Processes to achieve integrity assessments need improvement Inconsistency in publishers’ responses to integrity concerns about published research Evidence and suggested improvements

To collate, review and comment upon publishers' response to integrity concerns STUDY DESIGN AND SETTING: We conducted a narrative review of publications reporting the responses of publishers to concerns about the integrity of research published in their journals. We also drew upon extensive personal experience and a new analysis of publisher responses to integrity concerns about 172 clinical trial publications by a single research group 5 years after the concerns were raised simultaneously with affected publishers. Existing evidence reports that slow, incomplete and opaque responses from publishers to integrity concerns are common, in both clinical and preclinical disciplines. When we raised very similar concerns about a large set of journal articles simultaneously with publishers, times to resolution varied markedly, and outcomes ranged from no editorial action to all papers retracted. Publishers' responses to notification of concerns about the integrity of publications in their journals are markedly inconsistent, both in their timing and the nature of their editorial decisions. The reasons for these inconsistencies are unknown, but could be addressed by a collaborative and transparent process involving publisher integrity staff and academics with expertise in publication integrity. Understanding the reasons for the disparate outcomes is likely to facilitate improvements which will enhance the trustworthiness of the biomedical literature.