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Reflexiones sobre la autoría de los estudios científicos
Abstract
This document aims to comment on the currently used concepts of authorship of scientific articles. Parallelly, the question of the “order of the authors” is discussed. The concept of authorship according to contribution and of the “special case of the group publications” is approached. Special emphasis has been made in the bibliographic search on obtaining publications from groups of Spanish authors to illustrate how the group signing of the publications in our setting is done.Finally, the Clinical Research Group in Primary Care (G-ICAP) makes a series of recommendations in order to facilitate decision-making on these subjects, both for the studies of the G-ICAP itself as well as for other scientific studies developed in the health sciences setting.
... En este sentido, una producción prolífica de artículos científicos colabora en cierta medida como una buena carta de presentación y prestigio profesional, dependiendo de la contribución intelectual de ese trabajo. 2 Sin embargo, en el mundo académico no existe un consenso unificado para delimitar la inclusión de una autoría o el número de autores para un artículo, de manera que existen diversas formas, que puedan trasgredir factores éticos en una investigación e información. 3 Por tanto, la autoría injustificada suele ser uno de los problemas éticos que se presenta con mayor frecuencia en investigaciones donde, debido a su complejidad, participan varias personas y su práctica cada vez es más habitual en el contexto académico en ciencias de la salud (p.e., medicina, psicología, entre otras). ...
Sr. Director: Las publicaciones académicas son, por excelencia, la representación de la investigación, la cual es una actividad inherente a toda ciencia y que permite la constante actualización de los diversos campos del conocimiento. De manera que los investigadores alcanzan visibilidad en la medida que producen más artículos novedosos, renovados o rectificaciones que puedan servir, tanto para el intercambio y mejora en la comunicación científica como para el quehacer profesional. 1 La persona que firma un artículo científico se convierte en un autor, quien, por consecuencia, asume la responsabilidad de su contenido, así como el impacto académico que este pueda tener. En este sentido, una producción prolífica de artículos científicos colabora en cierta medida como una buena carta de presentación y prestigio profesional, dependiendo de la contribución intelectual de ese trabajo. 2 Sin embargo, en el mundo académico no existe un consenso unificado para delimitar la inclusión de una autoría o el número de autores para un artículo, de manera que existen diversas formas, que puedan trasgredir factores éticos en una investigación e información. 3 Por tanto, la autoría injustificada suele ser uno de los problemas éticos que se presenta con mayor frecuencia en investigaciones donde, debido a su complejidad, participan varias personas y su práctica cada vez es más habitual en el contexto académico
... Teaching and clinical research are essential tasks of internists26272829, irrespective of where they work303132333435. Internists must: ...
The working group on Competencies of Internal Medicine from the Spanish Society of Internal Medicine (SEMI) proposes a series of core competencies that we consider should be common to all European internal medicine specialists. The competencies include aspects related to patient care, clinical knowledge, technical skills, communication skills, professionalism, cost-awareness in medical care and academic activities. The proposal could be used as a working document for the Internal Medicine core curriculum in the context of the educational framework of medical specialties in Europe.
The working group of the Spanish Society of Internal Medicine (SEMI) on “Competencies of the Internist” has defined the basic medical knowledge, skills and attitudes that all internists in Spain should have. This list of competencies represents the Internal Medicine core curriculum within the context of the future educational framework of medical specialties in Health Sciences.
The evaluation of the research quality of individuals and institutions is essential for the appropriate use of resources, hiring of staff or the awarding of prizes and recognitions.Bibliometric indicators are especially used for this purpose. The most widely used among them is the impact factor.A new indicator has been introduced recently, the so-called h-index, which is growing in popularity for the evaluation of the quantity and quality of research using a single digit.However, although the h-index is useful, it has its limitations. In this paper, we refer specifically to these limits, stressing that, in our opinion, it is not completely suitable to assess the research quality of professionals who compete in any area.In this respect, we are proposing a new bibliographical index, which we have called the global index. Since it uses information from six bibliometric indicators, we consider that this index is more suitable for comparing the scientific quality of the researchers.
The Editors of the Rev Clin Esp inform herein on their editorial activity in the last year (November 2009 to October 2010) according to three different sections: (a) Objectives and achievements during 2010, (b) editorial activity, and (c) objectives for 2011. During 2010, we have updated the editorial algorithm (manuscript time lag). We have developed the "E-case reports" section and we have linked the abstracts of the Annual Congress of the Spanish Society of Internal Medicine (SEMI) to a journal supplement (electronically available). Since 2010, the subscribers have been able to receive all of the contents of the Rev Clin Esp on-line and to perform self-evaluations in order to obtain 1.7 credits per each journal issue (continuing education). In 2010 we handled 402 manuscripts (7.2% more than in 2009), 35% of which were accepted for publication. We asked 186 reviewers for their expert opinion, 75% of whom sent their reports in less than two weeks. The mean time needed to reach an editorial decision concerning original manuscripts ("accepted / rejected") was 44.5 days and for papers not sent to external reviewers 19.5 days. Collaboration with the work groups produced good results (2.4 published manuscripts per issue), but this could be improved if all the groups collaborated in all the journal sections. Our objectives for 2011 are to complete the renewal of the Rev Clin Esp scientific committee, in accordance with the SEMI Council, and to continue to proceed with the actions initiated to increase the journal impact factor. Rev Clim Esp is an open forum for all internal medicine specialists. Responsibility falls on all of us to collaborate in order to make our journal a little better day by day.
