KEY TAKEAWAYS

• US government executive orders targeting EDI programmes are prompting federally funded journals to censor demographic data and equity-focused language.
• Authors and editors are pushing back to ensure data are made available and to maintain the integrity of the scientific record.

Following US government executive orders to end federal equity, diversity, and inclusion (EDI) programmes and to only recognise two sexes, The BMJ has emphasised the importance of retaining sex and gender data in published research. In an article in Undark, Peter Andrey Smith highlights another example of the scientific community pushing back against federal pressure to remove EDI-related data.

Authors make a stand

Smith describes the case of anthropologist Tamar Antin and co-authors, who faced an unusual request from the federally funded journal Public Health Reports following acceptance of their paper on tobacco use. The editors requested removal of the word “equitably” and demographic data, citing compliance with executive orders. Rather than grant the request, Antin and co-authors withdrew their paper entirely and went public. This “act of defiance” was met with widespread support from the scientific community, who argued that removing demographic data doesn’t just affect one paper’s conclusions – it hampers future studies by denying other scientists the opportunity to reanalyse findings or build on existing research.

“Removing demographic data doesn’t just affect one paper’s conclusions – it hampers future studies by denying other scientists the opportunity to reanalyse findings or build on existing research.”

The bigger picture

Smith also shares examples of federally funded researchers requesting:

• withdrawal
• removal of authors from bylines
• specific wording changes

to accepted papers, citing the political landscape. While this affects a minority of submissions directly, maintaining the integrity of the scientific record is paramount.

Looking ahead, the Committee on Publication Ethics’ position statement emphasises that publishing decisions and language choices should not be influenced by politics or government policies, and there is no place for retractions to censor the scientific record.

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KEY TAKEAWAYS

• Visuals are an important tool in science communication, particularly for making complex information easier to understand.
• Visuals should be incorporated in storytelling from the start and designed for impact, inclusivity, and accessibility.

Effective use of visuals is a powerful tool in scientific storytelling: the subject of an article by Madhukara Kekulandara. Kekulandara (National Association of Science Writers) reported on a ScienceWriters2024 workshop where panellists Rachel Ehrenberg (Knowable Magazine), Jen Christiansen (Scientific American), and Beth Rakouskas (Science magazine) looked at benefits and potential pitfalls with visuals in scientific publishing.

The panellists discussed several key uses of visuals:

• acting as an “invitation” to a story
• driving the scientific narrative
• communicating complex ideas, sometimes through visuals that “function independently of the text”.

Opportunities to incorporate graphics should be identified early in the development process, with clear objectives set for each visual.

The panel raised potential challenges with using visuals in storytelling:

• Inclusivity of images: Ethical concerns arise when using sensitive images. Care must be taken to ensure inclusivity for under-represented groups whilst avoiding stereotypes. Engaging impacted communities in the process can be beneficial.
• Accessibility of visuals: Inclusion of effective alt text is crucial for visually impaired or blind readers.
• Engagement in the digital era: Interactive graphics or short-form videos can be particularly impactful in this digital age. Graphics should also be adjusted for viewing on smaller screens.
• Leveraging AI: The panellists recognised AI’s potential in visual creation, but warned against it substituting human creativity, as it “can perpetuate biases and stifle creative problem-solving”.

“AI should be viewed as an additional collaborator in developing engaging and informative visuals, working alongside writers and designers.”

There is no doubt that visuals can transform storytelling. Looking to the future, the panellists urged that AI should be viewed as an additional collaborator in developing engaging and informative visuals, working alongside writers and designers – not replacing them.

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KEY TAKEAWAYS

• A recent instruction from the Trump administration ordered CDC scientists to withdraw articles from scientific journals that include “forbidden terms” related to gender.
• BMJ editors urge other journals to maintain the integrity of scientific research by resisting “bow[ing] to political or ideological censorship”.

A recent instruction from the Trump administration directed US Centers for Disease Control and Prevention (CDC) scientists to withdraw or retract any submitted (but not yet published) articles that include “forbidden terms” such as gender, transgender, LGBT, or transsexual. In an opinion article published in The BMJ, Jocalyn Clark (International Editor) and Kamran Abbasi (Editor-in-Chief) warn of the dangers of blocking important medical information from publication.

Censoring sex and gender in published research

Clark and Abbasi explain that sex and gender data are critical for understanding differences among populations and individuals from outcome and experience perspectives. The authors emphasise that blocking gender-related data is not only harmful for patients, but compromises the integrity of scientific research as a whole. They believe that attempting to censor these data is a political maneuver based on “anti-gender ideology” and “a return to fundamentalist values”, in line with the recent disappearance of other politically charged content on topics like immunisation and contraception from CDC websites and datasets.

