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Friday, January 7, 2022

Srm university ph.d course work research and publication ethics rpe17001 august 2021 question paper.

SRM University Old Question Papers

Ph.D Course Work Examination 

AUGUST 2021 

Research and Publication Ethics - RPE17001

Use of Statistical tables, design data book and calculators are permitted

Time: 3:00 Hrs 

Max Marks : 100

Note: Attempt all questions. 

Part A is 20 marks and Part B is 80 marks

Scanned Copies:

model question paper for research and publication ethics

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100 Questions (and Answers) About Research Ethics

Emily Anderson

SAGE Publications Ltd

Research, questionnaires

978-1-5063-4868-1

Copyright © 2021 Central Library, Indian Institute of Technology Delhi. All Rights Reserved.         Developed by Mr. Satbir Chauhan  under the Guidance  CAD Central Library

Research guidance, Research Journals, Top Universities

Understanding Research & Publication Ethics through MCQ

Research and Publication Ethics : In this blog post (MCQ on Research & Publication Ethics), you will understand Research ethics through various MCQs.

Topics Covered : Literature Review, Review Paper Writing, Writing a Research article, etc;

MCQs on Research & Publication Ethics

1. In the Literature review, systematic reorganization and reshuffling of the information to develop knowledge/ reasoning/ problem definition is referred to as-

 Synthesizing

 Summarizing

 Both 1 and 2

 None of these

2. Rationale of the study is

 Logic leading to methodology

 Logic leading to aim and objectives

 Logic behind Introduction

 All the above

3. Literature review for which body of knowledge is collected from the supervisor is –

 Literature Survey

 Experience survey

 Objective survey

 Both 2 and 1

4. A literature review is ………… of research.

  Foundation

 Last step

 a formality

 Both 2 and 3

5. Doing literature review from broader topic to a focal point is the-

 Literature search

 Convergent search

 Objective search

 Both b and c

6. Objectives of a study must be –

 Specific & Measurable

 Relevant & Time-bound

 1 & 2 both

 Easy to do

7. Literature review/survey is a –

 Continuous process

 Initial stage process

 Offline process

 All of the above

8. Curly bracket {} will search for the –

 Specific phrases

 Fussy phrases

 Both a and b

9. Systematic and organized compilation and critical study of a related body of knowledge is called

 Literature review

 Data analysis

 Statistical analysis

 Result & Discussion

10. Boolean search does not include-

11. SHODHGANGOTRI is the databases of-

 Thesis

  Synopsis

12. PUBMED is maintained in the US by the

  NCBI

13. SHODHGANGA is the database of –

  Thesis

 Synopsis

14. INFLIBNET is –

 Informatics and Library Network Centre

 Library and Information Network Centre

 Information and Library Network Centre

15. Which does not cover the social sciences database

 Scopus

  Pubmed

 Web of Science

16. The free national repository of Indian synopsis database is/are

 Shodhshudhi

 Shodhganga

 Eshodhsindhu

 None of the above

17. Literature management tool/(s)-

 Mendeley

 Endnote

 b & c both

18. DOAR stands for –

 Directory of open access repository

 Dictionary of open access repository

 Development of analytical report

 Development of access report

19. Which is a huge subscription-based scientific citation indexing service

 Shodganga

 Shodgangotri

20. Endnote supports importing in

 BiBtex

 EndNote

 a & b both

Research & Publication Ethics MCQs on Review Paper

21. Outline of the review paper

 drawn in the planning stage in consultation with mentor and research team

 should be tight and focussed

 unique summarising and synthesizing of idea

22. The review paper is different from the literature review in

 size, shape, and approach

 size only

 shape only

 size and shape

23. Systematic reviews are common in

 social sciences

 sciences

 life sciences

 sciences and life sciences

24. The section of the article which must not have subheadings

 methods

 introduction

 discussion

25. Writing review paper should be started

 in the early stage of planning your research topic

 in the later stage of planning of your research topic

 in the final stage of execution of your research work

 a & c both

26. The first rule of writing a body of the paper is

 include many references

 stick to your outline

 use effective English

27. In the conclusion section

 no separate headings are used

 the objective of the paper is restated

 the expected outcome may be included

28. Review papers are written for

 giving a new direction to existing research

 increasing the h index of author/researcher

 wide readership

29. Abstract is

 same as your Ph.D. research synopsis

 a comprehensive research summary with good length

 crisp, short, and representative summary of research work

30. Review paper writing is associated with a paradox

 Intensive task but not much recognition as compared to research papers

 Less effort is needed but more recognition as compared to research papers

 No lab work but more readership as compared to research papers

31. Which one of the following should not be acknowledged in an article

 Project grant

 Analytical facility provider

 Gift sample providers

 Senior authors

32. Identify which one of the following is a correct pair

 Acknowledgment – sources of study

 Materials and methods – output of the experiments

 The abstract – central idea

 Discussion – rationality of the work

33. Which is not a good a practice

 to cut the work into smaller pieces of work

 Plan the preliminary promising studies which yielded good and novel results

 Select journals with good indexing or Impact factor

34. IMRaD stands for

 introduction, material /methods, results and discussion

 investigation, methods results and discussion

 investigation, methods, results, analysis discussion

35. Title of the paper should be?

 Simple

 Reader-friendly

 Representative of study

36. Two key features of the Method section are

 short and catchy sentences

 clarity and the reproducibility

 accuracy and precision

37. In the introduction, you should

 give a brief background and brief literature review

 introduce the topic

 identify research gap, define problem & present rationality

38. In the result section

 Do not exaggerate the results

 Do not be afraid of reporting negative results

 Statistical support must be there

39. Infographics

 must be self-explanatory

 must have suitable legends or footnotes

40. The materials and methods section is also known as

 Methods

 Experimental

 Methodology

41. Major factors to be considered in right referencing are

 Quality

 Quantity

 Uniform Styles/ guidelines

 All of these

42. Sources of information that you are giving at the end of your manuscript is termed as

  Reference

 Results

 Discussions

43. When references are listed in alphabetical order stating the last name of the first author like Smith, G. (2008) is –

 APA style

 MLA style

 CMS style

44. Graphical abstract may contain –

 A graph

 A figure

 An image

45. Suggested reviewers should not include-

 Your supervisor

 Field experts

 Both A and B

46. Keywords of a manuscript can be related to the –

 Title

 Content

47. When “neither author nor peer reviewers know about the names of each other” This technique are called as –

 Double-blind

 Single Blind

48. The proofreading step is the final step –

 After acceptance

 Before acceptance

49. One should Discuss the results-

 Critically

 With Logical reasoning

 With general statements

50. The author should address the reviewer’s comments –

 Humbly

 Logically

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Research and Publication Ethics (RPE)

Netaji Subhas Open University, Kolkata and IGNOU via Swayam Help

Module Name

Module 1: Philosophy And Ethics

Introduction to philosophy- scope, concept, branches.

Ethics: definition-moral philosophy,

nature of moral judgments

Module 2: Scientific Conduct

Ethics with respect to science and research; Intellectual honesty and research integrity

Scientific misconducts: Falsification- Fabrication, and Plagiarism -Redundant publications

Selective reporting and misrepresentation of data

Module 3: Publication Ethics

Publication ethics: definition, introduction and importance

Best practices/ standards setting initiatives and guidelines: COPE, WAME etc.

Publication misconduct: definition, concept, problems etc.

Violation of publication ethics, authorship and contributorship; Identification of publication misconduct, complaints and appeals

Predatory publishers and journals

Module 4: Open Access Publishing

Open access publications and initiatives

OER- Open licenses- types & uses

SHERPA/ ROMEO online resource to check publisher copyright & self- archiving policies etc.

Module 5: Publication Misconduct

Subject-specific issues, FFP, authorship

Conflicts of interest

Complaints and appeals: examples and fraud from India and abroad

Software tools :Introduction- Turnitin, Urkund and other open source software tools

Module 6: Databases and Research Metrics

Databases-Indexing databases

Citation databases: Web of Science, Scopus, etc.

Research Metrics-Impact Factor of journal as per Journal Citation Report, SNIP, SJR, IPP, Cite Score

Metrics: h-index, g index, etc.

Dr. Anirban Ghosh

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Research ethics and plagiarism, being a researcher (in information science and technology), related articles, 500+ ugc-approved online degrees from india’s top universities, swayam + nptel courses full list.

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Ethics in Research and Publication

Pradyumna pan.

Ashish Hospital and Research Centre, Pediatric Surgery Unit, Jabalpur, Madhya Pradesh, India

Published articles in scientific journals are a key method for knowledge-sharing. Researchers can face the pressures to publish and this can sometimes lead to a breach of ethical values, whether consciously or unconsciously. The prevention of such practices is achieved by the application of strict ethical guidelines applicable to experiments involving human subjects or biological tissues. Editors too are faced with ethical problems, including how best to handle peer-review bias, and find reviewers with experience, probity, and professionalism. This article emphasizes that authors and their sponsoring organizations need to be informed of the importance of upholding the guidelines in research and ethical rules when disclosing scientific work.

I NTRODUCTION

Accurate reporting of results of research depends on the integrity of the authors, their application of and compliance with guidelines relating to the assurance of an ethical approach throughout and also on robust institutional research governance protocols ensuring that study design, conduct, and analysis of research and the publishing process all comply to an ethical framework. There is a growing concern that research misconduct over the past two decades has become more common.[ 1 ] It is challenging to determine whether this apparent increase is a true increase in the number of misconducts committed or detection has increased during this period.[ 2 ]

W HAT IS P UBLICATION E THICS ?

It is important that persons involved in the research must be compliant with the ethical framework in which they should function. The Committee on Publication Ethics (COPE) published guidelines on Good Publication Practice in 1999[ 3 ] and continues to update these regularly.[ 4 ]

Study design

The design of the study is a collection of methods and procedures used to gather and analyze the data on variables defined in a research. A poorly designed study can never be recovered, whereas an inadequately analyzed study can be re-analyzed to reach a meaningful conclusion.[ 5 ] The study design should be clearly expressed in a written protocol. In clinical studies, the number of participants to be included in the analysis should be sufficiently large to give a definitive result. Local ethical research committees should hold back approval until the deficiencies in the design of the study have been corrected. All investigators should agree on the final protocol, and their contributions should be clearly defined.

Ethical approval

For all studies involving individuals or medical records, approval from a duly appointed research ethics committee is necessary. The research protocol should adhere strictly to the international standards such as those of the Council for International Medical Science Organizations.[ 6 ]

When human tissues or body fluids have been collected for one project for which ethical authorization and consent has been obtained, these preserved specimens cannot be used again without further permission. It should be presumed that no author can publish research of humans or animals that do not follow the ethical standards of the country where the article is published.[ 2 ]

Data analysis

The data analysis methodology should be clearly stated in the protocol. The variations such as post hoc analysis or data omission should be agreed upon and reported in the paper by all investigators.[ 7 ] The capacity for manipulating data electronically now is enormous. Original images should always be retained and any alteration should be revealed.

The International Committee of Medical Editors (the Vancouver Group) has developed authorship guidelines that allow each writer to make a substantial contribution throughout the process.[ 8 ] In the past honorary authorship had been employed widely. However, the concept that the professor or department head should inevitably find his/her way to a paper is no longer acceptable. Each contributor should be able to mention clearly how they took part in the study. Each author must take public responsibility for the work published in the journal, and it is desirable to have one senior author, to serve as a guarantor. Participation in fundraising, data collection, or general supervision of the research is insufficient for authorship. Authorship acknowledgment should be based on substantial contributions to: (1) concept and design, (2) interpretation of data, (3) drafts and critical revisions of intellectual content, and (4) final approval of the version to be published.[ 2 ]

There is a possible conflict of interest when an investigator, writer, publisher, or reviewer has a financial, personal interest, or opinion that may impair their objectivity, or improperly influence their behavior. Financial ties are the most visible competing interests. As a result of personal relationships, academic rivalry, and intellectual zeal, competing interests can also exist. Competing interests are not unethical as long as they are revealed. They should be disclosed to the ethics committee and to the editor of the journal to which a article is submitted.

P EER R EVIEW

Peer review is the method used to evaluate the quality of articles submitted to a journal. COPE has developed ethical guidelines for peer reviewers.[ 9 ] The affiliation between the author, the editor, and the peer reviewer is a confidential collaboration. It is only with the editor's permission the manuscript should be passed on to a colleague or other individuals. A reviewer or editor should not use the information contained in the paper for their benefit.[ 2 ] Journals should have clearly defined and communicated policies on the type of peer review used, for example, single-blinded, double-blinded, open, or postpublication.[ 10 ] Peer reviewers can play a vital function in figuring out data fabrication, falsification, plagiarism, image manipulation, unethical research, biased reporting, authorship abuse, redundant or duplicate publication, and undeclared conflicts of interest.[ 11 ]

D UTIES OF E DITORS

Editors are the wardens of the scientific literature and are responsible for maintaining high research and publishing ethics standards. There may be competing interests among participants, and it is the responsibility of the editor to ensure that they do not affect the journal. They should not be hesitant to publish work that challenges previously published studies in their journal, and they should not reject studies with negative results.[ 2 ] Editors must act promptly if a published paper is found to have publication misconduct.[ 12 ]

R ESEARCH AND P UBLICATION M ISCONDUCT

Research misconduct represents a spectrum ranging from the errors of judgment (mistakes made in good faith) to deliberate fraud, usually categorized as fabrication, falsification, and plagiarism.[ 13 ]

Falsification is the changing or omission of research results (data) or manipulation of images or representations in a manner that distorts the data to support claims or hypotheses.[ 13 ]

Fabrication is the construction or addition of data, observations, or characterizations that never occurred in the gathering of data or running of experiments.[ 13 ]

Plagiarism is the use of another individual or group's published work or unpublished ideas, language, thoughts, ideas, or expressions and makes the representation of them as one's original work.[ 14 ] The advent of digital material and its ease of accessibility have accelerated the use of plagiarism.[ 15 ] In some instances, plagiarism is used as a tool to cover up language problems for those whom English is not their first language. Where language is a problem, the authors should always be encouraged to obtain help in preparing their manuscript and not resort to using other people's words. It is unacceptable to republish a paper with minor changes, without referring to the primary publication, and to present it to the readership as a new source.[ 16 ]

R EDUNDANT P UBLICATION

Redundant publication (sometimes referred to as duplicate or triplicate publication) is the term used when two or more papers that overlap in a significant way are published in different journals without cross-reference.[ 17 ] It is not uncommon for two or more papers involving the same or similar patient database to be published in sequence. The authors should disclose this to the editor and make a cross-reference to previous papers. It is permissible to publish a paper in another language as long as this is disclosed.