Copyright © 2010. Published by Elsevier Espana.
A survey of perceived contributions to papers based on byline position and number of authors.
PURPOSE: To determine the number of researchers who fulfill the International Committee of Medical journal Editors (ICMJE) authorship criteria and to evaluate individual contributions. MATERIALS AND METHODS: The author contribution lists of Radiology articles published between 1998 and 2000 with at least three authors were reviewed. The fulfillment of ICMJE criteria for authorship and the contribution percentage were assessed according to each researcher's position in the byline and nationality (American vs international), number of researchers per article, and year of publication. RESULTS: Sixty-eight percent of researchers fulfilled the ICMJE authorship criteria. Position in the byline indicated a significant difference in fulfillment (P < .001): 98.9% and 85.3% for the first and second authors, respectively, and 52.8% and 66.5% for the middle and last authors, respectively. American researchers had a higher percentage (78%) of fulfillment than did international researchers (57%) (P < .001). Fulfillment decreased as the number of authors per article increased (P < .001), although there was no significant change throughout 1998-2000. The mean contribution percentages decreased greatly from first to second to last to middle authors. American researchers had a significantly larger mean contribution percentage than did international researchers. Of the total 6,686 researchers, 2,316 (35%) contributed to one or two categories. This rate was higher for middle and international authors. CONCLUSION: The 68% fulfillment of criteria for authorship was closely related to the large number of researchers contributing to one category or to categories belonging to the same ICMJE criterion. (C) RSNA, 2002.
A published article is the primary means whereby new work is communicated, priority is established, and academic promotion is determined. Publication depends on trust and requires that authors be held to standards of honesty, completeness, and fairness in their reporting, and to accountability for their statements. The system of authorship, while appropriate for articles with only 1 author, has become inappropriate as the average number of authors of an article has increased; as the work of coauthors has become more specialized and relationships between them have become more complex; and as both credit and, even more, responsibility have become obscured and diluted. Credit and accountability cannot be assessed unless the contributions of those named as authors are disclosed to readers, so the system is flawed. We argue for a radical conceptual and systematic change, to reflect the realities of multiple authorship and to buttress accountability. We propose dropping the outmoded notion of author in favor of the more useful and realistic one of contributor. This requires disclosure to readers of the contributions made to the research and to the manuscript by the contributors, so that they can accept both credit and responsibility. In addition, certain named contributors take on the role of guarantor for the integrity of the entire work. The requirement that all participants be named as contributors will eliminate the artificial distinction between authors and acknowledgees and will enhance the integrity of publication.
In April this year we suggested that the concept of authorship in science was so broken that it should be scrapped and replaced by something different.1 Instead of authors there should be contributors and guarantors. Since then the debate has begun to motor. The originator of the idea of contributors—Drummond Rennie, deputy editor (west) of JAMA —has spelt out the case for change in detail.2 The Lancet has adopted the system.3 Many people have written to us about the subject, and most favour change: today we publish 16 of their letters (p 744).4 We propose that, where the authors want it, we will publish lists of contributors and guarantors with papers describing original research. When authors choose not to do this, however, we will continue to publish lists of authors in the traditional way.
We will need to experiment with …
Authorship in biomedical publications establishes accountability, responsibility, and credit. Misappropriation of authorship undermines the integrity of the authorship system, but accurate data on its prevalence are limited.
To determine the prevalence of articles with honorary authors (named authors who have not met authorship criteria) and ghost authors (individuals not named as authors but who contributed substantially to the work) in peer-reviewed medical journals and to identify journal characteristics and article types associated with such authorship misappropriation.
Mailed, self-administered, confidential survey.
A total of 809 corresponding authors (1179 surveyed, 69% response rate) of articles published in 1996 in 3 peer-reviewed, large-circulation general medical journals (Annals of Internal Medicine, JAMA, and The New England Journal of Medicine) and 3 peer-reviewed, smaller-circulation journals that publish supplements (American Journal of Cardiology, American Journal of Medicine, and American Journal of Obstetrics and Gynecology).
Prevalence of articles with honorary authors and ghost authors, as reported by corresponding authors.
Of the 809 articles, 492 were original research reports, 240 were reviews and articles not reporting original data, and 77 were editorials. A total of 156 articles (1 9%) had evidence of honorary authors (range, 11%-25% among journals); 93 articles (11%) had evidence of ghost authors (range, 7%-16% among journals); and 13 articles (2%) had evidence of both. The prevalence of articles with honorary authors was greater among review articles than research articles (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.2-2.6) but did not differ significantly between large-circulation and smaller-circulation journals (OR, 1.4; 95% CI, 0.96-2.03). Compared with similar-type articles in large-circulation journals, articles with ghost authors in smaller-circulation journals were more likely to be reviews (OR, 4.2; 95% CI, 1.5-13.5) and less likely to be research articles (OR, 0.49; 95% CI, 0.27-0.88).
A substantial proportion of articles in peer-reviewed medical journals demonstrate evidence of honorary authors or ghost authors.
To determine the prevalence of honorary and ghost authorship in Cochrane reviews, how authorship is assigned, and the ways in which authors and Cochrane editorial teams contribute.
Using a Web-based, self-administered survey, corresponding authors for 577 reviews published in issues 1 and 2 from 1999 of The Cochrane Library were invited to report on the prevalence of honorary and ghost authors, contributions by authors listed in the byline and members of Cochrane editorial teams, and identification of methods of assigning authorship. Responses were received for 362 reviews (63% response rate), which contained 913 authors.
