Courtesy Authorship in Academic Surgery Publications

Honorary authorship is highly prevalent in health sciences: systematic review and meta-analysis of surveys

A systematic review and meta-analysis of survey research was conducted to estimate honorary authorship prevalence in health sciences. We searched PubMed, Lens.org, and Dimensions.ai. until January 5 2023. Methodological quality was assessed and quantitative syntheses were conducted. Nineteen surveys were included and rated as having low methodological quality. We found a pooled prevalence of 26% [95% CI 21-31] (6 surveys, 2758 respondents) of researchers that perceived co-author(s) as honorary on the publication at issue (when they were not referred to any authorship criteria). That prevalence was 18% [95% CI 15-21] (11 surveys, 4272 respondents) when researchers were referred to Committee of Medical Journal Editors (ICMJE) authorship criteria, and 51% [95% CI 47-56] (15 surveys, 5111 respondents) when researchers were asked to declare their co-author(s) contributions on the publication at issue (and these were then compared to ICMJE criteria). 10% of researchers [95% CI 9-12] (11 surveys, 3,663 respondents) reported being approached by others to include honorary author(s) on the publication at issue and 16% [95% CI 13-18] (2 surveys, 823 respondents) admitted adding (an) honorary author(s). Survey research consistently indicates that honorary authorship in the health sciences is highly prevalent, however the quality of the surveys' methods and reporting needs improvement.

Undeserved authorship in surgical research: an underestimated bias with potential side effects on academic careers

The incidence of courtesy authorship in research over time has probably increased due to the enormous pressure to publish to increase the bibliometric indexes necessary to achieve an academic role. The aim of this survey was to quantify and characterize this research malpractice among a very selected group of surgeons from different surgical specialties belonging to the European Association of Surgery (ESA). E-mail addresses for the invitation to take part to the survey were collected by the Twenty-eighth Annual Meeting final program. Five-item were designed and developed by the authors using an online platform. Eighty-six members from 21 countries completed the survey (female/male ratio: 0.09). In the last 10 years, almost half of the responders (41, 47.7%, 37 academics) have included colleagues for courtesy authorship. The most common reason of courtesy authorships was to support the academic career of another researcher (62.5%). Other reasons were fear of retaliation (12.5%), reciprocal authorship (12.5%) or support for a partner (10%). This survey showed that undeserved authorship is sadly confirmed to be a common research misconduct across any countries and medical specialties, even among a very selected group of surgeons with international reputation irrespective of the academic position.

Gender Discrepancies in Middle Author Publications in US Academic General Surgery

INTRODUCTION

To explore gender discrepancies in publications at general surgery departments, we performed a cross-sectional comparing the number of women and men at each academic rank and their number of first author (FA), middle author (MA), last author (LA), and total publications.

METHODS

Thirty academic general surgery departments were randomly selected. For each faculty, we tabulated: first, middle, last names, gender, academic rank, educational leadership, year of medical school graduation, and additional graduate degrees. Bibliography, H-index, and citations were downloaded from the Scopus database.

RESULTS

One thousand three hundred twenty-six faculty sampled, 881 (66.4%) men and 445 (33.5%) women. Men outnumbered women at all ranks, with increasing disparity at higher ranks. Men outnumbered women in all subspecialties-largest difference in transplant surgery (84.4% versus 15.6%, P < 0.001). Men at all ranks had more MA publications: assistant professor (rate ratio 1.20; 95% confidence interval, 1.01-1.43, P = 0.024), associate professor (1.65; 1.31-2.06, P < 0.001), and professor (1.50; 1.20-1.91, P = 0.008). Men associate professors had more LA publications (1.74; 1.34-2.37, P < 0.001). No differences found in FA publications at any rank, nor LA publications at assistant professor and professor ranks. At subspecialty level, men in surgical oncology (1.95; 1.55-2.45, P < 0.001) and transplant surgery (1.70; 1.09-2.66, P = 0.02) had more MA publications.

CONCLUSIONS

While FA and LA publications did not differ significantly across genders, the largest difference lies in MA publications, beginning at junior ranks and persisting with seniority. Discrepancies in MA publications may reflect gender discrepancies in collaborative opportunities, hence total publications should be used cautiously when determining academic productivity.