Motives for misconduct

The motives why investigators fabricate records are not understood. Improving understanding of why researchers commit misconduct and detrimental research practices (DRPs) is essential. A range of possible reasons are: (1) career and funding pressures, (2) institutional failures of oversight, (3) commercial conflicts of interest, (4) inadequate training, (5) erosion of standards of mentoring, and (6) part of a larger pattern of social deviance.[ 18 ]

Prevention of misconduct

The widespread nature of research and publication misconduct indicates that existing control measures are inadequate. Enhanced methods for detecting misconduct are required. Even if research policing were made more effective, the fundamental question of why certain individuals violate their duties as a scientist or medical researcher intentionally or unintentionally would not be addressed. Clear guidance on ethics should be emphasized during research training in all institutions actively involved in research.[ 19 ] Training is a crucial step in avoiding publication misconduct. All researchers should be presented with organizational guidance and publishing ethics when they join a new organization. Misconduct in the study may be more common when investigators are alone with an inadequate review of data by a project supervisor. Research integrity depends on excellent communication between contributors, with frequent discussion of project progress and openness to any difficulties in adhering to the research protocol. Everyone should agree with the changes to the protocol. Maintaining documents must be of the highest quality. The law requires data and photographic record of experimental results to be maintained for 15 years. The records of laboratory experiments should be held in the department where the study is carried out and should be available for review for at least 15 years.

Strategies to support research integrity

  • Ensure policies governing academic research not only are in place but are followed
  • Enforce expectations for process rigor
  • Communicate expectations for accurate accounting of time spent on research activities
  • Evaluate the grant accounting function
  • Establish an office of research integrity.[ 20 ]

C ONCLUSION

Accurate and ethical reporting is crucial to the quality of scientific research that is published. Unethical practices such as falsification of data and plagiarism cause long-term damage to the dependability of published literature. Whilst such practices do still exist, these can be prevented by having robust institutional ethical processes in place, regular training, and editorial vigilance.

Financial support and sponsorship

Conflicts of interest.

There are no conflicts of interest.

R EFERENCES

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Methodology

  • Ethical Considerations in Research | Types & Examples

Ethical Considerations in Research | Types & Examples

Published on October 18, 2021 by Pritha Bhandari . Revised on May 9, 2024.

Ethical considerations in research are a set of principles that guide your research designs and practices. Scientists and researchers must always adhere to a certain code of conduct when collecting data from people.

The goals of human research often include understanding real-life phenomena, studying effective treatments, investigating behaviors, and improving lives in other ways. What you decide to research and how you conduct that research involve key ethical considerations.

These considerations work to

  • protect the rights of research participants
  • enhance research validity
  • maintain scientific or academic integrity

Table of contents

Why do research ethics matter, getting ethical approval for your study, types of ethical issues, voluntary participation, informed consent, confidentiality, potential for harm, results communication, examples of ethical failures, other interesting articles, frequently asked questions about research ethics.

Research ethics matter for scientific integrity, human rights and dignity, and collaboration between science and society. These principles make sure that participation in studies is voluntary, informed, and safe for research subjects.

You’ll balance pursuing important research objectives with using ethical research methods and procedures. It’s always necessary to prevent permanent or excessive harm to participants, whether inadvertent or not.

Defying research ethics will also lower the credibility of your research because it’s hard for others to trust your data if your methods are morally questionable.

Even if a research idea is valuable to society, it doesn’t justify violating the human rights or dignity of your study participants.

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Before you start any study involving data collection with people, you’ll submit your research proposal to an institutional review board (IRB) .

An IRB is a committee that checks whether your research aims and research design are ethically acceptable and follow your institution’s code of conduct. They check that your research materials and procedures are up to code.

If successful, you’ll receive IRB approval, and you can begin collecting data according to the approved procedures. If you want to make any changes to your procedures or materials, you’ll need to submit a modification application to the IRB for approval.

If unsuccessful, you may be asked to re-submit with modifications or your research proposal may receive a rejection. To get IRB approval, it’s important to explicitly note how you’ll tackle each of the ethical issues that may arise in your study.

There are several ethical issues you should always pay attention to in your research design, and these issues can overlap with each other.

You’ll usually outline ways you’ll deal with each issue in your research proposal if you plan to collect data from participants.

Voluntary participation Your participants are free to opt in or out of the study at any point in time.
Informed consent Participants know the purpose, benefits, risks, and funding behind the study before they agree or decline to join.
Anonymity You don’t know the identities of the participants. Personally identifiable data is not collected.
Confidentiality You know who the participants are but you keep that information hidden from everyone else. You anonymize personally identifiable data so that it can’t be linked to other data by anyone else.
Potential for harm Physical, social, psychological and all other types of harm are kept to an absolute minimum.
Results communication You ensure your work is free of or research misconduct, and you accurately represent your results.

Voluntary participation means that all research subjects are free to choose to participate without any pressure or coercion.

All participants are able to withdraw from, or leave, the study at any point without feeling an obligation to continue. Your participants don’t need to provide a reason for leaving the study.

It’s important to make it clear to participants that there are no negative consequences or repercussions to their refusal to participate. After all, they’re taking the time to help you in the research process , so you should respect their decisions without trying to change their minds.

Voluntary participation is an ethical principle protected by international law and many scientific codes of conduct.

Take special care to ensure there’s no pressure on participants when you’re working with vulnerable groups of people who may find it hard to stop the study even when they want to.

Prevent plagiarism. Run a free check.

Informed consent refers to a situation in which all potential participants receive and understand all the information they need to decide whether they want to participate. This includes information about the study’s benefits, risks, funding, and institutional approval.

You make sure to provide all potential participants with all the relevant information about

  • what the study is about
  • the risks and benefits of taking part
  • how long the study will take
  • your supervisor’s contact information and the institution’s approval number

Usually, you’ll provide participants with a text for them to read and ask them if they have any questions. If they agree to participate, they can sign or initial the consent form. Note that this may not be sufficient for informed consent when you work with particularly vulnerable groups of people.

If you’re collecting data from people with low literacy, make sure to verbally explain the consent form to them before they agree to participate.

For participants with very limited English proficiency, you should always translate the study materials or work with an interpreter so they have all the information in their first language.

In research with children, you’ll often need informed permission for their participation from their parents or guardians. Although children cannot give informed consent, it’s best to also ask for their assent (agreement) to participate, depending on their age and maturity level.

Anonymity means that you don’t know who the participants are and you can’t link any individual participant to their data.

You can only guarantee anonymity by not collecting any personally identifying information—for example, names, phone numbers, email addresses, IP addresses, physical characteristics, photos, and videos.

In many cases, it may be impossible to truly anonymize data collection . For example, data collected in person or by phone cannot be considered fully anonymous because some personal identifiers (demographic information or phone numbers) are impossible to hide.

You’ll also need to collect some identifying information if you give your participants the option to withdraw their data at a later stage.

Data pseudonymization is an alternative method where you replace identifying information about participants with pseudonymous, or fake, identifiers. The data can still be linked to participants but it’s harder to do so because you separate personal information from the study data.

Confidentiality means that you know who the participants are, but you remove all identifying information from your report.

All participants have a right to privacy, so you should protect their personal data for as long as you store or use it. Even when you can’t collect data anonymously, you should secure confidentiality whenever you can.

Some research designs aren’t conducive to confidentiality, but it’s important to make all attempts and inform participants of the risks involved.

As a researcher, you have to consider all possible sources of harm to participants. Harm can come in many different forms.

  • Psychological harm: Sensitive questions or tasks may trigger negative emotions such as shame or anxiety.
  • Social harm: Participation can involve social risks, public embarrassment, or stigma.
  • Physical harm: Pain or injury can result from the study procedures.
  • Legal harm: Reporting sensitive data could lead to legal risks or a breach of privacy.

It’s best to consider every possible source of harm in your study as well as concrete ways to mitigate them. Involve your supervisor to discuss steps for harm reduction.

Make sure to disclose all possible risks of harm to participants before the study to get informed consent. If there is a risk of harm, prepare to provide participants with resources or counseling or medical services if needed.

Some of these questions may bring up negative emotions, so you inform participants about the sensitive nature of the survey and assure them that their responses will be confidential.

The way you communicate your research results can sometimes involve ethical issues. Good science communication is honest, reliable, and credible. It’s best to make your results as transparent as possible.

Take steps to actively avoid plagiarism and research misconduct wherever possible.

Plagiarism means submitting others’ works as your own. Although it can be unintentional, copying someone else’s work without proper credit amounts to stealing. It’s an ethical problem in research communication because you may benefit by harming other researchers.

Self-plagiarism is when you republish or re-submit parts of your own papers or reports without properly citing your original work.

This is problematic because you may benefit from presenting your ideas as new and original even though they’ve already been published elsewhere in the past. You may also be infringing on your previous publisher’s copyright, violating an ethical code, or wasting time and resources by doing so.

In extreme cases of self-plagiarism, entire datasets or papers are sometimes duplicated. These are major ethical violations because they can skew research findings if taken as original data.

You notice that two published studies have similar characteristics even though they are from different years. Their sample sizes, locations, treatments, and results are highly similar, and the studies share one author in common.

Research misconduct

Research misconduct means making up or falsifying data, manipulating data analyses, or misrepresenting results in research reports. It’s a form of academic fraud.

These actions are committed intentionally and can have serious consequences; research misconduct is not a simple mistake or a point of disagreement about data analyses.

Research misconduct is a serious ethical issue because it can undermine academic integrity and institutional credibility. It leads to a waste of funding and resources that could have been used for alternative research.

Later investigations revealed that they fabricated and manipulated their data to show a nonexistent link between vaccines and autism. Wakefield also neglected to disclose important conflicts of interest, and his medical license was taken away.

This fraudulent work sparked vaccine hesitancy among parents and caregivers. The rate of MMR vaccinations in children fell sharply, and measles outbreaks became more common due to a lack of herd immunity.

Research scandals with ethical failures are littered throughout history, but some took place not that long ago.

Some scientists in positions of power have historically mistreated or even abused research participants to investigate research problems at any cost. These participants were prisoners, under their care, or otherwise trusted them to treat them with dignity.

To demonstrate the importance of research ethics, we’ll briefly review two research studies that violated human rights in modern history.

These experiments were inhumane and resulted in trauma, permanent disabilities, or death in many cases.

After some Nazi doctors were put on trial for their crimes, the Nuremberg Code of research ethics for human experimentation was developed in 1947 to establish a new standard for human experimentation in medical research.

In reality, the actual goal was to study the effects of the disease when left untreated, and the researchers never informed participants about their diagnoses or the research aims.

Although participants experienced severe health problems, including blindness and other complications, the researchers only pretended to provide medical care.

When treatment became possible in 1943, 11 years after the study began, none of the participants were offered it, despite their health conditions and high risk of death.

Ethical failures like these resulted in severe harm to participants, wasted resources, and lower trust in science and scientists. This is why all research institutions have strict ethical guidelines for performing research.

If you want to know more about statistics , methodology , or research bias , make sure to check out some of our other articles with explanations and examples.

  • Normal distribution
  • Measures of central tendency
  • Chi square tests
  • Confidence interval
  • Quartiles & Quantiles
  • Cluster sampling
  • Stratified sampling
  • Thematic analysis
  • Cohort study
  • Peer review
  • Ethnography

Research bias

  • Implicit bias
  • Cognitive bias
  • Conformity bias
  • Hawthorne effect
  • Availability heuristic
  • Attrition bias
  • Social desirability bias

Ethical considerations in research are a set of principles that guide your research designs and practices. These principles include voluntary participation, informed consent, anonymity, confidentiality, potential for harm, and results communication.

Scientists and researchers must always adhere to a certain code of conduct when collecting data from others .

These considerations protect the rights of research participants, enhance research validity , and maintain scientific integrity.

Research ethics matter for scientific integrity, human rights and dignity, and collaboration between science and society. These principles make sure that participation in studies is voluntary, informed, and safe.

Anonymity means you don’t know who the participants are, while confidentiality means you know who they are but remove identifying information from your research report. Both are important ethical considerations .

You can only guarantee anonymity by not collecting any personally identifying information—for example, names, phone numbers, email addresses, IP addresses, physical characteristics, photos, or videos.

You can keep data confidential by using aggregate information in your research report, so that you only refer to groups of participants rather than individuals.

These actions are committed intentionally and can have serious consequences; research misconduct is not a simple mistake or a point of disagreement but a serious ethical failure.

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All submitted manuscripts must conform to MDPI’s policies as described. In all instances, MDPI closely follows the Committee on Publication Ethics ( COPE ) principles of publication ethics laid out in its core practices documents. Their advice includes support on handling issues such as: conflicts of interest, authorship and contributorship issues and disputes, misconduct allegations and data issues, overlap and plagiarism, and peer review integrity.

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Authors who submit their manuscripts to MDPI journals must:

  • Accurately present their research findings and include an objective discussion of the significance of their findings.
  • Uphold accurate authorship, by including all and only those who qualify for authorship and clearly stating their contribution.
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This list is not exhaustive, and authors should be aware of local regulations and accepted norms within academic publishing.

MDPI follows the International Committee of Medical Journal Editors ( ICMJE ) guidelines which state that in order to qualify for authorship of a manuscript, authors must meet all four criteria:

  • Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND
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  • Final approval of the version to be published; AND
  • Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Those who contributed to the work but do not qualify for authorship should be listed in the acknowledgments. More detailed guidance on authorship is given by ICMJE .

Different disciplines adopt their own criteria, for example, the ICMJE (International Committee of Medical Journal Editors) guidelines are well-known in biomedical fields, the APA (American Psychological Association) guidelines are used in Psychology, the EuChemS (European Chemical Society) guidelines are adopted in Chemistry, whereas in the arts, humanities and social sciences, publications by single authors are more common. However, the minimum recognized requirements for authorship are making a substantial contribution to the research and being accountable for the work undertaken ( COPE Discussion document: authorship ).

Any change to the author list during the editorial process or after publication should be approved by all authors, including any who have been removed. We reserve the right to request evidence of authorship, and changes to authorship after acceptance will be made at the discretion of MDPI.

Author Contributions

For complete transparency, all submitted manuscripts should include an author contributorship statement that specifies the work of each author. For research articles with several authors, a short paragraph specifying their individual contributions must be provided.

The following statements should be used: Conceptualization, X.X. and Y.Y.; methodology, X.X.; software, X.X.; validation, X.X., Y.Y. and Z.Z.; formal analysis, X.X.; investigation, X.X.; resources, X.X.; data curation, X.X.; writing—original draft preparation, X.X.; writing—review and editing, X.X.; visualization, X.X.; supervision, X.X.; project administration, X.X.; funding acquisition, Y.Y. All authors have read and agreed to the published version of the manuscript.

Please refer to CRediT taxonomy for an explanation of terms. Authorship must be limited to those who have contributed substantially to the work reported.

The corresponding author should act as a point of contact between the editor and the other authors, keep co-authors informed, and involve them in major decisions about the publication.

Joint first authors can be indicated by the inclusion of the statement “X and X contributed equally to this paper” in the manuscript. The roles of the equal authors should also be adequately disclosed in the contributorship statement.

For review articles, where individual statements are less applicable, a statement should be included that clarifies who was responsible for the ideation, who performed the literature search and/or data analysis, and who drafted and revised the work.

For articles that are principally based a student’s dissertation or thesis, MDPI recommends that the student is listed as principal author.

Consortium/Group Authorship

If authorship is retained by the consortium or group, the consortium or group should be listed as an author. Individual consortium/group author members listed in the author byline must qualify for authorship according to ICMJE guidelines.

Where work is presented by the author(s) on behalf of a consortium or group, this should be clarified in the author list, for example “Author A on behalf of XXX Consortium/Group”. The consortium/group will not retain authorship and will only appear in the author list.

If provided, the consortium/group members will be listed in a separate section at the end of the article in Acknowledgments, Appendix or Supplementary Materials.

