A Systematic Review of Survey Research of Honorary Authorship in Health Sciences

Reint A. Meursinge Reynders,1,2 Gerben ter Riet,3,4 Nicola Di Girolamo,5,6 Davide Cavagnetto,1,2 Mario Malički7


Perceived honorary authorship refers to the perception or opinion of survey respondents that 1 or more co-authors should not have been included as author(s) of a publication because they made no or insufficient contributions to qualify as authors. In this systematic review, the prevalence of perceived honorary authorship and 4 other honorary authorship issues in health sciences were assessed. These issues represent a subgroup of the research questions reported in a previously published protocol1 and build on prior research on honorary authorship.2,3


Surveys of authors of scientific publications on 5 honorary authorship issues in health sciences in any language were eligible. A search from inception until December 8, 2021, was done in PubMed, Lens.org, and Dimensions.ai. Two authors conducted the study selection and data extraction procedures independently. The prevalence of researchers perceiving other coauthor(s) as honorary author(s) on a publication (review item 1) and the prevalence of researchers having been approached by others to include honorary author(s) on a publication (review item 2) were the primary outcomes. Outcomes were exclusively based on what was asked in the questionnaires. The methodological quality of surveys was assessed with a self-developed 14-item checklist (available in the protocol).1 Qualitative and quantitative syntheses were conducted and Metaprop in Stata was used to perform the meta-analyses (random effects model) of the prevalence statistics. Double arcsine transformation was performed prior to statistical pooling.


After removal of duplicates, 1220 articles were screened, of which 8 surveys were eligible for review item 1. No surveys were eligible for review item 2 nor for any of the other 3 issues sought on perceived honorary authorship. Many surveys were excluded because of spin, ie, definitions of perceived honorary authorship in the main text were eligible, but not those used in the questionnaires. The pooled response rate on perceived honorary authorship in the 8 eligible surveys (15,553 contacted authors) was 24.8% (95% CI, 19.9%-29.9%). The pooled prevalence of perceived honorary authorship on 3132 survey respondents was 26.5% (95% CI, 21.3%-32.0%) (Figure 17). The low P value and large χ² (χ²7 = 72.58; P < .001) provide evidence of heterogeneity, and the high I2 (I2 = 90.4%) indicates considerable inconsistency across the prevalence statistics of the surveys. Characteristics of nonresponders were not reported in any of the eligible surveys. The methodological quality was critically low in all eligible surveys.


This systematic review found that 26.5% of health scientists perceived having at least 1 honorary author in at least 1 of their publications. However, this estimate should be interpreted with caution because of high risk of bias, considerable heterogeneity, and numerous uncertainties. Future studies should focus on interventions to prevent honorary authorship.3


1. Meursinge Reynders R, Ter Riet G, Di Girolamo N, Malički M. Honorary authorship in health sciences: a protocol for a systematic review of survey research. Syst Rev. 2022;11(1):57. doi:10.1186/s13643-022-01928-1

2. Marušić A, Bošnjak L, Jerončić A. A systematic review of research on the meaning, ethics and practices of authorship across scholarly disciplines. PLoS One. 2011;6(9):e23477. doi:10.1371/journal.pone.0023477

3. Patience GS, Galli F, Patience PA, Boffito DC. Intellectual contributions meriting authorship: survey results from the top cited authors across all science categories. PLoS One. 2019;14(1):e0198117. doi:10.1371/journal.pone.0198117

1Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Center, Amsterdam, the Netherlands, reyndersmail@gmail.com; 2Studio di Ortodonzia, Milan, Italy; 3Urban Vitality Centre of Expertise, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands; 4Department of Cardiology, Amsterdam University Medical Center, Amsterdam, the Netherlands; 5Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK, USA; 6EBMVet, Cremona, Italy; 7Meta-research Innovation Center at Stanford, Stanford University, Stanford, CA, USA

Conflict of Interest Disclosures

None reported.