“Blocking gender-related data is not only harmful for patients, but compromises the integrity of scientific research as a whole.”

Violation of publication ethics

Clark and Abbasi highlight several ways in which the instruction breaches publication ethics:

• Being at odds with the reporting standards adhered to by medical journals, such as the Sex and Gender Equity in Research (SAGER) guidelines.
• Conflicting with authorship criteria, which not only ensure that authors are credited for their work, but are accountable for it. Removing an author who qualifies for authorship, even at their own request, constitutes ghost writing.
• “Muzzling” important medical data. Although authors are within their rights to withdraw submitted papers from a given journal prior to publication, the data should still be published.

The authors call upon journal editors to resist the instruction on the grounds that they have a “duty to stand for integrity and equity”, which supersedes any “political or ideological censorship”.

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KEY TAKEAWAYS

• North America, Europe, and Oceania are global leaders for the output of high-quality AI-powered life science research.
• International collaboration may be key to unlocking AI’s full potential.

The use of artificial intelligence (AI) in life science research is rising exponentially, from aiding drug development to assisting in the publication process. However, geographical imbalances in AI use could lead to biased models and implications for medical care.

Geographical variation

In an article for Nature Communications, Dr Leo Schmallenbach and colleagues evaluated the geographical spread of AI-related life science research. Their analysis revealed geographical differences in the quantity, quality, and relevance of AI-related life science research. 

• Quantity: The USA and China published the largest share of research, while countries in Africa and Latin America lagged behind. In 2020, China surpassed the USA to lead the world in the number of AI-related life science publications per year, making Asia the continent with the largest cumulative output.
• Quality: Northern America, Europe, and Oceania had a greater proportion of research published in high-ranking journals than Asia, Latin America, and Africa.
• Relevance: Publications from Oceania, Europe, and Northern America were more frequently cited in life science and clinical research articles than those from Asia.

“Analysis revealed geographical differences in the quantity, quality, and relevance of AI-related life science research.”

International collaboration is key to success

The authors also compared research stemming from national versus international collaborations, with international collaborations defined as articles with authorship across 2 or more countries. International research collaborations were 35% more likely to be published in high-ranking journals and received 21% more citations in life science articles.

Speaking to Global Health Otherwise, Dr Schmallenbach concluded that “international collaboration is critical to unlocking the full potential of AI in healthcare” and called for policies encouraging more international partnerships.

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KEY TAKEAWAYS

• From January 2025, The BMJ is offering £50 or a 12-month online subscription to a BMJ journal for patients and members of the public who review an article.
• The BMJ hopes the policy will help to expand and diversify participation from its patient and public reviewers.

Patients, advocates, and public reviewers play an important role in the reporting of medical research by offering their lived experiences and perspectives. Starting from January 2025, The BMJ is complementing the 12-month BMJ online subscription given to all reviewers, adding £50 or a 12-month online subscription to any BMJ journal for patient and public reviewers.

The BMJ introduced patient and public reviews in 2014 and have accumulated over 2,600 patient and public reviews across various article types. These help to evaluate:

• the relevance and importance of research questions
• the appropriateness of outcome measures
• how patient and public involvement is reported.

The new BMJ policy aligns with National Institute for Health and Care Research (NIHR) guidelines on payments for public involvement in research and aims to:

• compensate the time and effort of patient and public reviewers
• expand and diversify patient reviewer participation.

Expanding representation in patient and public reviews

While The BMJ has over 1,000 engaged patient and public reviewers from over 20 countries, most reviews in the past decade were conducted by women based in the UK and US. The experiences of patient reviewers for The BMJ are positive, and their feedback has helped develop further guidance and training. Feedback from current reviewers and an international patient and public advisory panel also underpins the latest change in compensation.

The BMJ hopes that remuneration will diversify participation in reviews and increase representation.

The BMJ hopes that remuneration will diversify participation in reviews and increase representation across:

• geographic locations
• ethnicities
• genders
• areas of lived patient experiences.

How will this change the future of peer review?

The BMJ announcement acknowledges the value of patient perspectives in medical research, sitting alongside other initiatives to amplify patient engagement in scientific publications and address barriers to participation. However, broader discussions persist around whether clinical peer reviewers should be compensated and how to sustainably improve the peer review process while maintaining quality and integrity. The BMJ plan to monitor the impact of the new policy – we look forward to reading their updates.

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The 21^st Annual Meeting of ISMPP takes place May 12 – May 14 at the Grand Hyatt in Washington, D.C.

