Similar to the footnotes in an organization’s financial statement or annual report, a journal article’s acknowledgment section is often overlooked but an important source of information. The International Committee of Medical Journal Editors (ICMJE), of which the American Journal of Ophthalmology , Ophthalmology , and virtually all major journals are members, recently has revised the components of this section of a manuscript.
The first element comprises a summary of the authors’ commercial, governmental, or organizational funding in addition to any provided equipment or supplies. Relevant to this is a recent phenomenon at some academic institutions of the creation of intramural nonprofit foundations that function like commercial sponsors. Agreements between authors and study sponsors that interfere with the authors’ access to all of a study’s data, or that interfere with the authors’ ability to analyze and interpret all the data and to prepare and publish manuscripts independently, are not acceptable. To ensure that authors are not commercially fettered, the journals we edit require a statement confirming author independence.
The second component of the footnotes details financial disclosures, summarizing each author-generated statement from the ICMJE conflict-of-interest form, as discussed in a recent editorial. Our journals no longer accept blanket statements such as, “the authors do not have any financial disclosures (or conflicts of interest) with regard to the present manuscript.” Rather, we require authors to provide all disclosures in medicine so that peer reviewers and readers can come to their own conclusions about potential conflicts.
The third element documents the contributions of each author to the manuscript, specifying the 4 criteria that must be met for authorship. Until recently, authorship has required participation in each of the following 3 components: (1) substantial contributions to the conception or design of the work, or the acquisition, analysis, or interpretation of its data; AND (2) drafting the work or revising it critically for important intellectual content; AND (3) approval of the final version to be published. The fourth criterion for authorship recently added by the ICMJE is “an agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.” The ICJME wishes to emphasize that authorship is a serious commitment, requiring not just credit for the work but also responsibility and accountability.
Most journal editors eventually will be presented with a situation in which a postpublication issue cannot be resolved because the authors suddenly distance themselves from their own published work, instead pointing to someone else in the byline or failing to respond at all. Such experiences have led the journals we edit to discourage the practice of joint first authors and to request a single corresponding author. This representative should be the person most involved in the study and should be available at a reliable e-mail address for at least 1 year after the work is published.
This new ICMJE requirement for authorship implies that each author must understand the full scope of the work, know which coauthors are responsible for specific contributions, and have confidence in the coauthors’ ability and integrity. All authors, under the direction of the corresponding author, must participate in resolving any issue or dispute about the publication and be named in any relevant responses. “This new criterion better balances credit with responsibility, and establishes the expectation that editors may engage all authors in helping to determine the integrity of the work.” For similar reasons, our journals require that group studies list the writing authors in the byline or title page to specify unambiguously who put the words to the page and who will be required to address future issues or correspondence.
The fourth component, acknowledgments, lists the contributions, names, degrees, and affiliations for all persons who have made substantial contributions to the work but who do not fulfill the criteria for authorship, such as statisticians, medical writers, or industry writers. Ghost (hidden) authors or guest (honorary) authors are not permitted. Editorial assistants, photographers, artists, laboratory associates, copy editors, and others who assist employees are not listed, however valuable their service. All persons who are acknowledged must grant their permission for such, and this should be confirmed in the authors’ cover letter.
The corresponding author is responsible for ensuring that all authors understand the nuances of these requirements. We trust that authors provide authentic information and that they will respond to timely and relevant correspondence that criticizes or challenges a manuscript and any supplementary material. If irregularities are discovered, journals are obliged to report to the authors’ Institutional Review Board, to their academic institution, and to the readership.
Medical journals are increasingly scrutinized by those inside and outside of the profession, for their scientific information but also for public health implications and the application to guidelines or approval of new modalities of treatment. Public tabloids revel in uncovering undeclared financial conflicts by physicians and misleading industry-sponsored research. Indeed, the new ICMJE directives on disclosures and author contributions reflect the concerns of editors about these issues. Enhancing transparency reflects our commitment as editors to maintain physician and public trust.