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The ICMJE considers it to be unethical to submit an article to a journal when it is already being considered for publication elsewhere. Cochrane Reviews are considered as submitted for publication in the Cochrane Database of Systematic Reviews (CDSR) once the decision has been made to publish the protocol.

Cochrane Review Groups (CRGs) commit to keeping authors up to date regarding the development and editorial processing of their Cochrane Review, and to responding to queries from authors in a timely fashion. If CRGs fail to meet this commitment to communicate appropriately, then authors may be in the position to justify a release from the agreement to publish in CDSR.