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Consortium of otolaryngology--head and neck surgery journals to collaborate in maintenance of high ethical standards.

The Editors-in-Chief of the major medical journals in our specialty have reached an agreement intended to uphold high standards of ethical behavior on the part of our contributing authors. Although it represents only a tiny fraction of our submissions, each year we encounter a significant number of ethical lapses, sometimes minor, but occasionally serious in nature. These include plagiarism, duplicate publication (1-5), undisclosed conflicts of interest (6,7), inappropriate authorship (8,9), breaches in ethical research conduct including informed consent, and even outright scientific fraud. Heretofore, it was possible for an author who has engaged in unethical practices to simply resubmit his or her work to another specialty journal where the questionable practices might go undetected.

One of the easiest areas to identify is duplicate publication, which is not uncommon in peer-reviewed medical publications. (1-4) recent analysis has recognized six distinct duplication patterns: 1. identical samples and identical outcomes; 2. two or more articles assembled to make up another article; 3. identical samples and different outcomes; 4. increasing samples and identical outcomes; 5. decreasing samples and identical outcomes; 6. different samples and different outcomes from the main article. (1) The percentage of duplicate publications has been estimated to be 8.3% in anesthesia and analgesia articles (1) and 8.5% in otolaryngology articles. (2) A high majority of these articles are punished within one year of the index or main article, and they often do not reference the original articles. (1,2)

Plagiarism is another problem that is encountered occasionally in peer-reviewed journals. Although it is rare for a full article to be plagiarized, it can occur at times when an article is translated to another language, particularly in small or non-indexed journals. There are times when authors are confused about what is or what is not acceptable regarding how much of someone else's work can be used without getting permission. Fortunately, many of these issues can be addressed using recommendations from the U.S. Copyright Office. (10) Although "there are no legal rules permitting the use of a specific number of words ..., " (10) the person considering using the work should take into consideration the "amount and substantiality of the portion used in relation to the copyrighted work as a whole." (11)

There has been great interest by the Editors of the Otolaryngology journals in the United States in developing appropriate guidelines and criteria for authors regarding duplicate publications and plagiarism. General guidelines have been recognized in the "Instructions to Authors" of the journals. Although there may be specific instances in which it may be difficult for authors to determine whether their report is duplicative, based on the criteria above, or where there is a question about what can be considered plagiarism rather than referencing, most occurrences have been obvious. In some cases such activities are egregious in their scope and intent. If authors are unsure about these issues, they can refer to the articles cited above, or consult the editor of the journal to which the article is submitted.

Important areas of concern for us have been patient confidentiality and informed consent. The Hippocratic Oath requires that physicians protect the confidentiality of their patients. In the United States patient confidentiality is law. It is essential that scientific publications respect patient confidentiality. Published information must be de-identified to assure that the patient's rights are respected. This is also true of photographs and other images.

The physician has ethical obligations in human experimentation. All manuscripts submitted for consideration for publication must respect these principles. Clinical trials and experimental therapies must be peer-reviewed and approved by an institutional review committee prior to implementation. Manuscripts describing these clinical research projects require an indication of appropriate oversight.

An issue that has become apparent in the medical peer-reviewed literature is that there are not well-established policies to deal with authors who are grossly faulty of breaches in research and publication ethics. We, the Editors of the Otolaryngology journals in the United States, feel that these issues are substantive within our literature and such breaches do occur. This is particularly true for duplicate publications and plagiarism, which may occur not uncommonly. Although often more difficult to identify, undisclosed conflicts of interest, inappropriate authorship, breaches in ethical research conduct, and outright scientific fraud may also be identified.

Our group has agreed to implement two policies to better coordinate our response to serious lapses in publication ethics. First, we will share information through a notification system whereby all journals are informed of relevant incidents. Secondly, in particularly egregious cases, our group (after an appropriate deliberative process) may elect to limit the author's privilege to publish in our journals for a specified period of time. It is important to emphasize that this system is designed to respond only to ethical breaches which are of a troubling magnitude, not minor oversights. It is also designed to create an ethical environment in our journals that will act as a standard in medical peer-reviewed publishing. It is hoped that these measures, together with educational features and editorials published in our pages, will help to foster the highest possible ethical practices.

Michael S. Benninger

Otolaryngology--Head and Neck Surgery

Robert K. Jackler

Otology & Neurotology

Jonas T. Johnson


Michael M. Johns

Archives of Otolaryngology--Head and Neck Surgery

David W. Kennedy

American Journal of Rhinology

Robert J. Ruben

International Journal of Pediatric Otolaryngology

Robert T. Sataloff

Journal of Voice; Ear, Nose & Throat Journal

Richard J.H. Smith

Annals of Otology, Rhinology & Laryngology

Peter C. Weber

American Journal of Otolaryngology

Randal S. Weber

Head & Neck

Eric D. Young

Journal of the Association for Research in Otolaryngology


(1.) 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.

(2.) Rosenthal EL, Masdon JL, Buckman C, Hawn M. Duplicate publications in the otolaryngology literature. Laryngoscope 2003; 113: 772-774.

(3.)Benninger MS Duplicate publications in peer-reviewed journals Otolaryngol Head Neck Surg 2002; 126:209-210.

(4.) Bailey B. Duplicate publications in the field of otolaryngology-head and neck surgery. Otolaryngol Head Neck Surg 2002;126: 211-216.

(5.) Jackler RK. Policy on redundant publication [editorial]. Otol Neurotol 2003;24:131.

(6.) Benninger MS. Conflict of interest in peer-reviewed journals. Otolaryngol Head Neck Surg 2001;125:285-287.

(7.) Bailey BJ. Full disclosure of financial interests in biomedical publications--A reminder. Laryngoscope 2002; 112:211-212.

(8.) Benninger MS. Why is defining authorship so important? Otolaryngol Head Neck Surg 2001;124:1.

(9.) Bailey BJ. What is an author? Laryngoscope. 2000; 110:1787-8.


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Comment:Consortium of otolaryngology--head and neck surgery journals to collaborate in maintenance of high ethical standards.
Publication:Ear, Nose and Throat Journal
Article Type:Editorial
Geographic Code:1USA
Date:May 1, 2005
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