et al.Physician interpretations and textbook definitions of blinding terminology in randomized controlled trials.JAMA.2001;285:2000-2003.

—Egger M, Juni P, Bartlett C, for the CONSORT Group.Value of flow diagrams in reports of randomized clinical trials.JAMA.2001;285:1996-1999.

—Miller FG, Rosenstein DL.Reporting of ethical issues in publications of medical research.Lancet.2002;360:1326-1328.

—Moher D, Jones A, Lepage L, for the CONSORT Group.Use of the CONSORT statement and quality of reports of randomized trials: a comparative before-and-after evaluation.JAMA.2001;285:1992-1995.

Other Organizations for Editors

➢AMERBAC

The Mexican Association of Biomedical Journal Editors—Asociación Mexicana de Editores de Revistas Biomédicas (AMERBAC)—is a voluntary association of biomedical editors from Mexico and elsewhere who seek to foster national cooperation among editors of peer-reviewed and non–peer-reviewed biomedical journals.

AMERBAC was founded in 1997 to facilitate this cooperation by providing a semiannual forum for editors to analyze journals and discuss editorial issues with their peers.AMERBAC also fosters broader communication among members and disseminates information about WAME.

Biomedical journal editors have an important responsibility to ensure that reports of medical research provide valid information that is readily accessible by researchers, medical practitioners, students, and others who need it.In particular, AMERBAC aims to assist editors in removing obstacles they often face, such as difficulties in obtaining high-quality manuscripts and in selecting good reviewers, lack of formal training in editing,limited finances, and limited access to publication expertise.

➢Committee on Publication Ethics (COPE)

COPE provides guidance to editors and publishers on all aspects of publication ethics and, in particular, how to handle cases of research and publication misconduct.It provides resources such as flowcharts, a code of conduct, best practice guidelines, and a database of cases at http://www.publicationethics.org.Most of the COPE resources are freely available on its website, while other services (such as specific advice on cases from its Forum meetings) are available only to members.Membership is open to editors of peer-reviewed journals from any discipline.Subscription reductions or waivers are offered to editors from developing countries.

➢Council of Science Editors Inc

CSE aims to improve communication in the life sciences by educating authors, editors, and publishers; by providing means of cooperation among persons interested in publishing in the life sciences; and by promoting effective communication practices in primary and secondary publishing in any form.

➢The Danish Committee on Scientific Honesty

The Danish Research Agency is an independent institution under the Ministry of Research of Denmark,housing several departments responsible for the oversight of scientific research.An appointed panel of experts reviews cases referred for possible violation of good scientific practice, often involving publication issues.The cases and resulting conclusions are published on the web.

➢European Association of Science Editors

EASE aims to promote improved communication in science by providing efficient means for cooperation among editors in all disciplines of science, and to assist in the efficient operation of publications in the sciences.Although EASE is European-based, members are welcome wherever they live.

➢The International Academy of Nursing Editors(INANE)

INANE was established by a small group of nursing editors in the early 1980s for the purpose of networking and role development.A loose affiliation of nurse editors,the Academy has survived and thrived for over 20 years,operating without formal organization, bylaws, or officers.A listserv provides an ongoing means of communication.Annual program meetings are sponsored and planned by volunteer editors and held in locations throughout the world

➢Korean Association of Medical Journal Editors(KAMJE)

KAMJE, inaugurated 1996, aims to promote the quality of medical journals published in Korea by the exchange of the information on the editing and by the discussion on the editorial principles.KAMJE has maintained the KoreaMed (www.koreamed.org/) a searching system of medical journal papers published in Korea.

SYLLABUS FOR PROSPECTIVE AND NEWLY APPOINTED EDITORS

Responsibilities of Editors:

1.Editors are responsible to readers, and should learn about their needs and interests.

2.Editors are responsible for safeguarding the rights of study subjects and animals.

3.Editors are responsible for the editorial content of the journal; that is, the subject matter and types of articles and the actual content of the articles that are published in the journal.

4.Editors are responsible for establishing the policies for authorship and submission of manuscripts to the journal.

