Jan Seal-Roberts, BSc, Publishing Director, Adis, Springer Healthcare; Richard Sever, PhD, Assistant Director, Cold Spring Harbor Laboratory Press, and Cofounder, bioRxiv and medRxiv; Caroline Halford, BSc, Digital Publishing Manager, Adis, Springer Healthcare
Interviewed by: Sally Hassan, PhD, Papyrus Medical Communications Ltd, and Belinda Dean, BSc, ISMPP CMPP™, CMC Connect
On behalf of ISMPP, Sally Hassan and Belinda Dean interviewed Jan Seal-Roberts, Richard Sever, and Caroline Halford about the opportunities for preprint servers and traditional publishers to limit misinformation for their users. This is an area of broad interest in the wake of the COVID-19 pandemic in 2020 and 2021, with its impact continuing into 2022 and beyond. Preprints were added to the International Committee of Medical Journal Editors’ (ICMJE) Recommendations for ”Overlapping Publications” in December 2021. The following conversation has been edited for length and clarity.
COVID-19 research published as preprints has polarized the perception of the reliability of this publication format for medical research – how do you see preprints evolving to address this issue?
It is important to note that preprint servers enable rapid access to the latest data, but they do not claim them to be reliable. More than 70% of articles posted on preprint servers are subsequently published as peer-reviewed articles in traditional journals; so in that respect, they already are evolving. Preprint servers also link preprints to the final published journal article (once available) so that readers are aware of the latest and most accurate data/interpretation.
Since the start of the COVID-19 pandemic, there has been a shift in the readership of preprint servers. Before the pandemic, most readers of preprint servers were scientists who were likely aware of the need to take a skeptical and critical approach when reading preprints, but readership has since expanded to include the wider public and more members of the media.
Responsible preprint servers, such as bioRxiv, medRxiv, and InReview, recognize the legitimate concerns about reporting scientific data before peer review and, thus, have standard procedures to limit risks. These include:
- Preliminary screening by volunteer scientists and preprint server staff to minimize the likelihood of articles being posted that could be potentially dangerous to the public
- Inclusion of a prominent warning on the preprint server to emphasize to users that articles posted on the website have not yet undergone peer review
Whilst preprint servers need to continue their efforts in limiting misinformation, there is also a strong need for lay readers to be educated about the nature of preliminary, non–peer-reviewed work, and the media need to be encouraged to report scientific/medical news more responsibly; this, of course, applies to articles published in journals and on preprint servers.
Speed of publication is under the spotlight – how do you see traditional peer-reviewed medical journals adjusting their practices to improve the speed of publication?
When considering Adis as an example, there is recognition that the speed of publication is often critical (as highlighted during the COVID-19 pandemic), and approximately one-third of their journals provide rapid publication (including fast-track peer review) as standard for all articles. The remaining journals offer a rapid-track option for important articles. However, preprint servers and traditional journals may complement each other, especially for journals that cannot manage such fast timelines: preprint servers offer speed of access to the data, while traditional journals provide a rigorous peer-review process to confirm the validity of the results.
However, there are aspects that journal publishers can focus on to speed up the peer-review process and ensure rapid decision-making for the publication of an article, including:
- Utilizing a resource-heavy team to contact more than the required number of peer reviewers at the right time and to react quickly
- Expanding the peer-review pool by providing peer-review training and promoting incentives (e.g., a non-monetary credit system) to be a valuable peer reviewer
- Continuing to encourage authors to respond promptly
- Increasing efficiencies within the journal’s production department
Some authors continue to accept long lead times for prestigious, top-tier journals, but will this trend continue indefinitely? Will authors instead decide that good data can still be impactful even if not published in a prestigious journal and opt for speed and fully open access options? Alternatively, will top-tier journals manage to make significant improvements to their lead times? Watch this space!
What do you think led to uncontrolled misinformation about COVID-19 medical research on, for example, vaccines?
Misinformation is an inevitable consequence of open/unregulated communication. Until recently, the nature of mainstream media and the publication system meant only certain voices were heard, whereas now anyone can communicate to a potentially wide audience via social media (even anonymously). In addition, mainstream media figures, social media influencers, and politicians have all played a significant role in the spread of misinformation, and some of the most consequential examples to date have come from people in positions of power. In the United States, for example, there are evident differences in attitudes to the pandemic and preventative measures when looking across the political spectrum. Similarly, in the United Kingdom, notable differences in attitudes to things like mask wearing have been evident among representatives of different political parties. The most diligent preprint servers make serious attempts to limit misinformation (particularly if it pertains to a medically dangerous political agenda) and will reject submissions of concern via their screening process. However, the end users of preprint servers should continue to be reminded about the lack of peer review and encouraged to apply caution to what they read.
What actions can medical journals take to help prevent misinformation and misunderstanding of medical research?
With the growing prevalence of open access, journal readership increasingly includes a larger demographic, including non-experts and patients. Many publishers are now responding to this potential for a wider audience and the needs of readers with limited time by making the text more reader-friendly. However, some publishers (such as Adis) are also including plain language summaries and digital enhancements, such as infographics, visual/animated abstracts, and videos, to clearly explain findings and implications to both healthcare professionals and a broader audience, including patients. Interestingly, peer reviewers are now beginning to request such enhancements, too, in cases where they believe these would add value and limit the misunderstanding of complex science. Plain language summaries may also become mandated by journals in the future. For example, Cochrane reviews are always accompanied by a plain language summary, and The BMJ encourages educational articles to be written in plain English to facilitate understanding by lay audiences.
Within Adis journals, all preprint citations are highlighted as such, both in the text of a published article and in the citation list, to avoid any misunderstanding. However, journals can further position themselves as trusted and authoritative sources of information for non-expert readers. For example, commentary pieces published in journals that provide context on the meaning of presented data within a larger landscape (i.e., beyond articles included in their journal) can provide additional value.
In conclusion, although preprint servers can be useful in providing speed of access to data, subsequent full publication in a peer-reviewed journal is necessary to ensure the quality and validity of the data. Better education of end users of preprint servers and further steps by journals to improve the speed and understanding of publications will hopefully serve to reduce the spread of misinformation and increase the understanding of readers.