Biomedical research should include plans to communicate complete and accurate results
to the scientific community and the public in a timely manner. All too often, however,
such planning is lacking until after data have been generated. We developed a collaborative
professional statement following review of the indexed biomedical literature and relevant
professional society guidelines. Planning for publications before, during and after
biomedical research studies are conducted promotes the timely dissemination of accurate
and comprehensive results. Effective publication planning accounts for the work of
all contributors, encourages full transparency and contributes to overall scientific
integrity. Although the most obvious contribution of publication planning is to result
dissemination, the best planning may also help improve the overall quality of research
study design and the overall integrity of study conduct by keeping the final audience
in the forefront of the investigators' attention. Publication planning can help biomedical
researchers achieve and maintain high standards of transparency and integrity. Table 1
below highlights briefly some of the aspects to be included in a publication plan.
Introduction
Biomedical research delivers the evidence base that healthcare professionals rely
on for making individual and public health decisions 1. Generally, this research is
undertaken with a clear sense of the health issues under investigation; however, developing
quality research questions and choosing appropriate scientific methods for generating
and analysing data is not enough. A supportive and well‐organised plan ensuring that
the research and its results are communicated clearly to the scientific and healthcare
communities as well as the general public is essential. In fact, the most basic principles
of biomedical ethics outlined in the Declaration of Helsinki (2013) or the Pharmaceuticals
Research and Manufacturers (PhRMA) Code (2013) indicate that timely result dissemination
and publication is not only prudent but also imperative to support overall biomedical
research integrity 2, 3. Government research grants and corporate integrity agreements
between industry sponsors and regulators provide a further impetus for publication
planning 4.
The fourth principle of the recently published “Good Publication Practice for Communicating
Company‐Sponsored Medical Research: GPP3” states the following: “Publication planning
and development should be a collaboration among all persons involved (for example,
clinicians, statisticians, researchers, and publication professionals, including medical
writers) and reflect the collaborative nature of research and the range of skills
required to conduct, analyze, interpret, and report research findings” 5. In order
to ensure the accurate, complete and timely publication of the findings of biomedical
research, publications need to be planned in accordance with the objectives and outcomes
of the research.
A ‘publication plan’ is itself a document or an electronic repository that contains
key information about all publications, abstracts and presentations intended to be
generated from a given research study or clinical programme along with timing and
additional information (Table 1). Many corporate integrity agreements require an auditable
monitoring plan for publications, including timing 6, 7. Publication plans that list
abstract deadlines of scientific meetings, key data delivery dates and possible meta‐analyses
or subgroup analyses can facilitate resource allocation while helping to ensure complete
and timely disclosure of relevant data 3, 5, 8, 9. Although a plan is an important
component of overall publication planning, it is not synonymous with such planning,
which can have farther‐reaching effects than simple logistics.
Table 1
Information to be documented in an effective publication plan
Key element
Explanation
Authors
All persons who agree to meet the appropriate qualifications for authorship.
The author list should be updated prior to submission, once the authorship criteria
are verified. It may be helpful to list (as applicable) the corresponding author,
a lead academic author and/or a lead sponsor author in the publication plan.
Contributors
Additional contributors to the study or manuscript, including publication planners.
A key contact (with contact information) should be provided for each manuscript, abstract
and presentation.
Data and timing
Specific datasets/analyses, by planned manuscript or presentation.
Timing for data to be included in each manuscript, such as the date of the top line
report, last subject last visit and the deadline for including data in a results registry
all should be recorded or referred to the appropriate data owner (for example, the
clinical tracking records for individual studies or programmes).
The publication plan should clearly link primary and secondary analyses of any study,
even if they appear in different manuscripts, through the use of protocol numbers
or clinical trial registry numbers.
Journal(s) and other venues
The intended journal for submission and a backup in case of rejection, as well as
the names and locations of all congresses, where the data are planned to be presented.
Timing for congresses (submission deadlines, presentation deadlines), peer review,
journal revisions and page proofs should be documented in the publication plan.