5.Editors are responsible for establishing and maintaining a process for the constructive, prompt evaluation of manuscripts, whether accepted for publication or not.

6.Editors are responsible to authors for maintaining the integrity and confidentiality of the authors’ work while that work is being evaluated for publication.

7.Editors must be willing to make decisions and stand behind them, but be willing to reconsider their decisions when appropriate.

8.Editors should work to improve not only the quality of manuscripts but also the quality of research in the field.

9.Editors must be prepared to deal with error and allegations of misbehavior.

10.Editors should maintain editorial independence and work to ensure that authors have editorial freedom.

11.Editors must not have personal, financial, or other relationships linked in any way to any of their responsibilities as an editor.

12.Editors should plan for the future of their journals.

What Potential Editors Should Know Before Accepting the Position

Who owns and publishes the journal?

Journals are owned and published by medical societies or associations, universities, hospitals, research institutes, governmental organizations, or commercial publishers.Different publishers have different policies regarding the appointment of editors and the conditions under which editors will work.Relevant questions about these matters include:

o What is the history of the journal?

o Why did the previous editor leave?

o What are the terms of the editor’s appointment; eg,pay and duration of appointment? Does the editor have a written contract?

o To whom does the editor report—a publications committee, the president of the company, a university official, a government officer, or someone else?

o Will the editor have the freedom to publish whatever he/she believes should be published?

·What are the policies and objectives of the publisher for the journal?

A.What is the primary purpose of the journal? For example, it is educational, to publish work by members of a society, or to make money?

B.Is the editorial content (original scientific articles,review articles, opinion articles and editorials, and letters to the editor) of the journal fixed, or can the editor change it? Can the editor change the scientific direction of the journal or the space devoted to particular types of articles?

C.Does the publisher require publication of certain material with little or no review, for example reports of committees of a society or a governmental organization?

D.What are the publisher’s marketing and advertising policies? Are these policies acceptable to the potential editor?

E.How often is the journal published, are there limits on the number of pages that can be published in an issue or in a year, and are the editorial content and advertising content separated or intermingled?

F.Does the editor have responsibilities for copyediting and other aspects of the production of the journal?

G.Are there print and electronic versions of the journal?If there are the two versions, are they identical or does the content differ?

H.Where is the editorial office of the journal to be located?

What support will the owner provide for the editor and the editorial office of the journal?

A.Can the editor appoint one or more assistant editors or an editorial board?

B.Will support be provided for other staff, equipment(computers, manuscript-tracking software, internet and e-mail access), supplies, and rental of office space?

C: Will support be provided for the editor or assistant editors to attend scientific meetings or to attend meetings or courses for editors?The answers to the above questions should help the potential editor decide whether the position is attractive and the editor will have both the independence and the support needed to publish a journal of high quality.

The Editorial Process

➢Organization of the editorial officeThis will depend in part on the policies and procedures established for review of manuscripts.For example, is the handling of manuscripts centralized in a single office or will some manuscripts be handled by assistant editors elsewhere?

A.Staff is needed to log in and track manuscripts,contact reviewers, and ensure that the journal’s policies regarding manuscript style and related matters (see below) are maintained.

B.Required equipment usually includes computers,manuscript tracking software, and communications equipment.

C.Does the journal have (or need) an assistant editor or editors? Are they and the editor located in the same place, or will they work remotely? What are the responsibilities of the assistant editor(s)—to handle specific types of manuscripts, or simply to share the work overall? How will the flow of manuscripts and correspondence about manuscripts between editors and authors be handled? Who will make the decisions, the editor, the assistant editor(s), or both?

D.Is there an editorial board? What is the role of the board, and what are the qualifications for membership?An editorial board may be an important source of advice and support for an editor, or simply a group of qualified and willing manuscript reviewers.An editorial board is most likely to be helpful to the editor if its functions are clearly defined, its members have varied interests and expertise, and its size is limited.The term of service on the editorial board should be limited, so that the editor is continually exposed to new people and new ideas.

➢Determination of the editorial content of the journal.

