September 21, 2023

In 1978, following a gathering in Vancouver, a bunch of editors of main medical journals, the Vancouver Group, printed a draft report outlining proposed necessities for standardising the format of citations and suggesting commonplace methods of getting ready and submitting papers for publication in biomedical journals. The primary formal model of the necessities was printed in 1979, and since then the group, now often known as the Worldwide Committee of Medical Journal Editors (ICMJE), has printed additional variations of the doc, the title of which was modified in 2013 to the ICMJE Suggestions for the Conduct, Reporting, Modifying and Publication of Scholarly Work in Medical Journals.
These paperwork have been significantly influential in biomedical publishing and have performed an necessary half in varied methods: encouraging publication of protocols prematurely of research; within the institution of trial registries; in encouraging compliance with necessities for trial registration; in revealing potential conflicts of curiosity; in figuring out publications that increase issues and could also be thought-about for retraction; in defining the character of a peer reviewed journal; and lots of different issues. Nonetheless, it’s not clear to what extent the necessities/suggestions have helped authors reasonably than editors and will have inspired journals to focus extra on course of than on content material. A scientific overview of the proof that displays the extent to which the necessities/suggestions laid down within the ICMJE paperwork have been efficient and helpful in altering publication practices in biomedical journals could be of curiosity.

The Vancouver Declaration

In January 1978, the late Edward Huth, then editor of the Annals of Inside Medication,1 and Stephen Lock, editor of the British Medical Journal, because it was identified at the moment, now The BMJ, proposed organising a gathering of editors of influential medical journals to debate an ordinary format for citing references. Huth and Case have given an in depth account of the historical past of the occasion.2 In all, 19 journals have been represented on the assembly, and the committee of 11 included editors from the Annals of Inside Medication, The BMJ, The Journal of the American Medical Affiliation, The Lancet, The New England Journal of Medication, and different main biomedical journals.

The report that emerged, the Declaration of Vancouver,3 named after the town during which the assembly had been held, was printed within the British Medical Journal in Could 19784 and elsewhere later.56 It included an outline of the editors’ instructed technique of quotation, which has come to be often known as the Vancouver technique. Nonetheless, the report went additional than that. The editors had not restricted themselves to discussing strategies of quotation, however had encompassed different issues associated to how you can put together and submit a manuscript, together with particulars in regards to the title web page, the summary and key phrases, the textual content, the acknowledgments, how you can format tables and illustrations and their legends, and what abbreviations have been acceptable. Even the kind of paper for use was prescribed: “20.3 × 26.7 cm or 21.6 × 27.9 cm (8 × 10½ in or 8½ × 11 in) or ISO A4 (212 × 297 mm) white bond paper with margins of not less than 2.5 cm (1 in).”

The report was typically warmly acquired, and regardless of some reservations in regards to the supposed benefits of the brand new quotation technique over different strategies, such because the Harvard system,7 the brand new format was extensively adopted.

The unique publication of the report within the British Medical Journal was headed “For Debate,” however when a barely revised model was printed in February 1979, quickly after one other assembly of the committee, this time in Montreal, the heading grew to become “Type Issues”; the entire system had been extensively accepted.8 The one main change to the unique model concerned tables of abbreviations; these had beforehand lined (i) commonplace models of measurements and statistical phrases, (ii) so-called “combining elements,” from tera- (1012) right down to atto- (10−18), and (iii) different widespread abbreviations of a variety of biochemical and medical phrases. To those the revised version added an inventory of authorized abbreviations of the names of 108 journals, from Acta Med Scand to Surg Gynecol Obstet.

In 1979 the revised model was printed in a number of journals.910111213 And by December 1979, in keeping with an inventory printed in The BMJ,14 88 journals had signed as much as the necessities, from American Household Doctor to the Yale Journal of Biology and Medication, with a further entry for “World Well being Organisation [sic] journals.”

Earlier than lengthy, the Vancouver Group modified its identify to the Worldwide Committee of Medical Journal Editors (ICMJE), and over time expanded its pursuits to incorporate publication ethics and varied different issues, comparable to authorship, conflicts of curiosity, editorial freedom, plagiarism, duplicate publication, fraud, and retractions.

Common revisions of the doc resulted in main adjustments in 1997, 2003, and 2010. Then, in 2013 the committee renamed the doc, altering the phrase “necessities” to “suggestions”; the brand new doc bore the general title, as the newest model nonetheless does, “ICMJE Suggestions for the Conduct, Reporting, Modifying and Publication of Scholarly Work in Medical Journals,” or just “The ICMJE Suggestions.”15

The ICMJE suggestions

The 2013 model of the suggestions mounted the ICMJE’s standards for authorship of a paper by the addition of a fourth merchandise to the earlier three:

1. Substantial contributions to: the conception or design of the work; or the acquisition, evaluation, or interpretation of knowledge for the work;

2. Drafting the work or revising it critically for necessary mental content material;

3. Remaining approval of the model to be printed;

4. Settlement to be accountable for all facets of the work in making certain that questions associated to the accuracy or integrity of any a part of the work are appropriately investigated and resolved.