One hundred forty-one reviews (39%) had evidence of honorary authors, 32 (9%) had evidence of ghost authors (most commonly a member of the Cochrane editorial team), and 9 (2%) had evidence of both honorary and ghost authors. The editorial teams contributed in a wide variety of ways to 301 reviews (83%). Authorship was decided by the group of authors (31%) or lead author (25%) in most reviews. Authorship order was assigned according to contribution in most reviews (76%). The 3 functions contributed to most by those listed in the byline were assessing the quality of included studies (83%), interpreting data (82%), and abstracting data from included studies (77%).
A substantial proportion of reviews had evidence of honorary and ghost authorship. The Cochrane editorial teams contributed to most Cochrane reviews.
Authorship on scientific articles is an important form of academic productivity. We examined the influence of personal and professional relationships on authorship decisions, particularly as they may conflict with stated criteria of the International Committee of Medical Journal Editors (ICMJE).
We conducted an anonymous e-mail survey of corresponding authors of original research articles in the Archives of Family Medicine, British Medical Journal, New England Journal of Medicine, and the American Journal of Psychiatry in 1999. Assessments were made of how often concerns about personal and professional relationships enter authorship decisions as well as factors affecting authorship if that person does not meet ICMJE criteria.
Of 578 eligible individuals, 292 participated, for a response rate of 50.5%. Personal and professional relationship concerns enter into decisions about who should be named as an author Junior faculty and individuals whose job is dependent on publications were significantly more likely to feel obligated to consider adding an author who doesn't meet ICMJE criteria when that person has administrative power over them. Current strategies to improve the veracity of authorship were endorsed as moderately effective.
Authors arefaced with the difficult task of negotiating interpersonal relationships while allocating authorship according to ICMJE criteria. Mechanisms should be explored to provide greater protection of junior faculty from pressure by senior faculty.
A number of general medical journals and the International Committee of Medical Journal Editors (ICMJE) request authors to disclose their contributions. Little is known about the effect of journal policies on authors' disclosure of their contributions.
To determine the number of named authors who do not meet ICMJE criteria for authorship, according to their published contributions, in 3 medical journals with different contribution disclosure practices.
Observational study of authors' contributions in research articles published in 2002 in Annals of Internal Medicine (n = 72), BMJ (n = 107), and JAMA (n = 81). BMJ asks authors to describe research contributions in their own words; Annals asks authors to choose from a list of coded contributions; and JAMA uses a structured checklist with instructions on contributions that qualify for ICMJE authorship criteria. Honorary authorship was defined as the lack of contribution from the first ICMJE criterion (study conception and design, or acquisition of data, or analysis and interpretation of data) and/or second (drafting the article or critical revision for important intellectual content) ICMJE criterion.
According to authors' published contributions, the number of honorary authors was highest in Annals (121/562 authors, 21.5%), followed by BMJ (46/482, 9.5%), and JAMA (3/641, 0.5%) (chi2(2) = 146.67, P<.001). The number of articles with honorary authors was 60% in Annals, 21% in BMJ, and 4% in JAMA. Honorary authors had fewer published contributions than authors who met ICMJE criteria and were positioned more toward the end of the byline. Honorary authors either lacked contributions for both ICMJE criteria (10% in Annals and 22% in BMJ) or contributions to the second ICMJE criterion (75% in Annals, 67% in BMJ, and 2 out of 3 in JAMA).
General medical journals differed in prevalence of honorary authors according to published research contributions of named authors. Different authorship/contributorship policies and procedures should be explored as a possible explanation for the differences in contributions disclosed by authors among these journals.
Authorship in biomedical publication provides recognition and establishes accountability and responsibility. Recent litigation related to rofecoxib provided a unique opportunity to examine guest authorship and ghostwriting, practices that have been suspected in biomedical publication but for which there is little documentation.
To characterize different types and the extent of guest authorship and ghostwriting in 1 case study.
Court documents originally obtained during litigation related to rofecoxib against Merck & Co Inc. Documents were created predominantly between 1996 and 2004. In addition, publicly available articles related to rofecoxib identified via MEDLINE.
All documents were reviewed by one author, with selected review by coauthors, using an iterative process of review, discussion, and rereview of documents to identify information related to guest authorship or ghostwriting.
Approximately 250 documents were relevant to our review. For the publication of clinical trials, documents were found describing Merck employees working either independently or in collaboration with medical publishing companies to prepare manuscripts and subsequently recruiting external, academically affiliated investigators to be authors. Recruited authors were frequently placed in the first and second positions of the authorship list. For the publication of scientific review papers, documents were found describing Merck marketing employees developing plans for manuscripts, contracting with medical publishing companies to ghostwrite manuscripts, and recruiting external, academically affiliated investigators to be authors. Recruited authors were commonly the sole author on the manuscript and offered honoraria for their participation. Among 96 relevant published articles, we found that 92% (22 of 24) of clinical trial articles published a disclosure of Merck's financial support, but only 50% (36 of 72) of review articles published either a disclosure of Merck sponsorship or a disclosure of whether the author had received any financial compensation from the company.
This case-study review of industry documents demonstrates that clinical trial manuscripts related to rofecoxib were authored by sponsor employees but often attributed first authorship to academically affiliated investigators who did not always disclose industry financial support. Review manuscripts were often prepared by unacknowledged authors and subsequently attributed authorship to academically affiliated investigators who often did not disclose industry financial support.
