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Plagiarism in Medical Research: An Editor's View on Publication Ethics (Video)

Posted by Jessica Gopalakrishnan on Dec 13, 2012 10:05:00 AM

Esteemed editor for the Journal of the American Academy of Nurse Practitioners (JAANP), Charon Pierson, shares her experiences with plagiarism and misconduct within nursing and medical research, within publishing, and within teaching. Jason Chu from Turnitin speaks with Charon about medical publication ethics and how editors and researchers can avoid plagiarism.

Watch the video interview:

Plagiarism in Nursing and Medical Research (Interview) from Turnitin on Vimeo.


Jason: Hi Charon. Thank you for taking time to join us today. I want to take a moment to introduce you all to Charon. Charon Pierson is an educator. She’s an editor for the Journal of American Academy Nurse Practictioners. She’s also a member of the Committee on Publication Ethics (COPE).  Why don’t you share a bit about your background and what your focus is on right now.

Charon: I have been the editor for since 2000. I am also just recently elected to COPE, which is an organization that was founded in the UK to deal with many of the publication ethical issues that editors are facing. It provides a resource as well as place where people can talk about the problems they are facing. As editors, I think we all feel like nobody has ever faced this before and we don’t have a water cooler where we can stand around and talk about it. We all work on our own. I’m in my office at home, and we are all work like that. So, in order to get perspective on how other people are dealing with the same issues, and COPE is really that forum.

Jason: One of the things that strikes me as I hear you talk about the genesis of the group itself itself is the question about the role that the Internet has played just in terms of the increase in the number of submissions for publication. I’m wondering with the trend in that regard, how has that affected what you are seeing via COPE?

Charon: First of all, I think journals are much more discoverable with the Internet. People can find a better match for some of the articles because they are a lot more available. The Internet has also provided a submission platform so that everything can be done electronically. And that has helped to a certain extent but it’s also increased the workload for editors.

I just recently returned from the International Academy of Nursing Editors meeting in Montreal, and we talk about that all the time -- that it’s wonderful that people can find us, but sometimes too many people are finding us. We can’t really accept all the articles that are submitted.

Also, the availability of the iThenticate plagiarism detection software has increased our workload because there is no cutoff for an acceptable overlap in the submission. So we really have review everything very carefully, and that’s increased everybody’s workload, I think.

Jason: That brings me to a question that I think is on the minds of a lot of folks listening to this. That is namely the question about the effects of plagiarism, and the effects of research misconduct. You are on the front end seeing this, what can you share with folks about the ripple effects of plagiarism and misconduct.

Charon: Besides the dishonesty involved, that is the most serious problem. I have been a clinician for many years: I am a nurse practitioner and have used research evidence to make decisions about practice. It’s appalling to me to think that I have made decisions I may have made was based on fabricated data. Fabricated data to me is one of the biggest and most serious issues we have to deal with.

Then I think, adding onto that, if it’s not fabricated, if it’s plagiarism and if we are seeing multiple copies of the same studies that are being synthesized into systematic reviews and analyses we are getting inflated numbers in that respect because one study, one population of patients and one set of outcomes, it may be counted more than once in that analysis, and that skews the results.

Jason: Can you walk us through the process of what happens from the point of reception from when an article is received and how it gets shepherded into publication?

Charon: We were pretty early adopters of iThenticate with our journal submission system. We used the ScholarOne platform and our journal was actually one of the first to pilot test the interface with the connection between iThenticate and ScholarOne. It’s great to have iThenticate on our dashboard. We also put the iThenticate logo on our website so they know that we use plagiarism detection. We hope that it discourages people, it doesn’t all the time, since we still receive some with plagiarism.

If the article is potentially appropriate for our journal and it’s written for the right target audience, the managing editor submits the article to iThenticate prior to sending it out for review. The reason I do that is that we don’t want to waste reviewer time. I know a lot of journals get so many submissions that they can only really “iThenticate” the articles that are accepted for publication. In my opinion, I can’t tell just by looking at an article. I know that we have seen plagiarized articles that have gotten through, we see those in retractions. So for me the only thing that makes sense is to submit everything to iThenticate first.

