You are a medical publication professional and have achieved acceptance of a manuscript into a top-tier journal after much discussion among authors and peer reviewers, resulting in several rewrites of the manuscript and its associated conclusions. You have now received page proofs for which comments need to be returned to the journal within 48 hours. The journal editor has made additional substantial changes to the authors’ approved text – not only for journal style, but also changing the meaning of many of the concluding statements. The authors do not agree to the changes and have complained that the journal’s actions breach ICMJE authorship criteria and Good Publication Practice.

What would you do?

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