A.Editorial content may be predetermined by the owner(see above) and the discipline or geographic region in which the journal is published.

B.Editorial content also may be determined by decisions to accept or reject manuscripts on particular topics.If authors see articles on a topic in the journal, they will probably submit manuscripts on that topic.Conversely, if authors do not see articles on a topic, they will probably assume the journal doesn’t want articles on that topic and therefore submit their manuscripts elsewhere.

C.The editor should have a vision of what the content of the journal should include, based on the needs and interests of readers, the most promising areas of research in the field, and the extent to which the journal should try to attract and publish this research.

D.Should the content of the journal be narrowed, for example, by focusing on studies of particular topics, or broadened to include more topics? Similarly, should the contents of the journal be broadened with respect to types of articles published? For example, should the journal publish editorials, review articles, news articles or issues devoted to a particular topic (so-called theme issues)?

E.The editor can try to attract new or better manuscripts,manuscripts in new areas of research, or new types of manuscripts in several ways.Authors can be invited to submit manuscripts directly or invited to submit by medical societies or other institutions, or the journal can publish notes asking authors to submit manuscripts.Such invitations should be qualified by statements that any manuscript will be evaluated according to the journal’s usual procedures, and that acceptance is not guaranteed.

The publication policies of the journal.

➢Policies for authorship

I.The editor should establish, publish and enforce criteria for authorship.For example, are there limits on the number of authors, and are authors asked or required to describe their contributions to the work? If the latter, will this information be published? (See also Authorship issues.)

II.Authors should be required to identify the organizations that provided support for the research and describe the role played by these organizations in the study and the analysis of the results.Authors should have full access to all results of their studies.This is particularly important with respect to studies about drugs and devices supported by the manufacturers.(See also Conflicts of interest.)

III.Authors should be required to disclose to the editors all personal financial and other relationships they may have with the manufacturer of any product mentioned in the manuscript or the manufacturers of competing products.

IV.The contributions of persons who are acknowledged for their assistance in the research should be described, and their assent to be acknowledged should be documented.

Policies for submission of manuscripts.

V.The topics of research and types of articles considered for publication in the journal should be clearly defined and publicized.

VI.Authors should be required to verify the originality of manuscripts submitted for publication, and to identify other related manuscripts that they have published or submitted to other journals.

VII.The editor should establish policies regarding manuscripts whose contents are in large part already known, as a result of presentation of the contents at meetings or press conferences, publication of abstracts or as part of governmental reports,distribution of preprints, or posting on the Internet.Many editors will publish manuscripts describing work presented at meetings or published in abstract form or as part of a governmental report, but not manuscripts describing work made public in other ways.

VIII.Authors are often required to transfer copyright of the manuscript, if accepted, to the journal.

IX.The editor should require that authors document that their research was approved by the appropriate institutional review committee for the protection of human or animal subjects, and that all human subjects or their representatives gave informed consent.Many editors require that this information be included in manuscripts.(See also Human rights protection, privacy, and confidentiality [including IRB].)

X.The editor should establish policies regarding format and length of manuscripts; numbers of figures and tables allowed; use of published templates for reporting certain types of studies, for example the template for randomized trials.

XI.If the editor has a policy that reviewers not know the authors of manuscript (a "blinded" review), then authors can be asked to submit copies of the manuscript with the names and addresses and other possible indicators of authorship removed.

XII.The editor may choose to ask authors to designate people whom they think are qualified to serve as manuscript reviewers.

➢Information for authors.

XIII.The journal’s polices for authorship and submission of manuscripts should be written and freely available.

XIV.The journal’s information for authors may contain more detailed information about the journal’s polices regarding manuscript style, tables and figures,acceptable abbreviations, units of measurement,reference style, and related topics.XV.Other topics that may be included are a description of the journal’s process for evaluation of manuscripts and the results of the journal’s evaluation process.

Manuscript evaluation.

A.The editor must establish a process for the evaluation(review) of manuscripts.Will manuscripts be evaluated(reviewed) by the editor(s), editorial board members,external reviewers, or some combination of these people?An editor can serve as a peer reviewer as well as can people outside of the editorial office.Should the manuscript be posted on the journal’s Web site for a specified interval, so that many people can review it(open review)?