Publication team or steering committee members
If different from the authors and contributors.
Status
For initial manuscripts: draft, submitted, accepted or published. For rejected manuscripts:
reformatting, resubmitted, accepted or published.
Citations should be recorded for all presented or published work. It is helpful if
citations for abstracts, posters and the manuscript describing the same dataset are
linked in some way.
John Wiley & Sons, Ltd
We consider publication planning, consistent with statements issued by the International
Society of Medical Publication Professionals (ISMPP) and Good Publication Practice
(GPP3), to include tasks such as scheduling, organising working groups, selecting
authors and journals, supporting authors, managing correspondence and coordinating
meetings, as well as additional administrative tasks that may be required to ensure
that these activities run effectively and efficiently. Publication planning can contribute
to better and more responsible communication of biomedical research results. Table 1
above highlights key items to be included in a publication plan.
After making intellectual contributions to manuscripts, researchers may lack the time
required to complete additional administrative tasks, and could need assistance, which
has increasingly been provided by publication planning professionals. Furthermore,
particularly when incorporated in the design and conduct of biomedical research, publication
planning should involve an examination of how the research fits into the existing
field of knowledge, which can contribute to the overall quality of a study 5, 10,
11. In fact, publication planning is an important part of the core framework for responsible
scientific research because it promotes transparency and ethics at all stages of research
as well as accurate result reporting once a study is completed.
The publication planning field arose, largely in the last twenty years, as professional
medical writers and editors were called upon to assist authors with various tasks,
including manuscript preparation, journal selection and correspondence 8, 11. Professional
publication planners engage in various planning activities and maintain publication
plans, especially at medical communications agencies and in industry. The profession
has been associated in the popular press and biomedical journals with deliberate publication
bias, improper attribution of authorship and other ethical lapses 1, 12, 13, 14, 15,
16, 17, 18, 19. However, responsible publication planning can aid researchers and
sponsors in avoiding or correcting inappropriate authoring practices or bias and ensuring
the full and timely publications, thus increasing transparency. In addition, the direct
involvement of advisory boards and experts responsible for study design and data interpretation
in the publication planning process can lead to overall improvement in the research
itself. Publication planning continues to gain importance with the global growth of
health research and the proliferation of clinical trial registries, patient advocacy
web sites and social media.
Box 1
Ethical Issues in Publication Planning
Authorship
Communicating trial results of significant clinical importance
Contributorship
Duplicate/redundant publication
Plagiarism
Publication bias
Reportable transfers of value
Selective submission of positive results
Transparency
We discuss selected issues in publication ethics and the role of proper planning in
improving the overall integrity of the research process, from initial design to data
dissemination. Much more attention should be given to publication planning at the
onset of study design. Certain key questions should be part of this discussion. How
can this research contribute to the current body of knowledge in this area of medicine?
What do clinical scientists, healthcare providers and patients expect? Where should
we consider publishing or presenting study results? Which scientists, clinicians,
patient groups and editors should understand and engage in the discussion of this
research?
Publication ethics
Broadly conceived, biomedical ethics requires protection of the rights of patients
and human subjects enrolled in research studies 2. This research should be conducted
and communicated transparently, following applicable regulatory and professional guidelines
2, 20. Special concerns for authors, contributors and editors of biomedical publications,
such as authorship, financial disclosures and selective publishing of positive results,
have been addressed by various groups 2, 5, 10, 11.
The International Committee of Medical Journal Editors (ICMJE) published the initial
Uniform Requirements for Manuscripts Submitted to Biomedical Journals (1978) to specify
formatting standards. As they were called on to address topics such as author selection
and financial disclosure, the Uniform Requirements were updated to address ethical
concerns, such as authorship and the use of trial registries to help prevent redundant
or duplicate publication and make results more accessible 2, 5, 11, 20, 21. The ICMJE
released additional statements, notably, Sponsorship, Authorship and Accountability
(2003), which detailed the need for greater transparency in industry‐sponsored clinical
trial conduct and manuscript preparation as well as author accountability for study
results 12. In 2013, the Uniform Requirements were replaced by the Recommendations
for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals,
which links the overall quality of research to effective publication practices 20,
21.
