Authorship and medical publications are essential to disseminate knowledge about disease, communicate the latest findings from clinical research, and share experiences in patient management across the medical community. With these goals in mind, scientific journals represent the most trustworthy, evidence-based platform that assists healthcare professionals in decision-making to provide patients with the best therapies available. But, who are the brains behind the publications?

Authorship and medical publications issues are common during the publication of clinical research, mostly involving who deserves authorship or what should be the author order. The trend to include increasing numbers of authors in medical articles has led some peer-reviewed journals to limit the number of authors in research articles and reviews.

Likewise, some international oncology groups now also limit the number of authors in the studies presented at their annual meetings. Moreover, the concept of contributorship is becoming more prevalent in many journals, where authors have to declare their individual contributions to the development of the manuscript. The importance of the contribution of the individual authors to the final manuscript is traditionally reflected by the order of the authors in the list. However, while the first and last authors are usually well defined, the role of middle authors is often left to guessing.

Publishing clinical studies, especially in the field of oncology, where overall survival is a common endpoint, often can be compared to a long-distance race. Let’s take for our example the Tour de France. Cyclists need years of training and meticulous planning to be sure they arrive in perfect shape, and only the most fit will be in the “start” and “finish.” A place on the podium and/or the privilege to wear a distinguished jersey is earned with effort, day by day, at every stage. Each cyclist is responsible for his own actions and to compete with integrity. Even though only a few will make it to the front of the classification, the support from teammates throughout the race is vital to secure this top position.

Randomized clinical trials in oncology usually involve a large number of institutions and investigators to ensure that the target enrollment of patients is reached. While everyone wants recognition for their work and effort, recruitment of patients and conducting the study tasks with diligence is not enough to qualify as an author in the final publication. Only researchers who have substantially contributed throughout the entire “research journey” will make the cut and be part of the final author list.
The International Committee of Medical Journal Editors has developed guidelines to legitimately assign authorship, and ensure that publication in medical journals is conducted under best practice and ethical standards. The ICMJE states that authorship credit should be based on:

  • Substantial contributions during the conception or design of the study, or during the acquisition, analysis, or interpretation of the data
  • Drafting the manuscript or providing critical review of important intellectual content
  • Final approval of the version to be published
  • Agreement to be responsible for all aspects of the work related to accuracy and integrity

To qualify for authorship, authors should meet all 4 conditions.