Authorship and disclosure in medical writing

Medical writing is the work of turning scientific data into a readable text. Its quality is measured not by how smoothly the text reads but by how visible the responsibility behind it is.

Authorship is a responsibility, not a reward

Under the ICMJE criteria, authorship requires all four conditions to be met together: substantial contribution to the design of the work or to the acquisition, analysis or interpretation of data; drafting or critically revising the text; approval of the final version to be published; and acceptance of accountability for the work as a whole.

That framework names two common failures:

• Honorary authorship — listing someone who did not contribute, on the basis of seniority or position.
• Ghost authorship — omitting someone who made a substantial contribution to the text.

Both produce the same outcome: the reader cannot tell by whom, and from what vantage point, the text was constructed.

Declaring writing support

Receiving professional medical writing support is not in itself a problem. The problem is leaving that support invisible. Good Publication Practice directs that the provider of writing support, its funding source, and the stages at which it was involved should all be stated.

The scope of disclosure

Disclosure covers more than direct payment. Consultancy, speaker fees, research funding, patents and non-financial relationships fall within it. The test is whether a relationship could reasonably be thought to bear on a reader's appraisal; where there is doubt, declaring is the correct course.

Data access and independence of analysis

A question frequently asked of industry-supported studies is whether the authors had access to the raw data. Who performed the analysis, whether the authors were able to verify the data, and who held the decision to publish are what determine the independence of a text. Stating these openly does not diminish a study.

How the language is built

The language of a text is itself a declaration. Writing the result of a study that cannot establish causation in causal language changes the interpretation without changing the data. In an observational study, writing "was observed to be lower" rather than "reduced" is a question of accuracy, not of style.

In the same way:

• The result of a single study is not conveyed as settled knowledge.
• Subgroup findings, where not pre-specified, are presented as hypothesis-generating.
• Results from two studies that were never compared directly are not set against each other as though they had been.

A culture of correction

When an error is found in a published text, publishing the correction openly does not damage credibility; it reinforces it. Content altered quietly turns the alteration itself into the problem.