Happy (Green) New Year!

As hard as it is to believe, the holiday decorations have been taken down (or are fading), and new year's resolutions have been written (and hopefully not yet broken). If you don't have "Be More Green" on your list of resolutions, you should, and the December issue of the AMWA Journal is specially designed to help you keep that resolution.

A green theme runs throughout the current issue of the Journal, with a wealth of tips to help you save a bit of our environment while working more efficiently. Articles in the issue focus on how technology is helping to reduce those mounds of paper and to conserve other types of resources. Regulatory writing has seen this effect of technology, and the Regulatory Insights section describes the evolution from paper to electronic submission of regulatory documents.

Technology also brings us closer to each other, allowing us to work, network, and learn regardless of geographic distances. Telecommuting is an option offered by many employers these days, and Meredith Rogers, an "experienced" telecommuter, describes the joys (and woes) of telecommuting in a Practical Matters article. In the Social Media section, Cyndy Kryder relays stories of members who found success (ie, work!) through social networking sites, and elsewhere in the issue, David Caldwell describes how using podcasts can expand the reach of your chapter events. You haven't podcasted yet? Don't despair, a new AMWA Pocket Training on podcasting will be available this month.

Using less paper is perhaps the easiest way to be green. If you still use a hard copy résumé or CV and writing samples, take a look at Cheryl Lathrop's article on how to develop an electronic portfolio. Sharing your samples this way not only saves paper but also allows you to be creative in highlighting your experience or accomplishments.

To learn more about how to make your office paperless—or at least have less paper—check out the Freelance Forum, where our resident freelance experts talk about their versions of the paperless office. As medical writers, we often use a great deal of paper during research and source documentation. Why not read the reprinted article on creating a paperless office (thank you, International Journal of Clinical Practice), which provides advice on how to gather references and store them as electronic documents, helping to reduce the clutter in your office while saving trees. (If you're worried about how to use electronic files for source documentation, read Tim Peoples' article "An Electronic Method for Confirming Documentation," which was published in a previous issue of the Journal.)

You can learn more about being green and green initiatives by checking out the LinkedIn Groups and blogs noted in the Social Media section and the Web sites described in Web Wanderings. Also, in his summary of the (outstanding) 2011 AMWA Annual Conference, Steve Palmer lists several ways AMWA headquarters has gone green.

If you're already green enough, you still need to read the December issue because you will find additional valuable information. You'll find summaries of the invited lectures and several of the open sessions at the 2011 Annual Conference. (More summaries will be published in the March 2012 issue.) You can also read about AMWA members who were recognized with awards in 2011 and learn the steps to AMWA fellowship. The issue also features original research on the effect of editing on time to manuscript acceptance, and offers the debut of a new section—CME Rising. With the addition of this new section, the Journal now addresses the needs of the three greatest factions of AMWA membership: medical communicators in the regulatory, freelance, and continuing medical education settings.

Sadly, the December issue also marks the end of reign of our queen of medical word usage. Our Dear Edie column ends with thank you notes to Edie for more than 30 years of answering our grammar and usage questions. No words can convey our appreciation for her knowledge, humor, and commitment over the past decades.

If you need more inspiration for resolutions, review my list of new year's resolutions from last year. That blog post drew one of the biggest audiences, which can mean only one thing—medical communicators are dedicated to professional development! I'm pleased to report that I kept many of those resolutions in 2011—well, for varying lengths of time. I can definitely do better, and that's my resolution for 2012. My other resolutions for this year? To continue to improve the Journal during 2012, my last year at the helm (more on that in an upcoming post), and to post blog entries on a more regular schedule. I encourage you to make reading the Journal and the Journal blog one of your resolutions. Make that resolution greener by signing up to get the Journal online only.

Happy new year!

Our Spirit of Giving

AMWA's mission is education, but its spirit is giving. Our organization is one of the most volunteer-driven professional associations out there, with many members dedicating hours to AMWA at both the chapter and national levels. I always say—to anyone who will listen—that I have never met a group of people as generous as AMWA members. Our organization is full of people who give freely of their time and expertise to help other members, as evidenced by our chapter programs, networking events, and social media participation.

