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Biomedical authors’ awareness of publication ethics: an international survey
  1. Sara Schroter1,
  2. Jason Roberts2,
  3. Elizabeth Loder1,3,4,
  4. Donald B Penzien5,
  5. Sarah Mahadeo6,
  6. Timothy T Houle7
  1. 1 BMJ Publishing Group, London, UK
  2. 2 Headache: the Journal of Head and Face Pain, Ottawa, Ontario, Canada
  3. 3 Division of Headache, Department of Neurology, Brigham and Women’s/Faulkner Hospitals, Boston, Massachusetts, USA
  4. 4 Neurology, Harvard Medical School, Boston, Massachusetts, USA
  5. 5 Departments of Anesthesiology and Neurology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
  6. 6 BMJ Journals, BMJ Publishing Group, London, UK
  7. 7 Department of Anesthesiology, Massachusetts General Hospital, Boston, Massachusetts, USA
  1. Correspondence to Dr Sara Schroter; sschroter{at}


Objective The extent to which biomedical authors have received training in publication ethics, and their attitudes and opinions about the ethical aspects of specific behaviours, have been understudied. We sought to characterise the knowledge and attitudes of biomedical authors about common issues in publication ethics.

Design Cross-sectional online survey.

Setting and participants Corresponding authors of research submissions to 20 journals.

Main outcome measure(s) Perceived level of unethical behaviour (rated 0 to 10) presented in five vignettes containing key variables that were experimentally manipulated on entry to the survey and perceived level of knowledge of seven ethical topics related to publishing (prior publication, author omission, self-plagiarism, honorary authorship, conflicts of interest, image manipulation and plagiarism).

Results 4043/10 582 (38%) researchers responded. Respondents worked in 100 countries and reported varying levels of publishing experience. 67% (n=2700) had received some publication ethics training from a mentor, 41% (n=1677) a partial course, 28% (n=1130) a full course and 55% (n=2206) an online course; only a small proportion rated training received as excellent. There was a full range (0 to 10 points) in ratings of the extent of unethical behaviour within each vignette, illustrating a broad range of opinion about the ethical acceptability of the behaviours evaluated, but these opinions were little altered by the context in which it occurred. Participants reported substantial variability in their perceived knowledge of seven publication ethics topics; one-third perceived their knowledge to be less than ‘some knowledge’ for the sum of the seven ethical topics and only 9% perceived ‘substantial knowledge’ of all topics.

Conclusions We found a large degree of variability in espoused training and perceived knowledge, and variability in views about how ethical or unethical scenarios were. Ethical standards need to be better articulated and taught to improve consistency of training across institutions and countries.

  • medical ethics
  • ethics (see medical ethics)

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  • Contributors All authors (SS, JR, EL, DBP, SM, TTH) contributed to the design of the study and the survey tool, were involved in regular steering group meetings, and critically reviewed the manuscript and approved the final version before submission. SS, TTH and JR wrote the first draft of this manuscript. EL revised the manuscript and reference list and solicited comments from other authors. JR took the lead on reviewing the literature. SS and SM gathered the sample of authors. SS piloted the survey with students and experts. Chadwick de Voss developed the survey software, signed a confidentiality agreement for the BMJ and managed the electronic database. SS managed email responses and bounce-backs to the survey. TTH conducted all statistical analysis and was blinded to the respondents’ identities and signed a confidentiality statement for the BMJ. All authors (SS, JR, EL, DBP, SM, TTH) helped interpret the findings and approved the final version of the manuscript for publication.

  • Funding We received a £5000 research grant from the Committee on Publication Ethics to conduct the study.

  • Competing interests SS is a full-time employee of the BMJ Publishing Group and has access to all submission data and regularly undertakes research with its authors and reviewers. SM is a former employee of BMJ Publishing Group. EL receives salary support from The BMJ for her services as head of research. This is paid to her employing institution (the Brigham and Women’s Physician Organization). None of the authors work directly for BMJ Open or are involved in the decision-making process for articles submitted to BMJ Open. This paper was sent out for peer review in the usual way and treated in the same way as all submissions to the journal. TTH, JR and DBP have no relevant conflicts of interest.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data are available on reasonable request.