B.The editor may establish a system for rapid review of especially important manuscripts.This may include review only by editors or asking reviewers to complete their evaluations within a shorter period of time than is allowed routinely.Authors who seek rapid review should explain why their manuscripts merit such review.

C.The editor may accept manuscripts (with or without revision) without outside review, for example if the quality is deemed to be outstanding or the subject is particularly timely.

D.The editor may reject manuscripts without outside review, for example if the subject matter is outside the purview of the journal, a manuscript on the same topic is just about to be published, the quality of the manuscript is poor, or criteria for the submission of manuscripts are not met.

E.How many people besides the editor should review a manuscript? Many journals have manuscripts reviewed by two people, on the grounds that some manuscripts need to be evaluated by people with different types of expertise or to minimize the risk of editorial decision on the basis of one review that is biased.Other journals routinely have manuscripts evaluated by one reviewer, or three reviewers.

F.Reviewers are advisors to authors and editors.The editor may ask reviewers to make recommendations regarding acceptance or rejection of manuscripts, and should pay attention to the recommendations, but the editor must be the one who makes the decisions.

G.Should reviewers know the identity of authors?Reviewers who do not know who wrote the manuscript might be expected to provide less biased reviews and recommendations.However, masking manuscripts by removing authors’ names and other information is difficult and has not proven to improve the quality of reviews.Few journals at present conduct masked review.

H.Should reviewers be asked to sign their reviews, so that their names are known to the authors? Most journals do not require this, but tell reviewers they may sign their comments for transmittal to authors if they wish.If a reviewer does sign these comments the editor should not remove that signature.If a reviewer does not sign these comments the editor should not reveal the identity of the reviewer to the author or any other person.

Reviewers—their responsibilities, selection, and rewards.

➢Responsibilities of reviewers.

I.The first responsibility of reviewers is to evaluate manuscripts critically but constructively and to prepare detailed comments about the research and the manuscript to help authors improve their work.The evaluation should include assessments of the originality and importance of the research; the design of the study; the methods of study, including analytic and statistical methods; the presentation of the results;possible confounding; the strength of the conclusions;and the overall quality of the manuscript.

II.The second responsibility is to make recommendations to the editor regarding the suitability of the manuscript for publication in that journal.Reviewers may be asked to write some narrative comments about the manuscript that support their recommendation to the editor regarding acceptance or rejection.They also can be asked to grade some characteristics of the manuscript, such as originality,quality, accuracy, readability and interest to readers,or to complete detailed questionnaires about these qualities and even assign a priority score.

III.Reviewers should declare to the editor any potential conflicts of interest with respect to the authors or the content of a manuscript they are asked to review, and in most instances when such conflicts exist should decline to review the manuscript.

IV.Other responsibilities of reviewers include treating the manuscript as a confidential document and completing the review promptly.Reviewers should not show the manuscript to anyone else without the express consent of the editor.

V.Reviewers should not make derogatory comments about the manuscript in their comments for the authors.If reviewers do make such comments, the editor may choose to edit the comments or even withhold all the reviewer’s comments from the authors.

VI.Reviewers must not make any use of the work described in the manuscript.

VII.Reviewers should not communicate directly with authors or even identify themselves to authors, except by signing their reviews.

VIII.The editor should provide guidance to the reviewers,particularly new reviewers, regarding how the editor wishes the reviewers to evaluate the manuscript and how the reviewers should meet their dual responsibility of providing constructive comments for the author and advice to the editor.

➢Identification and evaluation of reviewers.

I.The editor should establish a reviewer database that includes information about the expertise of each reviewer as well as addresses and other contact information.

II.The editor may identify potential reviewers on the basis of personal knowledge of the topic or from among the authors of references in the manuscript,the membership of the society that publishes the journal, or computer searches of databases such as PubMed, or by asking for names from reviewers who decline to review the manuscript.