So once it’s been “iThenticated” and I’ve made a decision that there is not significant overlap, then I assign it to reviewers. The ScholarOne database has a mechanism for me to do that, and it’s all handled electronically. Reviewers submit their reviews electronically.

If they can’t do the review, they email me and say so. It has to some extent speeded up the submission and acceptance process or rejection process, but it is a huge system and it was a tremendous learning curve. I struggled with how this all comes together and I know that editors still have trouble with electronic submissions. I think we are getting better at it, but it’s a lot of work.

Jason: In addition to what you are doing at the institutional level, what else are you doing with COPE to try to raise awareness within the publishing community about ethics and how journals and even researchers can take steps to streamline the process?

Charon: COPE currently has about 7,000 members. The members are journals and publishers. So our journal is a member of COPE and as editor, I am a representative of that journal. That is how I got elected to COPE to co-council. The issue as to what COPE provides, I think for authors, there are very clear guidelines as to what constitutes authorship and who can be an author. I recently had an article submitted that had 18 authors on it. It was difficult for me to believe that 18 people actually contributed enough material that it would constitute calling themselves authors. And so, COPE has guidelines about that.

The COPE website is available to people who are not members of COPE because there are a lot of really good guidelines and alo there are outcomes of cases where people have tried various tactics to get articles published or submitted that have really been fraudulent and in ethical violations. So people can read about that. For editors, for me, COPE has been a lifeline. The first time of plagiarism in a published article appeared, it was something that had been written about 13 years ago, long before I had become editor of the journal, and I thought, has anybody else had to deal with this? Of course, there were guidelines by COPE to help deal with plagiarism in a submitted article as well how to deal with plagiarism in published articles, how to write a retraction. All of those guidleines were available on COPE so I didn’t have to reinvent the wheel as I was trying to figure out what to do.

It also helps when we can put those in our author guidelines. Our author guidelines clearly state that we follow the publication ethics guidelines from COPE. We proceed to follow up on any kind of publication misconduct that we discover. That should be a clear warning to authors. It’s too easy to catch plagiarism now.

Jason: Earlier in our conversation, you mentioned the work that the Office of Research Integrity (ORI) is doing. Can you share with us more information about what ORI does and its involvement with scholarly integrity?

Charon: The Office of Research Integrity is in the United States and there is a similar office in the UK. That has more to do with the institutional involvement. So, for the US, the ORI interacts with institutions like universities or medical centers that receive federal research funds. The guidelines for receiving those funds say you must follow ethical guidelines in doing research. You must have oversight of human protections, and oversight of animal protections. You have to do original work. You cannot be fabricating data. There are a whole bunch of wonderful guidance on the ORI website. Anybody who is involved with doing research in any institution really should be familiar with all of those guidelines and follow them carefully.

What happens, and this happened in one situation in our journal, a researcher submitted something that was plagiarized, and his funding had come from the Federal government. His institution investigated the case and found him guilty, and he lost his job, lost any further Federal funding, and was no longer able to participate in anything to do with Federal government funding. So these are very serious consequences and it can ruin your career.

Jason: How well informed would you say researchers are about plagiarism and research misconduct?

Charon: I don’t think we spend enough time talking about this in graduate programs, and that is one of the reasons why I did those videos (see Publication Ethics Video Series on the University of Texas at El Paso website). I have been teaching in graduate programs most of my academic career, masters and doctoratal programs, nursing and medical programs, and we spend a lot more time on the content and not so much on the process. And the same questions keep coming up over and over again. I did those videos in modules so if you only want to learn about authorship, then you can listen only to that one. So, we broke it up into five modules so people would have some idea about the scope of publication misconduct and what they can do to avoid sanctions or any kind of misconduct.

Jason: Maybe you can give us a teaser. What would you tell researchers to do to avoid some of the pitfalls we have been talking about today?

Charon: As far as the conduct of research, if you are planning a research project, ensure that you have a sufficient population to deal with, the question that you are trying to answer. We know that one of the most notorious cases in the medical publishing field had to do with an anesthesiologist who worked at a small institution who received funding and reported on hundreds of patients that he had never seen. If you ever looked at the number of patients that went through that hospital, you would have seen that there would be no way that he could have gotten that number of patients to conduct a study. So there were some glaring facts that pop out like that.

