In the year 1987, the International Committee of Medical Journal Editors (ICMJE) published recommendations to review best practices and ethical standards in the conduct and reporting of research and other material published in medical journals. The purpose of these guidelines was to help authors, editors, and other stakeholders involved in biomedical publishing to create and disseminate accurate and unbiased documents. The recommendations also serve to provide useful insights into the publication industry for patients, their families, and general readers.
Over the years, the recommendations have undergone multiple updates in accordance with the evolving publications industry norms. While the original guidelines were meant to provide a way of standardizing manuscript format and preparation across journals, the scope has now expanded well beyond standardization, prompting the renaming of these guidelines as “Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals” to better align with its broader scope.
The most recent updates of the ICMJE guidelines were released in January 2024. In this update, the main additions revolved around the use of artificial intelligence (AI) and natural language processing (NLP) tools in medical publishing. With the increasing use of AI in various fields, including the publication industry, it became an urgent need to address AI usage and provide guidance for its responsible use.
According to the 2024 updates on acknowledging AI use in writing, the guidelines now recommend that:
- The use of AI for writing should be reported in the acknowledgements section.
- The authors should also describe the use of AI in cover letter and in the main text, explaining in detail how the technology was used under appropriate heading. For example, if AI was used only for writing, it should be mentioned in the acknowledgements, if it was used for data collection or analysis, then it should be mentioned in the methods section, and so on.
- Essentially, authors who use AI technology should describe its use in sufficient detail and in such a way that replication of the task is possible by others.
Guidelines have also been added for reviewers and editors who may use AI to review or edit a manuscript on behalf of the journal. Key additions recommend that:
- The journal editors should be aware that use of AI can breach confidentiality since the document that they are handling is still unpublished. Therefore, it is recommended that journals include general guidance on AI use in their “Instruction to Authors” section.
- The reviewers should obtain permission from the journal to use AI during review. In the earlier version, simply disclosing the use of AI during review was sufficient and no permission was required.
Other than AI use, the 2024 updates also include changes to the following sections:
- Why authorship matters: In terms of including local researchers as authors, the update recommends that the journal editors should pay careful attention to investigators from low-income or middle-income countries, also called LMICs. Where applicable, LMIC investigators should be added as authors. This adds to the fairness of authorship and research reporting. Exclusion of local investigators as authors should prompt questioning by the editors and may lead to rejection of the manuscript.
- Carbon emissions in medical publishing: Since medical publishing also contributes to carbon emissions, which is a global planetary concern, guidance has also been included on this topic. The ICMJE recommends that editors, publishers, journal owners, and other stakeholders should work together to develop immediate strategies to reduce their carbon footprint, with a goal towards achieving net zero carbon emissions.
- Appropriate acknowledgement of funding support: Within a manuscript, the funding statement should include only direct support of the work described. General institutional support for an author’s time on the work should be distinguished from direct overall funding of the work. For example, an appropriate funding statement might be: “This study was funded by A; Dr. F’s time on the work was supported by B.”
- Protection of research participants: It has been suggested in the updated guidelines that not only should the authors seek approval to conduct research from the appropriate review board, but also be prepared to provide this documentation, when asked.
- Appropriate methods for citing references: Finally, the updated guidance encourages the writers to use published articles as references rather than the abstracts alone.
In summary, the new ICMJE updates embrace the use of AI, which will likely soon be a regular supportive tool in the publications industry.
