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case</h1> </div> <div class="hero__bottom"> </div> </div> </div> </div> <div class="page-main"> <div class="page-main__row"> <div class="page-main__col"> <main> <section id="content" class="region region-content"> <div id="block-system-main" class="block block-system clearfix"> <div class="content"> <div class="node-case node node-case view-mode-full "> <div class="node-case__left node-case__fields"> <div class="field field--short"> <div class="field-label">Case number:</div> <div class="field-item">24-07</div> </div> </div> <div class="node-case__body"> <div class="sidebar sidebar--offset"> <div class="sidebar__body"> <div class="node-case__fields"> <div class="field field-name-field-anonymised-text-of-the-ca field-type-text-long field-label-above"><div class="field-label">Case text (Anonymised): </div><div class="field-items"><div class="field-item even"><p>A case report was published in our journal after being approved by a peer reviewer and subjected to a technical review. The first author was a post-graduate trainee attached to the department of pathology of a prestigious national institute. A month later we received an email from a resident working at a specialist department of another institute claiming that the patient belonged to them and as the case appeared to be unique and due to the non-availability of some specific diagnostic services, the patient was referred to the pathology laboratory of this larger facility. The pathologists in this facility asked the patient for all previous medical reports, stating that without these the test results could not be handed out. After procuring all the necessary information, the postgraduate trainee of the pathology lab with five colleagues as coauthors wrote and submitted the case report to our journal where it was published.</p> <p>A letter of concern was sent to the authors who had published the case in our journal. The explanation given was as follows:</p> <p>The case was investigated for a rare disorder in their laboratory, belonging to a tertiary care facility. The pathologist could not have provided a final diagnosis without the previous investigations results therefore the patient was asked to bring them. Because it was a rare disorder the authors felt obliged to publish it for the benefit of the medical community. The present authors did not know that they should have sought permission from the treating physicians or included them as coauthors. The authors currently listed are all from the pathology laboratory and are all included in accordance with the ICMJE guidelines.</p> <p><em>Questions for the Forum:</em></p> <ul> <li>Who are the ‘real’ authors?</li> <li>The case ethically belonged to the resident from the medical facility. It was published without their knowledge and consent. What steps should be taken to rectify the injustice done?</li> <li>Is it excusable to claim ignorance about the ownership of the case, as the current authors are doing?</li> </ul> </div></div></div><div class="field field-name-field-advice field-type-text-long field-label-above"><div class="field-label">Advice: </div><div class="field-items"><div class="field-item even"><p>This is essentially an authorship issue which is beyond the ability of the journal to adjudicate. Several Forum attendees reported similar cases they had dealt with, and recommended contacting the authors’ institution to adjudicate the contested ownership. Additionally, the editor could consider informing the authors that it is their responsibility to follow up with the institution and that the journal will not take further action until they receive a judgement. In the meantime an expression of concern which outlines the situation would be a way to inform readers that there is a potential issue especially if the situation might take some time to resolve.</p> <p>Ultimately, if the authors do not have ownership of the case they cannot publish it as theirs. In that case a retraction may be appropriate, or even a full removal with a notice to explain that the article had been published without the consent of the data owner.<br /> </p> </div></div></div><div class="field field-name-field-follow-up field-type-text-long field-label-above"><div class="field-label">Follow up: </div><div class="field-items"><div class="field-item even"><p>After multiple mail exchanges with the complainants, the journal received a reply stating that they had reached out to the authors of the article. The authors acknowledged their<br /> mistake related to ICMJE authorship guidelines and apologised for the wrongdoing. They also wrote that the patient had been misdiagnosed for years and treated with the wrong medication. They had provided the accurate diagnosis which guided the treating physician to adopt the correct line of treatment. They had produced the case report with the good intention of creating awareness among the readers and pathologists regarding the importance of a correct diagnosis and treatment of such a case. Finally they requested the complainants to close the discussion and that they would be<br /> more careful in future. On our questioning, the complainants wrote back that their department had taken the decision to NOT pursue the case anymore.</p> <p>The journal is unsure how to handle the breach of authorship rules, which was missed by the journal office at the time of initial submission.