BACKGROUND AND OBJECTIVE:
Our goal was to evaluate the efficacy of internal medicine consulting (CIM) in primary care (PC) for the care of patients with dyspepsia.
PATIENTS AND METHOD:
Prospective case-control study of a population of 87,016 inhabitants during a 2 years period. We included patients with dyspepsia (319) jointly attended by a family physician (FP) and consulting internists (CI). The CI went weekly to the primary care center (PCC) to attend patients who would have been referred to the hospital outpatient clinic for specialized care (SC). As control group, 775 patients with dyspepsia were randomly and simultaneously chosen among a total of 29,317 first medical referrals during the period of the study.
RESULTS:
5.36% of the consultations for SC were patients with dyspepsia (annual incidence of 183 patients/1,000 inhabitants). We observed a significant reduction in: mean time for SC (26.4 days; 22.4-30.4), mean number of tests per patient ordered by SC (0.77; 0.42-1.12), mean time for patient information on the tests ordered by SC (27.3 days; 18.7-35,9), mean time for the resolution of the process (27.3 days; 18.4-36.2) and rate of specialized follow-up visits (25.2%; 18.5-31.9); p < 0.005 in all cases. The resolution rate of the process (37.2%; 25.7-48.7) and the discharge rate (38.7%; 28.9-48.5) were significantly higher for CIM (p < 0.01 in both cases). The referral rate for SC showed a negative correlation (r = -0.97; p < 0.01) with the quality of the management; this rate related to the type of training, age and years of medical practice of the GPs. Satisfaction of patients with the CIM was very high.
CONCLUSIONS:
The CIM with PC improves the efficacy of the specialized medical care of patients with dyspepsia.
"Authorship cannot be conferred; it may be undertaken by one who will shoulder the responsibility that goes with it."1Scientists who become authors display a rich variety of publication habits. Isaac Newton was famously reluctant to publish and, when he did, to attach his name to the work.2 More recently, and less famously, Yury Struchkov published one paper every 3.9 days for 10 years, while 20 researchers worldwide each published at least once every 11.3 days throughout the decade of the 1980s.3See also p 438.Whichever strategy is employed, the product of research is embodied in a manuscript that, once published, allows others to try to replicate and extend the work. Scientists believe they invest their lives in their research and in each manuscript. The published paper, though ostensibly merely a means of communication, is tangible evidence of this intellectual effort. Research workers, expecting to see
BACKGROUND AND OBJECTIVE:
We aimed to determine the clinical usefulness of transcranial Doppler (TCD) in critical neurological patients.
PATIENTS AND METHOD:
Prospective, multicenter study of 66 patients (44 men) with acute neurologic disorders (16 brain injury, 25 subarachnoid hemorrhage, 15 intracerebral hemorrhage, 2 ischemic stroke, 2 metabolic encephalopaty, 5 brain ischemia after cardiac arrest, and another pathology), admitted to 7 intensive care units. Data collection was performed during one month from 8 AM to 5 PM. An ultrasonographic study was performed in every patient every day; 234 studies were performed with 227 medium cerebral artery (MCA) blood flow determinations. Several patterns of cerebral blood flow were established: normal, hyperhemia, vasospasm, intracranial hypertension and brain death.
RESULTS:
Intracranial hypertension was found during 109 determinations (48%), a normal pattern was found in 104 (45.5%), hyperhemia in 9 (4%) and brain death in 5 (2.2%) patients. Doppler determinations meant that, in 195 cases (86%) no change in the clinical, diagnostic or therapeutic approach was necessary, in 18 cases (8%) medical treatment was changed, in 8 cases (3.5%) it was suggested to perform a CT scan and in 2 cases (0.9%) it was suggested to perform an EEG. Moreover, an intracranial pressure monitoring was indicated after one Doppler determination (0.4%) and in 3 cases (1.3%) a brain death diagnosis was done.
CONCLUSIONS:
The use of transcranial Doppler in critical neurological patients modified the management in 36% of them.
Background and objective
To know the durability of consecutive regimens of antiretroviral treatmentis important to design a long-term therapy, but there is not much information about thissubject.
Patients and method
Retrospective epidemiological study of a sample of 401 patients who beganantiretroviral treatment between January 1997 and April 2000 at ten Spanish hospitals.The duration of each consecutive antiretroviral regimen was calculated and the reasons for modificationand discontinuation were described.
Results
In the 3 years and 3 months covered by the study, 48.6% of the patients received morethan one regimen of therapy. Seventy five of the initial prescribed combinations included proteaseinhibitors. Median duration of consecutive lines of therapy was decreasing: 560, 360, 330 and202 days for the first, second, third and fourth regimens, respectively. The main reason to modificationwas intolerance or toxicity (46.2, 49.1 and 47.1% for the first, second and third modification).A fifth of changes was originated by difficulties to follow the therapy. Virological failure wasthe reason for modification in 21.8, 24.5 and 26.5% of first, second and third changes.
Conclusions
Duration of consecutive antiretroviral regimens progressively decreases. Intoleranceor drug toxicity were the main reasons conditioning the change of treatment.
Objective
To compare the effectiveness of manual therapy (MT) versus transcutaneous electrical nervous stimulation (TENS) in reducing the intensity of pain in patients with subacute or chronic neck pain (NP) attended at primary care physiotherapy units (PCPU).
Design
Randomised clinical trial.
Setting
Thirteen PCPU in 4 health districts of the Community of Madrid, Spain.
Participants
Ninety patients with subacute or chronic NP attended. Lost after intervention:3.