In 1997 the Committee on Publication Ethics (COPE) was formed during an informal meeting
of medical journal editors concerned to address a wide range of research misconduct
from fraud to authorship disputes. COPE went on to widely expand its membership as
well as developing ongoing guidance, particularly with regard to corrective measures,
such as corrections or retractions, to be taken when instances of research misconduct
are discovered in connection with already published work, and also to publish case
studies on a monthly basis. The COPE Guidelines, Code of Conduct and discussion documents
are supplemented regularly and are a beneficial source of information about current
ethical concerns and practice in biomedical publishing 22.
The introduction of Good Clinical, Laboratory and Quality Practice guidances for industry
by the International Conference on Harmonization (ICH) group, particularly during
the early 1990's, was designed to regularise drug development and clinical trial conduct
in industry and to set minimum standards for ethical study conduct 23. The ICH Guidelines
also indicated that information about planned publications should be included in clinical
trial protocols and reports 24, which spurred the development of more detailed guidelines
for manuscripts produced by industry sponsors. The initial ‘Good Publication Practice’
papers appeared in 2000 and 2003 8, 25. These publications were intended to encourage
transparency of research practices and results and to reiterate the obligations and
privileges associated with authorship. The recently published GPP3, the updated standard
for publication planning by industry sponsors and communication agencies, introduces
10 valuable principles for guiding publication practices and begins the guideline
with an entire section on publication planning. These provide valuable revisions to
GPP1 and GPP2 5, 8, 11, 24. GPP3 extends the recommendations of GPP2 regarding the
early planning for publications, the formation of steering committees, and clarifying
the roles of authors and other contributors, especially professional medical writers
11.
Professional organisations provide information about publication ethics. Specific
guidance for publication professionals includes the ISMPP Code of Ethics, a code that
focuses on the responsibilities of authors, writers and editors. PhRMA also introduced
a set of principles that recommend full disclosure of trial results in registries
and publications and emphasises that results of more significant medical importance
(such as findings that should affect current prescribing practice or trials of marketed
products currently used in children or other vulnerable populations) be prioritised
1, 3, 10. Many organisations, including medical centres, corporations, academic institutions
and government agencies develop and maintain publication policies; these policies
may limit the abilities of authors to accept writing assistance or the potential uses
of certain publications. Corporate Integrity Agreements often delineating minimum
standards for industry sponsors engaged in publishing biomedical research results,
including the need for publication plans and policies 26, 27. All authors and contributors
should be familiar with best practices and the codes of conduct and ethics for their
individual professions.
How planning may address key concerns in publication ethics
Some questionable publication practices, particularly problems with acknowledgements
and citations, may occur through ignorance or poor organisation and communication.
Publication professionals can provide guidance about best practices and ensure adequate
documentation and tracking of all stages of manuscript development, author agreements,
data checking and approvals. In environments where publication planners are not available,
authors should keep records of these activities. Authors or publication planners should
also develop and update a formal publication plan (see Table 1) that accounts for
anticipated publications and their timing on a regular basis; such a plan may stand
alone or be integrated to a more general data dissemination plan that includes any
public release of clinical data (for example, to trial registries or the press).
Planning should account for adequate time to perform all necessary tasks. Allotting
adequate time for review may help mitigate or prevent problems such as plagiarism.
Assigning responsibility and time for reference checking to one or more contributors
will permit the detection of unintentional copying or insufficient citations, which
can also be supported by the use of specialised software.
Authors should familiarise themselves with guidelines, such as GPP3 and the ICMJE
Recommendations. Professional publication planners or lead authors should encourage
and facilitate conversations about difficult topics, such as data interpretation and
authorship, to ensure that actual practice meets the scientific and ethical standards
of all professionals involved in discussions and authoring. Below, we discuss topics
of special interest: authorship and acknowledgement, transparency and duplicate or
redundant publication.