Authorship and the Use of AI or AI-Assisted Technologies

MDPI follows the Committee on Publication Ethics (COPE) position statement when it comes to the use of Artificial Intelligence (AI) and AI-assisted technology in manuscript preparation. Tools such as ChatGPT and other large language models (LLMs) do not meet authorship criteria and thus cannot be listed as authors on manuscripts.

In situations where AI or AI-assisted tools have been used in the preparation of a manuscript, this must be appropriately declared with sufficient details at submission via the cover letter. Furthermore, authors are required to be transparent about the use of these tools and disclose details of how the AI tool was used within the “Materials and Methods” section, in addition to providing the AI tool’s product details within the “Acknowledgments” section.

Authors are fully responsible for the originality, validity, and integrity of the content of their manuscript, including any material contributed by AI or AI-assisted tools, and must ensure, through carefully review, that this content complies with all MDPI’s publication ethics policies. MDPI reserves the right to request further information, and editorial decisions will be made in line with MDPI’s Editorial Process and our Terms and Conditions .

Deceased Authors

If a manuscript is submitted with a deceased author included in the authorship, or if an author passes away during peer review, the corresponding author, or co-authors, should inform the editorial office. If the deceased author was a corresponding author, the authorship group should nominate a co-author for this role. The corresponding author should confirm the contribution of the deceased author and any potential conflicts of interest. Upon publication, a note will be added under the author list.

Changes to Authorship

Authors are expected to carefully consider authorship before manuscript submission. Any change to the author list should be made during the editorial process, before manuscript acceptance. Authorship changes, including any addition, removal, or rearrangement of author names will require the approval of all authors including any to be removed. To request any change in authorship, the journal must receive a completed authorship change form that includes the signatures of all authors, and provides a reason for the change. Any changes to authorship requested after manuscript acceptance will result in a delay in publication. If the manuscript has already been published, requests for a change in authorship will be evaluated and require the publication of a Correction . We reserve the right to request evidence of authorship, and changes to authorship after acceptance will be made at the discretion of MDPI.

Authorship Disputes

MDPI follows the Committee on Publication Ethics (COPE) guidelines when it comes to resolving authorship disputes that may occur either during processing or post-publication. Here, COPE guidelines clearly state that Journals are not in a position to adjudicate on appropriate authorship contributions ( https:/publicationethics.org/resources/discussion-documents/authorship ) and that disputed authorship is not usually grounds for retraction when “there is no reason to doubt the validity of the findings” ( https://publicationethics.org/retraction-guidelines ).

In situations where disputes cannot be settled by the effected parties, Journals will reach out to an appropriate Institution or Governing Body for final adjudication. MDPI reserves the right to amend authorship lists in line with Institution or Governing Body recommendations.

Plagiarism is not acceptable in MDPI journals. Plagiarism includes copying text, ideas, images, or data from another source, even from your own publications, without giving credit to the original source.

Reuse of text that is copied from another source must be between quotation marks and the original source must be cited. If a study's design or the manuscript's structure or language has been inspired by previous studies, these studies must be explicitly cited.

All MDPI submissions are checked for plagiarism using the industry standard software iThenticate. If plagiarism is detected during the peer review process, the manuscript may be rejected. If plagiarism is detected after publication, an investigation will take place and action taken in accordance with our policies.

MDPI reserves the right to request original images at a sufficiently high resolution and unprocessed data files upon submission, during the peer review process, and for the purpose of post-publication investigation.

Image files must not be manipulated or adjusted in any way that could lead to misinterpretation of the information provided by the original image. Irregular manipulation includes 1) introduction, enhancement, moving, or removing features from the original image, 2) grouping of images that should obviously be presented separately (e.g., from different parts of the same gel, or from different gels), or 3) modifying the contrast, brightness or color balance to obscure, eliminate or enhance some information.

Any concerns raised over undeclared image modifications during manuscript processing or after publication will be investigated, and the authors will be requested to provide original images and unprocessed data. In case these data are unavailable upon request, the Editorial Office will halt the peer review process until the issues are satisfactorily resolved. If irregular image manipulation is identified and confirmed during the peer review process, the publisher may reject the manuscript. In instances where irregular image manipulation is identified and confirmed after publication, we may correct or retract the paper, and the issue may be raised with the authors’ institutions.

Data presented must be original and not inappropriately selected, manipulated, enhanced, or fabricated. This includes 1) exclusion of data points to enhance significance of conclusions, 2) fabrication of data, 3) selection of results that support a particular conclusion at the expense of contradictory data, 4) deliberate selection of analysis tools or methods to support a particular conclusion (including p-hacking). We strongly recommend preregistration of methods and analysis.

MDPI encourages authors to retain unprocessed data and metadata files after publication by archiving their datasets on their laboratory or institutional servers, or in public, community-supported repositories, for at least five years after publication.

When reporting on research that involves human subjects, human material, human tissues, or human data, authors must declare that the investigations were carried out following the rules of the Declaration of Helsinki of 1975 ( https://www.wma.net/what-we-do/medical-ethics/declaration-of-helsinki/ ), revised in 2013. According to point 23 of this declaration, an approval from the local institutional review board (IRB) or other appropriate ethics committee must be obtained before undertaking the research to confirm the study meets national and international guidelines. As a minimum, a statement including the project identification code, date of approval, and name of the ethics committee or institutional review board must be stated in Section ‘Institutional Review Board Statement’ of the article.

Example of an ethical statement: "All subjects gave their informed consent for inclusion before they participated in the study. The study was conducted in accordance with the Declaration of Helsinki, and the protocol was approved by the Ethics Committee of XXX (Project identification code)."

For non-interventional studies (e.g. surveys, questionnaires, social media research), all participants must be fully informed if the anonymity is assured, why the research is being conducted, how their data will be used and if there are any risks associated. As with all research involving humans, ethical approval from an appropriate ethics committee must be obtained prior to conducting the study. If ethical approval is not required, authors must either provide an exemption from the ethics committee or are encouraged to cite the local or national legislation that indicates ethics approval is not required for this type of study. Where a study has been granted exemption, the name of the ethics committee which provided this should be stated in Section ‘Institutional Review Board Statement’ with a full explanation regarding why ethical approval was not required.

A written informed consent for publication must be obtained from participating patients. Data relating to individual participants must be described in detail, but private information identifying participants need not be included unless the identifiable materials are of relevance to the research (for example, photographs of participants’ faces that show a particular symptom). Patients’ initials or other personal identifiers must not appear in any images. For manuscripts that include any case details, personal information, and/or images of patients, authors must obtain signed informed consent for publication from patients (or their relatives/guardians) before submitting to an MDPI journal. Patient details must be anonymized as far as possible, e.g., do not mention specific age, ethnicity, or occupation where they are not relevant to the conclusions. A template permission form is available to download. A blank version of the form used to obtain permission (without the patient names or signature) must be uploaded with your submission. Editors reserve the right to reject any submission that does not meet these requirements.

You may refer to our sample form and provide an appropriate form after consulting with your affiliated institution. For the purposes of publishing in MDPI journals, a consent, permission, or release form should include unlimited permission for publication in all formats (including print, electronic, and online), in sublicensed and reprinted versions (including translations and derived works), and in other works and products under open access license. To respect patients’ and any other individual’s privacy, please do not send signed forms. The journal reserves the right to ask authors to provide signed forms if necessary.

If the study reports research involving vulnerable groups, an additional check may be performed. The submitted manuscript will be scrutinized by the editorial office and upon request, documentary evidence (blank consent forms and any related discussion documents from the ethics board) must be supplied. Additionally, when studies describe groups by race, ethnicity, gender, disability, disease, etc., explanation regarding why such categorization was needed must be clearly stated in the article.

Research Involving the Use of Animals

The editors will require that the benefits potentially derived from any research causing harm to animals are significant in relation to any cost endured by animals, and that procedures followed are unlikely to cause offense to the majority of readers. Authors should particularly ensure that their research complies with the commonly-accepted '3Rs' [1]:

  • Replacement of animals by alternatives wherever possible;
  • Reduction in number of animals used; AND
  • Refinement of experimental conditions and procedures to minimize the harm to animals.

Authors must include details on housing, husbandry and pain management in their manuscript.

For further guidance authors should refer to the Code of Practice for the Housing and Care of Animals Used in Scientific Procedures [2], American Association for Laboratory Animal Science [3] or European Animal Research Association [4].

If national legislation requires it, studies involving vertebrates or higher invertebrates must only be carried out after obtaining approval from the appropriate ethics committee. As a minimum, the project identification code, date of approval and name of the ethics committee or institutional review board should be stated in Section ‘Institutional Review Board Statement’. Research procedures must be carried out in accordance with national and institutional regulations. Statements on animal welfare should confirm that the study complied with all relevant legislation. Clinical studies involving animals and interventions outside of routine care require ethics committee oversight as per the American Veterinary Medical Association. If the study involved client-owned animals, informed client consent must be obtained and certified in the manuscript report of the research. Owners must be fully informed if there are any risks associated with the procedures and that the research will be published. If available, a high standard of veterinary care must be provided. Authors are responsible for correctness of the statements provided in the manuscript.

If ethical approval is not required by national laws, authors must provide an exemption from the ethics committee, if one is available. Where a study has been granted exemption, the name of the ethics committee that provided this should be stated in Section ‘Institutional Review Board Statement’ with a full explanation on why the ethical approval was not required.

If no animal ethics committee is available to review applications, authors should be aware that the ethics of their research will be evaluated by reviewers and editors. Authors should provide a statement justifying the work from an ethical perspective, using the same utilitarian framework that is used by ethics committees. Authors may be asked to provide this even if they have received ethical approval.

MDPI endorses the ARRIVE guidelines ( arriveguidelines.org/ ) for reporting experiments using live animals. Authors and reviewers must use the ARRIVE guidelines as a checklist, which can be found at https://arriveguidelines.org/sites/arrive/files/documents/Author%20Checklist%20-%20Full.pdf . Editors reserve the right to ask for the checklist and to reject submissions that do not adhere to these guidelines, to reject submissions based on ethical or animal welfare concerns or if the procedure described does not appear to be justified by the value of the work presented.

  • NSW Department of Primary Industries and Animal Research Review Panel. Three Rs. Available online: https://www.animalethics.org.au/three-rs
  • Home Office. Animals (Scientific Procedures) Act 1986. Code of Practice for the Housing and Care of Animals Bred, Supplied or Used for Scientific Purposes. Available online: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/388535/CoPanimalsWeb.pdf
  • American Association for Laboratory Animal Science. The Scientific Basis for Regulation of Animal Care and Use. Available online: https://www.aalas.org/about-aalas/position-papers/scientific-basis-for-regulation-of-animal-care-and-use
  • European Animal Research Association. EU regulations on animal research. Available online: https://www.eara.eu/animal-research-law

Methods sections for submissions reporting on research with cell lines should state the origin of any cell lines. For established cell lines, the provenance should be stated and references must also be given to either a published paper or to a commercial source. If previously unpublished de novo cell lines were used, including those gifted from another laboratory, details of institutional review board or ethics committee approval must be given, and confirmation of written informed consent must be provided if the line is of human origin. Editors reserve the rights to reject any submission that does not meet these requirements.

An example of an ethical statement:

The HCT116 cell line was obtained from XXXX. The MLH1+ cell line was provided by XXXXX, Ltd. The DLD-1 cell line was obtained from Dr. XXXX. The DR-GFP and SA-GFP reporter plasmids were obtained from Dr. XXX and the Rad51K133A expression vector was obtained from Dr. XXXX.

Experimental research on plants (either cultivated or wild) including collection of plant material, must comply with institutional, national, or international guidelines. We recommend that authors comply with the Convention on Biological Diversity and the Convention on the Trade in Endangered Species of Wild Fauna and Flora .

For each submitted manuscript supporting genetic information and origin must be provided. For research manuscripts involving rare and non-model plants (other than, e.g., Arabidopsis thaliana, Nicotiana benthamiana, Oriza sativa , or many other typical model plants), voucher specimens must be deposited in an accessible herbarium or museum. Vouchers may be requested for review by future investigators to verify the identity of the material used in the study (especially if taxonomic rearrangements occur in the future). They should include details of the populations sampled on the site of collection (GPS coordinates), date of collection, and document the part(s) used in the study where appropriate. For rare, threatened or endangered species this can be waived but it is necessary for the author to describe this in the cover letter.

Editors reserve the rights to reject any submission that does not meet these requirements.

An example of Ethical Statements:

Torenia fournieri plants were used in this study. White-flowered Crown White (CrW) and violet-flowered Crown Violet (CrV) cultivars selected from ‘Crown Mix’ (XXX Company, City, Country) were kindly provided by Dr. XXX (XXX Institute, City, Country).

Arabidopis mutant lines (SALKxxxx, SAILxxxx,…) were kindly provided by Dr. XXX , institute, city, country).

Registration

MDPI follows the International Committee of Medical Journal Editors (ICMJE) guidelines which require and recommend registration of clinical trials in a public trials registry at or before the time of first patient enrollment as a condition of consideration for publication.

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  • Intake of sugar...

Intake of sugar sweetened beverages among children and adolescents in 185 countries between 1990 and 2018: population based study

  • Related content
  • Peer review
  • Renata Micha , professor 1 3 ,
  • Frederick Cudhea , biostatistician 1 ,
  • Victoria Miller , research fellow 1 4 5 ,
  • Peilin Shi , biostatistician 1 ,
  • Jianyi Zhang , biostatistician 6 ,
  • Julia R Sharib , researcher 1 ,
  • Josh Erndt-Marino , researcher 1 ,
  • Sean B Cash , professor 7 ,
  • Simon Barquera , director 8 ,
  • Dariush Mozaffarian , professor 1 9 10
  • on behalf of the Global Dietary Database
  • 1 Food is Medicine Institute, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
  • 2 Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
  • 3 University of Thessaly, Volos, Greece
  • 4 Department of Medicine, McMaster University, Hamilton, ON, Canada
  • 5 Population Health Research Institute, Hamilton, ON, Canada
  • 6 Center for Surgery and Public Health, Brigham and Women’s Hospital Boston, MA, USA
  • 7 Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
  • 8 Research Center on Nutrition and Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
  • 9 Tufts University School of Medicine, Boston, MA, USA
  • 10 Division of Cardiology, Tufts Medical Center, Boston, MA, USA
  • Correspondence to: L Lara-Castor lauralac{at}uw.edu
  • Accepted 11 June 2024

Objective To quantify global intakes of sugar sweetened beverages (SSBs) and trends over time among children and adolescents.

Design Population based study.

Setting Global Dietary Database.

Population Children and adolescents aged 3-19 years in 185 countries between 1990 and 2018, jointly stratified at subnational level by age, sex, parental education, and rural or urban residence.

Results In 2018, mean global SSB intake was 3.6 (standardized serving=248 g (8 oz)) servings/week (1.3 (95% uncertainly interval 1.0 to 1.9) in south Asia to 9.1 (8.3 to 10.1) in Latin America and the Caribbean). SSB intakes were higher in older versus younger children and adolescents, those resident in urban versus rural areas, and those of parents with higher versus lower education. Between 1990 and 2018, mean global SSB intakes increased by 0.68 servings/week (22.9%), with the largest increases in sub-Saharan Africa (2.17 servings/week; 106%). Of 185 countries included in the analysis, 56 (30.3%) had a mean SSB intake of ≥7 servings/week, representing 238 million children and adolescents, or 10.4% of the global population of young people.

