I appreciate Dr. Kissin’s interest1  in the Anesthesiology editorial which described, in the context of authorship integrity, escalating author counts in academic journals.2  He wonders whether escalating author count is also common among anesthesia publications. He cites his own article on “the most influential original clinical articles that fomented important developments in anesthesiology over the past 50 yr.”3  He concludes that there has been “some increase” in author numbers, that the rise in the average number of authors per article was much less than that in three major general medical journals, that significant multiauthorship was not observed, and the top count did not exceed 11 authors.

The analysis of Dr. Kissin is only partial. First, the analysis in his letter stops at 2007,1  yet his own article, used as the basis for his letter, analyzes to 2015.3  Second, the analysis in his article was not systematic, and, what constitutes “influential” is purely one opinion.

I conducted a systematic analysis of all the articles published in seven major anesthesiology journals (Anesthesiology, Anesthesia & Analgesia, Anesthesia, British Journal of Anesthesia, Critical Care Medicine, Pain, and Regional Anesthesia and Pain Medicine), from 1965 (or later if it commenced publication after that date) until the present (n = 123,431). The analysis determined the mean number of authors per article each year. In addition, the analysis determined the number of articles published each year with 10 or more authors (multiauthorship).

The results of the author analysis are shown in figure 1. First, it is abundantly clear that the average number of authors per article has increased steadily over the past 55 yr. The average number of authors (± SD) per article in 1965 was 2 ± 1 (median 2, n = 400), which increased to 6 ± 5 (median 5, n = 2,614) in 2021 (to date). Second, it is also clear that the number of multiauthor articles (10 or more authors per article) across these seven journals has increased approximately exponentially, from a total of zero in 1965 to a total of 455 in 2020 (from a median of zero to 65 multiauthored articles per journal). The top count was 100 authors in one manuscript. Third, this pattern is consistent across all seven anesthesiology journals.

The letter from Dr. Kissin notwithstanding, the comprehensive analysis reveals data on author numbers per article and multiauthorship that are entirely consistent with data pertaining to general scientific publication as cited in the editorial.2  Moreover, the threefold increase in author number in anesthesia journals is comparable with the threefold increase in author number reported for the three major general medical journals (Journal of the American Medical Association, New England Journal of Medicine, British Medical Journal) cited by Dr. Kissin.4  Escalating author count is indeed also common among anesthesia publications.

The author declares no competing interests.

1.
Kissin
I
:
Authorship and publication matters: Comment.
Anesthesiology
.
2022
;
136
:
244
2.
Kharasch
ED
,
Avram
MJ
,
Bateman
BT
,
Clark
JD
,
Culley
DJ
,
Davidson
AJ
,
Houle
TT
,
Jiang
Y
,
Levy
JH
,
London
MJ
,
Sleigh
JW
,
Vutskits
L
:
Authorship and publication matters: Credit and credibility.
Anesthesiology
.
2021
;
135
:
1
8
3.
Kissin
I
:
High-impact clinical studies that fomented new developments in anesthesia: History of achievements, 1966-2015.
Drug Des Devel Ther
.
2021
:
15
:
1
11
4.
Tilak
G
,
Prasad
V
,
Jena
AB
:
Authorship inflation in medical publications.
Inquiry
.
2015
;
52
:
0046958015598311