Health Services Research (HSR) Methods
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Hypothetical 2: The Publication

John Smith is a junior health services researcher at Ivy University. Smith agrees to work as a subcontractor to XYZ Think Tank on a research project funded under a contract from Federal Agency. The Principal Investigator on the project is Alice Middle at XYZ Think Tank. Smith is not involved in any negotiations between XYZ Think Tank and Federal Agency. The research project is one of the first evaluations of a new health care drug benefit. Findings from the study will have important policy implications. The study findings show some, but not overwhelming advantages of the benefit. Smith, who is the principal author on a paper about the study, is cautious in his conclusions about the ultimate advantages of this health care benefit. As Smith puts the finishing touches on the paper, he receives a call from Joe Sponsor at Federal Agency who is irate. Sponsor, who has read a draft of the paper, challenges Smith’s conclusions and demands that Smith refrain from submitting the paper to any journal until Sponsor has an opportunity to thoroughly review, edit, and approve the paper. He offers no timeframe under which he will provide Smith with his edits. Sponsor has been getting political pressure to ensure that the findings from this study strongly support the drug benefit. The paper, as currently structured, is too cautious and won’t be well-received from a political perspective.

Smith hangs up with Sponsor and calls Alice Middle at XYZ Think Tank. Middle explains that while there was a general understanding with Federal Agency that findings from the study would be published in a journal, the discussion about Federal Agency’s right to review, edit and approve any publications was rather vague. Middle reminds Smith that Federal Agency is an important funder and that future funding opportunities may depend on appeasing Joe Sponsor. Smith wonders whether he is at risk of alienating XYZ Think Tank and Federal Agency at this early stage in his career if he pushes the issue. Yet, he needs to publish in order to establish himself in the health services research community.


   What type of language could XYZ Think Tank have included in its contract with Federal Agency regarding each party’s 
        rights in the dissemination of findings? 
B.    What is Middle’s responsibility as PI on the project relative to negotiating publication rights at the start of the project? 
C.    What recourse does Smith have if Sponsor does not get back to him with edits? 
D.    What action, if any, should Smith take if Sponsor’s edits “shade” the findings but do not create substantially different 
E.    How does Smith balance his intellectual freedom and research integrity with his need to publish an important article 
       which may jumpstart his career as a well-known health service researcher? 
F.    Is it possible to balance the reality of political pressure with research freedom? 
G.   Setting aside political pressure, what if Joe Sponsor’s concerns about the study’s conclusions are legitimate? 
       Sponsor feels strongly that Federal Agency-funded work should not be published if it contains questionable 
       results. Sponsor recognizes that reasonable minds can differ about the strength of research results. What 
       steps could Sponsor take to protect Federal Agency, but not curtail Smith’s publication rights?

For further discussion of these questions, please join the Hypothetical 2: The Publication forum.