The second thing is, if you are doing a series of studies, or you are doing one large study and you want to try to break it up into a couple of papers, which most people do want to do, you want to be really careful that you are reporting new data in each of the articles that you submit.

Also, take the time to rewrite the introduction, the literature, etc. so that you aren’t plagiarizing or self-plagiarizing. A lot of people object to that term (self-plagiarism), but the problem is that if you have already written and published a section in a journal, the copyright holder of that material is probably the publisher -- or the publisher has exclusive copyright to publish it. So you cannot send that to another journal and claim that it is original work when it is in fact you are taking the same material from a previous article.

Jason: I think that is a point of confusion for many authors because they feel that they have done the work, they own it, they’ve done the research so why shouldn’t they be able to submit it to whichever journal they want -- and multiple times at no less?

Charon: It happens a lot with translations also (translated article). It’s not the words, the language per se, it’s the content of the article. You can’t just take an article that you find someplace and translate it. It’s really a worldwide body of literature. It’s not a local body of literature. The world has access to all of these articles that are available on the Internet, and really there are a lot of people that speak all of these different languages, and they are going to get caught.

Jason: What are the ethical dilemmas of working with a ghostwriter?

Charon: A writer should never be a ghost. If there is collaboration with writing or editing assistance, that should be declared, and the person should be named. It should be somebody who is clearly visible.

Whether or not that constitutes authorship, the individual needs to go the ICMJE (International Council of Medical Journal Editors) where they can find very clear criteria on authorship and determine whether or not the writing or editing assistance constitutes authorship. I know that many people who do not speak English as a first language have difficulty writing in English. I couldn’t do copyrighting in any other language even a language that I could speak or understand. To write a professional article, it’s very difficult. So, getting some kind of writing assistance is ethical as long as it is declared.

Another association that I belong to is the American Medical Writer’s Association (AMWA) they have very clear guidelines as to how people should use medical writers and how that must be transparent so that it doesn’t look like plagiarism.

Jason: What would you tell students about how to put into practice some of what you are sharing with us today?

Charon: I have a long history of working with English as a second language (ESL) students. I lived in Hawaii for many years and many people who lived there did not speak English as their first language. I also now live in El Paso, Texas which is an 85% hispanic community so most of our graduate students’ primary language was Spanish. Even if people are bi-lingual, one thing that students haven’t learned to do it is to synthesize and paraphrase information.

There are some good writing websites that will help students do that. For example, Purdue Online Writing Laboratory (OWL) has some excellent examples. I have a lot of students who will put the reference on the page, but they don’t put it in quotes. The point is, if you are using someone else’s words, you are quoting them, and you have to put those words in quotes to quote them exactly.

And, nobody really wants to read an article that is full of someone else’s quotes. What we want to hear from you, as the author, is your thoughts. How did you take this problem, research the literature, think about it, synthesize it in your mind and come up with what you think of it. We want your unique take about what you are writing about. For some people, that’s very difficult to do.

Jason: Kudos to you in doing the great work on those videos. Hopefully that will help to raise the bar on awareness for students to misconduct behaving researchers.

Charon: If they are going to progress in their careers, they have to learn that. With the competition to get an article published these days, you really have to have something to say, say it well and get your point across in as few words as possible.

Jason: Thank you, Charon, it’s been a great pleasure speaking with you today. Do you have any last thoughts for our audience?

Charon: Sometimes articles are rejected because it’s not a right fit with the journal. There is a whole lot of homework that needs to be done when trying to submit an article. A lot of times people will try to go for a high impact factor journal and they’ll waste a lot of time when the audience that they really want to talk to is reading another journals. It’s a learning experience when you start writing to figure out where your articles are going to be the best fit, and who is going to be reading and using the research that you are producing -- and that’s who you really want to be speaking to. I know that it will help you get promotions, tenure and pay raises and so forth, but really the objective of scholarly literature is to advance the sciences no matter what the science is. So, keep that in mind as you are writing and producing manuscripts for publication.


Editor notes: The article title was changed 12/13/12.


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