Transcript – BJUI Podcast - Roger Kirby

Roger Kirby Thank you John it’s really nice to be here and really good audience you have got here and I think the discussion already has been quite useful, so let’s think about what it really means to publish ethically. Well there’s the, kind of the, key words, probity, being honest, Intellectual honesty and being aware of conflicts of interest and then if you have them, stating them because everything in life is full of conflicts of interest but in scientific publishing at least you have to acknowledge them. So these are the topics I am going to just briefly waltz through. Honest reporting of results, Avoiding claims of plagiarism that we’ve already mentioned, conflicts of interest, ghost writers, peer review process and how it works, impact factors which are a quite controversial area in their own right and conflicts impacting on editor. I am editor of four-times per year journal called Prostate Cancer and Prostatic Disease, and also help the journal lot with BJUI and I know quite a bit about editorial conflicts as I have to, kind of, live through them. Okay, so let’s start with honest reporting of results. First rule never massage your results to make a negative finding positive. It’s already been mentioned, it’s so tempting to do that; so you have not only got to be honest about your results, probity in your results, you’ve got to be honest and straight forward in your interpretation of those results and in the discussion of those results. Again it’s tempting now to perhaps to take a bit of sensationalist attitude, it’s easy now to get in the media. Remember two days ago in my favourite newspaper the Independent, two cases of prostate cancer miraculous cure, only two cases that’s front page news on the Independent it was on Radio 4 headline news, so you know, if you are going to write something or if you’re going to publish something even if you are going to say something in public be prepared to standby and defend your conclusions. So, plagiarism - don’t, as John has already mentioned, reproduce chunks of other people’s work. In the digital age it’s pretty easy to do and it’s tempting to do. You’ve even got to be cautious about cutting and pasting your own work because the risk is you’ll get dual publication and I have written may be a 100 articles on variations on drug therapy for BPH over the years and it’s really hard to find a different way of saying the same thing again and again and again, but you have to do that and you must not change the title and send the paper again. Okay let’s talk about conflicts of interest. They are usually financial sometimes they can be political, if there’s a hint of a conflict of interest then say so. Ghost writers - that’s another interesting topic. There’s a lot of ghost writing going on out there, actually you’ll be surprised how much there is; they are professional writers and they are paid quite a large sums of money to produce copy. Ideally they should be, that writer should be acknowledged as an author, one of the on the list of authors and that’s the idea and then every other author on that list but you have to check pretty carefully that he or she can standby the conclusions of the paper and the results of course. Alternatively you can put in the end, you can say this, we would like to thank for editorial and writing support, the person who did the writing, and that’s legitimate. And I think we could ask John at the end of the session whether that influences his decision to accept a paper if he reads that because we know often some of the names are associated with ghost writing. Okay, let’s talk a little bit about the peer review process. We’ve now got a wealth of papers coming in, 10 papers a day John mentioned, he said two reviewers for the BJUI and more and more journals are taking more and more reviewers because if you take more, the more likely you’re somebody who’ll say, yes. The problem is there’s, kind of a, reviewer fatigue setting in because everybody is busy; nobody has got enough time; and there’s lots of other conflicts if you like, for your attention, other things that are actually more interesting to watch then on TV, for example, than doing a review. So a lot of people just won’t review any longer, so we are always looking for people to review and if you like to review for the BJUI, if you talk to John afterwards and we’ll add your name to our list. And we are increasing sub-specialization. There are people like me who just know nothing or anything apart from robot surgery on the prostate these days.

So it is tough to find people who have the broad knowledge to look at all the broad range of subjects coming into the BJUI. And again conflicts between reviewers have to be taken into the account although as I have already mentioned and the citation index is given to every journal at the end of the year and I’m going to show you the list of the very latest citation figures which apparently came up couple of days ago actually on my next slide. But what the citation index is that they take the number of papers a journal has published over the year and then they look at the number of citations per paper. So they calculate a figure for the number of citations per paper and it comes out. In urology it is between 1 and 5 just about that, but for the really famous journals that John has mentioned so and Nature, it really goes up to nearly 30. So their papers are on an average cited 30 times within a two-year period. Now this thing can be so called ‘gamed’ or it comes, this is why I am talking about, in terms of, so called ethics, because if you ask your authors when they’re sending their paper to quote other papers that have appeared in that journal then you can push up your citation index and there’s evidence of that being done. There are software programs now where you can actually look at the self-citation within the journals. And we know the journals that do this and we don’t think it is very ethical but it is quite hard to stop them. There are legitimate ways of increasing your citation index and in terms not so much immense but in science if you have your paper published in a highly cited journal like Nature, their actual implications in terms of funding for your department and in terms of your own salary, so it’s a big deal to get the citation index up for a journal, the higher your citation index is for the journal, the more paper that the scientists want to send papers in; so it becomes a self-fulfilling thing, so people take it quite seriously. There are other parameters by which you could judge a journal such as readability and that’s something that John had been working on in terms on the News page and the Mini Reviews and so on in the BJUI and you can also now measure very precisely the web traffic, well they are, I have showed this specially for John this is the numbers that we all look forward to; they’re published towards the end of June, in order they are the top 26 journals in Urology and Nephrology. They seem to have mixed in some Nephrology journals and there are some journals that we know are high on the basis of self citation. So I won’t dwell on the slide but those are the numbers, if you want to know between 3 and 3.2 and top one is 7. So conclusions, you are what you write in medicine and once you’ve written, it’s there for good, you know, they are just putting the news papers from 1850 on the World Wide Web. I noticed last week and then whatever you write now would be known in the web forever, so that’s one move as a positive but you better be sure that if what you publish is honest and true because if it isn’t you can never take it back. You can check on PubMed or Medline to review your publication status, real fun to do that to see the papers coming up as they get accepted, right as Killian says, write clearly, concisely and honestly; no massaging, massaging is great in a massage parlour but not when you are writing a paper and check anything that has your name on it carefully and don’t forget to state any possible Conflicts of Interest, thank you all so much. John Fitzpatrick Thanks Roger. The impact factor by the way is a formula which is the number of citations divided by the number of papers published in a particular journal. And so the impact factor for 2009 which has come out is the number of papers that have been cited in such a way in 2006 and 2007, during the calendar year of 2008. Do you see how confusing it is but that’s how the impact factor is. And so that’s for the liaison and for me it’s only of relative importance, I prefer a journal that is good to read, interesting, and contains papers which are of a very high quality. Any questions for Roger? Yes Markus. Markus Drake Thanks John, well John, the conflict of interest issue is obviously fundamental; you’ve alluded to the financial conflicts of interest which is pretty straight forward to declare, I got money for such and such but in fact the conflicts of interest are substantially more insidious than that. Because if

