To the Editor Drs Mentzelopoulos and Zakynthinos outlined the goals for maintaining the academic integrity of research in a Viewpoint.1 However, the current structure of promotions in most academic settings discourages rather than promotes collaboration. This current structure is not good for clinical research, as it perpetuates, rather than helps to resolve, the continuing problem that the majority of clinical trials are relatively small, single-site studies2 that may be underpowered and of questionable significance and potential to advance medicine. In clinical research involving human participants, high statistical variability is frequently seen. Thus, high-quality, meaningful research usually means large sample sizes. Except in rare cases, this requires collaboration among large groups of researchers. Under the present criteria for academic promotion at many universities, whereby investigators are heavily rewarded for either first or last authorship and promoted based largely on individual rather than collaborative efforts, the motivation to participate in large collaborative efforts is markedly diminished.
Wilkinson ST, Sanacora G. Authorship Credit for Large Clinical Trials. JAMA. 2018;319(7):722–723. doi:10.1001/jama.2017.20939
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