Prepared by the WAME Editorial Policy Committee
WAME encourages those who are qualified and interested to translate WAME policy into languages other than English (the language of record for WAME policies to date), and as a service to members will post links and/or copies of such translations on the WAME Web site if requested. However, WAME does not have the resources to assure the accuracy of such translations.
Definition of a Peer-Reviewed Journal
Posted October 19, 2007
A peer-reviewed biomedical journal is one that regularly obtains advice on individual manuscripts from reviewers who are not part of the journal’s editorial staff. Peer review is intended to improve the accuracy, clarity, and completeness of published manuscripts and to help editors decide which manuscripts to publish. Peer review does not guarantee manuscript quality and does not reliably detect scientific misconduct.
Peer reviewers should be experts in the manuscript’s content area, research methods, or both; a critique of writing style alone is not sufficient. Peer reviewers should be selected based on their expertise and ability to provide high quality, constructive, and fair reviews. For research manuscripts, editors may, in addition, seek the opinion of a statistical reviewer.
Peer reviewers advise editors on how a manuscript might be improved and on its priority for publication in that journal. Editors decide whether and under which conditions manuscripts are accepted for publication, assisted by reviewers’ advice.
Peer reviewers are sometimes paid for their efforts but usually provide their opinions free of charge, as a service to their profession. Editors should require all peer reviewers to disclose any conflicts of interest, financial or otherwise, related to a particular manuscript and should take this information into account when deciding how to use their review. Generally speaking, people with a direct financial interest in the results of the manuscripts should not be reviewers.
To be considered peer reviewed, a journal should have obtained external reviews for the majority of manuscripts it publishes, including all original research and review articles. Some editors request peer review for other kinds of articles, such as opinion pieces (commentaries/editorials) and correspondence. To have been peer reviewed, a manuscript should have been reviewed by at least one external reviewer; it is typical to have two reviewers and sometimes more opinions are sought.
Editors of peer-reviewed journals need not send all submitted manuscripts out for review. Manuscripts that seem unlikely to be published in that journal may be returned to authors without external review, to allow authors to submit the manuscript to another journal without delay and to make efficient use of reviewers’ and editors’ time.
Editors should state their journal’s peer review policies, including which kinds of article are peer reviewed and by how many reviewers, in the instructions for authors. Editors should also periodically publish statistics describing their journal’s review process, such as number of manuscripts submitted, acceptance rate, and average times from manuscript submission to rejection letter to authors and, for accepted manuscripts, time to publication.
Posted January 10, 2007
Authorship is a way of making explicit both credit and responsibility for the contents of published articles. Credit and responsibility are inseparable. The guiding principle for authorship decisions is to present an honest account of what took place. Criteria for authorship apply to all intellectual products, including print and electronic publications of words, data, and images. Journals should make their own policies on authorship transparent and accessible.
Criteria for Authorship. Everyone who has made substantial intellectual contributions to the study on which the article is based (for example, to the research question, design, analysis, interpretation, and written description) should be an author. It is dishonest to omit mention of someone who has participated in writing the manuscript (“ghost authorship”) and unfair to omit investigator who have had important engagement with other aspects of the work. (See the WAME policy statement, “Ghost Writing Initiated by Commercial Companies”)
Only an individual who has made substantial intellectual contributions should be an author. Performing technical services, translating text, identifying patients for study, supplying materials, and providing funding or administrative oversight over facilities where the work was done are not, in themselves, sufficient for authorship, although these contributions may be acknowledged in the manuscript, as described below. It is dishonest to include authors only because of their reputation, position of authority, or friendship (“guest authorship”).
Many journals publish the names and contributions of everyone who has participated in the work (“contributors”). Not all contributors necessarily qualify for authorship. The nature of each contributors’ participation can be made transparent by a statement, published with the article, of their names and contributions and WAME encourages this practice.
One author (a “guarantor”) should take responsibility for the integrity of the work as a whole. Often this is the corresponding author, the one who sends in the manuscript and receives reviews, but other authors can have this role. All authors should approve the final version of the manuscript.