At no other time is our volunteer effort more profound—and visible—than during our annual conference. This year, about 200 AMWA members are lending their expertise as leaders of breakfast roundtable, workshops, open sessions, and coffee klatches. Many are volunteering time to be conference coaches, helping first-time attendees learn how to get the most out of the conference. Others are volunteering to report on the conference, contributing posts to the conference blog and more in-depth summaries to the AMWA Journal. It's the spirit of giving en masse.

I have the honor of being one of the local arrangement coordinators of this year's conference in Jacksonville, FL. In that capacity, I have been working with many local establishments to negotiate deals for AMWA attendees, and I'm happy to say that the community has responded! Among the benefits that conference attendees can enjoy include

• 50% off admission at the Museum of Science and History (check out The Body Within exhibit and the space film in the planetarium)
  
• 50% off admission at the Museum of Contemporary Art (works of art, plus Café Nola, a popular restaurant serving lunch and dinner)
  
• 10% off dinner at Bistro Aix (named Jacksonville's best restaurant)
  
• Free house wine, home brewed ale, or soft drink with the purchase of an entrée at River City Brewing restaurant (fun restaurant and bar across the river, with the best bar deck downtown)
  
• 10% off dinner at Vito's Italian Café (conveniently located at Jacksonville Landing)
  
• 10% off Jacksonville's water taxi (purchase your discounted tickets at the Florida Chapter table)
  

We thank these local merchants for supporting AMWA and its conference! If you're coming to Jacksonville, make sure to stop by the Florida Chapter table (in the Exhibit Area) to find out more about these discounts, as well as other local information—and surprises too! You can get additional local information with a Jacksonville app—a few are available in the App Store. The spirit of giving grows.

The Florida Chapter is also proud to announce a special drive to collect donations for Hubbard House, a Jacksonville shelter for victims of domestic violence. The shelter has general needs as well as special holiday food and gift needs. We encourage conference attendees to pack "a little something extra" to help make the days easier and brighter for these women and their children. You can drop off your contribution to the Florida Chapter table. We thank you in advance for being part of this spirit of giving.

Two Florida Chapter members you may see at our chapter table are 2010-2011 AMWA President Melanie Ross and Publications Administrator Donna Miceli. Our chapter thanks Melanie and Donna for their service over the past few years, helping to develop and implement AMWA initiatives that enhance our organization as well as our profession. I am honored to count them among my chapter colleagues and friends.

I would also like to take this opportunity to thank a group of people who give to AMWA throughout the year with their work on the AMWA Journal. Most readers of the Journal probably skip right past the inside cover. But on that inside cover are the names of more than 50 people who raise the quality of the Journal with each issue. I am immensely proud of the Journal but prouder still of the largely unheralded contributions of this talented and dedicated group of people. Thank you, my friends and colleagues.

You can thank Journal volunteers too by visiting the AMWA Journal table (in the Exhibit Area) at the conference. While you're there, ask these volunteers about what they do—it just may be something you'd like to do yourself! And be sure to take a few minutes to complete a short survey on what you'd like to see in the Journal. You give us a few minutes, and we'll give you an opportunity to win an AMA Style Manual, 10th ed. Stop by the AMWA Journal table for more details.

One last note. According to weather.com, the days of the conference promise to uphold the state name, offering sunny skies, with temperatures in the high 70s. Perfect weather. AMWA and Jacksonville…we just keep giving.

People Are Talking

The topic of certification certainly has people talking. The last blog entry drew the most attention of all entries to date, with the topic generating quite the buzz. As is true for any important issue, debate is healthy and consideration of all aspects will ultimately lead to better decision-making and outcomes.

Medical communicators are talking about more than certification—they're also talking about medical communication. The most recent evidence of this conversation includes an interview on BitesizeBio (brain food for biologists), in which Lauren Donaldson, PhD, describes her move from science to medical writing, and an article published in Nature, in which Laura Bonetta discusses a medical writing career. Medical writers on the other side of the ocean have contributed to the conversation, primarily through MedComms Networking, a UK-based site that offers short videos of medical communicators describing their careers and other "starting out" resources.

I love that people are talking about medical communication as a career because, let's face it, our profession needs more exposure. (How many times have you had to explain exactly what it is you do?) However, two things concern me.