Interventions
At random, 47 patients were allocated to MT treatment and 43 to TENS.
Main measurements
Social and demographic characteristics and prognosis variables in the intervention groups were measured. Intensity of pain before and after intervention was calculated by mean values on the analogue visual scale (present moment, average and worst pain of the last 2 weeks). Side-effects were also measured.
Results
Difference between before-and-after pain was 21.83 mm (95% CI, 13.71-29.95) for the group treated with Transcutaneous electrical nervous stimulation and 22.87 mm (95% CI, 17.11-28.64) for manual therapy. The difference in averages on comparing the 2 procedures for improvement was 1.04 (95% CI,−8.66% to 10.75%).
Conclusions
TENS and MT significantly reduce patients’ perceived intensity of pain, although there were no differences between the 2 groups. There are no conclusive results for the alternative physiotherapy treatments that determine a clear strategy of intervention.
In 1989, THE JOURNAL instituted new requirements that all authors sign statements of authorship responsibility and financial disclosure,1 in addition to transfer of copyright. We are now receiving an increasing number of manuscripts with authorship attributed to a group. These include multicenter clinical trials, institutional reports, and statements from various councils and collaborative groups.Group Authorship
JAMA has permitted authorship to be attributed to a group, as long as all members of that group meet full criteria for authorship1,2 and sign a statement that each has "participated sufficiently in the conception and design of this work and the analysis of the data [when applicable], as well as the writing of the manuscript, to take public responsibility for it."3 The members of such groups have usually been listed in a box on the first or last page of the article or in the acknowledgment at the end of
Fundamento y objetivoEn todo el mundo el incremento de la actividad anestésica y la falta de anestesiólogos suscitan preocupación. En 2003 la Societat Catalana d’Anestesiologia, Reanimació i Terapèutica del Dolor llevó a cabo un estudio para cuantificar la actividad anestesiológica en Cataluña (España) (ANESCAT 2003).Pacientes y métodoANESCAT es un conjunto de 3 encuestas para cuantificar la actividad anestesiológica y los recursos. Se estimó que la muestra necesaria para la representación de las anestesias anuales en Cataluña era de 12.228 casos. Se llevó a cabo un estudio prospective transversal en forma de encuesta realizada en 14 días aleatorios del año 2003. Cada centro designó un coordinador responsible de que se cumplimentara un cuestionario para cada anestesia, el cual recogía información de las características del paciente, técnica anestésica y procedimiento para el que se realizaba.ResultadosEn ANESCAT participaron 131 centros sanitarios públicos y privados, el 100% de los que practicaron anestesias en el año 2003. La distribución geográfica de éstos fue: Barcelona ciudad, 54 (41,2%); resto de la provincia, 39 (29,8%); Tarragona, 15 (11,5%);Girona, 14 (10,7%), y Lleida 9, (6,9%). Se recogieron 23.136 cuestionarios de anestesias; la variación del número de cuestionarios recogidos los días laborables de corte fue de un 1,85% y el porcentaje de datos incompletos fue inferior al 5%. Además, se recibieron 765 cuestionarios unipersonales de actividad individualizada.ConclusionesCon una organización y método sencillos, y una elevada motivación de un colectivo de anestesiólogos, fue posible conducir un estudio extenso que permitió conocer con una gran precisión la actividad que realiza dentro de un territorio. Este tipo de estudios es necesario para introducir cambios en la organización y los requerimientos de recursos.Background and objectiveThe increasing workload in anesthesiology together with the shortage of anesthetists has led to worldwide concern within the specialty. In 2003, the Catalan Society of Anesthesiology,Critical Care and Pain Therapy undertook the ANESCAT survey to determine the anesthesia practice workload in Catalonia, Spain.Patients and methodA set of 3 questionnaires was used to quantify anesthesia practice and resources. A sample size of 12, 228 events was estimated to be necessary to be representative of the number of anesthetic procedures carried out in Catalonia annually. A prospective,cross-sectional survey was carried out on 14 randomly chosen days in 2003. Each hospital designated a coordinator responsible for ensuring that a questionnaire was filled in for each anesthetic procedure, to provide information about patient characteristics, anesthetic technique,and the intervention for which anesthesia was needed.ResultsAll 131 public and private hospitals in which anesthetic procedures were carried out participated. The geographic distribution was as follows: Barcelona city, 54 (41.2%); rest of the province of Barcelona, 39 (29.8%); Tarragona, 15 (11.5%); Girona, 14 (10.7%),and Lleida, 9 (6.9%). A total of 23,136 questionnaires about anesthesia procedures were received; the number of questionnaires returned on the selected workdays varied by 1.85% and the percentage of incomplete returns was less than 5%. The number of individual anesthetists returning questionnaires for processing was 765.ConclusionsThis large-scale study was possible thanks to a simple design and the strong motivation of a community of anesthesiologists.The results have provided an accurate picture of anesthesia practice within a specific geographical area. Such studies are necessary for introducing organizational changes and applying for additional resources.
