Introduction
The European Society of Radiology (ESR) advocates best practice in the research process
and requires all authors who submit their material to its peer-reviewed scientific
publications (European Radiology, Insights into Imaging, EPOS, EUROAD, ECR abstracts)
to comply with the highest ethical and scientific standards, as well as to its editorial
policy of promoting and protecting the original authors’ scientific work.
Research ethics
In biomedical research, it is of the utmost importance to comply with ethical principles
and avoid any form of unethical experimentation in human or animal studies, adhere
to ethical guidelines, seek ethics committee approval, obtain adequate subject consent
and protect the privacy of the participants.
The fundamental document in the field of ethics in biomedical research that has influenced
the formulation of international, regional and national legislation and codes of conduct
is the Declaration of Helsinki [1], issued by the World Medical Association in 1964
[2]. This Declaration has been developed as a statement of ethical principles for
medical research involving human subjects, including research on identifiable human
material and data [1]. As well as following this statement of basic values of ethical
biomedical research, investigators should follow all applicable rules and regulations,
including national laws and regulatory guidelines. The Council for International Organizations
of Medical Sciences (CIOMS), established jointly by WHO and UNESCO as an international,
non-governmental organisation, has issued its International Ethical Guidelines for
Biomedical Research Involving Human Subjects to serve the interests of the international
biomedical community and help countries in defining national policies on the ethics
of biomedical research involving human subjects [2]. Another basic source of reference
is the Medical Ethics Manual, published by the World Medical Association [3].
One of the most important basic requirements in research involving patients or healthy
test subjects is informed consent. This implies good communication, providing clear
explanations of the procedures, treatments, risks, burdens and potential benefits.
The approval of an ethics committee must be obtained; this committee should review
the comprehensibility of the written communication, the soundness of the methodology,
and assess the potential risks and burdens of the procedures in view of the anticipated
benefits for the participants or the group they represent. Researchers should also
make sure that the sample size is sufficiently high to provide statistically meaningful
results and seek the early help of a statistician whenever appropriate. It would be
unethical to subject patients (or animals) to risk and discomfort if a too-small sample
size does not allow significant scientific conclusions [4]. The European Institute
for Biomedical Imaging Research has compiled a document on best practice in biomedical
imaging, which provides a valuable resource of basic premises and principles of ethical
research [5].
Animal studies must follow the FELASA guidelines (Federation of European Laboratory
Animal Science Associations) for animal use and for the training of persons involved
in experimental animal care and use [6]. Before starting research involving animal
experimentation, investigators must consider alternatives to painful procedures, minimise
animal suffering, design a sound methodology and make sure that the knowledge to be
gained is sufficiently important to justify the study. Authors can also refer to the
guidelines issued by the National Institutes of Health [7, 8].
Patient privacy
Patient privacy in medical research is a basic right of all study participants, and
investigators must ensure that sensitive information about a person is thoroughly
protected against unintentional leaks. Obviously, articles must not contain identifiable
data of any sort within the text, tables and images. In addition, general principles
and regulations on how to handle personal data to guarantee confidentiality should
be adhered to. At the European level, this is regulated by the Directive 95/46/EC
on the protection of personal data, which was implemented in 1995 by the European
Commission [9]. The Directive sets strict limits on the collection and use of personal
data, and sets out some of the highest standards of data protection in the world [10].
The principles defined in this Directive also apply to the transfer of data to countries
outside the European Union, which is only permitted if the country ensures an adequate
level of protection or the person controlling the data can guarantee that the recipient
will comply with the data protection rules. Another useful reference for the planning
of research with regard to the protection of patient data is the Personal Information
in Medical Research guide provided by the UK Medical Research Council [11].
Originality of submitted material
All manuscripts submitted to ESR scientific publications should be original work,
created by the indicated author or author group. Gift authorship is strictly discouraged
[12] and it is the authors’ sole responsibility to ensure that authorship criteria
are fully met. If no part or specific task of a study can be attributed to a particular
person, then this individual is not meeting the requirements for authorship credit.
In general, submission of a manuscript to one of ESR’s scientific publications strictly
implies that the submitted work: (1) has not been published before, (2) is not under
consideration for publication anywhere else and (3) has been approved for publication
by all co-authors, if any, as well as by the responsible authorities, tacitly or explicitly,
at the institute where the work has been carried out. If authors are planning to use
their own previously published material to an extent that exceeds fair use, they must
obtain permission from the copyright holder.
The International Committee of Medical Journal Editors (ICMJE) provides practical
guidance to assist researchers in the preparation of manuscripts: The principles enshrined
in Uniform Requirements for Manuscripts Submitted to Biomedical Journals [13] are
incorporated into ESR’s publishing policies. Furthermore, ESR is also committed to
the principles laid down by the Committee on Publication Ethics (COPE), such as the
Code of Conduct and Best Practice Guidelines for Journal Editors [14]. COPE’s guidelines
cover ethical, editorial and publishing issues as well as practical considerations
regarding manuscript preparation.
Authors wishing to include images or text passages that have already been published
elsewhere must obtain permission from the copyright owner(s) and include evidence
that such permission has been granted when submitting their papers. Any material received
without such evidence will be assumed to originate from the authors. Paraphrased material
must be cited by source. If authors use information word for word, it should be in
quotation marks with appropriate bibliographical citation. The accuracy and completeness
of references in any submitted material is the sole responsibility of the authors.