First, many people talking about medical communication are not AMWA members, and I think this may skew the outside perception of our field. For example, in a videotaped panel discussion on science writing, one of five panelists (none of whom was an AMWA member), drew a distinction between "science writing" and "medical writing," noting that the latter "tends to be" writing regulatory documents. However, every type of "science" writing and editing discussed by the panel fell into the category of what we know as "medical writing." Pharmaceutical writing is also the focus of Donaldson's interview and the videos on the MedComms Networking; neither Donaldson nor the video presenters are AMWA members. In contrast, the Nature article includes information on various types of medical writing—probably because Bonetta spoke with several AMWA members in developing the article. (As a point of disclosure, I was one of the members quoted in the article.) We have to let people know that we are more than regulatory writers

The recent conversations on medical writing also included an article by one writer (not an AMWA member) who left the field because of authorship issues. Obviously, our profession is not presented at its best by articles declaring rampant authorship fraud. So, we also must let people know we are not g-writers! (AMWA members are loathe to spell out or say that dreaded word.) We should be talking about our ethical handling of authorship issues and the resources AMWA provides for such issues, primarily the AMWA Position Statement on the Contribution of Medical Writers, the AMWA Code of Ethics, and easy access to a host of publication and ethics guidelines and statements.

AMWA members should also be doing more of the talking because we know the value of AMWA's educational resources, particularly for those new to the field. If more AMWA members were engaged in the public conversation of our profession, people considering the field would not only better understand the various career options in the field but would also discover an organization that can help them enhance their professional skills and knowledge.

My second concern is the intended audience of these career descriptions. Most articles are directed at young scientists, with medical communication presented as a career alternative to a life at the bench. Targeting young scientists has a long history, and previous articles in magazines such as Science have extolled the virtues of our profession. What's wrong with this? Nothing in and of itself. But where are the articles targeted to people in nonscientific fields, such as writing, communication, mass media, English, and journalism? Where are the "starting out" videos for students who may be interested in applying their writing/communication education and skills to the field of medicine and health? Why is it always about attracting people in science who like to write rather than attracting people skilled at writing who may like the complexities and challenges of writing in the medical field?

Because of the paucity of articles directed at writing/communication professionals, I was thrilled when the Society for Technical Communication (STC) asked me last year to write an article about the medical communication profession for its member magazine. Together, I and Lili Fox Velez compared medical communication and technical communication as two branches of the same family tree, hoping to entice some technical communicators to venture out on our branch. It was the first time (to my knowledge), that another organization of communicators wanted to promote our specific profession. Similarly, the freelance writing community recognized our niche and interviewed AMWA member Cyndy Kryder about her life as a freelance medical writer, publishing the article on the FreelanceSwitch Web site. Kudos to Kryder for promoting AMWA as a valuable resource throughout the interview! But these two articles seem to be the exception, and for some reason, the writing/communication world has not presented medical writing as a career option to the same extent that the scientific community has. That means we must take it upon ourselves to promote our profession within the writing/communication world. And we should broaden the focus to encompass not only experienced writers but also writing students early in their education.

Why? Because our profession will benefit by having more people preparing for a career in medical communication rather than falling into it, as most of us have. Sure, the majority of us made successful career transitions, but just as we have benefitted from the expertise that scientists have brought from the bench, we will benefit from what writing/communication experts bring to the table. As Tom Lang has written, we create the most effective documents when we draw on the evidence base for writing and editing; ie, theories of composition, cognitive processing and learning, persuasion, publication design, visual perception, instructional design, Web design, memory, and so on. We need people with expertise in these areas in our profession.

AMWA has a variety of materials to promote itself, and they are valuable for both the nonscientific and the scientific community. One example is the AMWA Annual Conference Student Scholarship, and the subsequent success of scholarship recipients is a testimony to the value of conference attendance as a "starting out" resource. AMWA members also collaborated on a slide set that introduces medical writing as a career. I have used this slide set myself, as have others, to talk to research postdocs and students in pharmacology and other science-based programs. We need to use the slide set more often for students in writing/communication programs. The most recent AMWA effort is a compilation of AMWA Journal articles on the theme of exploring a career in medical communication. This compilation will be available as an e-book at the time of the annual conference. (You will hear more about it here when it's available.) We should ensure that this compilation is marketed to a broad audience in a variety of fields.

