Ethical issues in preparing and publishing systematic reviews.

The medical evidence base, or ‘literature’, forms the basis for clinical and policy decisions, so those who contribute to it have a responsibility to ensure that it is as accurate and unbiased as possible. Since publications are also used to judge the productivity of individuals and departments, and to select candidates for academic positions, it is important that those who did the work receive fair credit. Preparing a systematic review is a form of research, and should therefore be undertaken in a responsible manner to ensure integrity and avoid misconduct. This paper sets out practical and ethical issues to be considered when preparing and publishing a systematic review. It is written primarily for authors involved in The Cochrane Collaboration, but has broader relevance. Cochrane Review Groups, which are responsible for the quality of reviews that they publish, have highlighted concerns about unclear or inappropriate authorship, copying of material from other sources, and dual or duplicate publication. Various journals and editors’ organizations have produced publication guidelines and instructions for potential authors. One of the best known is the Uniform Requirements for Manuscripts Submitted to Biomedical Journals, produced by the International Committee of Medical Journal Editors (1). Guidance is also available in the Cochrane Handbook (2). However, many of the requirements and conventions are scattered, so it may be hard for researchers to get a complete picture of best practices. Another problem facing those preparing systematic reviews is that general guidance, designed mainly for preparing primary reports of research, may not be applicable or may not cover the special issues that arise with systematic reviews. This paper therefore aims to help review authors avoid ethical problems by providing an introduction and overview of good practice in preparing and publishing systematic reviews.