Finally, even if information that is freely distributed in the public domain is used
(e.g. taken from websites, etc.), the authors are profiting from the material and
must still, therefore, receive permission. Occurrences of plagiarism are grounds for
rejecting manuscripts.
Conflict of interest declaration
It is the policy of ESR to ensure balance, independence, objectivity and scientific
rigor in its publications. All authors are expected to disclose to the readers any
real or apparent conflict(s) of interest that may have a direct bearing on the subject
matter of the article. This pertains to relationships (remunerated or not) with pharmaceutical
companies, biomedical device manufacturers or other corporations whose products or
services may be related to the subject matter of the article. In particular, authors
must acknowledge those companies who have supported the Department(s) where the work
was carried out or may have sponsored the study in any way.
The intent of the policy is not to prevent authors who may have a conflict of interest
from publishing their work. It is merely intended that any potential conflict should
be identified openly so that the readers may form their own judgements about the article
with the full disclosure of the facts. It is for the readers to determine whether
the authors’ outside interest may reflect a possible bias in either the exposition
or the conclusions presented.
In addition, it is now considered good practice for each published article to be countersigned
by a ‘guarantor’ for the entire study. This may be the tenured senior author but it
could be the Head of Department, Research Lead or other tenured staff member who is
deemed to take overall responsibility for all aspects of the study (ethics, consent,
data handling and storage and all other aspects of Good Research Practice). ESR uses
this policy for original articles published in its journals [15].
Scientific misconduct
Possible scientific misconduct includes: redundant publications (submitting the same
article to different journals/media concurrently), data fabrication/falsification
(intentional alteration of research processes and results as well as image manipulation),
‘salami slicing’ (dividing the same study/patient group into two or more articles
and submitting them as different studies), overlapping publications (submitting a
similar manuscript to different journals with different readerships), gift authorship
(co-authorship awarded to a person with no or little involvement in the research process)
and undisclosed conflicts of interest. It is appreciated that such some of these events
may occur unintentionally or may sometimes arise out of naivety.
Copying ideas, writings, etc. from another and passing them off as one’s own is called
plagiarism. Plagiarism can take many forms and vary in degree, but is considered as
intellectual dishonesty.
As defined by the Committee on Publication Ethics (COPE) ‘Plagiarism ranges from the
unreferenced use of others’ published and unpublished ideas, including research grant
applications to submission under “new” authorship of a complete paper, sometimes in
a different language. It may occur at any stage of planning, research, writing, or
publication: it applies to print and electronic versions’ [16].
Accidental or unintentional plagiarism may occur when authors are largely unaware
of citation and documentation rules guiding scientific practice. Inexperience with
research methods, ignorance of citation rules and sloppiness are among the most common
causes for this type of plagiarism.
Detection of plagiarism and redundant publication
Reviewers for ESR’s scientific publications are chosen because they have intimate
knowledge of the area of science in question and are usually fully conversant with
the recent literature in their respective areas of expertise. Thus, the misappropriation
of source material is often brought to light thanks to highly alert reviewers.
In addition, ESR is currently employing plagiarism-detection software to robustly
detect highly and suspiciously similar written text. In instances where verbatim (word-for-word)
plagiarism or redundant publication is suspected, the editors will carry out further
investigation, with the help of editorial staff, expert reviewers and original copyright
holders. If an initial suspicion is reliably confirmed, appropriate action will be
taken, as recommended by COPE [14].
The first and obvious sanction in case of scientific misconduct, including plagiarism,
is that the paper in question is not accepted by the journal or online publication.
In other cases, some journals suggest that the (group of) author(s) are not entitled
to submit another article for a certain period (e.g. a year or more).
It is recommended that authors always notify the editor of previous articles (exhibiting
a high degree of similarity to the subject matter, theory, data or methodology used)
on similar topics. Furthermore, the discussion of any article should clearly point
out exactly how the current article builds on previous work and that it confirms/refutes
previous published statements. If the editor, as a result of the author’s failure
to disclose previous publication, is unaware of an apparent duplicate publication
at the time of going to press, the journal reserves the right to issue a notice of
duplicate publication and retract the paper as soon as redundancy is exposed. Similarly,
other forms of serious scientific misconduct may lead to formal retraction of the
paper.
Depending on the severity of the scientific misconduct, the editors may decide to
impose sanctions against authors who have transgressed; this involves a letter to
the Head of Department or University Dean, informing them about the malpractice and
asking for an official explanatory statement [17].
Management and execution of infringement
In cases of suspect behaviour, the corresponding authors and relevant superiors (such
as the Head of Department, the Head of Institution or the Dean of the Faculty) will
be informed.
Disciplinary steps can range, depending on the severity of the fraud, from publication
of an apology or erratum, withdrawal of the article, to the refusal to consider more
articles by that department or institution (e.g. for 6 months or up to 1 year). In
the most serious cases of infringement or where the situation is debatable, the case
could be referred to COPE (the Committee on Publication Ethics). Other Editors may
be informed and the withdrawal of all articles by the respective author might even
be considered.
Conclusions
This paper has demonstrated some of the problems encountered by the Publications Department
of the ESR and the way in which the Society reacts. Those issues related to publication
in journals are in some ways the easiest to identify and deal with, as there is considerable
written guidance on such issues. It is perhaps more difficult to spot duplication
in case reports submitted to an online teaching file or abstracts to conference proceedings.
However, the ESR is determined that exactly the same standards should be applied to
all submissions to the Society. It is hoped that this article will act as a ‘wake
up call’ to prospective authors and to Heads of Departments alike.