What can AMWA members do on the individual level? Volunteer for career day or a career exhibit at a local high school or university. Ask the faculty of university writing programs to consider a panel presentation on various careers in writing—and tell them you'd be happy to speak about medical communication. (You can use the AMWA slide presentation, after all.) Send flyers to colleges and universities about your chapter conferences and other regional events to give students an opportunity to learn about the field. Have copies of the AMWA Career Path brochure on hand for them. Most of all, just keep talking!

If you're not an AMWA member, why aren't you? Visit the AMWA Web site to see what you're missing, and join the conversation as an AMWA member.

Are We Certifiable?

Certification is a hot topic in all corners of the medical communication field. The concept of certification appeals to us for many reasons: it reflects skills and knowledge; it enhances credibility; it proves value; it may even command higher pay. Medical writers want certification to become a reality, but are we certifiable?

Beyond the personal advantages of certification, an objective measure of proficiency helps define a profession. According to most dictionary definitions, a profession is an occupation or vocation that requires mastery of a complex set of knowledge and skills that are gained through formal education and/or practical experience. Most of us, however, did not have formal education in medical writing, as that curriculum emerged only within the past decade. According to the AMWA 2010 membership survey, only 13% of us had formal education in English—a major you would expect for writers. The most popular formal education is biology/chemistry, with nearly one-third of members having this background. The lack of a universal core educational background leaves our profession to be defined most often by "practical experience."

The core problem is how to convey "mastery." I can say that I've been a medical writer/editor for more than 25 years, but does that necessarily mean I'm good? It would be easier for me to validate my abilities by saying "I'm a certified medical writer" than to rely on the testimonials of employers and clients. In the September Freelance Forum, devoted to the question of the value of certifications, long-time AMWA member Brian Bass notes that certifications "differentiate" medical writers. The ability to differentiate yourself is important in a time of tough competition among writers. A means to differentiate is also essential in a field in which any a person can one day declare "I'm a medical writer" without needing any documentation of formal education or a credential.

With no official credential available to us, some burgeoning medical writers may be tempted by the offerings of training companies that invite people to become "certified" in medical writing through educational programs of varying length and breadth of topics. Beware of these claims. You can only become "certified" if you successfully complete a credentialing examination. This means that we cannot call ourselves "certified" if we have completed an AMWA certificate program. The AMWA certificates certainly have value, as Kristina Wasson-Blader found in talking to many AMWA members, but we must not overstate ourselves. There is a tremendous difference between a certificate program and certification.

Although we cannot become certified in medical writing right now, we can add a veritable alphabet soup after our name by becoming certified in as many as six different medical communication niches:

• Editing (in life sciences): Board of Editors in the Life Sciences (BELS) certification
  
• Publications planning: Certified Medical Publications Planning (CMPP) certification
  
• Regulatory writing: Regulatory Affairs Certification (RAC)
  
• Continuing medical education: Certified CME Professional (CCMEP)
  
• Public relations: Accredited in Public Relations (APR) credential
  
• Grant writing: Grant Professional Certification (GPC) credential
  
  

The multiple choice questions on these certification exams address best practices and standards in fields broader than medical writing/editing, and an actual writing or editing component is lacking in most of these exams. (Only the grant writing certification exam includes a writing component.) Even the certification program recently developed by the Society for Technical Communication (STC) does not have a writing component. Completing an "editing exercise" is, however, part of that application process. It seems necessary (to me, anyway), that a medical writing certification process actually include a writing component. Yes, we should know best practices, standards, and ethics, but the bottom line is that employers and clients want to know if we can write well.

The availability of these various credentials is clearly not sufficient for many AMWA members, as evidenced by the 2010 member survey. Nearly two-thirds of us answered "yes" to the question "Is professional certification with a competency examination desirable for the medical communication profession?"

As the umbrella organization for all medical communicators, AMWA is best suited to develop a certification process specific to medical writing.
And our association has stepped up to the challenge and is committed to making us all certifiable. The September issue of the AMWA Journal features a discussion of medical writing certification, and the article (which has been granted public access) outlines AMWA's efforts to date and the challenges of developing a certification process that best measures the knowledge and skills of a medical writer.