 REGISTER TODAY!
Registration is open until April 25, 2025

The theme for ISMPP’s milestone 21^st Annual Meeting is Diversity and Innovation: In Concert. This meeting gathers diverse professionals to inspire creativity, foster innovation, and advance medical communications for a more inclusive and dynamic future.

Don’t miss the premier medical communications and medical publications conference of 2025!

Topics covered include:

• Artificial Intelligence
• Omnichannel
• Plain Language Summaries
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• Publication Planning
• Digital Extenders
• Metrics and Analytics

9 Educational Workshop Offerings – 4 NEW Topics this Year! For both newer professionals and experienced professionals. Spaces are limited so sign up today!

Keynote Speakers, Member Research Posters/Oral Presentations, Exhibitors, Receptions, Networking, Awards, and more!

Company Team Discount/Champion Sponsorship for 10 Team Members or More!

Please contact exh-spon@ismpp.org for a discount code.

VIEW the meeting agenda. REGISTER TODAY!
Learn about ISMPP at: www.ismpp.org

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KEY TAKEAWAYS

• In late 2024, the Declaration of Helsinki underwent its most radical update in 60 years, including a revision to protect healthy volunteers.
• However, critics suggest there is still a way to go and that other aspects of research ethics need to be incorporated, such as how to ensure the benefits of clinical research are felt by trial participants and their communities. 

The World Medical Association (WMA) recently updated a key ethical framework, the Declaration of Helsinki, at a scale not seen since the Declaration’s inception in 1964. As reported by Cathleen O’Grady in Science, the WMA hope that the changes will help to drive new standards in research equity.

“Humans”, not “subjects”, and the importance of healthy volunteers

As outlined by O’Grady, the 2024 revisions, which mark the tenth time the document has been updated, struck a new tone, with the Declaration’s title now referring to “human participants” rather than “human subjects”. The revisions, published in JAMA with accompanying editorial, also include the first ever mention of healthy volunteers, rather than considering only patient participants in research.

The 2024 revisions, which mark the tenth time the document has been updated, struck a new tone, with the Declaration’s title now referring to “human participants” rather than “human subjects”.

Expanded scope

These important steps forward are not the only signs of the Declaration’s expanded scope and ambition. Other changes include:

• a direction that all those involved in medical research should adopt the Declaration’s principles, not just doctors.
• a focus on ensuring vulnerable groups are included in medical research. Previous guidance aimed at protecting groups such as pregnant people inadvertently led to their exclusion from clinical trials. The revised Declaration notes that this can exacerbate disparities and that the harms of exclusion and inclusion should both be considered.

Radical, but complete?

The WMA General Assembly unanimously supported the 2024 update, which Dr Ashok Philip, President of the WMA, described as a “landmark revision”. However, as reported by O’Grady, some feel the revisions should have gone even further and that there are still key omissions, namely:

• Benefits for participants and the wider community: the update does not look at ways to ensure that trial participants and their communities benefit from research.
• Other types of research: the Declaration’s focus remains medical research, with epidemiological and behavioural studies not yet covered.
• Data protection: the use of data from insurance or pharmaceutical company databases in research, and related issues of informed consent, are not discussed.

Nevertheless, the Declaration of Helsinki remains a cornerstone of ethical conduct in medical research, and the latest revisions provide an important focus on the dignity of research participants. Chair of the revision workgroup, Dr Jack Resneck Jr, calls on all involved in medical research to uphold these renewed principles.

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KEY TAKEAWAYS

• Free-to-publish, free-to-read diamond OA may improve equity in publication opportunities, but uptake may be held back as authors are attracted to non-diamond journals with an established reputation.
• Questions remain around whether diamond OA will reduce the costs of publishing overall.

Open access (OA) is key to making research more accessible, with gold OA ever-growing: it accounted for 42% of Web of Science-indexed publications in 2023. In a recent article in Research Professional News, published by Clarivate, Ulrich Herb and Benedikt Schmal highlight that gold OA is no stranger to scrutiny. Article processing charges (APCs) can pose equity issues, and transformative agreements have not shifted the OA landscape as hoped. Diamond OA, providing both free-to-publish and free-to-read articles, has been hailed as a solution by funders, libraries, and OA advocates; however, it may not provide a complete fix.

Money, money, money

Herb and Schmal debate whether, on balance, diamond OA will lower the costs of publishing compared with the current landscape. They note that journals have many costs, including:

• managing peer review, editing, and quality control
• operational infrastructure
• indexing and archiving
• training and capacity building
• marketing and outreach.

Despite this long list, Herb and Schmal suggest that many assume large commercial publishers and non-profit outfits have the same costs. Think again. Diamond OA publishers are unlikely to replicate economies of scale at larger publishers, so face higher costs. By their nature, non-profit publishers also lack motivations to reduce costs to widen profit margins.

