Embargo pointing the finger the Ingelfinger.

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Well the blog is about education and this is a two way process, hopefully you gain useful knowledge and we are learning also. 

Yesterday I heard of the term “Ingelfinger rule” If I was a clinician I may have been more bothered before.

What is it?

Well first to Wikipaedia

In scientific publishing, the Ingelfinger rule stipulates that a scientist may not publish the same original research in two different outlets. It was created in 1969 by Franz J. Ingelfinger, who at the time was editor of The New England Journal of Medicine (NEJM), as an effort to prevent NEJM from losing originality. The rule was subsequently adopted by several other scientific journals, and shaped scientific publishing ever since.The Ingelfinger rule has been seen as having the aim of preventing authors from performing double publications which would unduly inflate their publication record.

Not publishing your stuff in more than only place at a time is indeed an acceptance requirement in all scientific journals and probably developed with the view of Copyright law. You used to sign the copyright over to the journal and there was a clear logic not to have the same paper published in two different places.

However when I read the post of the Ingelinger rule it seemed different
Scientists like the gag order of the Ingelfinger Rule, says new paper in PNAS. (see below) “More than half of US neuroscientists and more than 60% of German neuroscientists perceive the so-called Ingelfinger rule as still effective. According to that rule, “acceptance of a publication by a scientific journal [is] threatened if the research results have already been reported in the mass media” (This is different from the Wiki definition)

Apparently 71% to 83% of the respondents agreed that “scientists should communicate research findings to the general public only after they have been published in a scientific journal.

So this definition is somewhat different so lets go to NEJM to see what they say


Arnold S. Relman, M.D. The Ingelfinger Rule N Engl J Med 1981; 305:824-826October 1, 1981DOI: 0.1056/NEJM198110013051408



The Journal and its editor have lately come under considerable fire from some representatives of the media and from a few medical editors as well. These critics object to our “Ingelfinger Rule,” a policy intended to discourage dissemination of research reports in the medical newspapers and popular media before they are published in the Journal. (So Wiki is not correct)


Some of these criticisms stem from a misunderstanding of our policy and how we implement it. Others reflect disagreement on matters of principle that may not have been adequately explored. Further explanation seems to be needed to set the record straight, even at the risk of repetition.

In 1969, after Medical World News had published a summary of a report scheduled for publication in the Journal, our editor, Franz Ingelfinger, formulated a policy that we have followed ever since. As stated in the form letter we currently use to acknowledge receipt of new manuscripts: “… the Journal undertakes review with the understanding that neither the substance of the article nor any of its pictures or tables have been published (Not really the wiki view) or will be submitted for publication elsewhere (This is the wiki meaning) …. This restriction does not apply to abstracts published in connection with scientific meetings, or to news reports based solely on formal and public oral presentations at such meetings, but press conferences at these meetings are discouraged.” (The press conference discouraged is a key point here)


The purpose of this policy is twofold. In the first place, as Dr. Ingelfinger never hesitated to admit, it protects our newsworthiness. In the selection of manuscripts we have always emphasized originality. Work that has already been publicized, especially if its scientific substance has been presented in detail in the medical press or given full exposure by one or more major newspapers, has by our lights lost some of its interest. We consider that a kind of prior publication. In as much as we must reject a great deal of good original work simply for lack of space, prepublicized work would rarely receive a sufficiently high priority to be published in the Journal. In this respect our policy is no different from that of many major newspapers and newsmagazines, which do not publish certain medical stories already given full coverage elsewhere. (However, how many phase II and Phase III studies in MS have been published in NEJM..quite a few. How many of these had the details already been leaked..I would think quite a few). 



An ECTRIMS, the policy is that data in abstracts for presentation should not have been published. This causes a problem for some who only seen to talk about data in press or recently published.
We had to grovel when a paper got published before ECTRIMS. However it gets very boring when you go to a meeting full of expectation and all some Demi-god of Science can tell you is something that you have already read. Some will talk about published stuff and give you the odd slide of unpublished data but this is an info blip, where the data is shown and removed so quickly that if you blink you miss it. This is a common feature of talks from many labs. I like to go to meetings to listen and learn new stuff.

Why does this happen well it is the fear of being pipped to the post by someone doing similar things. This is a real concern for basic scientists where lots of people may be doing the same stuff, but because of the cot of clinical trials and the fact that the supply of drug is controlled by Pharma, the chances of being pipped at the post is almost nil. Therefore people can be more open when it comes to talk about trials. At each ECTRIMS pharma will announce the success of some trial or other and they will ensure that it gets some form of media coverage as it helps create awareness for selling drugs to customers. Do these papers reach NEJM? I would say yes. However, it is in the journals interest to publish such studies yes, even if there has been some publicity.



