EDITORIAL

COPE: The committee on publication ethics

David L. Turpin, Editor-in-Chief

Seattle, Wash

Through the foresight of Elsevier and its stableof scientific journals, the AJO-DO has joinedover 4000 members of the committee on pub-

lication ethics, or COPE. This organization providesa forum for publishers and editors of peer-reviewedjournals to strengthen the integrity of material submit-ted for publication.1 Membership benefits of COPEare numerous and include a searchable archive ofcases and advice related to handling ethical problems,a blog on publication ethics, auditing tools for yourjournal, and regularly updated guidelines on ethicsfor authors and editors.2

I found COPE’s version of ‘‘Guidelines on GoodPublication Practice’’ to be particularly helpful to mein dealing with complications that arise on receipt ofmany articles submitted for peer review and future pub-lication.3,4 Questions are routinely raised on issues suchas authorship, conflicts of interest, peer review, and ad-vertising. Problems that arise are often interesting andcan evoke strong feelings on all sides; the voice of an or-ganization such as COPE, with vastly more experiencein reaching a workable resolution, is valuable.

Authorship

In recent years, I have accepted articles for publica-tion with only 1 author to as many as 41 authors. Manyjournals—including this one—try to limit the number ofauthors to a maximum of 6, but that approach some-times fails to resolve all concerns. Most guidelines onthis issue make it clear that the award of authorshipshould balance the intellectual contributions to the con-ception, design, analysis, and writing of a study.4 If notask can reasonably be attributed to a particular person,then he or she should not be credited with authorship. Toavoid disputes, it is helpful to decide early in the plan-ning of the research who will be credited as authorsand who will be acknowledged. Once an article is sub-mitted, we require all authors to agree to any authorshipchanges, such as the addition or deletion of an author, ora promotion or demotion.

Am J Orthod Dentofacial Orthop 2009;136:617-8

0889-5406/$36.00

Copyright � 2009 by the American Association of Orthodontists.

doi:10.1016/j.ajodo.2009.09.002

Conflicts of interest

Conflicts of interest are sometimes obvious but caninclude relationships that might not be fully apparentthat could influence the judgment of authors, reviewers,and editors. Conflicts of interest are relationships that,when revealed later, would make a reasonable readerfeel misled or deceived. They can be personal, commer-cial, political, academic, or financial. Such interests,when relevant, must be declared to editors by re-searchers, authors, and reviewers. We receive such noti-fications nearly every day, and, on receipt of thisinformation, we have an obligation to disclose theseconflicts of interest to our readers. Even when in doubtand the perception of conflict is present, notes COPE, itis better to disclose.

Medicine has already suffered from being too lax inenforcing the responsibilities of authorship combinedwith commercial conflicts of interest; it is now payinga heavy price. An article, ‘‘Medical papers by ghost-writers pushed therapy,’’ by Natasha Singer,5 whichwas recently published in the New York Times, detailsthe harm that can result from this type of negligence.A total of 26 scientific articles, published in medicaljournals between 1998 and 2005, emphasized the bene-fits and deemphasized the risks of taking hormones toprotect against maladies such as aging skin, heart dis-ease, and dementia. Wyeth, a pharmaceutical companywhose products include the hormone drugs Premarinand Prempro, paid a medical communications firm todraft the articles. The supposed medical consensusbenefited Wyeth, since sales of those drugs soared tonearly $2 billion in 2001. But things fell apart in2002, when a huge federal study on hormone therapywas stopped after researchers found that women whotook certain hormones for relief of menopausal symp-toms had increased risks of invasive breast cancer, heartdisease, and stroke. It was then shown that well-knownscientists were coaxed into signing on as authors to thereview articles written by Wyeth employees to gain ac-ceptance and publication in respected medical journals.These ghostwritten articles were typically reviews inwhich an author weighed a large body of medical re-search and offered a bottom-line judgment about howto treat a particular ailment. The AJO-DO has had

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a policy since 2002 against publishing any review arti-cle submitted by authors with a financial conflict ofinterest.

Peer review

Peer reviewers are external experts chosen by edi-tors to provide opinions, with the aim of improvingthe study as submitted for publication.3 Authors mustmake certain that they do not inadvertently disclosetheir schools or their identities when submitting a man-uscript. What is guarded even more carefully is the iden-tity of each reviewer selected by the editor. This is whywe never ask authors to suggest reviewers who might beavailable to review a newly submitted article for publi-cation. Overall, reviewers provide speedy, accurate, andunbiased reports that determine which articles are pub-lished. When reviewers suspect misconduct in themethods used in a scientific study, they are encouragedto report this to the editor in strict confidence. It is alsothe responsibility of journal editors to provide regularaudits of their acceptance rates and publication times.

Advertising

Because most scientific journals derive significantincome from advertising, editorial decisions must notbe influenced by advertising revenue. To accomplishthis task, the editorial and advertising administrationsof a journal must be clearly separated. Advertisementsthat mislead must be refused, and editors should be will-ing to support scientific findings that are critical of prod-ucts whose companies purchase advertising in theprofession’s publications.3 In the American Associationof Orthodontists, a high-level committee of the board is

responsible for screening all advertising in its publica-tions, which include the AJO-DO. This committee fre-quently requires companies to change the wording intheir ads to reflect the latest evidence as published inthe Journal. Ninety percent of the time, the advertisingagencies representing these companies willingly com-ply with these requests, and the advertising is published.

The fact that COPE has grown rapidly in its influ-ence since its foundation in 1997 speaks to the needfor finding practical ways to deal with the many ethicalissues that encompass good practice. As the guidelineson good publication practice note, ‘‘We thought it essen-tial to attempt to define best practice in the ethics of sci-entific publishing. These guidelines should be useful forauthors, editors, editorial board members, readers,owners of journals, and publishers.’’3 I can certainlyadd that your AJO-DO editors, staff, and editorial boardadopt and strive to enforce in a practical way theseguidelines of publication as stated so well by COPE.

REFERENCES

1. COPE membership. Available at: http://publicationethics.org/

allmembers. Accessed August 11, 2009.

2. COPE home page. Available at: http://publicationethics.org/. Ac-

cessed August 11, 2009.

3. Guidelines on good publication practice. The COPE report, 1999.

Available at: http://publicationethics.org/guidelines. Accessed

August 11, 2009.

4. How to handle authorship disputes: a guide for new researchers.

The COPE report, 2003. Available at: http://publicationethics.

org/guidelines. Accessed August 11, 2009.

5. Singer N. Medical papers by ghostwriters pushed therapy. The New

York Times 2009 Aug 4. Available at: http://www.nytimes.com/

2009/08/05/health/research/05ghost.html?_r51&emc5. Accessed

August 11, 2009.