Courtesy Authorship Practices Among First and Senior Authors: Evaluation of Motivations, Gender Bias, and Inequities

OBJECTIVES

A courtesy author is an individual who has not met authorship criteria but is listed as an author. This practice is common and often seen as victimless. Because publications are used for funding and promotion decisions, it is critical to understand biases in this practice.

METHODS

An anonymous survey was conducted from March to October 2020 of first and senior authors of publications from 2014 to 2015 in 8 surgical journals. Authors were surveyed about demographic data, practice setting, and courtesy author practices.

RESULTS

Three hundred forty-one authors responded (16% response rate). 75% were from academic practice settings. 14% reported adding courtesy authors 5 or more times in the past year. Courtesy authors were more often male (80%, P = 0.023), older (75%), and of higher academic rank (65%) than first/senior authors. All author groups were >75% white. When a reason was reported, 46% added a courtesy author due to avoid retaliation; 64% to avoid awkwardness. 26% expected reciprocal authorship offers. 92% of respondents acknowledge understanding International Committee of Medical Journal Editors authorship criteria. Women were less common among those added from goodwill than those added from fear (P = 0.039.) When courtesy authors were of a lower rank than first/senior authors, they were nearly twice as likely to be female (P = 0.0056) or non-white (P = 0.0184.).

CONCLUSION

Courtesy authors were more often male, older, and higher rank than first/senior authors. Fear of career consequences was a major motivator for including courtesy authors. Understanding the motivations and pressures leading to courtesy authorship will help to correct this practice.

Authorship and justice: Credit and responsibility

According to the International Committee of Medical Journal Editors (ICMJE), those who make significant intellectual contributions to a research project, and accept indirect responsibility for the entirety of the work should be listed as authors. All other contributors should be merely acknowledged. I argue that the ICMJE policy is unjust by consequentialist, deontological, and common sense standards. Because different sorts of contributions are incommensurable, ranking contributions is usually impossible. In particular, privileging intellectual contributions, and banishing non-intellectual contributions (e.g. funding, administration, routine data collection) to the Acknowledgments section is unfair to non-intellectual contributors. Holding contributors responsible for the errors or misconduct of others is also unjust. Contributors should be blamed (and sometimes punished) for all and only their own errors or misconduct. Their punishment should be proportional to the harm done; their blame to the ease with which their errors and misconduct could have been avoided. The ICMJE policy goes wrong by using the outdated, overly constraining practice of authorship as a vehicle for allocation of credit and responsibility. My alternative policy would replace the author byline and Acknowledgment sections of articles with Contributors pages listing all contributors to the research project, along with descriptions of their contributions.

Have ignorance and abuse of authorship criteria decreased over the past 15 years?

OBJECTIVE

A high prevalence of authorship problems can have a severe impact on the integrity of the research process. We evaluated the authorship practices of clinicians from the same university hospital in 2019 to compare them with our 2003 data and to find out if the practices had changed.

METHODS

Practitioners were randomly selected from the hospital database (Hospices Civils de Lyon, France). The telephone interviews were conducted by a single researcher (HM) using a simplified interview guide compared with the one used in 2003. The doctors were informed that their answers would be aggregated without the possibility of identifying the respondents. During the interviews, the researcher ticked the boxes with the answers on a paper file.

RESULTS

We interviewed 26 clinicians (mean age 49±8 years) from various medical specialties. They were unfamiliar with the ICMJE (International Committee of Medical Journal Editors) criteria for writing medical articles and felt that these criteria were not well met in general. With regard to ways of reducing the practice of honorary authors, the participants clearly felt that asking for a signature was hypocritical and of little use. The ghost authors were well known; this practice was considered as rather rare. The 'publish or perish' has always been cited as being responsible for bad practices (26/26: 100%). We compared these results with those observed in 2003 and no improvement has been observed in the past 15 years.

CONCLUSION

For the second time in France, within a 15-year interval, we have shown that the ICMJE criteria were ignored and that honorary authorship was frequent.