The impact factor (IF) of an academic journal is a measure reflecting the average number of citations to recent articles published in the journal. It is frequently used as a proxy for the relative importance of a journal within its field, with journals with higher impact factors deemed to be more important than those with lower ones. The impact factor was devised by Eugene Garfield, the founder of the Institute for Scientific Information. The impact factor for NEJM is very high at over 50 many,many journals are less than two. So Universities want their scientists to publish in these journals, they become exclusive as they get more papers submitted than can be published, this allows them to charge page charges to publish the results. Publishing trials means that the journal will get lots of citations and this increases the impact factor will increase or stay high, so the re-inforcing the standard of the journal. It also means that pharma will pay the journal loads of cash for reprints that they will buy for marketing reasons. Furthermore it increases the chance that people will subscribe to the magazine and NEJM sells hundreds of thousands of subscriptions and you can even get it on Kindle. 




However, if we go back to the article



Notice that the Ingelfinger Rule specifically exempts abstracts published in connection with scientific meetings, as well as news coverage of such meetings. (Just as well then..given the ECTRIMS jamboree..the place is littered with Bloggers and journalists). Although this point is frequently misunderstood, we have always regarded material presented at open scientific meetings as in the public realm and have never rejected a manuscript merely because the work was presented at such a meeting and then reported in the press. However, we are concerned about press coverage that goes substantially beyond the information presented at the meeting, particularly if it includes additional data, illustrations, or tables that in effect duplicate the manuscript under consideration. The popular press rarely uses so much detail, but the medical news publications sometimes do (yep), and most of the cases at issue have involved prior publication in those periodicals(Bad Pharma).



We have cautioned would-be Journal authors against holding press conferences because that practice may result in the kind of detailed advance publication that concerns us. Unfortunately, that admonition has led to the misapprehension that any conversation with reporters to clarify what was said at a meeting will disqualify a manuscript. Although the unreviewed and unpublished work presented at scientific meetings is often not a reliable source of information for the public (This is a good point which we will deal with this in a minute, however much of that presented in meetings is a work in progress. Maybe at the meeting someone with give you an ace idea on how to finish the work). it is important that reporters who do cover such meetings get their facts straight. (Hear Hear. Most Journalists get it wrong.. for the clinical trial stuff they are spoon fed the information by the marketing departments of the pharma companies but my experience of the science stuff is it is normally over-inflated and often incorrect). The Journal does not object if authors help them, provided that this does not result in the prior publication of the essential substance of a manuscript submitted to us. To avoid misunderstanding, our form letter will henceforth make this point clear.




We also exempt pre-publication dissemination of public-health information that needs to be brought to the public’s or profession’s attention without delay…………


The second reason we have stood by the Ingelfinger Rule is that we believe medical research should be subjected to peer review and published in the scientific literature before it is touted to the public or the profession. Physicians should have an opportunity to read the full reports of new developments in order to judge their merits. With the evidence as well as the conclusions at hand, doctors are in a better position to evaluate medical news on behalf of their patients. Premature publicity about medical research and publicity about work that has not yet been documented cause confusion among laymen and the profession alike. We believe strongly in the importance of an informed public and in the public’s right to know, but we also believe that it is important to take the time to make sure that the public is not misled.


You can read the rest if interested.


So back to the original piece piece


There’s a more cynical reason scientists may not want to share data too early, namely that they fear getting scooped by bigger labs

Does this happen? Of course it does. We it did ourselves last month when we published our findings in a full paper before a paper by others has surfaced. Has it been done to us? Yes it has. 


If you present data a meeting, an abstract of the work may appear in the literature, or maybe you saw the talk, although it doesn’t make it to Pubmed. However, then the information is fair game. If you are a lab of a few people how can you compete with a lab of fifty who can go into overdrive to get the work finished and in a state thats publishable. Maybe you have 90% of the story and the information you glean fills in the Jigsaw.




