Publications and promotions for the clinical investigator.

If cooperative clinical trials are to compete with other types of clinical research for the attention of physician investigators, they must offer rewards in the form of publication credits and academic recognition. Large-scale multi-institutional clinical trials provide less opportunity for authorship than individual or small-group research. This problem cannot be solved by attempts to multiply publications unnecessarily or to blur the meaning of authorship. Only those who contribute significantly to the design and interpretation of an experiment should be designated as authors; journals should be prepared to recognize all those who meet that test. Increased opportunities for authorship can be provided if the National Institutes of Health (NIH) encourage small-scale clinical trials carried out by individual investigators. Academic recognition of the clinical investigator in increasing and would be greatly strengthened by an NIH policy of greater support for this kind of research.