Duplicate publication independently confirmed. Now what

Sir, In a letter to the editor of Pediatric Radiology, Hansen and Frikke [1] accuse Fitzgerald and McClain of having violated the ethics of biomedical publishing. According to Hansen and Frikke, two papers on hemophagocytic lymphohistiocytosis (HLH), the first by Fitzgerald and McClain published in Pediatric Radiology [2] and the second by Rooms et al. published in Pediatrics [3], contain identical material. Furthermore, along with the rearrangement of authorship, they note that the clinical details of the same case have been changed accordingly to fit a different interpretation of the findings. In the article in Pediatrics, Rooms et al. report that head CT scans and radiographic changes of long bones in three patients, initially attributed to inflicted injury (child abuse), were subsequently recognized as part of the manifestations of HLH. As a result, the authors recommend caution to avoid misinterpretation of HLH findings as those of child abuse. Both articles were received by the respective journals in 2002 within a few days of each other. In a letter to the editor of Pediatrics, Frikke and Hansen argue that Rooms et al. had erred in misinterpreting inflicted injury as being a part of coexisting HLH [4]. Duplicate publishing has been condemned in a long list of prestigious biomedical journals as seriously damaging their credibility and accountability. The practice inflates the numbers of cases of any disease, interferes with the accuracy of meta-analysis, takes up valuable journal space and unfairly increases the academic credentials of those who manage to slip through the attention of editors and reviewers. Penalties and sanctions have been proposed for those who violate this rule; thus reporting a violation of the ethics regarding duplicate publishing is quite valuable. Because the letter of Hansen and Frikke makes a very serious accusation, I decided to search the merits of the charge, despite the fact that no one appointed me to this task and I do not know the parties involved. In the paper received by Pediatric Radiology on 31 July 2002, and accepted for publication on 21 January 2003 [2], Fitzgerald and McClain report the imaging findings in 25 patients with HLH, noting some similarity but denying any suspicion of inflicted injury [2]. On 19 August 2002, the paper by Rooms et al. [3] was received by Pediatrics describing HLH as a clinical entity that may simulate child abuse. Rooms et al. warn readers to avoid misinterpreting HLH as abuse. Figure 1 of this article is identical to Fig. 5 of the article published in Pediatric Radiology [2]. I conclude that this is, indeed, a case of inappropriate simultaneous dual submission and ultimate publication of at least one case of HLH, with a different interpretation in each instance. As the 24 other cases are presented in table form, individual details are incomplete and I cannot confirm double presentation of any of the other patients. The accepted proper behavior should have been to cross reference the papers, explain the authors’ different conclusions, and let the editors and reviewers decide. An attempt to justify the breach of ethics may be raised based on the inclusion of many more cases in the Pediatric Radiology article, but I find this a weak defense. Is there anything that can be done now? I will leave this to the sound judgment of Dr. Slovis and his editorial staff. Pediatr Radiol (2008) 38:124–125 DOI 10.1007/s00247-007-0679-7