It is preferable that all authors be familiar with all aspects of the work. However, modern research is often done in teams with complementary expertise so that every author may not be equally familiar with all aspects of the work. For example, a biostatistician may have greater mastery of statistical aspects of the manuscript than other authors, but have somewhat less understanding of clinical variables or laboratory measurements. Therefore, some authors’ contributions may be limited to specific aspects of the work as a whole.
All authors should comply with the journals’ policies on conflict of interest.
Number of Authors. Editors should not arbitrarily limit the number of authors. There are legitimate reasons for multiple authors in some kinds of research, such as multi-center, randomized controlled trials. In these situations, a subset of authors may be listed with the title, with the notation that they have prepared the manuscript on behalf of all contributors, who are then listed in an appendix to the published article. Alternatively, a “corporate” author (e.g., a “Group” name) representing all authors in a named study may be listed, as long as one investigator takes responsibility for the work as a whole. In either case, all individuals listed as authors should meet criteria for authorship whether or not they are listed explicitly on the byline. If editors believe the number of authors is unusually large, relative to the scope and complexity of the work, they can ask for a detailed description of each author’s contributions to the work. If some do not meet criteria for authorship, editors can require that their names be removed as a condition of publication.
Order of Authorship. The authors themselves should decide the order in which authors are listed in an article. No one else knows as well as they do their respective contributions and the agreements they have made among themselves. Many different criteria are used to decide order of authorship. Among these are relative contributions to the work and, in situations where all authors have contributed equally, alphabetical or random order. Readers cannot know, and should not assume, the meaning of order of authorship unless the approach to assigning order has been described by the authors. Authors may want to include with their manuscript a description of how order was decided. If so, editors should welcome this information and publish it with the manuscript.
Authorship Disputes. Disputes about authorship are best settled at the local level, before journals review the manuscript. However, at their discretion editors may become involved in resolving authorship disputes. Changes in authorship at any stage of manuscript review, revision, or acceptance should be accompanied by a written request and explanation from all of the original authors.
The Registration of Clinical Trials
Posted July 22, 2005
Addendum March 12, 2013
The effectiveness of medical interventions should be based on the results of all properly conducted clinical trials, whether or not the trials have been published. The results of unpublished trials are systematically different from those that are published; they tend to be "negative" (find no effect or harm) or fail to support the interests of the funding agency. Therefore, relying on published trials alone can provide a biased view of effectiveness and safety.
Registration of clinical trials at their inception, in widely available registries, makes it possible for all stakeholders to take unpublished trials into account when summarizing the evidence for an intervention's effects. Information in registries can also prompt efforts to discover the original objectives and results of unpublished trials and the reasons why they were not published.
For these reasons, the World Association of Medical Editors supports efforts to register all clinical trials at their inception. Because registration is useful only to the extent that it includes all trials, it should be required of the research community as a whole and not voluntary according to the source of funding or preferences of the investigators. The contents of registries should be freely accessible and searchable to anyone in the world who wants to examine them.
Many practical issues will need to be resolved before universal trial registration is a reality. A single, worldwide registry would be ideal but multiple registries are more feasible in the short term because trials are conducted in many regions of the world and in many clinical research areas and there is currently no single body that oversees the world's research. To ensure the integrity of registries, they should be managed by groups without potential conflict of interest in the results of the trials they include.
Journal editors should support the development of registries by participating in efforts to develop a consensus on requirements for registry contents, responsibility, access, search ability, and comprehensiveness and by promoting their implementation. When suitable registries are available, editors should require prior registration of all trials published in their journals. Editors of small journals with limited resources should be engaged in this process to ensure that their role in registries is feasible in their setting.
Addendum, March 12, 2013, in support of the Alltrials.net
initiative and posted on their website:
World Association of Medical Editors (WAME) seeks to promote the highest standards in conducting, reporting, and disseminating medical research in the service of improving personal and public health worldwide. To this end, WAME lends its full support to the AllTrials initiative
, extending WAME’s policy
that all clinical trials should be registered. We echo the call to governments, regulators, research and medical associations, universities, ethics committees, as well as medical journals and publishers, to commit to publishing in full all treatments tested in clinical trials.
