Ethics: Increasing accountability

What authors, editors and reviewers should do to improve peer review.

Peer review is not currently designed to detect deception, nor does it guarantee the validity of research findings. It should, however, identify flaws in the design, presentation, analysis and interpretation of science and provide prompt, detailed, constructive criticism to improve research.

In order to function well, the journal peer-review system relies on the the integrity and accountability of authors, editors and reviewers. Each may behave unethically in the competitive world of science. Although we do not know how often crimes occur, forms of misconduct could include stealing or suppressing ideas and information, favouritism, and misleading reviews. Financial or personal competing interests can provide the motivation for misconduct. Failure to disclose these has eroded the credibility of scientific research and public trust in the publication process.

We discuss a number of policies and mechanisms that all scientific journals could adopt to improve transparency and promote fair peer review.

Improving transparency

  • Publish editorial decision-making and peer-review process
  • Require disclosure of all competing interests
  • Sanctions for misconduct or failure to disclose competing interests
  • Open peer review

Peer-review systems and editorial policies differ greatly among scientific journals. Most journals publish detailed instructions for authors submitting manuscripts. But the responsibilities and expectations of authors, editors and reviewers would be clearer if all journals published their policies on editorial decision-making and peer review.

Most medical journals have policies on author competing interests, but less than half have competing-interests policies for editors and reviewers, and only 12% or less publish editor or reviewer disclosures of competing interests1. Establishing required, structured reporting for the disclosure of competing interests for all parties, as well as policies for handling conflicts when they arise, would ensure a more equitable and transparent peer-review process.

Disclosure of competing interests leads to enhanced critical appraisal of research2, but does not necessarily mean rejection3.

We encourage journals to develop tougher sanctions for those who fail to disclose competing interests, like those of Environmental Health Perspectives and the Journal of Thoracic and Cardiovascular Surgery. There is little enforcement of current disclosure policies. Adopting policies that ban authors and their institutions from publishing for some period of time at the journal where the offence occurred would encourage disclosure. Some want to create an international, central blacklist for those who have committed more serious acts of misconduct. But there are legal issues and practical difficulties in investigating allegations of misconduct, in maintaining and enforcing such a list, and in protecting innocent co-authors from punishment.

Open peer review, where the identity of the reviewer is known to the author, allows authors and readers to determine whether the review process has been just. Although the arguments for and against open peer review are discussed by others in this debate, it clearly has a role to play in improving the transparency of peer review.

Promoting fair review

  • Appeals process
  • Ombudsman
  • Ethics review boards

Although many journals have an appeals process for rejected papers, authors may not be aware of such policies. In addition, the process varies widely between journals. Editors and reviewers do make mistakes. We recommend that all journals provide and publish details of a formal appeals process.

A journal could appoint an ombudsman to conduct independent, confidential investigations and give advice. Since 1996, for example, The Lancet has included an ombudsman in their peer-review process4. The presence of an ombudsman could minimize editorial misconduct, provide recourse for authors and reviewers who have been unfairly treated, and help maintain a journal's integrity and independence.

Some journals have ethics committees (for example, the British Medical Journal) or ethics review boards (for example, the PLoS journals). These clarify and develop existing editorial policies (for instance, on competing interests or confidentiality) and formulate new policies. They also advise editors on ethical questions regarding peer review and authorship, for example, and give guidance on moral responsibilities, such as the handling and reporting of scientific misconduct. The committee usually functions independently, is advisory in nature and publishes its decisions.

In addition, external committees have been formed to offer guidance to editors and improve standards through networking and education. These include the Council of Science Editors, the World Association of Medical Editors and the Committee on Publication Ethics. Although the majority of members and participating journals have a biomedical focus, we encourage editors of all scientific journals to draw on these organizations for resources, advice and support in developing their own policies and procedures.

Facilitating peer review

  • Trial registration
  • Data audit
  • Specific instructions and evaluation tools for reviewers
  • Rewards for reviewers

Access to data and analyses that are not fully reported in a submitted manuscript may be necessary for thorough peer review. The Council of Science Editors recommends that journals establish data-access policies for editorial evaluation and peer review before and after publication so that the validity of the work can be verified or errors corrected.

Clinical trial registration is one way to promote data access and is now a requirement for publication at many biomedical journals5. But, as it currently stands, trial registration does not guarantee access to the raw data and applies only to research involving human subjects. Many practical issues will need to be worked out before we have universal trial registration. Therefore, to apply to all scientific journals, we also recommend the development of policies that allow journals to audit or request any type of raw data for research they believe to be suspect or in need of more thorough peer review.

Although reviewing raw data can be difficult, time-consuming and expensive, having such a policy would hold authors more accountable for the accuracy of their data and potentially reduce scientific fraud or misconduct.

To get the most out of reviewers, journals should provide specific instructions as well as evaluation tools or checklists for assessing certain types of manuscripts. In addition, rewarding peer reviewers may help to increase and maintain a pool of good reviewers6. Rewards could take the form of public acknowledgement (a formal letter, published list of reviewers or credit in the final publication), payment, discounted subscription or a continuing medical education credit.

These recommendations are by no means comprehensive, but they would improve accountability of those involved in the peer review process: authors, editors and reviewers. Such changes should help to ensure the integrity of research and the dissemination of research findings in the scientific literature.

REFERENCES:

1. Cooper, R. J., Gupta, M., Wilkes, M. S. & Hoffman, J. R. Conflict of interest disclosure policies and practices of peer-reviewed biomedical journals Proc. 5th Int. Cong. Peer Rev. Biomed. Pub. (Chicago, 2005).

2. Schroter, S., Morris, J., Chaudhry, S., Smith, R. & Barratt, H. BMJ 328, 742-743 (2004).

3. Laine, C., Schaeffer, M. & Stack, C.. Conflicts of interest disclosed by authors of manuscripts submitted to a general medical journal Proc. 5th Int. Cong. Peer Rev. Biomed. Pub. (Chicago, 2005).

4. Horton R. J. Am. Med. Assoc. 280, 298-299 (1998).

5. DeAngelis, C. D. et al. J. Am. Med. Assoc. 292, 1363-1364 (2004).

6. Schaeffer, M., Laine, C. & Stack, C. Continuing medical education credit as an incentive for participation in peer review Proc. 5th Int. Cong. Peer Rev. Biomed. Pub. (Chicago, 2005).

RELATED LINKS:

The Council of Science Editors (CSE)

World Association of Medical Editors (WAME)

Committee on Publication Ethics (COPE)

Kirby Lee is a clinical pharmacist with primary interests in evidence-based healthcare, health policy and therapeutic outcomes of chronic disease. His research evaluates editorial decision-making and peer review, assessing the quality and accuracy of health information, and developing interventions to improve the appropriateness of drug prescribing and drug taking in older adults (http://www.ucsf.edu/clpharm/leek.htm).

Lisa Bero is a pharmacologist with primary interests in how clinical and basic sciences are translated into clinical practice and health policy. She is an adviser to the World Health Organization Drug Action Programme, a member of the Cochrane Collaboration Steering Group and serves on several national and international committees related to research dissemination and conflicts of interest (http://www.ucsf.edu/tobacco/lisa.htm).

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