Fundamento y objetivoEl proyecto ESEMeD-España es un estudio epidemiológico sobre los trastornos mentales en nuestro país. Se presentan la prevalencia-año y prevalencia-vida de los principales trastornos del estado de ánimo, de ansiedad y de abuso de alcohol, así como la influencia de los factores de riesgo sociodemográficos en su presencia y la edad de inicio de los trastornos.Sujetos y métodoEncuesta personal domiciliaria realizada a una muestra representativa de la población española mayor de 18 años de 5.473 individuos. El instrumento utilizado fue la versión del Composite International Diagnostic Interview (WMH-CIDI) desarrollada para la iniciativa Encuestas de Salud Mental de la Organización Mundial de la Salud (WHO World Mental Health Surveys). La tasa de respuesta fue del 78,6%. Los resultados se presentan ponderados a la población española.ResultadosUn 19,5% de las personas presentaron un trastorno mental en algún momento de su vida (prevalencia-vida) y un 8,4% en los últimos 12 meses (prevalencia-año). El trastorno mental más frecuente es el episodio depresivo mayor, que tiene un 3,9% de prevalencia-año y un 10,5% de prevalencia-vida. Después del episodio depresivo mayor, los trastornos con mayor prevalencia-vida son la fobia específica, el trastorno por abuso de alcohol y la distimia. Los factores asociados a padecer un trastorno mental son el sexo femenino, estar separado, divorciado o viudo, y estar desempleado, de baja laboral o con una incapacidad. La fobia social, la agorafobia y la fobia específica aparecen a edades más tempranas. Los trastornos del estado de ánimo (episodio de depresión mayor y distimia), junto con el trastorno de angustia, muestran una aparición más tardía.ConclusionesEl estudio ESEMeD-España puede proporcionar resultados necesarios para conocer el impacto de los trastornos mentales en España.Background and objectiveThe ESEMeD-Spain project is an epidemiological study about mental disorders in Spain. We present 12 month-prevalence and lifetime-prevalence of the main mood, anxiety and alcohol use disorders; the influence of sociodemographic factors on its presence and age of onset of the disorders.Subjects and methodCross-sectional household survey of a representative sample of the population of Spain 18 years or older. Sample size was 5.473 individuals. The WHO World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (WMHCIDI) was used. Response rate was 78.6%. Results have been weighted to represent the population of Spain.Results19.5% of the individuals presented a mental disorder sometime in their lifetime (lifetime- prevalence) and 8.4% in the last 12 months (12 month-prevalence). The most frequent mental disorder was major depressive episode, with a 12-month prevalence of 3.9% and a lifetime- prevalence of 10.5%. The other most lifetime prevalent disorders were specific phobia, alcohol abuse disorder, and disthymia. Factors associated to presenting a mental disorder were being female, being separated, divorced or widowed, and being unemployed, on sick leave or incapacitated. Social phobia, agoraphobia and specific phobia appear at younger ages, while mood disorders and panic disorder appears later in life.ConclusionsThe ESEMeD-Spain study can provide careful outcomes to understand the impact of mental disorders in Spain.
Fraud is a dramatic offense in scientific publishing but other offenses are more frequent and probably far more damaging. The most frequent lesser offenses are irresponsible authorship and wasteful publication. The authorship problems include listing of "authors" who made little or no contribution to the work reported and omitting of persons who made major contributions. Wasteful publication includes dividing the results in a single study into two or more papers ("salami science"); republishing the same material in successive papers (which need not have identical format and content); and blending data from one study with additional data to extract yet another paper that could not make its way on the second set of data alone ("meat extenders"). Wasteful publication may be the most frequent of these offenses and is probably the most damaging because of its economic implications for publishers, readers, libraries, and indexes.
Coauthorship of articles and case reports in medical journals is causing serious academic problems. Many persons who are listed as authors do not contribute as authors but rather as clinical investigators, statisticians, or program directors. In effect, a dishonest practice has developed that allows contributors to medical research to receive the honorific title of author when this title is not deserved. To help stop this practice, we urge a shift from the concept of authorship to a more general concept of receiving credit. Persons who contribute to articles as authors should be so credited, but those who contribute as clinical investigators, for example, should receive credit as clinical investigators, not authors. Instead, clinical investigators should receive credit by having their names listed alongside the authors' and by being permitted to list their nonauthorial contributions in their curricula vitae.
To determine the contributions of each author to multiauthored biomedical research papers.
Mailed, self-administered survey.
A total of 184 first authors from a consecutive sample of 200 papers with four or more authors published in 10 leading biomedical journals.
First authors' ratings of which authors had made substantial contributions to the following: initial conception of the study, design of the study, provision of needed resources, collection of data, analysis and interpretation of data, and writing the first draft of the paper or revising drafts for important intellectual content.
The contributions of nonfirst authors varied greatly within and among papers. Even second and last authors--though they generally contributed more than other nonfirst authors--were markedly inconsistent in the extent and pattern of their contributions. Time spent on the research differed among authors by orders of magnitude. An appreciable number of authors made few or no substantial contributions to the research.
The nature and extent of contributions of nonfirst authors to biomedical research reported in multiauthored papers cannot reliably be discerned (or discounted) by authorship or order of authors. The two core purposes of scientific authorship--to confer credit and denote responsibility for research--are not adequately being met by these authorship practices.
The purpose was to assess authorship trends over time by taking account of publication type and controlling for number of investigating centers and funding status in a multivariable analysis.
A database of 403 randomized studies and 193 controlled observational studies was assembled by means of a combination of electronic and hand search of 4 generic obstetrics and gynecology journals for the years 1975, 1980, 1985, 1990, and 1995. A multivariable logistic regression model was built for evaluating the effect of time on authorship with multiauthored articles as the binary outcome variable (articles were classified as either those with <6 authors or those with >/=6). The analysis was performed separately for the 2 types of publications, and it was adjusted for the confounding effects of number of centers, funding status, and journal of publication. The beta coefficient (and its exponent) associated with the time term in the logistic model provided a measure of the trend in publication of multiauthored articles.