Ghost Writing Initiated by Commercial Companies
Posted April 19, 2005
Revised June 20, 2005
The integrity of the published record of scientific research depends not only on the validity of the science but also on honesty in authorship. Editors and readers need to be confident that authors have undertaken the work described and have ensured that the manuscript accurately reflects their work, irrespective of whether they took the lead in writing or sought assistance from a medical writer. The scientific record is distorted if the primary purpose of an article is to persuade readers in favor of a special interest, rather than to inform and educate, and this purpose is concealed.
Ghost authorship exists when someone has made substantial contributions to writing a manuscript and this role is not mentioned in the manuscript itself. WAME considers ghost authorship dishonest and unacceptable. Ghost authors generally work on behalf of companies, or agents acting for those companies, with a commercial interest in the topic, and this compounds the problem. For example, a writer employed by a commercial company may prepare an article, then invite an expert in the field to submit the work, perhaps with minor revisions, under his or her own name. The submitting author may be paid, directly or indirectly, for this service. In other circumstances, investigators may pay a professional writer to help them prepare their article but not mention this assistance, gaining credit for writing they have not done. Although editors seek to avoid publication of ghost written articles, these articles are often very difficult to detect.
Submitting authors bear primary responsibility for naming all contributors to manuscripts and describing their contributions. Ghost authorship would be avoided if corresponding authors listed everyone else who participated in the work, including those who contributed only to the writing, along with their individual contributions and institutional affiliations; stated explicitly how the work was paid for; and fully disclosed any further potential competing interests.
However, responsibility for ghost written manuscripts goes beyond individual authors. Other parties, including companies—such as marketing, communications, and medical education companies who are paid to assist pharmaceutical and medical device companies in disseminating favorable messages about their products—may initiate the sequence of events for which the author is the final and most easily identified participant. These other participants are also responsible for ghost written manuscripts and addressing their roles should be part of the solution.
To prevent some instances of ghost authorship, editors should make clear in their journal's information for authors that medical writers can be legitimate contributors and that their roles and affiliations should be described in the manuscript. When editors detect ghost written manuscripts, their actions should involve both the submitting authors and commercial participants if they are involved. Several actions are possible:
publish a notice that a manuscript has been ghost written, along with the names of the responsible companies and the submitting author;
alert the authors' academic institutions, identifying the commercial companies;
provide specific names if contacted by the popular media or government organizations; and
share their experiences on the WAME Listserve and within other forums.
Together, these actions would increase transparency and public accountability about ghost writing and its manipulation of the scientific record and deter others from this practice.
Posted April 7, 2004
Impact factor is widely regarded by authors and academic programs to be a measure of a journal's prestige and value and can be important for authors' career advancement in academic medicine. However, impact factor can be affected by a number of aspects unrelated to journal quality, including self-citation by a journal, publication timing, and types of articles published. As a result, impact factor has become a highly discussed issue among journal authors and editors. WAME list-serve discussions have addressed its benefits and fallacies. On the basis of this discussion, the WAME Board makes the following recommendations to WAME members:
More research is needed to evaluate the impact factor and other measures of journal and article quality. We urge fellow editors to consider important research questions and conduct research in this field. WAME offers its virtual discussion room for contacts and plans.
Journal editors should look beyond impact factor as a summary statistics and present other indicators of journal visibility, such as circulation, number of published articles, and the distribution of the citations. Such demographics of a journal should be regularly published to inform journal readers and authors.
Journal editors have the responsibility to educate their readers, authors, administrators, and their scientific community in general about impact factor and its relevance, as well as about other measures of journal and article quality.
Geopolitical Intrusion on Editorial Decisions
Posted March 23, 2004
Decisions to edit and publish manuscripts submitted to biomedical journals should be based on characteristics of the manuscripts themselves and how they relate to the journal's purposes and readers. Among these characteristics are importance of the topic, originality, scientific strength, clarity and completeness of written expression, and potential interest to readers. Editors should also take into account whether studies are ethical and whether their publication might cause harm to readers or to the public interest.
Editorial decisions should not be affected by the origins of the manuscript, including the nationality, ethnicity, political beliefs, race, or religion of the authors. Decisions to edit and publish should not be determined by the policies of governments or other agencies outside of the journal itself.
Editors should defend this principle, as they do other principles of sound editorial practice, and enlist their colleagues' support in this effort if necessary.