However, for many meetings the abstracts do not go on the web and so you have to be there to know the story. Some people may get to see the title but not the content. We have had many companies ask if we would give people out presentations…I always tell them they have to wait until it is published. Many people secretly film or photograph the work. However, these days there are many bloggers,journalists who attend meetings hunting for a story. I was in Greece in November and this bloke kept on talking photographs of the speakers..it turned out to be a freelance journalist. Therefore, your story may get put in the media before it is ready. I had the pleasure on going on BBC radio to say what shocking reporting they sometimes do. I was at a cannabinoid meeting talking about EAE when the next thing I know, I am taking about multiple sclerosis another bloke was causing psychosis when there was nothing mentioned except a mouse. The BBC journalist was reporting on the story of another journalist reporting the meeting. Each embellished the story…such that it is complete nonsense by the time it surfaced.



However it is not necessarily the journalists you have to watch but the market analysts also often it is not the academic media, that spill the beans but the financial media as companies report to their share holders and the news of trial results invariably enters the public domain before the papers describing the work are published). 


“The Ingelfinger can be self-perpetuating: Junior scientists may just be doing whatever senior researchers model for them. However, the rule is not simply imposed on reluctant scientists by jealous journal editors attempting to protect the exclusivity of the content of their journals”…I would say dream-on to this, you just have to read the embargo policy of some of the journals, e.g. Nature, where it is very clear talk to the media at your peril, if you want the paper published. or other papers that are less media greedy it is another matter. 

However journals accept that you may present your data at a scientific meeting in abstract from before the full publication you just keep your mouths shut if journalists come looking for a story. It is only the journals that court the media have these types of embargo policies many journals are much more camera shy as are the scientists that publish in them.


However the papers miss one major point and that is in relation to patents. Although for publication of a clinical trial this is not really an issue as patents have been filed long before the drugs went into the human trials, patents typically must be filed before public disclosure. This means before a meeting or a publication and these must be deposited and they only remain invisible for a year after filing. 


If you are slow getting all data together before going to the meeting the data may be visible. 


This information is scoured by the pharmaceutical industry, it could also be in the power of journalists to see and report on this. There are now journals specialised in reporting the contents of patents and there is probably more information in untapped patent data bases than in the academic literature. I got a highly cited paper simply by reporting the contents of two patents on an novel receptor.  


Anyway what was the paper all about the original article is



The present article presents an up-to-date account of the current media relations of scientists, based on a comprehensive analysis of relevant surveys. The evidence suggests that most scientists consider visibility in the media important and responding to journalists a professional duty—an attitude that is reinforced by universities and other science organizations. Scientific communities continue to regulate media contacts with their members by certain norms that compete with the motivating and regulating influences of public information departments. Most scientists assume a two-arena model with a gap between the arenas of internal scientific and public communication. They want to meet the public in the public arena, not in the arena of internal scientific communication. Despite obvious changes in science and in the media system, the orientations of scientists toward the media, as well as the patterns of interaction with journalists, have their roots in the early 1980s. Although there is more influence on public communication from the science organizations and more emphasis on strategic considerations today, the available data do not indicate abrupt changes in communication practices or in the relevant beliefs and attitudes of scientists in the past 30 year. Changes in the science–media interface may be expected from the ongoing structural transformation of the public communication system. However, as yet, there is little evidence of an erosion of the dominant orientation toward the public and public communication within the younger generation of scientists.




So we like to present data at scientific meetings before it gets published for the digestion of the public. So no change there then

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MouseDoctor

1 comment

  • Excellent research on a somewhat fraught and thorny subject MD. If Ingelfinger was Prof 'Smith' I wonder whether there would have been the same attachment to the moniker.

    As to the genesis of the practice with NEJM, I see the policy as 'protectionist' to preserve the prestige of NEJM, and the cudos that is attracted by being published in this journal, – in a culture, society and academia that is predicated upon publish or perish. My University recently offered a "cash incentive" of $5000 to any member of staff who has work published in a top tier journal. So 'cash for rankings' in the top Universities sphere.

    Your concerns extend to being 'gazumped' in terms of being the first to publish results, having results 'kidnapped' by other researchers – can only be rebutted by the sentiment that my socialist heart tells me that what is important that knowledge does not have an owner. However, if it were my life's blood sweat and tears that had gone into the research I would probably want to put my name to it – just not the ego attachment.

    I understand only too well journalists not letting the facts get in the way of a good story- having experienced that in my former working life.

    Although there is a move towards 'open access' journals which may threaten the prestige stranglehold of journals like NEJM ( I think this blog has commented on this issue before), and whilst the Ingelfinger rule may continue to be diluted by the ability of social media to ofter a rapid way of disseminating results – it will be a while yet, methinks before Ingelfinger is given the "middle" finger.

    Extra piece of cheese, MD for the research work done to clarify this issue.

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