In randomized studies the odds of publishing a multiauthored article, given the number of centers, funding status, and journal, were increased on average by 6% with every 5-year increment in time (odds ratio, 1.06; 95% confidence interval, 1.02-1. 10; P =.007). Similarly, in controlled observational studies, there was a 10% increase in the odds of publishing multiauthored articles (odds ratio, 1.10; 95% confidence interval, 1.01-1.20; P =.03).
There is an inflationary trend in authorship that is not explained solely by the increased collaboration between centers and funding for research.
When blood pressure (BP)-lowering efficacy is assessed by measurements taken in a clinic setting, angiotensin II-receptor antagonists show similar efficacy to angiotensin-converting enzyme inhibitors and better tolerability. A search of MEDLINE to date, however, reveals no randomized, double-blind studies using ambulatory BP monitoring (ABPM) to compare the BP-lowering efficacy of irbesartan and enalapril in a large number of patients ( > 200) with essential hypertension.
This study compared 24-hour BP reduction and BP control, as assessed by ABPM, in patients with mild to moderate essential hypertension treated with irbesartan or enalapril. The relative tolerability of the 2 treatments was also evaluated.
This was a multicenter, randomized, double-blind study in patients with mild to moderate essential hypertension (office diastolic BP [DBP] 90-109 mm Hg or systolic BP [SBP] 140-179 mm Hg). After a 3-week, single-blind placebo washout phase, patients with a mean daytime DBP > or = 85 mm Hg, as measured by ABPM between 10 AM and 8 PM, were randomized to 12 weeks of active treatment with irbesartan or enalapril. Starting doses were 150 and 10 mg/d, respectively, with titration to 300 or 20 mg/d if clinic DBP was > or = 90 mm Hg at week 4 or 8. Based on clinic measurements, BP control was defined as a BP reading < 140/90 mm Hg after 12 weeks of treatment; patients achieving a reduction in DBP of > or = 10 mm Hg at 12 weeks were considered responders. The ABPM criterion for BP control, independent of clinic values, was achievement of a daytime BP < 130/85 mm Hg after 12 weeks of treatment; patients achieving a reduction in 24-hour DBP > or = 5 mm Hg at 12 weeks were considered responders, in dependent of clinic values.
A total of 238 patients were randomized to treatment, 115 to irbesartan and 123 to enalapril. The study population was approximately 52.0% female and 48.0% male, with a mean ( +/- SD) age of 52.7 +/- 10.6 years. The study was completed by 111 patients in the irbesartan group (dose titrated to 300 mg/d in 72.0% of patients) and 115 patients in the enalapril group (dose titrated to 20 mg/d in 76.5% of patients). BP reductions were similar in the 2 groups, both as measured in the clinic (DBP, 12.7 +/- 8.8 mm Hg irbesartan vs 12.4 +/- 7.4 mm Hg enalapril; SBP, 19.0 +/- 14.1 mm Hg vs 17.5 +/- 14.0 mm Hg) and by 24-hour ABPM (DBP, 9.4 +/- 8.5 mm Hg vs 8.8 +/- 8.5 mm Hg: SBP, 14.7 +/- 14.7 mm Hg vs 12.6 +/- 13.1 mm Hg). As assessed by ABPM, rates of BP control were 40.5% (45/111) for irbesartan and 33.9% (39/115) for enalapril, and the response rates were a respective 71.2% (79/111) and 71.3% (82/115). The overall incidence of adverse events (40.0% irbesartan, 51.2% enalapril) was not statistically different between groups, although the incidence of adverse events considered probably related to antihypertensive treatment was significantly higher with enalapril than with irbesartan (24.6% vs 9.2%, respectively; P = 0.026), essentially because of the higher incidence of cough (8.1% vs 0.9%).
As assessed by ABPM, irbesartan 150 to 300 mg/d was as effective in lowering BP and achieving BP control as enalapril 10 to 20 mg/d. Based on the number of treatment-related adverse events, irbesartan was better tolerated than enalapril.
To know the durability of consecutive regimens of antiretroviral treatment is important to design a long-term therapy, but there is not much information about this subject.
Retrospective epidemiological study of a sample of 401 patients who began antiretroviral treatment between January 1997 and April 2000 at ten Spanish hospitals. The duration of each consecutive antiretroviral regimen was calculated and the reasons for modification and discontinuation were described.
In the 3 years and 3 months covered by the study, 48.6% of the patients received more than one regimen of therapy. Seventy five of the initial prescribed combinations included protease inhibitors. Median duration of consecutive lines of therapy was decreasing: 560, 360, 330 and 202 days for the first, second, third and fourth regimens, respectively. The main reason to modification was intolerance or toxicity (46.2, 49.1 and 47.1% for the first, second and third modification). A fifth of changes was originated by difficulties to follow the therapy. Virological failure was the reason for modification in 21.8, 24.5 and 26.5% of first, second and third changes.
Duration of consecutive antiretroviral regimens progressively decreases. Intolerance or drug toxicity were the main reasons conditioning the change of treatment.
To determine the number of researchers who fulfill the International Committee of Medical Journal Editors (ICMJE) authorship criteria and to evaluate individual contributions.
The author contribution lists of Radiology articles published between 1998 and 2000 with at least three authors were reviewed. The fulfillment of ICMJE criteria for authorship and the contribution percentage were assessed according to each researcher's position in the byline and nationality (American vs international), number of researchers per article, and year of publication.