</p> <p><em>Questions for the Forum:</em></p> <ul> <li>Should a note of concern (regarding authorship) be placed on this article? OR</li> <li>Should no further action be taken since the authors belonging to the pathology laboratory and the scientists who owned the case have come to a mutual agreement?</li> </ul> </div></div></div><div class="field field-name-field-advice-on-follow-up field-type-text-long field-label-above"><div class="field-label">Advice on follow up: </div><div class="field-items"><div class="field-item even"><p><em>Advice on this follow-up is from a small number of COPE Council Members. Most cases on the COPE website are presented to the <a href="https://publicationethics.org/copeforum">COPE Forum</a> where advice is offered by a wider group<br /> of COPE Members and COPE Council Members. Advice on individual cases is not formal COPE guidance.</em></p> <p>If the authors have reached a conclusion about how to resolve the conflict, the journal should accept that and take no further action. Indeed, an expression of concern could have the unintended effect of calling the veracity of the case report into question, which does not appear to be at issue.<br /> <br /> In more general terms, Council noted that it can be difficult to apply the ICMJE criteria to case studies, as no one ‘owns’ the patient’s case or their data except for the patient themselves. Unlike experiments and clinical trials, case reports often describe patient scenarios involving many caregivers. It is not uncommon for patients and their case records to be passed in sequence during care, or for a second (or third) physician to write up an interesting case report without including earlier care providers. <br /> <br /> ICMJE authorship guidelines are satisfied if all listed authors meet the authorship guidelines, and all those who met those requirements are listed as an author. In this case, it appears that the final correct diagnosis made by the referral institution was the focus of the paper, though it’s unclear from the description if the referral centre also handled the subsequent treatment regimen, or how much of the data collected by the first care providers were presented and in what context. <br /> <br /> If the authors of the article really did address the initial misdiagnosis or mistreatment of the patient, then their authorship may be warranted even if they did use some of the data from the first institution. While COPE believes it would have been considerate for the second team to have informed the original carers about the report and invited them to contribute in a way which qualified them as authors, it is not absolutely necessary. <br /> <br /> The current authors could still offer an acknowledgement; ICMJE says acknowledgment is appropriate for clinical investigators who “collected data” or “provided and cared for study patients."<br /> <br /> For future cases, we recommend that the journal ask authors to provide a statement at the submission phase stating that all authors listed contributed to the manuscript and that all those who contributed were listed as authors. If the journal receives many case reports and anticipates that this kind of scenario may arise again, it would also be useful to include language in their author guidelines that speak directly to the ICJME guidelines on authorship and acknowledgement as applied to case reports. Two further considerations for the journal are whether a paper has a distinctive focus which merits authorship from one clinical team in particular; and whether the patient gave consent for publication to that team. </p> </div></div></div><div class="field field-name-field-resolution field-type-list-text field-label-above"><div class="field-label">Resolution: </div><div class="field-items"><div class="field-item even">On-going</div></div></div><div class="field field-name-taxonomy-vocabulary-9 field-type-taxonomy-term-reference field-label-above"><div class="field-label">Year: </div><div class="field-items"><div class="field-item even"><a href="/taxonomy/term/4478">2024</a></div></div></div><div class="field field--classifications field--short"><div class="field-label">Core practices:</div><div class="item-list"><ul><li class="first"><a href="/authorship" title="View all "Authorship and contributorship" content">Authorship and contributorship</a></li> <li><a href="/data" title="View all "Data and reproducibility" content">Data and reproducibility</a></li> <li class="last"><a href="/postpublication" title="View all "Post-publication discussions and corrections" content">Post-publication discussions and corrections</a></li> </ul></div></div> </div> <aside class="sidebar__aside"> <div class="sidebar__aside__col"> <div class="sidebar__aside__inner"> <div class="contextual-links-region"><h3>COPE Forum</h3><div class="entity entity-bean bean-editable"> <div > <div class="field field-name-field-block-text field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even"><p>COPE Members:<br /> do you have a publication ethics case and need help with next steps?<br /> <a href="https://publicationethics.org/copeforum">Submit your case</a></p> <p>Registration is now open for the 9 December Forum where new cases are discussed. 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