Geopolitical Intrusion on Editorial Decisions (Spanish)
Organizations and Journals Supporting the Statement on Geopolitical Intrusion on Editorial Decisions
The Responsibilities of Medical Editors
Posted August 5, 2003
The following statement was drafted at a meeting of the World Association of Medical Editors (WAME) during a meeting at the Rockefeller Foundation Study and Conference Center in Bellagio, Italy, January 22-26, 2001. It has been revised by the Editorial Policy Committee and reviewed by the Executive Committee of the WAME Board before being posted on the WAME website.
1. Respect their journal’s constituents (readers, authors, reviewers, and the human subjects of research) by:
Making the journal’s processes (e.g., governance, editorial staff members, number of reviewers, review times, acceptance rate) transparent;
Thanking reviewers for their work;
Protecting the confidentiality of human subjects.
2. Promote self-correction in science and participate in efforts to improve the practice of scientific investigation by:
Publishing corrections, retractions, and critiques of published articles;
Take responsibility for improving the level of scientific investigation and medical writing in the larger community of potential authors and readers.
3. Assure honesty and integrity of the content of their journal and minimize bias by:
Managing conflicts of interest;
Maintaining confidentiality of information;
Separating the editorial and business functions of the journal.
4. Improve the quality of their journal by:
Becoming familiar with the best practice in editing, peer review, research ethics, methods of investigation, and the rationale and evidence base supporting them;
Establishing appropriate programs to monitor journals’ performance;
Soliciting external evaluations of the journal’s effectiveness.
Regional Workshops for Medical Editors
Posted May 27, 2003
WAME strongly encourages regional or local initiatives to provide workshops or conferences, etc, for editors of peer-reviewed medical journals, to encourage the highest standards of reporting medical science. Although funds are not available, WAME is prepared to assist in the planning of workshops or conferences, to help in finding appropriate faculty, and to help negotiate some assistance to facilitate clearly planned projects that rely primarily on local or regional resources. Inquiries should be directed the WAME President or Secretary. (Click here for contact information.)
Free Journal Access for Poor Nations
In response to the World Health Organization Health InterNetwork Access to Research Initiative
an increasing number of the world's leading medical publishers are allowing free Web-based access to scientific journals in those countries that cannot afford to pay for them. Since we as medical editors view disseminating medical knowledge as among our greatest honors and responsibilities, we heartily endorse this practice, and encourage all medical editors and publishers around the world to adopt it.
The Relationship Between Journal Editors-in-Chief and Owners (formerly titled Editorial Independence)
Originally posted June 19, 2000; modified versions posted May 15, 2006 and July 25, 2009
Editors-in-Chief and the owners of their journals both want the journals to succeed but they have different roles. The editors-in-chief’s primary responsibilities are to inform and educate readers, with attention to the accuracy and importance of journal articles, and to protect and strengthen the integrity and quality of the journal and its processes. Owners (whether professional associations or for-profit companies) support the core values and policies of their organization and are ultimately responsible for all aspects of publishing the journal, including its staff, budget, and business policies. The relationship between owners and editors-in-chief should be based on mutual respect and trust, and recognition of each other’s authority and responsibilities. Conflicts can damage both the intellectual integrity and reputation of the journal and its financial success.
The following are guidelines for protecting the responsibility and authority of both editors-in-chief and owners:
The conditions of the editors-in-chief's employment, including authority, responsibilities, term of appointment, reporting relationships, and mechanisms for resolving conflict, should be explicitly stated in writing and approved by both editor and owner before the editor is appointed. Those conditions bearing on editorial freedom should be shared with readers by publication in the journal or on its website.
Editors-in-chief should have full authority over the editorial content of the journal, generally referred to as “editorial independence.” Editorial content includes original research, opinion articles and news reports, both in print or electronic format, and how and when information is published. Owners should not interfere in the evaluation, selection or editing of individual articles, either directly or by creating an environment in which editorial decisions are strongly influenced.
Editorial decisions should be based mainly on the validity of the work and its importance to readers, not the policies or commercial success of the owner. Editors should be free to publish critical but responsible views about all aspects of medicine without fear of retribution, even if these views might conflict with the policies or commercial goals of the owner. To maintain this position, editors should seek input from a broad array of advisors such as reviewers, editorial staff, an editorial board, and readers.