Sixty-eight percent of researchers fulfilled the ICMJE authorship criteria. Position in the byline indicated a significant difference in fulfillment (P <.001): 98.9% and 85.3% for the first and second authors, respectively, and 52.8% and 66.5% for the middle and last authors, respectively. American researchers had a higher percentage (78%) of fulfillment than did international researchers (57%) (P <.001). Fulfillment decreased as the number of authors per article increased (P <.001), although there was no significant change throughout 1998-2000. The mean contribution percentages decreased greatly from first to second to last to middle authors. American researchers had a significantly larger mean contribution percentage than did international researchers. Of the total 6,686 researchers, 2,316 (35%) contributed to one or two categories. This rate was higher for middle and international authors.
The 68% fulfillment of criteria for authorship was closely related to the large number of researchers contributing to one category or to categories belonging to the same ICMJE criterion.
The increasing workload in anesthesiology together with the shortage of anesthetists has led to worldwide concern within the specialty. In 2003, the Catalan Society of Anesthesiology, Critical Care and Pain Therapy undertook the ANESCAT survey to determine the anesthesia practice workload in Catalonia, Spain.
A set of 3 questionnaires was used to quantify anesthesia practice and resources. A sample size of 12,228 events was estimated to be necessary to be representative of the number of anesthetic procedures carried out in Catalonia annually. A prospective, cross-sectional survey was carried out on 14 randomly chosen days in 2003. Each hospital designated a coordinator responsible for ensuring that a questionnaire was filled in for each anesthetic procedure, to provide information about patient characteristics, anesthetic technique, and the intervention for which anesthesia was needed.
All 131 public and private hospitals in which anesthetic procedures were carried out participated. The geographic distribution was as follows: Barcelona city, 54 (41.2%); rest of the province of Barcelona, 39 (29.8%); Tarragona, 15 (11.5%); Girona, 14 (10.7%), and Lleida, 9 (6.9%). A total of 23,136 questionnaires about anesthesia procedures were received; the number of questionnaires returned on the selected workdays varied by 1.85% and the percentage of incomplete returns was less than 5%. The number of individual anesthetists returning questionnaires for processing was 765.
This large-scale study was possible thanks to a simple design and the strong motivation of a community of anesthesiologists. The results have provided an accurate picture of anesthesia practice within a specific geographical area. Such studies are necessary for introducing organizational changes and applying for additional resources.
The emphasis on publications for promotion in academic medicine would lead one to the theory that authorship numbers would increase proportionally with this emphasis. To investigate authorship trends across a number of periodicals, we performed a descriptive study comparing two full years of published articles spaced ten years apart from five medical journals.
Physician reviewers each reviewed all articles of one medical journal for the 1995 and 2005 publication years. Reviewed journals included Academic Emergency Medicine (AEM), Annals of Emergency Medicine (AnnEM), Annals of Internal Medicine (AIM), Journal of Trauma (JT), and New England Journal of Medicine (NEJM). Data collected for each article were number of authors, ordinal number of the corresponding author, type of study described, whether the described study was a multicenter trial, whether authorship listed included a "study group," and whether any author was also an editor of the journal.
A total of 2927 articles were published in the five journals in 1995, and of these, 1401 (47.9%) were analyzed after the exclusion criteria had been applied; for 2005 a total of 3630 articles were published and of these, 1351 (37.2%) were included in the analysis. Across all five journals the mean number of authors per article increased from 4.66 to 5.73 between 1995 and 2005 (P < 0.0001), and four of the five journals individually had statistically significant increases in the number of authors per article. More articles had a journal editor as an author in 2005 (increased from 7.8% to 11.0%, P = 0.004), though no single journal had a statistically significant increase.
We describe a trend of increasing mean authors, editorial authorship, study groups, and multicenter trials over time with fewer solo authors now publishing original research or case reports. The academic medical community must pursue an authorship requirement consensus to assure that a standard of contribution for all authors on a given paper is met.
Adhering to authorship criteria in research while maintaining good relations with colleagues may be difficult, but it is an ideal to which we must continually aspire
The write position. A survey of perceived contributions to papers based on byline position and number of authors
- J D Wren
- K Z Kozak
- K R Johnson
- S J Deakyne
- L M Schilling
- R P Dellavalle
Wren JD, Kozak KZ, Johnson KR, Deakyne SJ, Schilling LM, Dellavalle RP. The write position. A survey of perceived contributions to papers based on byline position and number of authors.
EMBO Rep. 2007;8:988-91.
Who´s the author? Problems with biomedical authorship, and some possible solutions
Davidoff F for the CSE Task Force on Authorship. Who´s the
author? Problems with biomedical authorship, and some possible solutions. Report to the Council of Biology Editors; 2000.
[Consultado 10-10-2008]. Disponible en: http://www.councilscienceeditors.org/publications/v23n4p111-119.pdf.
A new standard for authorship
- P J Friedman
Friedman PJ. A new standard for authorship; 2009. [Consultado
9-2-2009]. Disponible en: http://www.councilscienceeditors.
org/services/friedman_article.cfm.
Código de buenas prácticas científicas. En: García Conde J, editor. Metodología de la inves-tigación clínica. Barcelona: Ars Médica
- Camí J M Beato
Camí J, López-Botet M, Beato M. Código de buenas prácticas científicas. En: García Conde J, editor. Metodología de la inves-tigación clínica. Barcelona: Ars Médica; 2003. p. 155-66.