Conclusion This study found that intakes of SSBs among children and adolescents aged 3-19 years in 185 countries increased by 23% from 1990 to 2018, parallel to the rise in prevalence of obesity among this population globally. SSB intakes showed large heterogeneity among children and adolescents worldwide and by age, parental level of education, and urbanicity. This research should help to inform policies to reduce SSB intake among young people, particularly those with larger intakes across all education levels in urban and rural areas in Latin America and the Caribbean, and the growing problem of SSBs for public health in sub-Saharan Africa.

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Introduction

In 2015, obesity was estimated to affect more than 100 million children and adolescents, in line with observed increases in body mass index among this population from 1975 to 2016 in most world regions. 1 43 Among the main risk factors for obesity, unhealthy diets play a crucial role. 2 In particular, intake of sugar sweetened beverages (SSBs) has been consistently reported to increase the risk of obesity among children and adolescents. 2 3 This is especially concerning because obesity in childhood tends to persist into adulthood, increasing the risk of type 2 diabetes, cardiovascular disease, and premature mortality. 4 Explanations for the increase in intake of SSBs include globalization of markets, transformation of food systems, aggressive marketing strategies directed at children and adolescents, and lack of (or poor) regulatory measures to limit intake. 5 6 In studies at national and subnational level, policies and strategies such as taxation on sugar sweetened drinks, restrictions on food marketing, regulations for front-of-package labeling, and restrictions at school level have proven to curb the intake of SSBs among children and adolescents. 6 7 8

Although quantifying the intake of SSBs among children and adolescents is critical to further evaluate the impact of these beverages on disease and the effectiveness of policies to control intake, recent national estimates among young people are unavailable for most countries. 6 The lack of such data prevents an analysis of the trends in SSB intake over time, as well as the role of key sociodemographic factors such as age, sex, education, and urbanicity to more accurately inform current and future policies. In this study we present SSB intakes among children and adolescents aged 3-19 years at global, regional, and national level and trends over time from 1990 to 2018, jointly stratified at subnational level by age, sex, parental level of education, and area of residence.

Study design

This investigation is based on a serial cross sectional analysis of SSB intakes from the Global Dietary Database 2018 for 185 countries. Details on the methods and standardized data collection protocol are described in detail elsewhere. 9 10 11 12 13 Compared with the Global Dietary Database 2010, innovations include major expansion of individual level dietary surveys and global coverage up to 2018; inclusion of new data jointly stratified at subnational level by age, sex, education level, and urban or rural residence; and updated modeling methods, covariates, and validation to improve prediction of stratum specific mean intakes and uncertainty. This present analysis focused on children and adolescents aged 3-19 years.

Data sources

The approach and results of our survey search strategy by dietary factor, time, and region are reported in detail elsewhere. 11 We performed systematic online searches for individual level dietary surveys in global and regional databases: PubMed, Embase, Web of science, LILACS, African Index Medicus, and the South-east Asia Index Medicus, using search terms “nutrition” or “diet” or “food habits” or “nutrition surveys” or “diet surveys” or “food habits”[mesh] or “diet”[mesh] or “nutrition surveys”[mesh] or “diet surveys”[mesh] and (“country of interest”). Additionally, we identified surveys through extensive personal communications with researchers and government authorities throughout the world, inviting them to be corresponding members of the Global Dietary Database. The search included surveys that collected data on at least one of 54 foods, beverages, nutrients, or dietary indices, including SSBs. A single reviewer screened identified studies by title and abstract, a random subset of articles was screened by a second reviewer to ensure consistency and accuracy, and a third reviewer screened studies to ensure that survey inclusion criteria were met. Surveys were prioritized if they were performed at national or subnational level and used individual level dietary assessments with standardized 24 hour recalls, food frequency questionnaires, or short standardized questionnaires (eg, Demographic Health Survey questionnaires). When national or subnational surveys at individual level were not identified for a country, we searched for individual level surveys from large cohorts, the World Health Organization (WHO) Global Infobase, and the WHO Stepwise Approach to Surveillance database. When individual level dietary surveys were not identified for a particular country, we considered household budget surveys. We excluded surveys focused on special populations (eg, exclusively pregnant or nursing mothers, individuals with a specific disease) or cohorts (eg, specific occupations or dietary patterns). Supplementary methods 1-3, supplementary tables 1-2, and supplementary figure 1 provide additional details on the methods. The final Global Dietary Database model incorporated 1224 dietary surveys from 185 countries, with 89% representative at national or subnational level, thus covering about 99.0% of the global population in 2018. Among these, 450 surveys reported data on SSBs, 85% of which provided individual level data. These 450 originated from 118 countries and surveyed a total of 2.9 million individuals, with 94% being representative at national or subnational level (see supplementary tables 4 and 5). Supplementary data 1 provides details on the characteristics of the survey.

Data extraction

For each survey, we used standardized methods to extract data on survey characteristics and dietary metrics, units, and mean and standard deviation of intake by age, sex, education level, and urban or rural residence (see supplementary methods 1). 12 All intakes are reported adjusted to 5439 kilojoules (kJ) daily (1300 kilocalories (kcal) daily) for ages 3-5 years, 7113 kJ/day (1700 kcal/day) for ages 6-10 years, and 8368 kJ/day (2000 kcal/day) for ages 11-19 years. SSBs were defined as any beverages with added sugars and ≥209 kJ (50 kcal) for each 237 g serving, including commercial or homemade beverages, soft drinks, energy drinks, fruit drinks, punch, lemonade, and aguas frescas. This definition excluded 100% fruit and vegetable juices, non-caloric artificially sweetened drinks, and sweetened milk. All included surveys used this definition.

Data modeling

Our model estimates intakes of SSBs for years for which we have survey data available. To incorporate and deal with differences in data comparability and sampling uncertainty, we used a bayesian model with a nested hierarchical structure (with random effects by country and region) to estimate the mean consumption of SSBs and its statistical uncertainty for each of 264 population strata across 185 countries for 1990, 1995, 2000, 2005, 2010, 2015, and 2018. Our model incorporated seven world regions: central and eastern Europe and central Asia, high income countries, Latin America and the Caribbean, the Middle East and north Africa, south Asia, southeast and east Asia, and sub-Saharan Africa. Our team and others (eg, the Global Burden of Disease study) have previously used this (or similar) classification for world regions, which aims to group nations by general similarities in risk profiles and disease outcomes. Although the current analysis only focuses on children and adolescents aged 3-19 years, the model used all age data to generate the strata predictions. Modeling all age groups jointly allows the use of the full set of available data and covariates to inform estimates, including age patterns, relationships between predictors and SSB intakes, and influence of covariates (eg, dietary assessment methods).

Primary inputs were the survey level quantitative data on SSB intakes (by country, time, age, sex, education level, and urban or rural residence), survey characteristics (dietary assessment method, type of dietary metric), and country-year specific covariates (see supplementary methods 2). The model included overdispersion of survey level variance for surveys that were not nationally representative or not stratified by smaller age groups (≤10 years), sex, education level, or urbanicity. Survey level covariates addressed potential survey bias, and the overdispersion parameter non-sampling variation due to survey level error (from imperfect study design and quality). The model then estimated intakes jointly stratified by age (<1, 1-2, 3-4, 5-9, 10-14, 15-19, 20-24, 25-29, 30-34, 35-39, 40-44, 45-49, 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, 80-84, 85-89, 90-94, ≥95 years), sex, education (≤6 years, >6-12 years, >12 years), and urbanicity (urban, rural). For children and adolescents (age <20 years) the stratification by education refers to parental education.

The uncertainty of each stratum specific estimate was quantified using 4000 Monte Carlo iterations to determine posterior predictive distributions of mean intake jointly by country, year, and sociodemographic subgroup. We computed the median intake and the 95% uncertainty interval (UI) for each stratum as the 50th, 2.5th, and 97.5th percentiles of the 4000 draws, respectively. For model selection and validation, we compared results from fivefold cross validation (randomly omitting 20% of the survey data at the stratum level and using that to evaluate predictive ability, run five times), compared predicted country intakes with survey observed intakes, assessed implausible estimates (see supplementary table 2), and visually assessed global and national mean intakes using heat maps.

A second bayesian model was used to strengthen time trend estimates for dietary factors (including SSBs) with corresponding available date on food or nutrients from the Food and Agriculture Organization’s food balance sheets 14 or the Global Expanded Nutrient Supply dataset. 15 No time component was formally included in the model; rather, time was captured by the underlying time variation in the model covariates. This second model incorporated country level intercepts and slopes, along with their correlation estimated across countries. The model is commonly referred to as a varying slopes model structure, and it leverages two dimensional partial pooling between intercepts and slopes to regularize all parameters and minimize the risk of overfitting. 16 17 The final presented results are a combination of these two bayesian models, as detailed in supplementary methods 3.

Statistical analysis

Global, regional, national, and within country population subgroup intakes of SSBs and their uncertainty were calculated as population weighted averages using all 4000 posterior predictions for each of the 264 demographic strata in each country-year. Population weights for each year were derived from the United Nations (UN) Population Division, 18 supplemented with data for education and urban or rural status from Barro and Lee 19 and the UN. 20

Intakes were calculated as 248 g (8 oz) servings weekly, or two thirds of a common 355 mL (12 oz) can of a sugar sweetened drink weekly. Absolute changes and percentage changes in consumption between 1990 and 2005, 2005 and 2018, and 1990 and 2018 were calculated at the stratum specific prediction level to account for the full spectrum of uncertainty and standardized to the proportion of individuals within each stratum in 2018 to account for changes in population characteristics over time. Stratum specific predictions were summed to calculate the differences in intake between all children and adolescents aged 3-19 years, high and low parental education (>12 years and ≤6 years, respectively), and urban and rural residence, further stratified by sex, age, parental education, and area of residence, as appropriate.

National intakes of SSBs and trends were assessed by sociodemographic development index, including trends over time between 1990 and 2005, 2005 and 2018, and 1990 and 2018. The sociodemographic development index is a measure of the development of a country or region, ranging from 0 to 1, with 0 representing the minimum level and 1 the maximum level of development of a given nation, and it is based on income per capita, average educational attainment, and fertility rates. 21 Our UIs are derived from a bayesian model and can be interpreted as at least 95% probability that the true mean is contained within the interval. For comparisons between groups (or over time), if the 95% UI of the difference (or change over time) does not include zero, this can be interpreted as at least 95% probability of a true difference. No hypothesis testing was conducted, as estimation with uncertainty has been recognized as a more informative approach. 22

Patient and public involvement

No patients or members of the public were involved in the study as we did not collect data directly from individuals, the funding source did not provide support for direct patient and public involvement, and the study was initiated before patient and public involvement was common. The present analysis used modeled data derived from dietary data that had been previously collected, and we engaged with a diverse set of 320 corresponding members in nations around the world.

Global, regional, and national SSB intakes in 2018

In 2018, the mean global intake of SSBs among children and adolescents was 3.6 (standardized serving=248 g (8 oz)) servings/week (95% UI 3.3 to 4.0), with wide (sevenfold) variation across world regions, from 1.3 servings/week (1.0 to 1.9) in south Asia to 9.1 (8.3 to 10.1) in Latin America and the Caribbean ( table 1 ). Among the 25 countries with the largest population of children and adolescents worldwide, mean highest intakes were in Mexico (10.1 (9.1 to 11.3)), followed by Uganda (6.9 (4.5 to 10.6)), Pakistan (6.4 (4.3 to 9.7)), South Africa (6.2 (4.7 to 8.1)), and the US (6.2 (5.9 to 6.6)); while the lowest intakes were in India and Bangladesh (0.3 servings/week each) ( fig 1 , also see supplementary figure 9). Of the 185 countries included in the analysis, 56 (30.3%) had mean SSB intakes of ≥7 servings/week, representing 238 million young people aged 3-19 years, or 10.4% of the global population for this age group.

Global and regional mean intake of SSBs (248 g (8 oz) serving/week) in children and adolescents aged 3-19 years, by age, sex, parental education, and area of residence across 185 countries in 2018

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Fig 1

National mean intakes of SSBs (standardized 248 g (8 oz) serving/week for this analysis) in children and adolescents aged 3-19 years across 185 countries in 2018. SSBs were defined as any beverage with added sugars and ≥209 kJ (50 kcal) per 237 g serving, including commercial or homemade beverages, soft drinks, energy drinks, fruit drinks, punch, lemonade, and aguas frescas. This definition excludes 100% fruit and vegetable juices, non-caloric artificially sweetened drinks, and sweetened milk. For this visual representation, values were truncated at 21 servings/week to better reflect the distribution of intakes globally. The figure was created using the rworldmap package (v1.3-6). SSB=sugar sweetened beverage

SSB intake by sex and age in 2018

Globally, regionally, and nationally, SSB intakes between male and female children and adolescents aged 3-19 years did not differ noticeably, as observed by the 95% UI of the differences including zero ( table 1 , also see supplementary tables 7 and 8). Intake of SSBs in young people was greater with increasing age globally and regionally, although with varying magnitude of these differences by region ( table 1 and fig 2 ). For instance, intakes of SSBs exceeded 9 servings/week among children aged ≥10 years in Latin America and the Caribbean and in the Middle East and north Africa but were just over 1 serving/week among young people of the same age in south Asia. Regionally, patterns of intake by age were similar between young people (see supplementary figure 2). Considering both age and region, the highest weekly intakes of SSBs were in Latin America and the Caribbean in 15-19 year olds (11.5 servings/week) and lowest in southeast and east Asia in 3-4 year olds (0.9 servings/week) ( table 1 ). Among the 25 most populous countries, the highest intakes of SSBs were in Mexico among 10-14 year olds (11.9 servings/week) and 15-19 year olds (12.8 servings/week) and lowest in Kenya and China among 3-4 year olds (0.2 servings/week each) (supplementary table 6).

Fig 2

Global and regional intakes of SSBs (standardized 248 g (8 oz) serving/week for this analysis) by age in children and adolescents aged 3-19 years in 2018. SSBs were defined as any beverage with added sugars and ≥209 kJ (50 kcal) per 237 g serving, including commercial or homemade beverages, soft drinks, energy drinks, fruit drinks, punch, lemonade, and aguas frescas. This definition excludes 100% fruit and vegetable juices, non-caloric artificially sweetened drinks, and sweetened milk. The filled circles represent the mean SSBs intake (248 g (8 oz) serving/week) and the error bars the 95% UIs. In previous Global Dietary Database reports, the region central and eastern Europe and central Asia was referred to as the former Soviet Union, and southeast and east Asia was referred to as Asia. SSBs=sugar sweetened beverages; UI=uncertainty interval

SSB intake by parental education and urbanicity in 2018

Intakes of SSBs were greater in children and adolescents from urban areas than those from rural areas (4.6 servings/week (4.2 to 5.0) v 2.7 servings/week (2.4 to 3.1); table 1 ). When parental education and area of residence was assessed jointly, globally the highest intakes of SSBs were among children and adolescents of parents with high education in urban areas (5.15 servings/week (4.76 to 5.64)), representing 11.2% of the global population of children and adolescents ( fig 3 ). Regionally, a similar pattern was observed in Latin America and the Caribbean, south Asia, and sub-Saharan Africa, with the largest intakes of SSBs in children and adolescents of parents with high and medium education in urban and rural areas in Latin America and the Caribbean (≥9 servings/week each), representing 56% of the population of children and adolescents in that region. Intakes of SSBs by area of residence and education were inverted in the Middle East and north Africa, with larger intakes among children and adolescents from rural areas and of parents with lower education, and little variation was observed in other world regions. See supplementary tables 7, 9, and 10, supplementary figures 3 and 4, and supplementary results for further details on SSB intakes by parental education and area of residence.

