RE: Letter-to-the-Editor from Murali Krishna Sayana

We thank Mr. Sayana for his kind comments regarding our editorial. He raises a difficult question: “How do you decide what is a Least Publishable Unit?” In our editorial we wrote: “Material containing essentially similar aims or hypotheses, datasets, conclusions, and references will likely all fall within the framework of redundant publication.”2-4 All readers of scientific articles recognize there are times when one of these is identical in two or more articles, but there are differences in the others. We consider these to reflect least publishable units. As we noted, the problem is that these can be identified only in retrospect since the articles are usually published in different journals. The prospective identification of such articles is not easy in a large editorial office which may process large numbers of manuscripts per year.

Mr. Sayana raises a second question: “Do JBJS and CORR have a policy on ‘Least Publishable Unit’, or is the designation at the discretion of the editors and reviewers?” The Journal of Bone and Joint Surgery (Am) and Clinical Orthopaedics and Related Research do have policies in place. The editors initially contact each other and editors of other journals when relevant to discuss such cases. When only a limited amount of material is identical or similar, but much is not, we judge these to be cases of least publishable units. When either editor raises a question of closer similarity of the articles, we send blinded copies to expert independent reviewers for their opinion. Based upon whether those reviewers believe the articles redundant publication, we take what we believe is appropriate action. We write authors asking for an explanation, remind them of potential misconduct,1 and request the explanatory letter be signed by all authors. Further action is based upon their response, but at a minimum includes sending identical letters from both (or all) editors to the authors reminding them of the unethical nature of redundant or similar publication. The Committee on Publication Ethics1 has outlined a variety of additional actions, depending upon the nature of misconduct and we adhere to those guidelines.

Finally, Mr. Sayana raises a question of “clear policy on Least Publishable Unit.“ All three of our Journals require authors to sign a cover letter stating the contents have not been submitted or published elsewhere. We believe our statements to be quite clear and we are always available to discuss uncertain areas with the authors prior to submission.

Journals have very limited ability to police unethical submissions. Authors on the other hand have a responsibility to adhere to ethical standards. Each of our journals institutes appropriate enquiries and actions when the ethical standards are challenged.

Richard A. Brand, MD Editor-in-Chief Clinical Orthopaedics & Related Research Philadelphia, PA

James D. Heckman, MD Editor-in-Chief The Journal of Bone and Joint Surgery – American Boston, MA

James Scott, FRCS Editor The Journal of Bone and Joint Surgery - British London, UK

References:

1. The COPE Report 1999. Committee on Publication Ethics, http://www.publicationethics.org.uk/, 2003. 2. Brand RA, Heckman JD, Scott J: Changing ethical standards in scientific publication. Clin Orthop:1-2, 2004. 3. Brand RA, Heckman JD, Scott J: Changing ethical standards in scientific publication. J Bone Joint Surg Am 86-A:1855-1856, 2004. 4. Brand RA, Heckman JD, Scott J: Changing ethical standards in scientific publication. J Bone Joint Surg Br 86B, 2004.

Dear Sir,

It was heartening to read the editorial this month by the BIG THREE. This editorial is a step in right direction, but leaves other questions unanswered. How do you decide what is a Least Publishable Unit? Do the JBJS and CORR have a policy on "Least Publishable Unit", or is the designation at the discretion of the editors and reviewers?

The editorial also discusses "meat extenders" and it could be argued that the article by Beaule, et al (1) is a meat extender of a recent article, "Risk Factors Affecting Outcome of Metal-on-Metal Surface Arthroplasty of the Hip" by Beaule, et al,(CORR: 418, Jan 2004, 87-93). The data are based on 94 hips in 83 patients. Compare Table 4 on page 90 of the CORR article to Table 1 of the JBJS article. There are discrepancies and similarities in these two tables probably based on the same data. The conclusions are the same - valgus positioning is better than varus.

One wonders why the calculations were done exclusively in the patients who were 40 years and younger? Why was the radiographic and biomechanical analysis not done on the whole sample of 400 patients on whom the 2-6 year follow up was published in January this year?

The counter-argument could be that it would be too extensive for all of the information to be included in one article. This is the reason why we need a clear policy on Least Publishable Unit by the BIG THREE that should be included in the instructions to the authors (2).

References:

1. Beaule,P.E., et al, Orientation of the Femoral Component in Surface Arthroplasty of the Hip. A Biomechanical and Clinical Analysis. JBJS, 86-A, 2015-2021, 2004

2. Doherty M. The Misconduct of Redundant Publication. The COPE Report 1998. www.publicationethics.org.uk/cope1998/pages1998/contents.phtml