III.Authors may suggest reviewers for their manuscript,whether invited to do so by the editor or not.The editor may choose to use one or more of these reviewers,but are under no obligation to do so.

IV.The editor should ask reviewers, by telephone, fax or e-mail, if they are willing to review a particular manuscript, and give them a date that the review is due at the editorial office (usually 2 to 3 weeks), rather than simply sending the manuscript to the reviewer.As the same time, the editor can ask for the names of others who might review the manuscript should the person initially contacted decline.

V.The editor is responsible for keeping track of reviewers, and taking steps to make sure reviews are completed in a timely manner.The editor may also wish to include in the reviewer database judgments regarding the promptness and quality of reviewers.

VI.If a reviewer does not complete a review on a timely basis, the editor should proceed with evaluation of the manuscript.He can make a decision to accept or reject the manuscript based on the comments and recommendations of another reviewer(s) or his own evaluation of the manuscript, or by seeking additional review.

➢Rewarding reviewers.

I.Avoid overworking reviewers, by limiting the number of manuscripts a person is asked to review.A sensible approach to limiting overwork is to ask reviewers to evaluate no more than one manuscript per month, or to not ask a person already reviewing a manuscript for the journal to review another manuscript.

II.Few journals pay reviewers, but they may be rewarded by being publicly thanked for reviewing in the journal each year or given free copies or subscriptions to the journal.

III.Inform reviewers of editorial decisions and send them copies of the comments of other reviewers.

Editorial decision making and communication with authors.

A.The editor must establish a system for deciding whether a manuscript is acceptable, acceptable if revised appropriately, or rejected.Will the decisions be made by the editor alone, assistant editors, or both?

B.What considerations should enter into the decision?These may include the comments and recommendations of the reviewers, the availability of space, and—most important—the judgment of the editor(s) regarding the suitability of the manuscript for the journal and the value and interest of the manuscript to the journal’s readers.

C.The editor may always seek additional review and advice, but must keep in mind that this delays decision making.

D.Decisions are communicated to authors by the editor.This means that the editor may need to provide explanations for the decision independent of the comments of the reviewers that are to be sent to the authors.

E.The editor should actively encourage revision of manuscripts thought to be potentially acceptable.When an editor seeks revision of a manuscript, he should make clear which revisions are essential, and which are optional.If the comments of the reviewers are contradictory, the editor must decide and tell the authors which comments the authors should follow.Editors may add their own comments and suggestions for revision,and they (or some person in the editorial office designated by the editor) are responsible for ensuring that manuscripts meet the journal’s policies regarding length and style.

F.In general, manuscripts that are potentially acceptable but need very major revision or additional data should be rejected, but the editor can encourage resubmission.When this is done, the editor should explain precisely what is needed to make the manuscript acceptable.It is a disservice to authors to request revision and then later reject the manuscript.As an alternative, the editor may choose to work closely with the authors to make the manuscript acceptable for publication.

G.Decisions to reject a manuscript may be based on scientific weakness (poor research design, inappropriate methods of study), lack of originality, lack of importance and interest to readers, or simply lack of space.The editor should explain to authors the reasons for decisions to reject manuscripts.This is particularly important when the editor rejects a manuscript but the tone of the comments of the reviewers that will be sent to the authors is favorable.

H.The editor should not make decisions regarding manuscripts about which he may have a conflict of interest, for example manuscripts submitted by members of the editor’s own institution or people who have been collaborators of the editor in the past.In this instance, the manuscript should be handled by an assistant editor or preferably a person outside of the editorial office who is given full power to select reviewers and make decisions regarding acceptance or rejection.The same policy should be followed if the editor himself submits a manuscript - other than an editorial - to his journal, which he should only rarely.

I.Revised manuscripts should be evaluated by editors,to determine if the revisions are satisfactory, and not returned to reviewers.An exception might be when the revised manuscript includes changes that may have introduced important new shortcomings about which the editor needs advice from one or more of the original reviewers.Revised manuscripts should not be sent to new reviewers.