Fig 3

Global and regional mean SSB intakes (standardized 248 g (8 oz) serving/week for this analysis) in children and adolescents aged 3-19 years by area of residence and parental education level in 2018. SSBs were defined as any beverage with added sugars and ≥209 kJ (50 kcal) per 237 g serving, including commercial or homemade beverages, soft drinks, energy drinks, fruit drinks, punch, lemonade, and aguas frescas. This definition excludes 100% fruit and vegetable juices, non-caloric artificially sweetened drinks, and sweetened milk. Error bars represent 95% UIs. Values were truncated at 11.5 servings/week to better reflect the distribution of intakes. Upper 95% UIs above that value are shown with a dashed line. In previous Global Dietary Database reports, the region central and eastern Europe and central Asia was referred to as the former Soviet Union, and southeast and east Asia was referred to as Asia. SSBs=sugar sweetened beverages; UI=uncertainty interval

Trends in SSB intake during 1990-2005, 2005-18, and 1990-2018

Supplementary tables 11-14 and supplementary figures 5-8 show absolute global, regional, and national intakes of SSBs for 1990 and 2005. Globally, from 1990 to 2018, intakes among children and adolescents increased by 0.68 servings/week (95% UI 0.54 to 0.85; 22.9%) ( fig 4 , also see supplementary data 2). The magnitude of global increase was similar from 1990 to 2005 (0.33 (0.25 to 0.43); 11.0%) and from 2005 to 2018 (0.35 (0.26 to 0.47); 10.7%). However, regionally, changes did not follow the same global pattern. Between 1990 and 2005, increases in intakes of SSBs were observed in most regions, with the largest increase in high income countries (1.48 (1.37 to 1.60); 29.1%), little change in central and eastern Europe and central Asia and in south Asia, and a decrease in Latin America and the Caribbean (−1.20 (−1.54 to −0.88); −12.7%). More recently, from 2005 to 2018, increases continued in most regions, with the largest in sub-Saharan Africa (1.38 (1.01 to 1.85); 49.2%), except for south Asia where little change was evident and high income countries where intakes decreased (−1.59 (−1.71 to −1.47); −24.1%). In the overall period from 1990 to 2018, the largest regional increase was in sub-Saharan Africa (2.17 (1.60 to 2.88); 106%), with other world regions showing steady, more modest increases over time. Exceptions were high income countries and Latin America and the Caribbean, where intakes increased after 1990 and then decreased close to 1990 levels by 2018. The supplementary results and supplementary table 15 describe regional trends over time by age, sex, parental education, and urbanicity.

Fig 4

(Top panel) Mean SSB intakes (standardized 248 g (8 oz) serving/week for this analysis) by world region in 1990, 2005, and 2018, and absolute changes from 1990 to 2005, 2005-18, and 1990-2018 in children and adolescents aged 3-19 years. (Bottom panel) Absolute changes in SSB intakes from 1990-2005, 2005-18, and 1990-2018. SSBs were defined as any beverage with added sugars and ≥209 kJ (50 kcal) per 237 g serving, including commercial or homemade beverages, soft drinks, energy drinks, fruit drinks, punch, lemonade, and aguas frescas. This definition excludes 100% fruit and vegetable juices, non-caloric artificially sweetened drinks, and sweetened milk. Error bars represent 95% UIs. In previous Global Dietary Database reports, the region central and eastern Europe and central Asia was referred to as the former Soviet Union, and southeast and east Asia was referred to as Asia. SSBs=sugar sweetened beverages; UI=uncertainty interval

Among the 25 most populous countries, the largest increase from 1990 to 2005 was in the US (2.95 (2.73 to 3.17); 43.2%) and the largest decrease was in Brazil (−3.42 (−3.95 to −2.97); −40.6%) (see supplementary data 2 and supplementary figure 9). From 2005 to 2018, the largest increase was in Uganda (4.30 (2.31 to 7.39); 173%), and the largest decrease was in the US (−3.55 (−3.81 to −3.30); −36.4%). Overall, between 1990 and 2018, the largest increased was in Uganda (6.73 (4.38 to 10.39); 5573%) and the largest decrease was in Brazil (−3.29 (−3.79 to −2.86); −39.0%) (see supplementary data 2 and supplementary figure 10). The supplementary results and supplementary tables 16-19 show trends over time within the 25 most populous countries by age, sex, parental education, and urbanicity.

SSB intakes and trends by sociodemographic development index and obesity

In 1990 and 2005 a positive correlation was evident between national intakes of SSBs and sociodemographic development index, with greater intakes observed in countries with a higher sociodemographic development index (see supplementary figures 11 and 12). However, this correlation was no longer present in 2018 (r=−0.001, P=0.99). Intakes of SSBs and prevalence of obesity were positively correlated in both 1990 (r=0.28, P<0.001) and 2018 (r=0.23, P<0.001) (see supplementary figure 13).

Intakes of SSBs among children and adolescents aged 3-19 years in 185 countries increased by 23% (0.68 servings/week (0.54 to 0.85)) from 1990 to 2018, parallel to the rise in prevalence of obesity among this population globally. 23 We found a positive correlation between intake of SSBs and prevalence of obesity among children and adolescents in all years. This finding needs particular attention given the incremental economic costs associated with overweight and obesity globally, which are projected to increase from about $2.0tn (£1.6tn; €1.9tn) in 2020 to $18tn by 2060, exceeding 3% of the world’s gross domestic product. 24 Chronic diet related conditions such as obesity have been recognized as part of a global syndemic along with undernutrition given their interaction and shared underlying societal drivers. 25 Tackling drivers of obesity and other diet related diseases among children and adolescents is also critical to be better equipped for potential future pandemics, as cardiometabolic conditions such as obesity, diabetes, and hypertension were top drivers of increased risk of hospital admission and death with covid-19. 26 The increase in intakes of SSBs among children and adolescents corresponded to nearly twice the absolute increase in intake observed among the adult population from 1990 to 2018, for which policies targeting specifically children and adolescents are critical. 13 Young people are particularly appealing to the food industry as they are easily influenced by food marketing, having an effect on not only their current intakes but also their preferences as they develop into adulthood. 27 Their susceptibility to marketing, rising trends in obesity, and accelerated increases in intakes of SSBs underline the necessity for interventions such as taxes, regulations on front-of-package labeling, and regulations in the school environment to curb intakes of SSBs. 6 8 27 28

Changes in intakes of SSBs in children and adolescents from 1990 to 2018 varied substantially by world region. As with the adult population, the largest increase from 1990 to 2018 was in sub-Saharan Africa, emphasizing the need for prompt interventions in this region. Young people in the Middle East and north Africa and in southeast and east Asia showed a more accelerated increase in SSB consumption compared with adults, underlining the importance of policies targeting young people in these regions. The Middle East and north Africa had the second highest intakes of SSBs among children and adolescents in 2018, which differed from our findings among adults, where the Middle East and north Africa occupied third place after sub-Saharan Africa.

Latin America and the Caribbean experienced an overall decrease in intakes of SSBs from 1990 to 2005, which could be attributed to the economic crisis experienced among most of the major economies in the region during this period, 29 in addition to potential greater health awareness as a result of healthy eating campaigns in several countries in the region. 30 In contrast, the increases in intakes in this region from 2005 to 2018 may relate to economic recovery, increased marketing campaigns, and industry opposition to public policies to reduce the intake of SSBs. 31 These findings align with findings in the adult population of this region. 13 Over the past 30 years, Latin America and the Caribbean has undergone an accelerated transformation in the food systems, resulting in wider availability of unhealthy foods, including SSBs, that could explain the large intakes in this region. 7 Moreover, the influence of multinational corporations responsible for ultra-processed foods, marketing strategies targeted at young people, lack of (or poor) regulatory measures to limit the intake of SSBs have also been consistently observed in Latin America and other regions with improving economies. 1 6 7 The use of social media and TV to target advertising at young people has been identified as being especially high in Latin America as well as in the Middle East. 6 27

High income countries experienced an overall decrease in intakes of SSBs from 2005 to 2018. This might be explained by the increasing scientific and public health attention on the harms of SSBs as well as obesity in these nations during this period, which may have led to increased media and public awareness about the harms to health associated with SSBs, wider formulation, promotion, and availability of non-caloric sweetened beverage substitutes, and, more recently, taxation on SSBs in several of these nations. 32

The potential role of sociodemographic factors on intakes of SSBs was evidenced by the large variations in intake by parental education and urbanicity, particularly in south Asia and sub-Saharan Africa, evidencing the need to account for these factors in the design of policies and interventions. At national level, the correlation between intake of SSBs and sociodemographic development index changed from positive in 1990 to null in 2018 (see supplementary figure 11), suggesting that the association between the two might be reversing. This is similar to what was observed in adults, where the association between intake of SSBs and sociodemographic index changed from null to negative from 1990 to 2018. 13 Our new findings show similar directional trends in national and subnational intakes of SSBs among young people compared with adults, 13 although with generally higher absolute intakes among young people, suggesting nation specific influences on SSB intakes are at least partly shared across the lifespan. Further efforts are needed to incorporate data on other social determinants of health, such as income, access to water, access to healthcare, and race/ethnicity to elucidate additional potential heterogeneities.

Strengths and limitations of this study

Our study has several strengths. We assessed and reported global, regional, and national estimates of SSB intakes jointly stratified by age, sex, parental education, and urbanicity among children and adolescents. Compared with previous estimates, our current model included a larger number of dietary surveys, additional demographic subgroups, and years of assessment. Our updated bayesian hierarchical model better incorporated survey and country level covariates—and addressed heterogeneity and uncertainty about sampling and modeling. 13 33 Intakes were estimated from 450 surveys—mostly representative at national and subnational levels and collected at individual level—and represented 87.1% of the world’s population. Other recent estimates for global intakes of SSBs relied mostly on national per capita estimates of food availability (eg, Food and Agriculture Organization food balance sheets) or sales data. 34 Such estimates can substantially overestimate and underestimate intake compared with individual level data 35 and are less robust for characterizing differences across population subgroups. Our estimates are informed by dietary data at individual level collected from both 24 hour recalls (24% of surveys), considered the ideal method for assessing nutritional intakes of populations), and food frequency questionnaires (61% of surveys), a validated approach for measuring intakes of SSBs 36 (see supplementary table 4).

Overall, our findings should be taken as the best currently available, but nonetheless imperfect, estimates of SSB intakes worldwide. Even with systematic searches for all relevant surveys, we identified limited availability of data for several countries (particularly lower income nations) and time periods. 11 Thus, estimated findings in countries with no primary individual level surveys have higher corresponding uncertainty, informing surveillance needs to assess SSBs nationally and in populations at subnational level. Particularly, we identified limited surveys for south Asia (n=9) and sub-Saharan Africa (n=22), which might have affected the accuracy of our estimates in those regions (see supplementary table 4). This finding emphasizes the critical need for further efforts in data collection and surveillance, particularly in these regions. Categorization by age, parental education, and urbanicity were in groups rather than in more nuanced classifications, balancing the interest in subgroup detail versus the realities required from a global demographic effort of de novo harmonized analyses of individual level dietary data from hundreds of different dietary surveys and corresponding members globally. All types of dietary assessments include some errors, whether from individual level surveys, national food availability estimates, or other sources. Our model’s incorporation of multiple types and sources of dietary assessments provided the best available estimates of global diets, as well as the uncertainty of these estimates. For instance, self-reported data rely on the memory and personal biases of the respondents, thus introducing potential bias from underreporting or overreporting of actual intakes. Furthermore, assumptions relating to standardization of serving sizes, SSB definitions, energy adjustment, and disaggregation at household level, as well as of no interaction between sociodemographic variables in our model, could have impacted our estimates. To minimize these limitations, we used standardized approaches and carefully documented each survey’s methods and standardization processes to maximize transparency.

Our definition and data collection on SSBs excluded 100% fruit juice, sugar sweetened milk, tea, and coffee, given that evidence for health effects of these beverages is inconsistent and does not achieve at least probable evidence for causal harms. 37 38 These differences may relate to additional nutrients, such as calcium, vitamin D, fats, and protein in milk, caffeine and polyphenols in coffee and tea, and fiber and vitamins in 100% juice; or to differences in rapidity of consumption and drinking patterns. Each of these beverages is generally also excluded in policy and surveillance efforts around SSBs. A recent meta-analysis suggested a modest positive association between 100% fruit juices and body mass index in children (0.03 units higher for each daily serving), 39 highlighting the need for more research on the health impacts of these and other beverages in children. Sweetened milks are mostly targeted at children and adolescents, and in some regions are mostly consumed by the youngest children. 40 Given that our SSBs definition excluded sweetened milk, this could partially explain the low intakes observed in our study among the youngest age categories. Future studies should also look into characterizing intakes of sweetened milks, especially in countries such as the US, Australia, Pakistan, and Chile where high intakes among children and adolescents have been reported. 40 41 Home sweetened teas and coffees were not explicitly excluded from the definition of SSBs at the time of data collection, but tea and coffee were collected as separate variables and thus most likely excluded by data owners from the SSBs category. SSBs were defined as beverages with added sugars and ≥209 kJ (50 kcal) per 237g serving, capturing most of the SSBs during the time period of our investigation that typically contained about 418 kJ (100 kcal) per serving. More recently, some SSBs with slightly less than 10 g of added sugar have entered the market. As these are a relatively recent addition, their exclusion is unlikely to meaningfully alter our findings, but future research should focus on more refined surveillance of SSBs to allow flexibility in beverage group definitions—for example, similar to the data harmonized in our collaboration with the FAO/WHO GIFT food consumption data tool. 42 Our current definition leveraging product name and caloric content to identify beverages with added sugar across the world ensures consistency in reporting.

Intakes of SSBs among children and adolescents aged 3-19 years in 185 countries increased by almost a quarter from 1990 to 2018, parallel to the rise in prevalence of obesity among this population globally. Policies and approaches at both a national level and a more targeted level are needed to reduce intakes of SSBs among young people worldwide, highlighting the larger intakes across all education levels in urban and rural areas in Latin America and the Caribbean, and the growing problem of SSBs for public health in sub-Saharan Africa. Our findings are intended to inform current and future policies to curb SSB intakes, adding to the UN’s 2030 Agenda for Sustainable Development for improving health and wellbeing, reducing inequities, responsible consumption, poverty, and access to clean water.