Any would-be co-author needed to fulfil all 4 standards to be eligible, and the ultimate criterion specified accountability as an necessary element. With out accountability, a co-author may declare that any scientific misconduct that was subsequently found was not their duty, because it had concerned some facet of the research or the publication during which they’d not taken half. It additionally implied that even when there was a side of the work during which they weren’t professional or which they maybe couldn’t totally perceive, they’d ample confidence of their co-authors to simply accept duty for what these co-authors had finished or written.

The brand new suggestions additionally prolonged the scope for declaring potential conflicts of curiosity, inspired authors to pre-publish protocols describing proposed research designs and to make out there knowledge obtained throughout an interventional trial, and inspired the publication of the outcomes of a trial, whether or not the result was optimistic, impartial (i.e. missing statistical significance in both path), or unfavourable. In addition they advisable that editorial selections needs to be based mostly on “the relevance of a manuscript and its originality, high quality, and contribution to proof about necessary questions, and never on industrial pursuits, private relationships or agendas ….”

Since then the suggestions have been repeatedly reviewed and up to date.


The ICMJE’s suggestions have proved extremely influential in biomedical publishing and have performed an necessary half in encouraging publication of protocols prematurely of research; within the institution of trial registries and compliance with necessities for trial registration; in publicising potential conflicts of curiosity; in defining facets of publications that increase issues and could also be thought-about for retraction; and in defining the character of a peer reviewed journal. All these and different issues have been mentioned by Ed Huth and Kathleen Case in 2004 after the publication of the then most up-to-date model of the necessities.2

The introduction to the August 2013 New ICMJE Suggestions careworn that the institution of a standardised strategy within the preparation of manuscripts could be of assist to authors, however it’s not clear to what extent that hope was fulfilled. It’s in reality a lot simpler for authors to not must observe strict tips in regards to the preparation of a manuscript, besides maybe that when a paper is rejected by one journal it’s robotically prepared for submission to a different. Even then, if uniform requirements weren’t relevant authors wouldn’t must revise a manuscript every time they submitted it to a distinct journal. Certainly, there’s a case for permitting authors to submit a paper in any format they assume appropriate and to ask them to format it within the journal’s fashion solely after it has been accepted. The appearance of preprint servers has proven that publication in an author-driven format is suitable to the scientific group.16

Then again, uniform suggestions are more likely to be of assist to editors of journals, copy editors, and reviewers. Editors, for instance, will choose that papers submitted to their journals needs to be offered in uniform vogue, giving the journal an identification that’s recognisable by reviewers and helps to reinforce its popularity. Copy editors, in flip, won’t must go to nice lengths to make sure that all manuscripts are correctly ready for publication; the appearance of computerised submission programs has significantly contributed to their policing actions, because the laptop doesn’t enable an writer to submit a manuscript until all the necessities that the journal lays down have been fulfilled; after submission, authors might be pissed off by repeated requests from copy editors to take care of probably the most minor facets of presentation that aren’t lined by the pc. Common reviewers, to whom editors search for dependable judgments, may additionally choose to be offered with materials in a recognisable format, permitting them to formulate their judgments extra readily.

The uniform requirement/suggestions may additionally have inspired journals to focus extra on course of and magnificence reasonably than content material. The formatting of articles of particular varieties is outlined not, or not wholly, by material, however by size, variety of references, and limitations on the variety of tables or figures, though the subject might demand a distinct strategy. The journal might not have one other commonplace format underneath which the subject could also be appropriately lined, though the subject material is related to its pursuits.

Some research and a last thought

A particular instance additionally reveals how the Vancouver technique of quotation might have affected co-authorship. In an evaluation of articles from random volumes of eight biomedical journals, Epstein discovered that a lot of the journals confirmed a development in the direction of rising authorship numbers in the course of the research interval of 1982–92.17 Normal medical journals that printed articles with a median of six to seven authors per publication printed far fewer research with seven authors than six. Because the Vancouver system restricted quotation of greater than six authors at a time, he instructed that senior authors, whose identify sometimes comes final within the listing, would possibly choose six-author papers to seven-author ones.

A web-based survey of 1226 first authors of Cochrane critiques printed between October 2016 and December 2018, of whom 666 (54%) replied, confirmed that the prevalence of reward authorship was 41%; this was solely partly as a result of ignorance of the ICMJE’s authorship standards.18

In a research of 41 Cochrane critiques with group authorships (median 32, vary 6–91), 19 of which have been printed from 2015 to 2019, solely 39% met ICMJE’s first authorship criterion, 41% the second, and 12% the third; in solely two research did all of the authors meet all three standards.19

It could be of curiosity to see a scientific overview of the proof that displays the extent to which the necessities/suggestions laid down within the ICMJE paperwork have been efficient in altering publication practices in biomedical journals.


  • Competing pursuits: JKA’s profession, comparable to it’s, doesn’t rely on printed outputs or on the place of his identify in any listing of authors.

  • Provenance and peer overview: Not commissioned; not peer reviewed.