Editors-in-chief should establish procedures that guard against the influence of commercial, organizational, and personal self-interest on editorial decisions and should make these procedures clear and transparent to all interested parties. They should be compensated for their work on the journal in a manner that does not create a conflict of interest for the manuscripts they consider (see Conflict of Interest Policy Statement).
Owners have the right to hire and fire editors-in-chief but they should dismiss them only for substantial reasons such as a pattern of bad editorial decisions, disagreement with the long-term editorial direction of the journal, or personal behavior (such as criminal acts) that are incompatible with a position of trust. It may also be appropriate to end the editor’s service if, for whatever reason, owners and editors find they are unable to work together in a spirit of mutual trust and collaboration. Termination of an editor’s appointment should be a deliberate process, involving open discussion at the highest level of the organization, and should not be precipitous, except for egregious wrongdoing.
The limits of editorial freedom are difficult to define in the general case. Editors should be receptive to articles representing all legitimate points of view and should be free to publish any responsible positions. However, owners cannot be expected to retain editors who take strong, consistent, one-sided positions against the core values and policies of their parent organization.
Editors-in-chief should report to the highest governing body of the owning organization, not its administrative officers. Major decisions regarding the editor’s employment should be made by this body with open discussion and time to hear from all interested parties. Some organizations have found it useful to establish an independent oversight committee to advise them on major decisions regarding their editor and journal. Both owners and editors should have a meaningful role in appointment of members, since both are stake-holders in the committee’s effectiveness. The work of such committees should be transparent and publicly available.
Editors should resist any actions that might compromise these principles in their journals, even if it places their own position at risk. If major transgressions do occur, all editors should participate in drawing them to the attention of the international medical, academic, and lay communities.
Best Practices for Peer Reviewer Selection and Contact to Prevent Peer Review Manipulation by Authors
Posted April 6, 2015
The problem of manipulation of manuscript peer review by authors has recently surfaced (discussed here
). Peer review manipulation, also referred to as fraudulent peer review, can be defined as subversion of the peer review process by an author or another person engaged on behalf of the author to deceive a journal editor into sending a peer review invitation, such that the authors or a third party related to them can determine or control the contents of the review. The following statement addresses the selection and process of contacting peer reviewers with specific reference to avoiding peer review manipulation, based on the cases identified to date. It does not address the peer review process comprehensively (WAME’s general recommendations regarding peer reviewers are available from here
The discovery of peer review manipulation has resulted in many retractions (see discussion
). In many of these instances, authors had recommended peer reviewers, either real experts in the field of their work or imaginary persons, with fake reviewer email addresses that were controlled by either the authors themselves or a third party associated with, or hired by, the authors. The editors used the authors’ suggested reviewers, including emails, and were thus deceived into sending reviewer invitations and links for submission of peer reviews to these email addresses, enabling authors or a third party related to them to submit or control reviews of their own manuscripts.
WAME recommends that, ideally, an editor should only use author-suggested reviewers if the editor is already familiar with the reviewers and their potential conflicts of interest and has their contact information in the journal database. Peer review of a manuscript should include at least one reviewer not suggested by the author. However, WAME recognizes that editors, at times, face challenges in finding peer reviewers for manuscripts, particularly in small, specialized fields, and may find author suggestions for reviewers helpful. WAME recommends that, in such situations, editors take the following steps to avoid peer review manipulation. Best practices for appropriate selection of reviewers for valid peer review are also provided.
Peer Reviewer Selection Best Practices
Editors should make every effort to find expert reviewers in the topics(s) addressed in the manuscript who are free of significant conflicts of interest. These efforts include the editors’ own expertise, and use of electronic databases, manuscript reference lists, editorial board recommendations, journal database searches, and the like. For highly specialized areas, chairs of departments and the like may have suggestions as to faculty with expertise. To avoid inviting peer reviewers with significant conflicts of interest, editors generally should exclude from consideration: (a) individuals who have coauthored manuscripts with the authors in the recent (e.g.