What is already known in this topic

The intake of sugar sweetened beverages (SSBs) has been consistently reported to increase the risk of obesity among children and adolescents

This is especially concerning given that obesity in childhood tends to persist into adulthood, increasing the risk of type 2 diabetes, cardiovascular disease, and premature mortality

Quantification of SSB intakes among children and adolescents is therefore critical, yet recent estimates among children and adolescents are unavailable for most nations

What this study adds

Intakes of SSBs among children and adolescents aged 3-19 years in 185 countries increased by almost a quarter from 1990 to 2018, parallel to the rise in prevalence of obesity among this population globally

Larger intakes were identified across all education levels in urban and rural areas in Latin America and the Caribbean, along with the growing problem of SSBs for public health in sub-Saharan Africa

Intake of SSBs among children and adolescents showed large heterogeneity by region and population characteristics, informing the need for national and targeted policies and approaches to reduce SSB intake among this population worldwide

Ethics statements

Ethical approval.

This investigation was exempt from ethical review board approval because it was based on published deidentified nationally representative data, without personally identifiable information. Individual surveys underwent ethical review board approval required for the applicable local context.

Data availability statement

The individual SSB intake estimate distribution data used in this as means and uncertainty (SE) for each strata in the analysis are available freely online at the Global Dietary Database (Download 2018 Final Estimates: https://www.globaldietarydatabase.org/data-download ). Global Dietary Database data were utilized in agreement with the database guidelines. Absolute and relative differences by strata and by year presented in this analysis were calculated using the 4000 simulations corresponding to the stratum level intake data derived from the bayesian model. The 4000 simulations files can be made available to researchers upon request. Eligibility criteria for such requests include utilization for non-profit purposes only, for appropriate scientific use based on a robust research plan, and by investigators from an academic institution. If you are interested in requesting access to the data, please submit the following documents: (1) proposed research plan (please download and complete the proposed research plan form: https://www.globaldietarydatabase.org/sites/default/files/manual_upload/research-proposal-template.pdf ), (2) data-sharing agreement (please download this form https://www.globaldietarydatabase.org/sites/default/files/manual_upload/tufts-gdd-data-sharing-agreement.docx and complete the highlighted fields, have someone who is authorized to enter your institution into a binding legal agreement with outside institutions sign the document. Note that this agreement does not apply when protected health information or personally identifiable information are shared), (3) email items (1) and (2) [email protected]. Please use the subject line “GDD Code Access Request.” Once all documents have been received, the Global Dietary Database team will be in contact with you within 2-4 weeks about subsequent steps. Data will be shared as .csv or .xlsx files, using a compressed format when appropriate. Population weights for each strata and year were derived from the United Nations Population Division ( https://population.un.org/wpp/ ), supplemented with data for education and urban or rural status from Barro and Lee (doi: 10.3386/w15902 ) and the United Nations ( https://population.un.org/wup/Download/ ).

Acknowledgments

We acknowledge the Tufts University High Performance Computing Cluster ( https://it.tufts.edu/high-performance-computing ), which was used for the research reported in this paper.

Members of the Global Dietary Database (see supplementary text 1 for affiliations)

Antonia Trichopoulou, Murat Bas, Jemal Haidar Ali, Tatyana El-Kour, Anand Krishnan, Puneet Misra, Nahla Hwalla, Chandrashekar Janakiram, Nur Indrawaty Lipoeto, Abdulrahman Musaiger, Farhad Pourfarzi, Iftikhar Alam, Celine Termote, Anjum Memon, Marieke Vossenaar, Paramita Mazumdar, Ingrid Rached, Alicia Rovirosa, María Elisa Zapata, Roya Kelishadi, Tamene Taye Asayehu, Francis Oduor, Julia Boedecker, Lilian Aluso, Emanuele Marconi, Laura D’Addezio, Raffaela Piccinelli, Stefania Sette, Johana Ortiz-Ulloa, J V Meenakshi, Giuseppe Grosso, Anna Waskiewicz, Umber S Khan, Kenneth Brown, Lene Frost Andersen, Anastasia Thanopoulou, Reza Malekzadeh, Neville Calleja, Anca Ioana Nicolau, Cornelia Tudorie, Marga Ocke, Zohreh Etemad, Mohannad Al Nsour, Lydiah M Waswa, Maryam Hashemian, Eha Nurk, Joanne Arsenault, Patricio Lopez-Jaramillo, Abla Mehio Sibai, Albertino Damasceno, Pulani Lanerolle, Carukshi Arambepola, Carla Lopes, Milton Severo, Nuno Lunet, Duarte Torres, Heli Tapanainen, Jaana 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Keinan-Boker, Rebecca Goldsmith, Tal Shimony, Gudrun B Keding, Shivanand C Mastiholi, Moses Mwangi, Yeri Kombe, Zipporah Bukania, Eman Alissa, Nasser Al-Daghri, Shaun Sabico, Rajesh Jeewon, Martin Gulliford, Tshilenge S Diba, Kyungwon Oh, Sihyun Park, Sungha Yun, Yoonsu Cho, Suad Al-Hooti, Chanthaly Luangphaxay, Daovieng Douangvichit, Latsamy Siengsounthone, Pedro Marques-Vidal, Peter Vollenweider, Constance Rybak, Amy Luke, Nipa Rojroongwasinkul, Noppawan Piaseu, Kalyana Sundram, Jeremy Koster, Donka Baykova, Parvin Abedi, Sandjaja Sandjaja, Fariza Fadzil, Noriklil Bukhary Ismail Bukhary, Pascal Bovet, Yu Chen, Norie Sawada, Shoichiro Tsugane, Lalka Rangelova, Stefka Petrova, Vesselka Duleva, Ward Siamusantu, Lucjan Szponar, Hsing-Yi Chang, Makiko Sekiyama, Khanh Le Nguyen Bao, Sesikeran Boindala, Jalila El Ati, Ivonne Ramirez Silva, Juan Rivera Dommarco, Luz Maria Sanchez-Romero, Simon Barquera, Sonia Rodríguez-Ramírez, Nayu Ikeda, Sahar Zaghloul, Anahita Houshiar-rad, Fatemeh Mohammadi-Nasrabadi, Morteza Abdollahi, Khun-Aik Chuah, Zaleha Abdullah Mahdy, Alison Eldridge, Eric L Ding, Herculina Kruger, Sigrun Henjum, Milton Fabian Suarez-Ortegon, Nawal Al-Hamad, Veronika Janská, Reema Tayyem, Bemnet Tedla, Parvin Mirmiran, Almut Richter, Gert Mensink, Lothar Wieler, Daniel Hoffman, Benoit Salanave, Shashi Chiplonkar, Anne Fernandez, Androniki Naska, Karin De Ridder, Cho-il Kim, Rebecca Kuriyan, Sumathi Swaminathan, Didier Garriguet, Anna Karin Lindroos, Eva Warensjo Lemming, Jessica Petrelius Sipinen, Lotta Moraeus, Saeed Dastgiri, Sirje Vaask, Tilakavati Karupaiah, Fatemeh Vida Zohoori, Alireza Esteghamati, Sina Noshad, Suhad Abumweis, Elizabeth Mwaniki, Simon G Anderson, Justin Chileshe, Sydney Mwanza, Lydia Lera Marques, Samuel Duran Aguero, Mariana Oleas, Luz Posada, Angelica Ochoa, Alan Martin Preston, Khadijah Shamsuddin, Zalilah Mohd Shariff, Hamid Jan Bin Jan Mohamed, Wan Manan, Bee Koon Poh, Pamela Abbott, Mohammadreza Pakseresht, Sangita Sharma, Tor 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Contributors: LLC, RM, and DM conceived the study. FC, PS, JZ, JRS, JEM, VM, LLC, RM, DM curated the data. FC, LLC, RM, and DM were responsible for the methodology. LLC, JRS, VM, and RM collected the data. FC, PS, JZ, JEM, VM, and LLC developed the software. FC, PS, JZ, VM, LLC, RM, and DM validated the data. LLC, SBC, SB, RM, and DM performed the formal analysis. LLC prepared the original draft of the manuscript. LLC, FC, PS, JZ, JRS, JEM, VM, SBC, SB, RM, and DM wrote, reviewed, and edited the manuscript. LLC generated the original figures and tables; SBC, SB, RM, and DM supervised the analysis, manuscript draft, and generation of figures and tables. LLC, RM, and DM acquired funding. They are the guarantors. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.

Funding: This research was supported by the Bill & Melinda Gates Foundation (grant OPP1176682 to DM), the American Heart Association (grant 903679 to LLC), and Consejo Nacional de Ciencia y Tecnología in Mexico (to LLC). This material is based upon work supported by the National Science Foundation under grant number 2018149. The computational resource is under active development by Research Technology, Tufts Technology Services. The funding agencies had no role in the design of the study; collection, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit for publication.

Competing interests: All authors have completed the ICMJE uniform disclosure form at https://www.icmje.org/disclosure-of-interest/ and declare the following: support from the Bill & Melinda Gates Foundation, American Heart Association, and Consejo Nacional de Ciencia y Tecnología in Mexico. LLC reports research funding from the Bill & Melinda Gates Foundation, the American Heart Association, and Consejo Nacional de Ciencia y Tecnología in Mexico (CONACyT), outside of the submitted work. RM reports research funding from the Bill & Melinda Gates Foundation; and (ended) the US National Institutes of Health, Danone, and Nestle. She also reports consulting from Development Initiatives and as IEG chair for the Global Nutrition Report, outside of the submitted work. FC, JZ, and PS report research funding from the Bill & Melinda Gates Foundation, as well as the National Institutes of Health, outside of the submitted work. VM reports research funding the Canadian Institutes of Health Research and from the American Heart Association, outside the submitted work. JRS reports research funding from the Bill & Melinda Gates Foundation, as well as the National Institutes of Health, Nestlé, Rockefeller Foundation, and Kaiser Permanent Fund at East Bay Community Foundation, outside of the submitted work. SBC reports research funding from the US. National Institutes of Health, US. Department of Agriculture, the Rockefeller Foundation, US. Agency for International Development, and the Kaiser Permanente Fund at East Bay Community Foundation, outside the submitted work. SB reports funding from Bloomberg Philanthropies, CONACyT, United Nations International Children’s Emergency Fund (Unicef), and Fundación Rio Arronte, outside the submitted work. DM reports research funding from the US National Institutes of Health, the Bill & Melinda Gates Foundation, the Rockefeller Foundation, Vail Innovative Global Research, and the Kaiser Permanente Fund at East Bay Community Foundation; personal fees from Acasti Pharma, Barilla, Danone, and Motif FoodWorks; is on the scientific advisory board for Beren Therapeutics, Brightseed, Calibrate, Elysium Health, Filtricine, HumanCo, Instacart, January, Perfect Day, Tiny Organics, and (ended) Day Two, Discern Dx, and Season Health; has stock ownership in Calibrate and HumanCo; and receives chapter royalties from UpToDate, outside the submitted work. The investigators did not receive funding from a pharmaceutical company or other agency to write this report, and declare no other relationships or activities that could appear to have influenced the submitted work.

Transparency: The lead author (LLC) affirms that the manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as originally planned (and, if relevant, registered) have been explained.

Dissemination to participants and related patient and public communities: Our research will be disseminated to the scientific community in a scientific conference and scientific publications; to the public through our website and social media; and to funders and interested ministries in various nations through presentations and brief reports.

Provenance and peer review: Not commissioned; externally peer reviewed.

Publisher’s note: Published maps are provided without any warranty of any kind, either express or implied. BMJ remains neutral with regard to jurisdictional claims in published maps.

Editor’s note: The visual abstract was included in this article on 9 August 2024 post-publication.

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/ .

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model question paper for research and publication ethics

  • Open access
  • Published: 07 August 2024

Ethical considerations in public engagement: developing tools for assessing the boundaries of research and involvement

  • Jaime Garcia-Iglesias 1 ,
  • Iona Beange 2 ,
  • Donald Davidson 2 ,
  • Suzanne Goopy 3 ,
  • Huayi Huang 3 ,
  • Fiona Murray 4 ,
  • Carol Porteous 5 ,
  • Elizabeth Stevenson 6 ,
  • Sinead Rhodes 7 ,
  • Faye Watson 8 &
  • Sue Fletcher-Watson 7  

Research Involvement and Engagement volume  10 , Article number:  83 ( 2024 ) Cite this article

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Public engagement with research (PEwR) has become increasingly integral to research practices. This paper explores the process and outcomes of a collaborative effort to address the ethical implications of PEwR activities and develop tools to navigate them within the context of a University Medical School. The activities this paper reflects on aimed to establish boundaries between research data collection and PEwR activities, support colleagues in identifying the ethical considerations relevant to their planned activities, and build confidence and capacity among staff to conduct PEwR projects. The development process involved the creation of a taxonomy outlining key terms used in PEwR work, a self-assessment tool to evaluate the need for formal ethical review, and a code of conduct for ethical PEwR. These tools were refined through iterative discussions and feedback from stakeholders, resulting in practical guidance for researchers navigating the ethical complexities of PEwR. Additionally, reflective prompts were developed to guide researchers in planning and conducting engagement activities, addressing a crucial aspect often overlooked in formal ethical review processes. The paper reflects on the broader regulatory landscape and the limitations of existing approval and governance processes, and prompts critical reflection on the compatibility of formal approval processes with the ethos of PEwR. Overall, the paper offers insights and practical guidance for researchers and institutions grappling with ethical considerations in PEwR, contributing to the ongoing conversation surrounding responsible research practices.

Plain English summary

This paper talks about making research fairer for everyone involved. Sometimes, researchers ask members of the public for advice, guidance or insight, or for help to design or do research, this is sometimes known as ‘public engagement with research’. But figuring out how to do this in a fair and respectful way can be tricky. In this paper, we discuss how we tried to make some helpful tools. These tools help researchers decide if they need to get formal permission, known as ethical approval, for their work when they are engaging with members of the public or communities. They also give tips on how to do the work in a good and fair way. We produced three main tools. One helps people understand the important words used in this kind of work (known as a taxonomy). Another tool helps researchers decide if they need to ask for special permission (a self-assessment tool). And the last tool gives guidelines on how to do the work in a respectful way (a code of conduct). These tools are meant to help researchers do their work better and treat everyone involved fairly. The paper also talks about how more work is needed in the area, but these tools are a good start to making research fairer and more respectful for everyone.

Peer Review reports

Introduction

In recent decades, “public involvement in research” has experienced significant development, becoming an essential element of the research landscape. In fact, it has been argued, public involvement may make research better and more relevant [ 7 , p. 1]. Patients’ roles, traditionally study participants, have transformed to become “active partners and co-designers” [ 17 , p. 1]. This evolution has led to the appearance of a multitude of definitions and terms to refer to these activities. In the UK, the National Co-ordinating Centre for Public Engagement, defines public engagement as the “many ways organisations seek to involve the public in their work” [ 9 ]. In this paper, we also refer to “public involvement,” which is defined as “research being carried out ‘with’ or ‘by’ members of the public rather than ‘to’, ‘about’ or ‘for’ them” (UK Standards for Public Involvement). Further to this, the Health Research Authority (also in the UK), defines public engagement with research as “all the ways in which the research community works together with people including patients, carers, advocates, service users and members of the community” [ 6 ]; [ 9 ]. These terms encompass a wide variety of theorizations, levels of engagement, and terminology, such as ‘patient-oriented research’, ‘participatory’ research or services or ‘patient engagement’ [ 17 , p. 2]. For this paper, we use the term ‘public engagement with research’ or PEwR in this way.

