Quandaries in Authorship

Who should be an author on a research paper? Should authorship be reserved for the individual person who types the words onto the parchment (or into the computer)? Should authorship include those who read the draft and edit the grammar, comment on the order of results, or point out a limitation to include in the discussion? Should authorship include the study coordinator who worked daily toward the study’s successful progression, the research assistant who enrolled and tracked all the subjects, or the mentor who helped to write the analysis portion of the grant that funded the project? What about patients and community members in participatory research projects? And what about the study subjects—should they be coauthors?

The emergence and growth of patient- and community-engaged research built on the foundation of community-based participatory research has brought this quandary to the forefront of medical research and publishing. Who gets to be an author on a manuscript? Who should be an author? And in what order should these names appear?

Figure 1.

International Committee for Medical Journal Editors Authorship Requirements

WHAT IS THE PURPOSE OF AUTHORSHIP?

Historically, authorship has served the dual purpose of providing credit to the individuals who did the research and wrote the paper and offer the research community the names of those accountable for the integrity of the research.^1,2 The International Committee for Medical Journal Editors³ states that all authors must meet four criteria; conversely, anyone who meets these four criteria should be listed as an author (Figure 1).

Authorship has frequently been given to individuals as a benefit of membership in a research team, for recruiting study subjects, or being part of an advisory group. There are countless medical papers with 10, 20, even 30 authors. It is unlikely that 20 authors can be held accountable for all aspects of the research project. Some journals attempt to limit the number of authors or require that large groups of authors be listed as a group with just one or two individual names listed (e.g., Smith J, on behalf of the SuperStudy Writing Group).⁴ Other members of the writing group are listed in an acknowledgement section of the paper. The inconsistent application of authorship standards leans toward benefit to academics and professionals, while limiting acknowledgement of patients and community members as contributors to science.

Authorship on peer-reviewed manuscripts, particularly first authorship, is a required element for academic success, funding, and promotion, and, as such, is a high priority for university research faculty. In the publish or perish world of academic medicine, authorship can be the difference between promotion and loss of faculty appointment. And, let’s be honest, for many of us, seeing our name in print is just cool—a personal accomplishment. Many community members do not have the same authorship needs. Their regular work may not value authorship, and the time spent participating in research and writing may actually interfere with their regular day job and personal lives. So, why bother having patients and community members as co-authors?

Traditional authorship guidelines may not adequately support patient- and community-engaged research.

Authorship can be a declaration of the voices and expertise that participated in the research. The list of names attached to a research paper provides the reader with some reassurance the findings are credible, the interpretation is appropriate, and the conclusions are meaningful. When faced with rigid authorship criteria or limits, investigators are faced with few options. Listing people in an acknowledgement section of a paper is one option, but may not appropriately recognize their contribution to the study and final published manuscript. There are so many contributions to a study before a paper ever gets written that to limit authorship only to the person who puts pen to paper may be disrespectful and, frankly, dishonest. Engaged participatory research would be nothing without patients, community members, organizations, and groups. Patient- and community-engaged research joins the best science of the academic team with the...