Is reputation everything?

Diamond OA levels the financial playing field for authors, but Herb and Schmal ask whether this will truly provide equity. With reputation often a key factor in journal selection, the authors question whether there is sufficient appetite for new diamond OA journals: these would need to compete with established rivals to build their reputation and gain broader appeal.

Diamond OA levels the financial playing field for authors, but Herb and Schmal ask whether this will truly provide equity.

Herb and Schmal push for a pragmatic assessment of diamond OA models to establish their viability and sustainability – or note that OA advocates once again risk disappointment.

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KEY TAKEAWAYS

• OA publishing can place financial stress on authors, but avenues like publisher discounts can offset costs and improve equity.
• Immediate OA mandates for US federally funded research challenge publishing models and author’s control over their work.

Debate continues following the 2022 White House directive mandating immediate open access (OA) for all US federally funded research by the end of 2025. While OA publication has many virtues, including improving access to research and citation diversity, some issues are far from resolved.

Are OA fees prohibitive for authors?

Challenges for OA publication include inequitable opportunities and inconsistent benefits to visibility in the scientific space. In a recent Career Feature article in Nature, Nikki Forrester builds on reports of prohibitive article processing charges, particularly for authors in low- and middle-income countries. Forrester shares advice on offsetting OA costs from experienced researchers, such as:

• seeking support from co-authors, funders, or institutions
• taking advantage of scientific society grants (eg, in partnership with Research4Life)
• utilising publisher fee waivers and discounts, where available.

How will OA mandates affect publishers?

Scientific publishing models rely on payment from authors and subscriptions, and are threatened by immediate OA, notes Kathryn Palmer for Inside Higher Ed: the 2022 directive will require embargo-free deposition of publications in designated, publicly accessible repositories.

Further, some libraries have pushed for use of the federal purpose licence for federally funded work—allowing free publication and reproduction—to simplify processes for authors. US Congress and publishing associations are concerned this move would limit authors’ control, with broad OA licences permitting reproduction, modification, and commercialisation. Given the federal purpose licence is non-exclusive, author and library bodies have rebuffed some copyright-related concerns, simply seeing a “business model conflict” for publishers who held exclusive copyright for articles published under subscription models.

Given the federal purpose licence is non-exclusive, author and library bodies have rebuffed some copyright-related concerns, simply seeing a “business model conflict” for publishers.

In any case, Palmer notes that publishers will face difficult decisions as the OA landscape continues to shift.

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KEY TAKEAWAYS

• Researchers in less affluent countries report challenges getting APC discounts or waivers, posing barriers to OA publication.
• Tiered pricing and alternative funding models have been suggested to improve global equity in access to OA publication.

As scientific publishing shifts to open access (OA) models, authors—particularly in less affluent countries—face challenges paying article processing charges (APCs). A recent news feature in Science by Jeffrey Brainard highlights growing concerns about equity in OA.

Free to read, not free to publish

With ~50% of scientific papers now published under author-pays OA, 2023 saw gold and hybrid OA revenue triple for 6 large publishers versus 2019. This excludes potential reductions from discounts and waivers, relied on by many authors from low- and lower middle-income countries to publish OA. However, processes to obtain discounts or waivers can be complex, and they may not be offered by hybrid journals (who offer free, but paywalled, publication).

APCs can put financial strain on researchers worldwide when grant funding does not cover the fees: some even resort to paying from their own pocket. Brainard notes that when considering journal options likely to aid career advancement, authors in developed countries often prioritise journal reputation—one factor linked to higher APCs—over APC affordability. However, this may not be an option for scientists in developing regions. In the words of one researcher from Brazil, unaffordable APCs risk science from the Global South becoming “nonexistent”, perpetuating global disparities.

Unaffordable APCs risk science from the Global South becoming “nonexistent”, perpetuating global disparities.

Proposed solutions

Making journal articles both free to read and affordable to publish is challenging, but publishers are exploring alternatives to author-paid APCs. Potential solutions include:

• transformative agreements with institutions, allowing affiliated researchers to publish without paying APCs (and access paywalled content)
• tiered pricing based on a country’s wealth and purchasing power. While this would reduce APCs for many countries, costs would increase in wealthier nations if publishers offset lost revenue
• diamond OA, with government or philanthropic funding eliminating individual APCs. Brainard notes this has boosted OA publishing in some regions already, but absent impact factors for many journals can reduce the appeal.

Brainard highlights that OA publishing is actively changing: cOAlition S, Elsevier, and Springer Nature have introduced tiered pricing initiatives this year. We look forward to seeing how the OA landscape continues to evolve.

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