The Dutch publisher Wolters Kluwer has scrapped some of its citation and study-registration requirements at a top-ranked surgery journal founded by the U.K. plastic surgeon Riaz Agha, Retraction Watch has learned.
The move follows our investigation last month that found mandatory citation of reporting guidelines developed by Agha and published in the International Journal of Surgery (IJS) had inflated the impact factor of the open-access title, making it more attractive to authors and readers.
A blanket requirement to register all human studies before manuscript submission, contrary to recommendations from the International Committee of Medical Journal Editors, appeared to serve another of Agha’s business interests: a paid research registry he founded in 2015.
A spokesperson for the publisher confirmed it had updated IJS’ instructions for authors and was continuing “to review and update policies across the IJS family of publications.”
“Citation of the guidelines is no longer a requirement,” the spokesperson said. “Previously, the journals requested that all guidelines used be cited, irrespective of authorship … Following review, the policy has been updated to align with prevailing industry practice, while continuing to emphasize the importance of using appropriate reporting standards.”
Lokman Meho, a bibliometrician at the American University of Beirut in Lebanon who helped analyze the effect of the citation requirement, called the move “a step in the right direction.”
“However, these practices have already had a substantial impact on impact factors, and this will not reverse quickly or easily,” he said. “Even without formal requirements, strong editorial guidance can still influence citation behavior.”
IJS is the flagship title of IJS Publishing Group (IJSPG), a small publisher Agha founded in 2003, when he was 23 years old. Wolters Kluwer bought the company in 2022, but Agha continues to edit several of the journals, including IJS.
Two years after the acquisition, Agha launched the London-based publishing house Premier Science and took his reporting guidelines with him. The citation mandate remained in place at the IJSPG journals, securing a steady flow of citations from Wolters Kluwer to Premier Science.
While the citation requirement has been scrubbed from IJS’ author instructions, manuscripts submitted to IJSPG journals must still adhere to specific reporting guidelines, some of which were developed by Agha and include citation requirements. The spokesperson for Wolters Kluwer, which is now recruiting for a research integrity lead, said the publisher was “working to align any contradictions that may arise” from the editorial changes.
Our investigation also highlighted an AI guideline called TITAN that Agha developed and published at Premier Science in 2025. As we reported, “virtually all of its roughly 2,300 cites indexed by Google Scholar come from the IJSPG series. An anonymous commenter flagged this unusual citation pattern at PubPeer and pointed to a paper in IJS ‘showing evidence of coercive citation.’”
In a newsletter item about our story, publishing consultant James Butcher pointed out the TITAN guideline was the world’s third-most highly cited paper last year. When it was published, Butcher noted, Agha was still editor-in-chief of the Premier Journal of Science, Premier Science’s flagship publication.
“It appears that the journal’s Editor-in-Chief, owner, and corresponding author of its most highly cited paper are one and the same person,” Butcher wrote, adding that the paper had reported no conflicts of interest.
“We currently do not require authors to use or cite TITAN guidelines, and they are not featured in our” instructions to authors, the spokesperson for Wolters Kluwer said. “We are reviewing past protocols to ensure we are operating with clear recommendations moving forward.”
The publisher has also changed its requirement to register all human studies, even retrospective ones, before submission. As we reported in our investigation, “Since April 2018, when Agha started charging £99 per registration, more than 9,000 studies have been entered into his database, potentially bringing in fees close to US$1.2 million.” We also wrote about irregular study registrations that appeared to have been made by paper millers.
“We provide a registry list for authors to choose from when submitting human-participant research. In line with WHO and ICMJE guidelines, we have made clearer which article types require research registration and updated the list to alphabetical order,” the spokesperson said. “On the Research Registry website, we have added a message to clarify that the registry does not review or approve any study listed. The site provides an open registry where authors can register their research, and others can view the registered information.”
However, the registry’s website claims it is curated and states a “registry is only as good as the data it holds.”
“Given registration is instant, it’s important to curate the registrations as part of a quality control and assurance process and to maintain the integrity and reputation of the research registry,” the website continues.
IJS’ updated instructions to authors now also include a note stating “that the Research Registry was owned by International Journal of Surgery’s Editor-in-Chief, Dr Riaz Agha, from 2015-2022. It has been owned by Wolters Kluwer since September 30, 2022, with Dr Agha acting as a paid consultant on behalf of Wolters Kluwer.”
The spokesperson said Agha’s services to Wolters Kluwer comprise “his roles as Editor-in-Chief for select journals in the IJS family of publications and as the operator of Research Registry.”
Agha has not responded to requests for comment. But after we emailed him for our investigation, he added a declaration of interests on Premier Science’s website clarifying his work for Wolters Kluwer and his involvement with the STROCSS, PROCESS, SCARE and TITAN guidelines.
“The added transparency is welcome,” Meho said, “but concerns about conflicts of interest and the role of paid registries remain. The real impact of these changes will need to be seen over time.”
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