Discussion

An ‘author’ is generally considered to be someone who has made substantive intellectual contributions to a published study. Unfortunately, we are witnessing research ethics misbehaviour in this regard, as biomedical authorship continues to have important academic, social and financial implications.

In this study, corresponding authors admitted that they had included honorary authors with a prevalence of 33.4%. This type of authorship abuse has been documented in previous studies in the range 19–44%.7 ,10–14 These variations in prevalence may be due to the era in which the study was conducted, differences in the author surveyed (first vs corresponding), study origin, sample size or type of article studied (review vs all types).

There are several possible explanations for this trend in authorship abuse. One is that researchers are often asked to prove productivity in order to gain promotion, which may push them to place their names on as many papers as possible. Another possible explanation is that authorship is occasionally awarded out of respect or friendship, with the presumption, at least in some cases, that their names will be added similarly by others. An additional possible cause, particularly prominent in the case of junior researchers, is to inappropriately add the name of well-established senior researchers to facilitate the publication of their projects. A final possible cause is that authorship is gained by senior researchers or heads of departments using intimidation strategies.

The findings of geographical variation in self-reporting of honorary authorship is interesting. This may be due to researchers’ perceived respect or perceived domination of heads of departments or institutions due to local cultural practices. The association between unjust authorship and increasing number of coauthors is also interesting. It is possible that when the number exceeds five, it is easy not to care about the number of coauthors as opposed to when only two or three authors are included.

It was disappointing to note that there was no difference in self-reporting of honorary authorship between researchers working in academic institutions (universities) and those working in non-academic ones (government and private). We also noted that honorary authorship is practised by both senior and junior researchers. Both these findings are intriguing and signify the size of the problem and the need for intervention.

It is noteworthy that most (75%) of the corresponding authors regretted the addition of unjust authors to their papers. It would be worth looking into subsequent publications by the same authors to know whether they changed their behaviour upon admitting misbehaviour.

Because of the large increase in the number of authors on papers submitted to biomedical journals, the International Committee of Medical Journal Editors (ICMJE; http://www.icmje.org) has recommended the following: ‘authorship credit should be based on (1) substantial contributions to conception and design, 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’. All other contributors should be listed in the acknowledgements section. The guidelines also stated that ‘acquisition of funding, collection of data, or general supervision of the research group alone does not constitute authorship’. Accordingly, we believe that if the respondents used the strict ICMJE criteria for authorship, the prevalence of self-reporting of honorary authorship would have been higher than the 33.4% reported in this study.

Among the efforts designed to diminish and preclude authorship abuse, some journals now request information about the contributions of each person named as having participated in a submitted study (contributorship). Furthermore, each institution should encourage researchers to comply with The ICMJE position regarding authorship. Journal editors should be aware of the efforts of the Committee on Publication Ethics (http://www.publicationethics.org/) on all aspects of publication ethics and, in particular, how to handle cases of research and publication misconduct. However, in our opinion, major impact will only occur when researchers consider authorship to be a responsibility and not viewed only as a reward as suggested by Huth.15

In summary, honorary authorship is relatively common in biomedical research. Scientists should not underestimate the issue of misconduct research behaviour because the entire research and publication process relies on trust. An important question was raised by Wager16: if scientists or clinicians are prepared to lie about the people involved with a research project or a publication, why should we expect them to be any more honest about their findings?