The first step in developing any certification process is to define the competencies needed for the profession. That step has been made, but down only one medical writing pathway. As published in the June issue of the Journal, a special interest group in the Drug Information Association (DIA) developed a competency model to describe the work functions, activities, knowledge, skills, and behaviors deemed necessary to perform successfully as a medical writer in the pharmaceutical industry. Despite being relevant only to regulatory writers, many attributes in the model could be applied more universally, which could make the model a starting point for defining competency more broadly. However, the broad approach has its problems. As Tom Lang notes in this month's featured discussion, a "one-size-fits-all" exam may not be the best tool to assess medical writing competency because of the wide variety of tasks performed by medical writers and editors in a range of settings.

The challenges are clear. How do you develop a certification process that is both broad and specific? Can we assess skills essential for medical writing in all areas without the questions being too basic? Can we establish objective measures for something as subjective as a writing sample or portfolio? Can we address our diversity through eligibility criteria or through a core exam, with additional exam "modules" based on specialty area?

These are just some of the many issues AMWA is tackling in the early stages of exploring certification in medical communication. AMWA is consulting with experts both within our ranks and in other organizations to find solutions. And we are lucky to now have the expertise of Susan Krug, who joined AMWA to replace Donna Munari as Executive Director when Donna retires in October. Susan has worked with other organizations that have developed a certification program and is eager to help us achieve our goal of becoming certifiable.

Until that goal is reached, we must rely on our writing to speak for itself.

What Do YOU Make?

Salary is usually a taboo topic. No one wants to let others know what he or she makes. But admit it, you want to know what other people make, don't you? Well, you have to give a little to get a little, so open up and participate in the 2011 AMWA Salary Survey. In the end, you'll know what your colleagues make, yet your information will remain anonymous. It's a win-win, if you ask me.

How exactly do you benefit by participating in AMWA's effort to collect data on salaries? In a nutshell, AMWA is the largest organization of medical writers, which makes the results of our survey the best representation of what medical writers and editors actually earn.

Having an accurate account of what medical communicators earn is important no matter where you are in your career. If you are looking for a job, knowing the true industry standard will arm you with the ammunition to negotiate a fair salary. The same goes for those of you preparing for an annual review as well as freelances deciding whether to accept a client's offer. If you're thinking about jumping ship to try another, less stressful career, you can compare the industry standards for medical writing and quiltmaking (for example). If you're a hiring manager, you can use salary survey data for salary benchmarking to make sure you're paying your employees fairly. If you're solidly employed, you should know your market value. So, every one of us has a reason to take part in the survey!

If you need further evidence for participating, you should know that other sources of salary data can't compete with the AMWA Salary Survey in terms of value. Often, the discrepancy is related to the lack of an appropriate job definition. For example, the US Department of Labor doesn't have "medical writing" as a job classification; the closest job is "technical writer." It seems as though medical writers could be found in the sub-industries of "Management, Scientific and Technical Consulting Services" or "Scientific Research and Development," which happen to be two of the four sub-industries with the highest levels of employment of technical writers. According to US Labor statistics from 2010, the mean annual wages for these two sub-industries were $67,400 and $66,140, respectively. These wages are far lower than the majority of wages reported 3 years ago in the 2007 AMWA Salary Survey. The lowest AMWA survey-reported mean salary was $68,769, which was for women with no more than an associate's degree. (Don't get me started on the gender differences in salary!) Most of us have more education than this, and reported wages ranged from $73,522 to $101,872 for bachelor's degree up to advanced degree.

Are other sources of salary data better than the US Department of Labor? There's salaryexpert.com, but that name seems to be a misnomer, given that the site reports US national averages for "medical technical writer" in 10 states, with a range of $34,208 (Phoenix, AZ) to $52,148 (New York, NY). What??

You'll find higher salaries at salary.com, where you can search salaries according to state. There is a listing for "medical writer" with levels of I, II, and III, and the description indicates a position in the pharma/biotech industry. The median salaries (for a Boston location) listed on the site are $62,475; $65,410; and $82,663 for the three levels. These compare with medians of $93,000 (pharma) and $94,500 (biotech) reported in the 2007 AMWA survey. Not only that, but the pharma/biotech industry typically offers the highest wages, which means salaries in other medical communication settings would be lower than those reported on salary.com. Only one of the 14 settings in the 2007 AMWA survey had a mean salary lower than $62,475 (publishing, including journalism: $58,692).