, 10 years) past, (b) individuals who work at the same institution as the authors, particularly if they are in the same area as an author or the institution is small, and (c) individuals who have other conflicts of interest, financial or otherwise, for or against the paper (for a discussion of conflicts of interest see here
). If editors make exceptions to these general principles when inviting reviewers, they should keep in mind the exception and its potential implications for the reviewer’s recommendations. Potential reviewers should be asked to recuse themselves prior to accepting a peer review invitation if they have a conflict of interest for or against the manuscript or if they are otherwise unable to review the manuscript objectively. Reviewers who agree to review and then discover a potential conflict should contact the editor. Every peer-reviewed medical journal should have its own Conflict of Interest policies for authors, reviewers, and editors that are publicly available and these should be provided to potential reviewers (see here
). Journal peer review systems should include a step asking the reviewers to report their potential conflicts of interest, requesting explanation and preventing review without editor intervention if reviewers answer in the affirmative.
Avoiding Selection of Fraudulent Peer Reviewers
Editors should avoid using only author-recommended peer reviewers to review a paper.
Editors should not use an author-recommended reviewer unless the person’s contact information is obtained from an independently validated source, e.g., from the reviewer’s publications or referred by a member of the Journal’s editorial board. Note that email addresses with top level domains such as .edu are more likely to be reliably linked to the correct individual than those with other less tightly controlled domains (e.g., gmail or yahoo accounts). However, editors should not require reviewers to use their .edu or other professional email addresses because some institutions may not have reliable email access, particularly in low or middle income countries, and their faculty may prefer to use non-institutional email addresses. [In these limited cases, Editors may want to encourage potential reviewers to include the non-institutional email address on their institutional Web page]. Editors should consider applying similar diligence to reviewer-suggested reviewer names and emails.
ORCID (Open Researcher and Contributor ID
) identification numbers are a possible mechanism for helping to validate reviewer identity and contact information. Editors should encourage reviewers to enroll in ORCID, while being alert to the possibility of misrepresentation of ORCID identification numbers.
If the editor determines that an author has supplied a reviewer email address that is not correct, then the editor should ask the author for an explanation. Merely supplying an incorrect email address (e.g., with a typo or an outdated email address) does not imply a deliberate intent to deceive or manipulate. If the email address appears to have been submitted with intent to deceive the editor as to the address's owner, then the editor should take additional steps depending on the source of the deception, such as contacting the author’s institution.
Detecting Fraudulent Peer Review
Editors should remain alert to the possibility of peer review manipulation, especially if reviewer comments are submitted extremely rapidly or the review is extremely positive and superficial. In such cases, it may be helpful to invite an additional, independent review, or to redouble efforts to check the identity and contact details of the suggested reviewer.
While these recommendations are intended to help prevent the problem of fraudulent peer review, other methods to subvert peer review undoubtedly will be developed. Editors should be appropriately skeptical of potential new sources of reviewer names and contact information.
Approved by the WAME Ethics and Policy Committee (21 January 2015).
Promoting Global Health
Posted May 31, 2015
The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide. For purposes of this statement global health is defined as follows: “Global health is an area for study, research, and practice that places a priority on improving health and achieving equity in health for all people worldwide. Global health emphasizes transnational health issues, determinants, and solutions; involves many disciplines within and beyond the health sciences and promotes interdisciplinary collaboration; and is a synthesis of population-based prevention with individual-level clinical care.” 
More specifically, all medical journal editors, regardless of their location, should strive to:
(a) Publish research addressing the greatest global health concerns;
(b) Specifically encourage the publication of innovative and solution-focused research in all fields of medicine, public health, and health promotion; in particular, research applicable to low- and middle-income countries;
(c) Encourage the publication of research from authors in low- and middle-income countries;
(d) Provide free Web-based access to research articles to readers in countries that cannot afford to pay for them;
(e) Provide publication fee waivers for research conducted and authored primarily by researchers from low- and middle-income countries;
For editors in high-income countries:
(f) Invite researchers from low- and middle-income countries to participate on editorial boards of their journals;
(g) Invite researchers from low- and middle-income countries to participate as peer reviewers for articles submitted to their journals;
(h) Invite researchers from low-and middle-income countries to write editorials and commentaries on the local or regional impact of and, if relevant, responses to global health issues to help educate readers in high-income countries about the human costs and consequences of these issues.
This Statement has been approved by the WAME Ethics and Policy Committee and endorsed by the WAME Board.
May 31, 2015