J.The editor should have a mechanism to deal with appeals of decisions, particularly decisions to reject manuscripts.Was the basis for the decision clearly explained to the author? Could the decision have been wrong, based for example on an incorrect reading of the manuscript or bad advice from a reviewer? Editors are not obligated to reconsider every manuscript that was rejected, no matter how forcefully the author may request reconsideration, but should do so if the author provides good reasons why the decision may have been wrong and is willing to revise the manuscript in response to many of the comments of the reviewers.

K.Editors should immediately reject a resubmitted manuscript that was previously rejected and has not been revised.

L.If the editor agrees to reconsider a rejected manuscript,how should the resubmitted manuscript be reviewed?One reasonable policy is to have the revised manuscript evaluated by an original reviewer and one or two new reviewers.Alternatively, the editor may consider the manuscript as a new manuscript, and have it reviewed by reviewers who had not seen it before.

Special features of journals.

A.Editorials.Who will write them, the editor or others solicited by the editor? Who will review and accept them,seek revision, or reject them? Should all editorials be linked to original articles published at the same time, or should they be about any topic the editor chooses?

B.Review articles.Review articles may be commissioned by editors, or submitted by authors in the same way as are original research articles.They should be evaluated in the same way as the research articles.Should a review be commissioned, the author should be asked to submit an outline for the editor’s review and approval before writing the article.

C.Letters to the editors.All journals should have space in which published work can be questioned, and errors pointed out.Authors should always be given the opportunity to reply to any letter about their work that is accepted for publication.Later work that amplifies previously published work may also warrant publication as a letter to the editor rather than publication as new original article.

D.All journals should publish corrections for errors of fact in articles that were published earlier.

Other editorial responsibilities.

A.The editor should know the publisher’s policies about advertising.The editorial process should be conducted independently of the procurement of advertisements.The editorial content of the journal should be separated from the advertising content to the greatest extent possible in the published journal, whether printed or electronic.

B.Protection of human and animal rights.As noted above (see Policies for submission of manuscripts), the editor should require that authors document that their research was approved by the appropriate institutional review committee for the protection of human or animal subjects, and that all human subjects or their representatives gave informed consent.Editors should be prepared to direct investigators to institutional review committees that could review the investigators’ plans.A study reviewed and approved after completion is the same as a study not reviewed at all.Editors may on occasion publish studies not approved by such a committee if they are satisfied that the study subjects,whether human or animal, were adequately protected.Conversely, editors may on occasion decline to publish studies they consider unethical even if approved by an institutional committee.

C.Dealing with the media.The public is not served by premature release of research that has not undergone peer review and has not been published.Editors should establish policies regarding how they as editors and authors who have submitted manuscripts to their journal should communicate with the public.In general, authors should not publicize their work until it has been reviewed and published, except in the rare circumstances in which the research is of vital public health importance.Then,the editor may grant permission for a manuscript that has been reviewed and accepted for publication to be disseminated to the public before actual publication.

D.Dealing with allegations of misbehavior.Editors have a responsibility to investigate all allegations of misbehavior, to determine if there is a reasonable basis for the allegation.Those making allegations must describe the alleged misbehavior in detail.The editor should then communicate the allegations to the accused.Then, if in the editor’s judgment there is some evidence of misbehavior, the matter should be referred to the appropriate academic institution for further investigation.Should such allegations be made before publication,publication should be suspended until the matter is resolved.If the allegations are made, and proved, after publication, the editor should publish that fact, which may include a letter from one or more of the authors and an institutional official retracting the article.Editors should not retract articles on their own initiative.

E.The editor should maintain and publish records of the journal’s evaluation process, for example the number of manuscripts submitted per year, the average time needed to evaluate them, and the rate of acceptance.

Sources

1.WAME.Conflict of Interest in Peer-Reviewed Medical Journals.http://www.wame.org/conflict-of-interest-in-peer-reviewed-medical-journals.

Acessed October 20, 2011.

2.WAME.Policy Statements.http://www.wame.org/resources/policies.Acessed October 20, 2011.

3.WAME.Resources for Editors from Sources Other Than WAME.http://www.wame.org/resources/resources-for-medical-editors.Acessed October 20, 2011.