Authorship and acknowledgements
Publication planners are regularly called upon to provide advice regarding appropriate
practices for author and journal selection. Where the desire to adhere to ethical
practice exists, unintended problems related to authorship may be avoided through
rigorous planning. For example, a missing acknowledgement of writing support results
in a ghost written paper, a serious ethical lapse, which can raise concerns regarding
the overall integrity of the manuscript. If the named authors did not significantly
contribute to the paper, guest authorship results and can raise similar concerns.
The larger the number of contributors involved in a study or publication, the greater
the challenge to include and document all expert views. Proper planning can allow
authors and writers to track comments and contributions more effectively.
Planning for good authoring practice requires a familiarity with the criteria for
authorship. The most commonly used criteria: contribution to the study or interpretation
of data, writing or substantially editing the manuscript, and approving the paper
for publication; appeared in the ICMJE Uniform Requirements in 1988 and have been
cited in GPP3 and corporate integrity agreements issued in the USA 4, 11, 20. As with
other topics in the Uniform Requirements, authorship criteria have been clarified
and expanded over the years. The 2013 ‘Recommendations’ expanded these criteria to
include taking public responsibility for the work and guaranteeing that all work reported
in the publication was undertaken correctly 20. This shift reflects updates to the
2002 and 2005 Uniform Requirements, which request that data be guaranteed by at least
one author and that all authors should take public responsibility for the work they
performed 21.
Regulatory requirements for the initiation and conduct of clinical trials allow for
early attention to publication plans. GPP3, ICH Good Clinical Practice, and guidelines
from the World Health Organization (WHO), European Medicines Agency (EMA) and PhRMA
indicate that roles and responsibilities for trial conduct and authorship should be
identified before writing begins, if possible during the study design phase, and updated
as needed 3, 5, 11. The EMA and ICH suggest the early identification of a principal
investigator who could serve as the chair of a steering committee or the lead author
for primary publications 23, 24. Large‐scale clinical trials are generally conducted
by large, multidisciplinary groups of researchers and administrators. Effective publication
planning must account for different configurations of such groups and allow time for
discussions to manage differing thoughts.
Assignment of roles and responsibilities for publications early in the study process
can limit problems at a later stage. Authors, reviewers and professional medical writers
should receive clear guidance regarding the scope and timing of their responsibilities
well before publication writing begins, ideally before the statistical analysis plan
is finalised. Completion of authoring tasks should be documented. Writing should never
begin before careful consultation with all authors, who should be informed of their
duties well in advance of data availability. Furthermore, professional medical writers
should not be engaged unless all authors have had a clear opportunity to opt in or
out of receiving such support, particularly when assistance might be reportable, as
under the Physician's Payment Sunshine Act, or considered a potential financial bias
6, 7, 11. Publication planning can create an environment in which each participant
is confident that work is being undertaken only after appropriate input and permission
have been received.
Effective time management may also limit the risk of certain problems. Giving sufficient
notice of the expected timing for authoring, review and approval for manuscripts can
help authors avoid questions about whether they meet ICMJE criteria by allowing adequate
time to make substantive contributions. Providing adequate lead and review time, as
well as clear instructions for authors and reviewers will help avoid problems in attributing
authorship.
Transparency
The discussion of publication ethics by journal editors and scholars reflects an increasing
emphasis on the need for scientific transparency 9, 12, 13, 14, 15, 16, 17, 18, 19.
Publications of large‐scale, randomised, controlled clinical trial results provide
the most reliable data to address specific scientific questions, and therefore receive
more scrutiny than review papers or results of smaller or less statistically robust
studies. Requirements and guidelines for sharing clinical trial data have the overarching
goal of increasing transparency by making the data more widely accessible 9, 28, 29,
30.
