Susan M. Kaup, PhD, ISMPP CMPPTM; Michelle Daniels, MD, ISMPP CMPPTM; Brian Szente, PhD; inScience Communications, Springer Healthcare, Philadelphia, PA, USA

Several guidelines have been instrumental for implementing practices to fairly credit contributors to the development of medical/scientific manuscripts, including those individuals who frequently do not satisfy traditional authorship criteria (eg, statisticians, laboratory technicians, and professional medical writers). The implementation of a “contributorship model,” particularly to standardize the practice for disclosure of author involvement in a manuscript, has proven to be a reasonable approach to acknowledge authors’ roles and contributions. While the roles of some individuals are more easily characterized, there is a lack of consistency with the manner in which professional medical writers are acknowledged for their contributions, indicating a need for continued improvement and, ideally, the eventual adoption of standard language and formats.

A Historical Perspective of the Guidelines and Contributorship Models

In 2007, as an attempt to address the lack of uniform, standard language for crediting medical writer involvement in preparing journal articles, the International Society for Medical Publication Professionals (ISMPP) released a position statement endorsing the “contributorship model” for disclosing detailed information about all individuals, including medical writers, who contributed to a manuscript’s research, development, and/or publication.1,2 The ISMPP position statement described several specific tasks (eg, literature searches, preparation of figures and tables, and tracking author feedback) that a medical writer might perform for manuscript preparation.

Good Publication Practice (GPP) and professional medical writing guidelines also require the acknowledgment of professional medical writer contributions to the development of a medical and/or scientific publication.3,4 The most recent 2015 update to the GPP guidelines, GPP3 (,3 suggests acknowledging non-author contributions, such as those from a medical writer, by including the writer’s name, along with their company affiliation and disclosure of the specific task(s) performed by the writer (eg, drafting the manuscript), or by following the acknowledgment guidelines provided by the target journal.

Subsequently, a joint position statement pertaining to the role of professional medical writers was released in January 2017, by the American Medical Writers Association (AMWA), the European Medical Writers Association (EMWA), and ISMPP. This statement also provided guidance on acknowledging medical writing support (,5 indicating that such an acknowledgment should describe the type of support, information about the medical writer, and disclosure of financial sources. The following example was provided as a template for the disclosure statement:

“The authors thank [name and qualifications] of [company, city, country] for providing medical writing support/editorial support [specify and/or expand as appropriate], which was funded by [sponsor, city, country] in accordance with Good Publication Practice (GPP3) guidelines (”

The International Committee of Medical Journal Editors (ICMJE)6 and the World Association of Medical Editors (WAME)7 have also been instrumental in emphasizing the importance of contributorship policies to journal editors, with a particular emphasis on listing the specific details about authors’ contributions. The extent to which a contributorship model is implemented is at the discretion of an individual journal, thus resulting in some degree of variability in the level of transparency across journals.8

A related effort that merits mention is the Contributor Roles Taxonomy (CRediT) initiative ( for presenting contributor roles in research outputs. CRediT was developed following an International Workshop on Contributorship and Scholarly Attribution in 20129 and a subsequent 2013 survey10 evaluating a sample contributor role taxonomy in comparison to the traditional presentation of author and non-author acknowledgments. The concept behind CRediT is similar in principle to the guidance provided in the GPP3 guidelines and the AMWA–EMWA–ISMPP joint position statement, and presents a model that could be adapted and applied to medical writer acknowledgment.

Problems With Medical Writer Acknowledgment

While the acknowledgment of medical writer contributions is widely practiced, there is a lack of standardized guidance concerning the format and terminology for acknowledging the medical writer’s specific contributions. Medical writer acknowledgments often, but not always, include the name of the writer and their affiliated company; however, sometimes only the company’s name or the writer’s name is listed.8 An assessment of the literature in 2016 examined how well the format of medical writer acknowledgments reflected the suggestions put forth in GPP3 and the ISMPP “contributorship model.”8 In general, medical writers and their affiliated companies were well acknowledged, as were the sources of financial support. However, the specific contribution(s) of the writer was often unclear. The terms used most frequently to describe these contributions were very general and not particularly informative. Broad terms such as “editorial services” and “technical services” were used, as well as narrowly focused terms such as “development of first draft,” “collating comments,” or “formatting references.” Some of the most frequently used terms were “medical writing,” “medical writing or writing assistance/support,” “editorial assistance/support,” and “preparing the manuscript” (see Figure 1).

Figure 1. The Most Frequently Used Terms to Describe Medical Writer Contributions8

Conclusions and Suggestions for Improving Medical Writer Acknowledgment

Current medical writer acknowledgments in most publications still fall somewhat short of the proposed contributorship models. Typically, the role of the medical writer is described in broad, general terms, largely ignoring the AMWA–EMWA–ISMPP joint position statement’s guidance to “specify and/or expand as appropriate” regarding the particular tasks of the writer. What is missing is the use of consistent formalized terminology for medical writer acknowledgment that would more clearly identify the various roles and responsibilities of these individuals. This may require the development of a standardized lexicon, as has been done by some journals (eg, J Clin Oncol [] and Lancet Oncol []) for noting author contributions. A basic lexicon for formally characterizing medical writer contributions to manuscript development and preparation is presented in Table 1.

Table 1. Proposed Lexicon for Acknowledgment of Professional Medical Writing Services

Nevertheless, a key factor in the adoption of a standardized format for medical writer acknowledgment involves the practices of the medical and scientific journals themselves. Individual medical and scientific journals have well-established practices that are unique to every journal, and these practices are far from uniform. While some journals have moved toward a contributorship model for authors of medical publications, most do not yet require this. It is likely that practices for medical writer acknowledgment will be similarly variable and trail author contributorship practices on a journal-by-journal basis. This may be one of the key reasons why the practice of acknowledging medical writers using a “contributorship model” has not sufficiently progressed.

Given that organizations representing medical publication professionals (eg, ISMPP, AMWA, and EMWA) and medical journal editors (eg, ICMJE and WAME) have taken similar positions and achieved some level of consistency on medical writer acknowledgment, it may now be time to work toward a consensus on the implementation of a contributorship model to more fully acknowledge the contributions of professional medical writers.


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