Institutions have been set up to support PEwR activities. In the UK these include the UK Standards for Public Involvement in Research (supported by the National Institute for Health and Care Research), INVOLVE, and the National Coordinating Centre for Public Engagement (NCCPE). Most recently, in 2023, the UK’s largest funders and healthcare bodies signed a joint statement “to improve the extent and quality of public involvement across the sector so that it is consistently excellent” [ 6 ]. In turn, this has often translated to public engagement becoming a requisite for securing research funding or institutional ethical permissions [ 3 , p. 2], as well as reporting and publishing research [ 15 ]. Despite this welcomed infrastructure to support PEwR, there remain gaps in knowledge and standards in the delivery of PEwR. One such gap concerns the extent to which PEwR should be subject to formal ethical review in the same way as data collection for research.

In 2016, the UK Health Research Authority and INVOLVE published a joint statement suggesting that “involving the public in the design and development of research does not generally raise any ethical concerns” [ 7 , p. 2]. We presume that this statement is using the phrase ‘ethical concerns’ to narrowly refer to the kinds of concerns addressed by a formal research ethics review process, such as safeguarding, withdrawal from research, etc. Footnote 1 . To such an extent, we agree that public involvement with research is not inherently ‘riskier’ than other research activities.

Furthermore, a blanket need for formal ethical review risks demoting or disempowering non-academic contributors from the roles of consultants, co-researchers, or advisors to a more passive status as participants. Attending a meeting as an expert, discussing new project ideas, setting priorities, designing studies and, or interpreting findings does not require that we sign a consent form. Indeed, to do so clearly removes the locus of power away from the person signing and into the hands of the person who wrote the consent form. This particular risk is exacerbated when institutional, formal ethical review processes operate in complex, convoluted and obscure ways that often baffle researchers let alone members of the public.

However, we also recognize that PEwR is not without potential to do harm – something which formal research ethics review aims to anticipate and minimise. For example, a public lecture or a workshop could cause distress to audience members or participants if they learn for the first time that aspects of their lifestyle or personal history put them at higher risk of dementia. When patients are invited to join advisory panels, they may feel pressure to reveal personal details about their medical history to reinforce their expertise or legitimise their presence – especially in a room where most other people have potentially intimidating professional qualifications. Some patient groups may be exploited, if research involvement roles are positioned as an opportunity, or even a duty, and not properly reimbursed. When patients are more deeply involved in research roles, such as collecting or analysing data, they might experience distress, particularly if interacting with participants triggers their own painful or emotional memories [ 14 , p. 98]. Thus, at all levels of PEwR from science communication to embedded co-production, there is a danger of harm to patients or members of the public, and a duty of care on the part of the research team and broader institution who invited them in.

These concerns are not accessory to PEwR activities but rather exist at their heart. Following a review on the impacts of public engagement, Brett et al. conclude that “developing a wide view which considers the impact of PPI [public and patient involvement] on the people involved in the process can be critical to our understanding of why some studies that involve patients and the public thrive, while others fail” [ 1 , p. 388]. Despite the importance of these considerations, there is a stark absence of consistent guidance as to whether different forms of PEwR require formal ethical review. Nor is there, to our knowledge, any sustained attempt to provide a framework for ethical conduct of PEwR in the absence of formal review (see Pandya-Wood et al. [ 11 ]; Greenhalgh et al. [ 5 ]). This is, in part, due to there being a wide heterogeneity of practices, communities, and levels of engagement [ 8 , p. 6] that resists generalizable principles or frameworks.

The lack of frameworks about whether or how PEwR requires formal ethical review can, ironically, be a key barrier to PEwR happening. In our work as members of a university ethics review committee, we have found this lack of guidance to hamper appropriate ethical PEwR in several ways. Researchers may avoid developing PEwR initiatives altogether for fear of having to spend time or resources in securing formal ethical review (especially when this process is lengthy or resource-intensive). Likewise, they may avoid PEwR for fear that its conduction would be unethical. On the other hand, others could assume that the lack of a requirement for formal ethical review means there are no ethical issues or risks involved in PEwR.

Similarly, experts in PEwR who are not experienced with formal research ethics review may face barriers as their PEwR process becomes more elaborate, in-depth, or complex. For example, although a priority-setting exercise with members of an online community of people with depression was assessed as not requiring ethics review, the funding panel requested that formal ethics review be undergone for a follow-up exercised aimed at collecting data answering one of the priority questions identified in the previous priority-setting. It is crucial that innovations in PEwR and findings from this work are shared and yet academic teams may be unable to publish their work in certain journals which require evidence of having undergone formal ethical review. Finally, ethics committees such as ours often must rely on anecdotal knowledge to make judgements about what does or does not require formal ethical review, given the absence of standardized frameworks.

About this paper

In this paper, we report and reflect on the development of specific tools and processes for assessing the ethical needs of PEwR initiatives, as members of an ethics review committee for a large University medical school. These tools aim to delineate boundaries between research data collection and PEwR activities of various kinds, provide a self-assessment framework for ethical practice in PEwR and, overall, give people greater confidence when conducting PEwR work. We describe and critically reflect on the development of the following resources:

a taxonomy to define key terms relating to PEwR with associated resource recommendations.

a self-assessment tool to support people understanding where their planned activities fall in relation to research or PEwR.

a code of conduct for ethical conduct of PEwR (appended to the self-assessment tool).

We will, first, describe our work as part of an institutional ethics committee, the identification of a need for specific guidance, and our key assumptions; we will then describe the process of developing these tools and processes; provide an overview of the tools themselves; and reflect on early feedback received and future work needed.

Developing specific tools for PEWR in ethics

Identifying needs, goals and outputs.

The Edinburgh Medical School Research Ethics Committee (EMREC) provides ethical opinions to members of staff and postgraduate researchers within the University of Edinburgh Medical School in relation to planned research to be conducted on humans i.e. their data, or tissues. These research activities come from a wide range of disciplines, including public health, epidemiology, social science or psychology. EMREC does not review research that involves recruitment of NHS patients, use of NHS data, or other health service resources: such projects are evaluated by an NHS research ethics committee. EMREC is led by two co-directors and formed of over 38 members, which include experienced academics and academic-clinicians from a variety of disciplines. There are also 2–4 lay members who are not researchers.

EMREC receives regular enquiries about whether a specific piece of PEwR work (such as holding a workshop with people living with endometriosis to identify research priorities or interviewing HIV activists about their work during COVID-19) requires formal ethics review. In addition, often teams contact EMREC following completion of a PEwR activity that they want to publish because the journal in which they wish to publish has requested evidence of the work having undergone formal ethics approval. These enquiries are happening in the context of an institutional investment in staffing, leading to a significant degree of distributed expertise across the Medical School about diverse forms of PEwR.

Responding to this, in the summer of 2022, a Public and Patient Involvement and Engagement working group was formed by EMREC with the aim of developing new tools and processes to navigate the ethical implications of PEWR within the University of Edinburgh Medical School. The group’s original understandings were that:

PEwR is both important and skilled work that presents a unique set of ethical implications,

PEwR is a fragmented landscape where many people have relevant but different expertise and where a wide range of terminology is in use, and.

there is no existing widely-agreed framework for ethical PEwR.

This working group was designed to be temporary, lasting approximately six months. It was composed of eleven members with different degrees of seniority and disciplinary backgrounds - both members of EMREC and those from other parts of the Medical School, and other parts of the University of Edinburgh. Among these, there were both academics and PEwR experts in professional services (i.e. primarily non-academic) roles. The working group met four times (August, September and November 2022; and January 2023).

The group identified three key goals and, in relation to these, key outputs needed. The goals were: (1) help establish boundaries between research data collection (requiring an ethical opinion from EMREC) and PEwR activities of various kinds (requiring ethical reflection/practice but not a formal EMREC ethical opinion), (2) support colleagues to identify where their planned activities fell in the research-PEwR continuum and consequently the relevant ethical framework, and (3) identify ways of building confidence and capacity among staff to conduct PEwR projects. In relation to these goals, the working group initially agreed on producing the following key outputs:

A taxonomy outlining and defining key terms used in the PEwR work, with examples. While not universal or definitive, the taxonomy should help colleagues identify and label their activities and help determine the ethical considerations that would apply to conduct the work with integrity. It would also facilitate conversations between staff with varying levels and types of experience, and ensure that decisions around ethical conduct would be based on more than choice of terminology.

A self-assessment tool to provide a more systematic way to evaluate whether a given academic activity, involving a non-academic partner (organisation or individual) requires formal evaluation by a research ethics committee.

A list of resources collected both from within and beyond our institution that are relevant to the issue of ethics and PEwR and can serve as ‘further reading’ and training.

While we aimed to develop this work with a view to it being useful within the remit of the University of Edinburgh Medical School, we also understood that there was significant potential for these outputs to be of interest and relevance more widely. In this way, we aimed to position them as a pragmatic addition to existing guidance and resources, such as the NIHR Reflective Questions [ 2 ].

Our process

Across the first three meetings, the group worked together on the simultaneous development of the three outputs (taxonomy, self-assessment tool, and resources). The initial taxonomy was informed by the guidance produced by the Public Involvement Resource Hub at Imperial College London [ 10 ]. The taxonomy was developed as a table that included key terms (such as ‘public engagement’, ‘co-production’, or ‘market research’), with their definitions, examples, and synonyms. From early on, it was decided that different key terms would not be defined by the methods used, as there could be significant overlap among these – e.g. something called a focus group might be a part of a consultation, market research or research data collection.

A draft table (with just six categories) was presented in the first meeting and group members were asked to work on the table between meetings, including providing additional examples, amending language, or any other suggestions. This was done on a shared document using ‘comments’ so that contradictory views could be identified and agreements reached. The table was also shared with colleagues from outside the University of Edinburgh Medical School to capture the range of terminologies used across disciplines, recognising the interdisciplinary nature of much research.

Through this process, additional key terms were identified, such as “science communication” and “action research,” definitions were developed more fully, and synonyms were sometimes contextualized (by indicating, for example, shades of difference or usages specific to an area). Upon further work, three additional sections were added to the taxonomy tool: first, an introduction was developed that explained what terminology our specific institution used and noted that the boundaries between different terms were often “fuzzy and flexible.” In addition, the group agreed that it would be useful to provide a narrative example of how different forms of public engagement with research might co-exist and flow from one to another. To this end, a fictional example was developed where a team of clinical researchers interested in diabetes are described engaging in scoping work, research, co-production, science communication and action research at different times of their research programme. Finally, a section was also added that prompted researchers to reflect on the processes of negotiating how partners can be described in research (for example, whether to use terms such as ‘patient’ or ‘lay member’).

For the self-assessment tool, a first iteration was a table with two columns (one for research or work requiring formal ethical review and one for PEwR or work not requiring formal ethical review). The aim was for group members to fill the table with examples of activities that would fall under each category, with a view to identifying generalizable characteristics. However, this task proved complicated given the wide diversity of possible activities, multitude of contexts, and sheer number of exceptions. To address this, group members were asked to complete a case-based exercise. They were presented with the following situation: “I tell you I’m planning a focus group with some autistic folk” and asked how they would determine whether the activity would be a form of data collection for a research project (requiring formal ethical review) or another form of PEwR. Group members were asked, with a view to developing the self-assessment tool, to identify which questions they would ask to assess the activity. The replies of working group members were synthesized by one of the authors (SFW) and presented at the following meeting.

Through discussion as a group, we determined that the questions identified as useful in identifying if an activity required formal ethical review fell, roughly, under four main areas. Under each area, some indicators of activities were provided which were “less likely to need ethics review” and some “more likely to need ethics review”. The four umbrella questions were:

What is the purpose and the planned outcome of the activity? (see Table  1 for an excerpt of the initial draft answer to this question)

What is the status of the people involved in the activity? (indicators of less likely to need ethics review were “participants will be equal partners with academic team” or “participants will be advisors” and indicators more likely to require ethics approval were “participants will undertake tasks determined by academics” or “participants will contribute data or sign consent forms”).

What kind of information is being collected? (indicators of less likely to need ethics review were “asking about expert opinion on a topic” or “sessions will be minuted and notes taken” and indicators more likely to require ethics approval were “sessions will be recorded and transcribed” or “asking about participants’ personal experiences”).

What are the risks inherent in this activity? (indicators of less likely to need ethics review were “participants will be involved in decision-making” or “participants will be credited for their role in a manner of their choosing” and indicators more likely to require ethics approval were “participants’ involvement will and must be anonymized fully” or “participants have a choice between following protocol or withdrawing from the study”).

Upon further work, the group decided to modify this initial iteration in several ways leading to the final version. First, a brief introduction explaining the purpose of the tool was written. This included information about the aims of the tool, and a very brief overview of the process of formal research ethics review. It also emphasised the importance of discussion of the tool within the team, with PEwR experts and sometimes with EMREC members, depending on how clear-cut the outcome was. Second, we included brief information about what are ‘research’ and ‘public engagement with research’ with a view to supporting people who may not be familiar with how these concepts are used by ethics review committees (for example, lay co-applicants or co-researchers). Third, we included key guidance about how to use the tool, including ‘next steps’ if the activity was determined to be research or engagement. Importantly, this emphasised that none of the questions posed and indicators given were definitive of something needing or not needing formal research ethics review, but instead they should be used collectively to signpost a team towards, or away from, formal review.

Finally, while the four umbrella questions remained the same as in the previous iteration, the indicators under each were further refined. In discussing the previous version, the group agreed that, while some indicators could relate to an activity falling into either category (research or engagement) depending on other factors, there were others that were much more likely to fall under one category than the other. In other words, while no single indicator was deterministic of needing or not needing formal review, some indicators were more influential than others on the final self-assessment outcome. Thus, we divided the indicators associated with each umbrella question into two sub-groups. The more influential indicators were labelled as either “probably doesn’t need ethical review” or “almost certainly needs ethical review”. Less influential indicators were labelled as either “less likely to need ethical review” or “more likely to need ethical review.” This is shown in Table  2 .

This new format retains the awareness of the sometimes-blurry lines between research and PEwR for many activities, but also seeks to provide stronger direction through indicative activities that are more clear-cut, with a particular view to supporting early-career researchers and people new to ethics reviews and/or engagement processes.

A key concern of the group was what would happen next if a planned activity, using the self-assessment tool, was deemed as PEwR. The formal review process for research would not be available for a planned activity identified as PEwR i.e. completing a series of documents and a number of protocols to deal with issues such as data protection, safeguarding, etc. This would leave a vacuum in terms of guidance for ethical conduction of PEwR. The group was concerned that some people using the self-assessment tool might arrive at the conclusion that their planned activity was entirely without ethical risks, given that it was not required to undergo formal review. Others might be conscious of the risks but feel adrift as to how to proceed. This was a particular concern with early-career researchers and indeed established academics turning to PEwR for the first time: we wanted to facilitate their involvement with PEwR but we were also aware that many may lack experience and resources. To address this, the group decided to develop an additional output comprising a series of reflective prompts to guide researchers in planning and conducting engagement activities.