Then there is payscale.com, which bills itself as a "leader in online compensation information." On that site, the "typical" salary for a "medical writer" is $81,602, which is a bit closer to many of the AMWA survey-reported wages in 2007. But the "high" salary ($96,494) is lower than most salaries in the 90th percentile in the 2007 AMWA survey.

Only one of our sister organizations provides data on salaries, and that's the Society for Technical Communication (STC). The findings of the STC surveys are not publicly available (you must purchase the STC salary database). The Editorial Freelancers Association (EFA) offers guidelines on hourly rates for a range of editorial services but no data on annual salaries. This information is of limited benefit; although you can easily multiply the hourly rate of $50-$100 to get a annual salary of $104,000-$208,000, that salary does not take into account nonbillable hours and overhead and applies only to freelance writers and editors (in all specialty areas). You can, however, compare the rate with the mean hourly rate for full-time freelances in the 2007 AMWA survey: $90. At last, a match! (The topic of hourly vs. project-based rates is one for another blog post.)

It should be clear to you by now that other sources offer poor representations of what we really earn. Would you want the information from one of these sources if you were seeking a new job, preparing to ask for a raise, or just wanting to feel good about your work? Without a doubt, the AMWA Survey paints a brighter picture of our worth.

The AMWA Salary Survey also paints a more detailed picture, with salaries broken down by many variables (geographic area, employment level, years of experience, employment setting, job category [writing, editing, supervising] etc.). Plus, a nifty formula lets you start with a base salary and then add specific dollar amounts according to your employment setting, years of experience, educational level, and gender. (Do you know that if you're a man, you get to add nearly $9,000 to the base salary?? I told you not to get me started!) So, in addition to all the other benefits already mentioned, the AMWA survey data can help you decide if the money really is greener in a medical education company than in an association/professional society (about 8,500 shades greener) or if an advanced degree is worth the investment (you can add nearly $28,000 to your base annual salary according to the 2007 formula—take that, men!).

I don't need to tell you that the more of you who participate in the survey, the more representative the data are of our field. In 2007, just under one third of AMWA's members participated, but 47% of members answered the 1994 survey, so let's think big and try to break that record. This means I'm counting on around 2,600 of you to take the survey. Don't let me down.

The survey is easy and takes about 10 minutes to complete. So grab last year's tax form and log onto the survey. Act fast—the last day of the survey is Wednesday, May 25. If you still need motivation, participants can enter a drawing to win one of three great prizes. But the real prize is the survey results, which will bring you a wealth of information about your worth.

Note: The results of the 2011 Salary Survey will be published in an upcoming issue of the AMWA Journal.

New Guidelines Related to Ethical Misconduct

Following up on the last post, new guidelines on investigating claims of ethical misconduct in journal publishing are now available. The International Society of Managing & Technical Editors (ISMTE) is offering its newly released "Publishing Ethics 101: A Guide for the Editorial Office" for free but you should act fast, because the resource is freely available for only 30 days (from today, April 26, 2011). The guide describes different types of publishing misconduct, presents the basics of a solid ethics policy, and outlines steps for correcting literature associated with verified misconduct. One appendix to the guide includes examples of policies and procedures from such associations/journals as the American Statistical Association, Gastroenterology, The Endocrine Society Ethical Guidelines, The Journal of Biological Chemistry, and The New England Journal of Medicine. A second appendix provides examples of letters used in investigating and resolving claims of misconduct.

Don't miss out on the opportunity to obtain this resource. After the 30-day free period, the guide will be available only to ISMTE members.

While we're on the subject of ethics, remember that AMWA has its own Code of Ethics, and all AMWA members (and all medical communicators) should be familiar with the code's eight principles, as well as with the AMWA Position Statement on the Contributions of Medical Writers to Scientific Publications. You can also learn more about ethical situations and decision-making in various medical communication settings at the 2011 AMWA Annual Conference, which features five workshops on ethics. The AMWA Annual Conference will be held October 20-22, in Jacksonville, FL.

Beware the Retraction

The MMR vaccine is linked to autism.
Embryonic stem cell lines can be established from cloned human embryos. These are just two claims made in articles—published in prestigious medical journals—that were retracted from the scientific literature, but not before they had a substantial impact in the scientific community and beyond. Consider that the 1998 Lancet article linking the MMR vaccine to autism led to a worldwide campaign against vaccination. The rate of MMR vaccination in the United States alone dropped from 93% to 79%, and the number of mumps cases increased 21-fold from 2005 to 2006.