you publish a paper with an exciting result you would become famous, you’ll be cited a lot, you’ll then get invited to do talks around the world and as a consequence of all that the temptation is there to massage the figures, but I just wonder have we got any means by which we can overcome this sort of insidious conflict of interest that I think does lead us astray in rather more situations than perhaps we would like to admit? Roger Kirby Well, I can’t think of a mechanism, I think you know giving talks like this about probity, because you know the reality is that you can do a hundred good things and people don’t remember you and if you do one bad thing and you’re marked for life. Say, if we do a hundred operations and they go well and if you have one where the patient has disastrous consequences, you know, everybody remembers that one and that’s all they are talking about and that’s the world we live in now. But you know your credibility, it is the same in your personal life, isn’t it, if only once you’ve lost your credibility you’ve lost your honest and straight forward stuff. John Fitzpatrick Roger, thank you very much. Any other questions, yes, yeah. Joe Philip It’s about the reviewer, scientific reviewers, the first question was you know how do you select them, secondly like in the BJUI they have a section where the author could suggest two, three reviewers and suggest two, three who they do not think should review, so there could be a conflict of interest there, like for example, if I suggest somebody who I work with and they tend to be like, so how do you go about. Roger Kirby Well, John you’ll answer that question. John Fitzpatrick Well, I mean, you know, if you mention your colleague as a reviewer. (Name) No, I don’t mean… John Fitzpatrick No, no, not you, you have to be aware of the fact that, you know, I probably wouldn’t fall for that one. Usually what happens is I don’t pay any attention to who suggest the reviewers but on the other hand sometimes it can be helpful and we do chose them, but we don’t fall for simple tricks. So I mean if you, not you, if one were to use such a ruse, such a really gross thing say I suggest my brother to review that I would probably not fall for that. Okay anything else, any burning issue, Ah! Another burning issue, excellent. Tell us who you are? (Name) I’m a young SpR, can I ask what does the committee think about aiming high and going for the high impact factor journal, still rejects and then doing their own say a year before you get publication, or do you, sort of, say, honest label and I don’t get that in and --- John Fitzpatrick No, that won’t work. No I wouldn’t recommend that I think what was said earlier by Killian and by Roger and by myself is you send it to the journal the audience of which you would like to read it, don’t make that mistake, here now hold on. (Name) John, I was going to ask you that you have detected plagiarism in relation to publications from within the British Isles and if that’s the case what you perhaps have done about it?

John Fitzpatrick The answer for that is I haven’t actually, so there it is, but if I did then the answer is as follows. I would write to the author and tell him that this had happened and that he was guilty of it and I would send a copy of that letter to each of the other editors of the journals, I would include as many journals as I could, and I would tell the author that in fact he would not have any more papers published in any of these journals for three to four years, and there it is. So the cost is absolutely gigantic and it’s just so, so dangerous for that person’s career and I then get a whole series of letters say, ‘oh, the chap is a trainee, he made a mistake couldn’t you do’, no, I can’t. (Name) Good thank you. John Fitzpatrick Thanks. Oh yeah! Yeah! Deepak Batura This is on a different note, I am Deepak Batura from Northwick Park, and this is on a different note, you said that one of the largest stumbling blocks is statistics and we find that a lot of people have fairly complex statistics, so what’s the best way to go around it? Get a statistician on board before hand or… John Fitzpatrick Yes, for example, if you are doing a randomized study you’ve to power that study at the beginning of it to show a difference or not to show a difference depending what it is, but you have to get statistical advice on that, so that your first port of call is into the statistician. So you need to know how many people you have in each of the two groups or three groups or whatever it is because otherwise introduce a bias depending on the size of it or not, I am just answering the question. And so therefore that’s where the issue is, so statistical advice before you start so that you will know how many people to put it.