The prompts were organized under four headings. First, “Data Minimisation and Security” included information about required compliance with data protection legislation, suggestions about collecting and processing information, and ideas around ensuring confidentiality. Second, “Safeguarding Collaborators and Emotional Labour” prompted researchers to think about the risk of partners becoming distressed and suggested what things should be planned for in this regard. Third, “Professional Conduct and Intellectual Property” included advice on how to clearly manage partners’ expectations around their contributions, impact, and intellectual property. Finally, fourth, under “Power Imbalances”, the guidance discusses how researchers may work to address the inherent imbalances that exist in relationships with partners. It prompts the researcher to think about choice of location, information sharing, and authorship among others. While the Edinburgh Medical School Research Ethics Committee remains available for consultation on all these matters, as well as dedicated and professional PEwR staff, the group developed these guidelines with a view both to emphasizing the fact that an activity not requiring formal ethical review did not mean that the activity was absent of risk or did not require careful ethical planning; and to support those who may be unfamiliar with how to develop engagement activities. It was decided that this guideline should follow the self-assessment tool for clarity.

Finally, in the process of developing these outputs (the planned taxonomy and assessment tool, and the additional reflective prompts appended to the assessment tool), the group collected a large number of resources, including academic papers (e.g. Staniszewska et al. [ 16 ]; Schroeder et al. [ 13 ]; Redman et al. [ 12 ]; Fletcher-Watson et al. [ 4 ]), guidance produced by other institutions, and key online sites with information about national frameworks or policy. Among these, key resources were selected and appended to the taxonomy document. The final version of these documents can be found as appendices (Supplementary Material  1 : Assessment tool and reflective prompts; Supplementary Material  2 : Taxonomy and resources).

Further considerations and early results

The guidance and tools presented here are designed to clarify a boundary between research and engagement that is poorly defined and could cause harm if not well understood. In sharing them, we aim to facilitate researchers’ engagement with PEwR by providing familiarity with the terminology and approaches, examples, and suggesting key considerations. Most importantly, they support researchers to determine whether their planned activity should undergo a formal ethical review process or not – and if not, guides them towards ethical conduct in the absence of formal review. Reflecting on the process much of what we have explained essentially reflects a distinction between PEwR and research data collection that can be encapsulated within the idea of ‘locus of control’: namely that during PEwR the locus of control, as far as possible, sits with the engaged communities or members.

It should be noted, however, that researchers and these guidance and tools exist within a larger landscape, with added regulatory processes. Thus, researchers may need (regardless of whether their planned activity is research or engagement) to navigate additional compliance such as data protection or information security protocols and / or to consider reputational risk associated with certain topics. We are aware that the overlap of complex and sometimes obscure regulatory demands complicates the task of conducting both research and PEwR, as it requires researchers to juggle multiple procedures, documents, and approvals. This publication does not resolve all the questions that exist, but it does attempt to take a bold step towards confronting grey areas and providing systematic processes to navigate them.

The outputs described above were made available on the University of Edinburgh Medical School Research Ethics Committee intranet site under the heading “Public Engagement with Research.” While we do not collect statistics on the number of times the resources have been used, the committee has received positive feedback from people who have engaged with the documents. For example, one researcher commented that, in the process of developing an engagement activity, they had been “grappling with precisely these questions (of whether this qualifies as research, and whether it requires ethical review)” and that the documents were “quite timely and helpful. It allows me to think about these considerations in a systematic manner and it’s handy for me to send on to others as a framework for discussion should we have differing opinions.” It was this mention to the possibility of these documents being used as a framework for discussion that prompted us to write this paper as a way of sharing them beyond the University of Edinburgh College of Medicine and Veterinary Medicine (where they are already used for training early-career researchers and in the MSc in Science Communication and Public Engagement). While we think they can be useful, we also encourage potential users to adapt them to their specific contexts, with different institutions potentially establishing differing procedures or requirements. To that end, we have shared in this paper the process of writing these documents so that other people and teams may also think through them productively and creatively.

Final reflections

In developing these documents, we sought to answer a need among members of our immediate community, seeking to better assess whether an activity required formal ethical review and wanting guidance to ethically conduct PEwR work. However, we also came to realize the limitations of existing approval and governance processes. In our case, a key reason why these documents were developed is because existing formal ethical review processes would not be adequate to capture the particularities and complexities of PEwR in our large, diverse Medical School.

Looking back at the tools we developed and the feedback received, we are also satisfied with the pragmatic approach we took. There is a vast amount of resources and literature available about how to conduct PEwR, as well as a multitude of accounts and reflections both of an anecdotal and epistemological nature. Building on this conceptual work and associated principles, we sought to develop pragmatic, clear, applicable tools, without overwhelming users with a multitude of available resources and complex theory. This is, we feel, particularly applicable to contexts like ours: a large, very diverse medical school which encompasses biomedical to social science disciplines where researchers and funders have vastly differing expectations and knowledge of PEwR.

This process also led us to reflect on the practical functions of formal ethical review. Formal ethics approval provides applicants with structured resources to think and plan about their work, feedback and guidance about their plans, and—most commonly—a code and letter than can be used to easily report to journals that your research has met a specific ethical threshold. With these documents we have sought to provide some similar, pragmatic guidance to support and empower people, through a self-assessment process. This begs the question, what, if any, formal approval processes should be developed for PEwR? Are such formal processes in any way adequate to the ethos of PEwR? Would formal independent review necessarily conflict with the values of PEwR, namely the empowerment of community members as decision-makers and experts? Thus, these documents and this paper contribute to an ongoing conversation as PEwR continues to develop in frequency and sophistication in health and social care research.

Data availability

No datasets were generated or analysed during the current study.

The difference between research and public engagement is a complex one. Formal ethics approval, which is often seen as a regulatory or compliance mechanism, may not always be a good marker of this boundary, as it may ignore complex issues such as the distribution of power, the ethos of the activities, or their aims. Furthermore, different institutions use different criteria to determine what activities require ethics approval or are considered research. In this paper we reflect on the process of developing tools which we intended as pragmatic interventions that would support researchers, especially those without previous experience of PEwR to label their planned activities and understand their implications. Thus, we employ—even if not at all times comfortably—the framework that equates research with activities requiring ethics approval and PEwR with activities not requiring ethics approval.

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This research was supported, in part, by the Economic and Social Research Council [ES/X003604/1].

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Garcia-Iglesias, J., Beange, I., Davidson, D. et al. Ethical considerations in public engagement: developing tools for assessing the boundaries of research and involvement. Res Involv Engagem 10 , 83 (2024). https://doi.org/10.1186/s40900-024-00617-8

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The course may be useful for the Ph.D. students as they can earn 2-credit from the SWAYAM-MOOC. This course has total six modules focusing on basics of philosophy of science and ethics, research integrity, publication ethics, and identifying research misconduct and predatory publications. Indexing and citation database, open access publications, research metrics and plagiarism tools has been discussed in the course. In this online course (MOOC) recorded lectures, e-text, self assessment questions, quizzes will be the part of the pedagogy. There will term-end examination for certification. 

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Week 1

RPE 01: Philosophy and Ethics

·         Introduction to Philosophy

·         Origin of Philosophy

·         Characteristics of Philosophy

·         Common sense and Philosophy

·         Relationship between  Philosophy & Science

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RPE 02: Scientific Conduct

·         Integrity  and Ethics

·         Ethics with Respect to Science & Research

·         Intellectual Honesty & Research Integrity: Scientific Misconducts & Redundant Publications

·         Selective Reporting and Misrepresentation of data

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RPE 03: Publication Ethics

·         Publication Ethics,

·         Best Practices/Standards Setting

·         Initiatives & Guidelines: COPE, WAME etc.

·         Conflict of Interest; Publication Misconduct

·         Violation of Publication Ethics, Authorship and Contributorship; Identification of Publication Misconduct, Complacent & Appeals

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Week 4

RPE 04: Open Access Publishing

 

·         Concept of OER

·         Concept of open license

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·         Open access content management

Week 5

RPE 05: Publication Misconduct

·         Publication Misconduct

·         Ethical issues in various Disciplines

·         Fabrication, Falsification and Plagiarism (FFP)

·         Authorshp : Definition and types

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·         Software Tools

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RPE 06: Database and Research Metrics

·         Indexing Databases

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Books and references

Bird,A. (2006). Philosophy of Sciences. Routledge

MacIntyre, Alasdair (1967). A Short History of Ethics. London

P.Chandah. (2018). Ethics in Competitive Research: Do not get Scooped; do not get plagiarized.

National Academy of Sciences, National Academy of Engineering and Institute of Medicine (2009)., National  On being a Scientist: A guide to responsible conduct in Research : third edition, National Academies Press

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How to cite ChatGPT

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We, the APA Style team, are not robots. We can all pass a CAPTCHA test , and we know our roles in a Turing test . And, like so many nonrobot human beings this year, we’ve spent a fair amount of time reading, learning, and thinking about issues related to large language models, artificial intelligence (AI), AI-generated text, and specifically ChatGPT . We’ve also been gathering opinions and feedback about the use and citation of ChatGPT. Thank you to everyone who has contributed and shared ideas, opinions, research, and feedback.

In this post, I discuss situations where students and researchers use ChatGPT to create text and to facilitate their research, not to write the full text of their paper or manuscript. We know instructors have differing opinions about how or even whether students should use ChatGPT, and we’ll be continuing to collect feedback about instructor and student questions. As always, defer to instructor guidelines when writing student papers. For more about guidelines and policies about student and author use of ChatGPT, see the last section of this post.

Quoting or reproducing the text created by ChatGPT in your paper

If you’ve used ChatGPT or other AI tools in your research, describe how you used the tool in your Method section or in a comparable section of your paper. For literature reviews or other types of essays or response or reaction papers, you might describe how you used the tool in your introduction. In your text, provide the prompt you used and then any portion of the relevant text that was generated in response.

Unfortunately, the results of a ChatGPT “chat” are not retrievable by other readers, and although nonretrievable data or quotations in APA Style papers are usually cited as personal communications , with ChatGPT-generated text there is no person communicating. Quoting ChatGPT’s text from a chat session is therefore more like sharing an algorithm’s output; thus, credit the author of the algorithm with a reference list entry and the corresponding in-text citation.

When prompted with “Is the left brain right brain divide real or a metaphor?” the ChatGPT-generated text indicated that although the two brain hemispheres are somewhat specialized, “the notation that people can be characterized as ‘left-brained’ or ‘right-brained’ is considered to be an oversimplification and a popular myth” (OpenAI, 2023).

OpenAI. (2023). ChatGPT (Mar 14 version) [Large language model]. https://chat.openai.com/chat

You may also put the full text of long responses from ChatGPT in an appendix of your paper or in online supplemental materials, so readers have access to the exact text that was generated. It is particularly important to document the exact text created because ChatGPT will generate a unique response in each chat session, even if given the same prompt. If you create appendices or supplemental materials, remember that each should be called out at least once in the body of your APA Style paper.

When given a follow-up prompt of “What is a more accurate representation?” the ChatGPT-generated text indicated that “different brain regions work together to support various cognitive processes” and “the functional specialization of different regions can change in response to experience and environmental factors” (OpenAI, 2023; see Appendix A for the full transcript).

Creating a reference to ChatGPT or other AI models and software

The in-text citations and references above are adapted from the reference template for software in Section 10.10 of the Publication Manual (American Psychological Association, 2020, Chapter 10). Although here we focus on ChatGPT, because these guidelines are based on the software template, they can be adapted to note the use of other large language models (e.g., Bard), algorithms, and similar software.

The reference and in-text citations for ChatGPT are formatted as follows:

  • Parenthetical citation: (OpenAI, 2023)
  • Narrative citation: OpenAI (2023)

Let’s break that reference down and look at the four elements (author, date, title, and source):

Author: The author of the model is OpenAI.

Date: The date is the year of the version you used. Following the template in Section 10.10, you need to include only the year, not the exact date. The version number provides the specific date information a reader might need.

Title: The name of the model is “ChatGPT,” so that serves as the title and is italicized in your reference, as shown in the template. Although OpenAI labels unique iterations (i.e., ChatGPT-3, ChatGPT-4), they are using “ChatGPT” as the general name of the model, with updates identified with version numbers.

The version number is included after the title in parentheses. The format for the version number in ChatGPT references includes the date because that is how OpenAI is labeling the versions. Different large language models or software might use different version numbering; use the version number in the format the author or publisher provides, which may be a numbering system (e.g., Version 2.0) or other methods.

Bracketed text is used in references for additional descriptions when they are needed to help a reader understand what’s being cited. References for a number of common sources, such as journal articles and books, do not include bracketed descriptions, but things outside of the typical peer-reviewed system often do. In the case of a reference for ChatGPT, provide the descriptor “Large language model” in square brackets. OpenAI describes ChatGPT-4 as a “large multimodal model,” so that description may be provided instead if you are using ChatGPT-4. Later versions and software or models from other companies may need different descriptions, based on how the publishers describe the model. The goal of the bracketed text is to briefly describe the kind of model to your reader.

Source: When the publisher name and the author name are the same, do not repeat the publisher name in the source element of the reference, and move directly to the URL. This is the case for ChatGPT. The URL for ChatGPT is https://chat.openai.com/chat . For other models or products for which you may create a reference, use the URL that links as directly as possible to the source (i.e., the page where you can access the model, not the publisher’s homepage).

Other questions about citing ChatGPT

You may have noticed the confidence with which ChatGPT described the ideas of brain lateralization and how the brain operates, without citing any sources. I asked for a list of sources to support those claims and ChatGPT provided five references—four of which I was able to find online. The fifth does not seem to be a real article; the digital object identifier given for that reference belongs to a different article, and I was not able to find any article with the authors, date, title, and source details that ChatGPT provided. Authors using ChatGPT or similar AI tools for research should consider making this scrutiny of the primary sources a standard process. If the sources are real, accurate, and relevant, it may be better to read those original sources to learn from that research and paraphrase or quote from those articles, as applicable, than to use the model’s interpretation of them.

We’ve also received a number of other questions about ChatGPT. Should students be allowed to use it? What guidelines should instructors create for students using AI? Does using AI-generated text constitute plagiarism? Should authors who use ChatGPT credit ChatGPT or OpenAI in their byline? What are the copyright implications ?

On these questions, researchers, editors, instructors, and others are actively debating and creating parameters and guidelines. Many of you have sent us feedback, and we encourage you to continue to do so in the comments below. We will also study the policies and procedures being established by instructors, publishers, and academic institutions, with a goal of creating guidelines that reflect the many real-world applications of AI-generated text.

For questions about manuscript byline credit, plagiarism, and related ChatGPT and AI topics, the APA Style team is seeking the recommendations of APA Journals editors. APA Style guidelines based on those recommendations will be posted on this blog and on the APA Style site later this year.

Update: APA Journals has published policies on the use of generative AI in scholarly materials .

We, the APA Style team humans, appreciate your patience as we navigate these unique challenges and new ways of thinking about how authors, researchers, and students learn, write, and work with new technologies.

American Psychological Association. (2020). Publication manual of the American Psychological Association (7th ed.). https://doi.org/10.1037/0000165-000

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  25. How to cite ChatGPT

    In this post, I discuss situations where students and researchers use ChatGPT to create text and to facilitate their research, not to write the full text of their paper or manuscript. We know instructors have differing opinions about how or even whether students should use ChatGPT, and we'll be continuing to collect feedback about instructor ...