Not all retractions have such widespread effect. Still, many people accept scientific data or interpretations as valid before fraud is recognized. In listing the top 10 retractions of 2010, The Scientist noted that four articles were cited 200-300 times and the MMR vaccine-autism article was cited 640 times before it was retracted by The Lancet in 2010. Even more astonishing is the finding by Redman et al that 325 retracted articles were cited 3,942 times before retraction and 4,501 times after retraction!

An exploration of some "striking trends" in retractions is the lead feature article in the March issue of the AMWA Journal. The author of the article, R. Grant Steen, found that 788 scientific articles were retracted in the past decade. Steen has been busy in his pursuit of gaining a better understanding of retractions. His AMWA Journal article is one of four that have been published since November 2010. In the first of these articles, he reported that more than half of fraudulent articles were written by a first author who had written other retracted articles; in
the second, he noted an increase in the level of retractions since 2000 (which may, he says, be either a real increase in misconduct or the result of greater efforts to police the literature); and in the third article, he noted that error is a more common reason for retraction than fraud.

    Steen has found that most retractions (nearly three-quarters) were errors (mistakes, duplicate publication, plagiarism, etc) and that the remaining quarter or so of retractions were considered fraud—either data fabrication (15%) or falsification (13%). When Elizabeth Wager and Peter Williams, members of the UK-based Committee on Publication Ethics (COPE), analyzed 312 of 529 retractions in PubMed (from 1988 to 2008), they found data fabrication and falsification to be the least common reasons (5% and 4%, respectively) for retractions, with "honest research errors" as the most common reason (28%). Wager and Williams reported these findings at the 2009 Peer Review Congress.

It is difficult to know the actual reasons for retraction because most journals do not indicate a reason, according to a news article in the March issue of the Canadian Medical Association Journal. This is despite guidance from the International Committee of Medical Journal Editors (ICMJE) stating, "The text of the retraction should explain why the article is being retracted and include a complete citation reference to that article."

Regardless of the reasons for retractions, the big question is how to identify articles that should be retracted. Some point to the need for improved peer review, but most disagree with this as a solution. In an examination of the peer review process in a 1995 AMWA Journal article, Kendall Wills Sterling wrote that while the peer review process needs improvement, the process is unable to detect falsified data (or plagiarism). Similarly, in his 2006 Swanberg Address, Dale Hammerschmidt, MD, FACP, said, "…peer review was not introduced with the idea of detecting and preventing fraud, and peer reviewers are not now given that task by journals."

Whose job is it, then? The ICMJE guidance notes that if there is "substantial doubt" about the honesty or integrity of a manuscript (either submitted or published), it is the editor's responsibility "to ensure that the question is appropriately pursued, usually by the authors' sponsoring institution." Journal editors can find additional resources on dealing with suspected misconduct from the US Office of Research Integrity, which offers "Managing Allegations of Scientific Misconduct," and COPE, which has developed 17 flowcharts for handling suspected cases. In his AMWA Journal article, Steen notes that all stakeholders—first authors, coauthors, editors, referees, and peers—must share responsibility for maintaining scientific integrity.

The good news in all of this (I always look for that silver lining) is that medical writers seem to be far from the madding crowd of retractions. In her Keynote Address at the 2009 AMWA Annual Conference, Karen Wooley, PhD, noted that her research (also presented at the 2009 Peer Review Congress) showed that very few retracted articles had declared medical writing and industry support or declared medical writing support alone. Although the significance of this finding is uncertain because of the overall low rate of declared medical writing support, it is interesting that almost all of the retractions were articles with no declared industry funding—articles that have been criticized much less than those with industry support.

    You can keep up with retractions by following Retraction Watch, a blog written by Adam Marcus (Managing Editor of Anesthesiology News) and Ivan Oransky, MD (Executive Editor of Reuters Health). Dr. Oransky, along with Liz Wager and editors of prominent medical journals, will speak at "What Can Editors Do to Deter and Detect Scientific Misconduct?" a session at the 2011 annual meeting of the Council of Science Editors (CSE). If you're attending the CSE meeting, your report on this session would be a valuable asset to the AMWA Journal. Contact the Journal Editor at amwajournaleditor@editorialrx.com for more information.