A familiarity with guidelines on the conduct of clinical trials and standard data
presentations for reports, registries and periodic safety updates may contribute to
better planning by ensuring that 3, 9, 24 all required disclosures of clinical trial
data, including the publications, are accounted for in statistical planning. Consolidated
statistical analysis plans for all data dissemination may help prevent minor discrepancies
between publications and clinical trial registries, which may result if statistical
tables for publications are generated separately from those used in regulatory documents.
Adequate planning before the statistical analysis plan is finalised can prevent unintentional
data discrepancies.
Duplicate, redundant or selective publication
‘Sponsorship, Authorship, and Accountability’ 12 introduced the notion that all publications
detailing the results of clinical trials should contain a unique identifier to help
prevent redundant and duplicate publication. Additional measures may be necessary
to avoid other forms of publication bias, such as selective publication of positive
results.
Publishing as data become available, rather than using other priorities, may help
prevent a bias towards positive results, provided that results considered to be of
significant medical importance 3 are not delayed within a queue of data otherwise
not having direct application to current clinical practice. As mentioned above, the
scheduling of publications could also appear in a general data dissemination plan
that accounts for data posting on trial registries. Effective planning can also help
identify the scientific and clinical relevance of publications, while helping to avoid
inappropriate practices, such as duplicate or premature publication of partial results,
especially from large multicentre studies with complex designs. Systematic publication
planning provides a reliable and auditable framework to document such decisions and
their scientific justification.
Electronic planning tools may be helpful in promoting transparency within authoring
or study groups by making updated information available on an ongoing basis. Publication
planners can ensure that such systems are chosen, maintained and updated appropriately.
To promote transparency, publication plans for appropriate datasets should be available
to all authors and steering committees as well as any other investigators who wish
to understand the publication process or timing. Appointing a publication planner
to manage communications can foster a culture of transparent communication among researchers
and contributors while allowing authors to concentrate their energies on scientific
discussion rather than untangling logistical issues.
The contribution of publication planning to biomedical research
The publication of biomedical research is fundamental to the scientific process and
requires planning from the initial stages of protocol development. Too often, researchers
are confronted with datasets for which no organised communication plan exists. In
many cases, writing and results communication is overlooked until after the last patient
is sent home and the data have been cleaned and analysed, resulting in delaying the
dissemination of results. Research that goes unreported, or is incorrectly reported,
may undermine the current body of scientific evidence and the health interventions
that rely upon it. Publication planning is the most effective way to ensure that the
scientific objectives of research are communicated to the medical community, health
authorities and patients in a timely manner, as suggested by the Declaration of Helsinki
and the PhRMA Code 2, 3.
Robust and effective publication planning fosters a culture of ethical conduct and
objective, truthful and transparent results reporting. Furthermore, publication planning
provides an opportunity to demonstrate the scientific rigour with which clinical trials
are developed and executed. Researchers seeking to integrate their findings into a
broader literature can use the planning process to consider meta‐analyses or to comment
more systematically on study design, outcome measures, technological advances, treatment
guidelines or government recommendations. In addition, planning offers an opportunity
to consider the optimal means of relating regulatory reporting requirements 24 to
developing contextual and explanatory scientific publications 20. Added attention
to planning each step of the research process will help ensure that study data contribute
to clinical practice and advances in the health sciences.
Publication plans alone cannot ensure good practice for the communication of scientific
information, even if they provide important support for maintaining scientific and
ethical research standards. It remains necessary for all authors and contributors
to biomedical research to understand and seek to adhere to ethical guidelines while
committing to acting with integrity if planning is to assist in this endeavour.
Publication planning remains a young discipline within the wide field of biomedical
research. It should be recognised and valued, specifically through its contributions
to transparency and integrity. This is not to say that smaller research groups without
the resources to hire professional planners should neglect publication planning. The
increasing tendency of government agencies and corporate integrity agreements to mandate
publication planning encourages this positive development for promoting more rigorous
and trusted science and medicine in all settings: academic, governmental and corporate.
Disclosures
Author's affiliations reflect current potential conflicts of interest. All authors
have had past affiliations within the pharmaceutical, medical communications agency
or publishing fields.