Preprints in Medicine: Useful or Harmful?

Exploring the current dynamics of preprints

Preprints are non-peer-reviewed and publicly available articles for open and transparent research communication. Preprint servers host the submission of such manuscripts, and despite the presence of established preprint servers, their numbers have continued to rise in recent times. A steep increasing pattern in posted preprints and their accommodating servers has been observed over the last decade. In this article, we explored the global trends in the preprint adoption and its involvement in promoting open and transparent research findings across various domains. We further emphasized the importance of preprinting, highlighting its significant impact during the pandemic through effective information sharing, and advocating for its broader integration in scholarly communication.

Making science public: a review of journalists' use of Open Access research

Science journalists are uniquely positioned to increase the societal impact of open research outputs by contextualizing and communicating findings in ways that highlight their relevance and implications for non-specialist audiences. Yet, it is unclear to what degree journalists use open research outputs, such as open access publications or preprints, in their reporting; what factors motivate or constrain this use; and how the recent surge in openly available research seen during the COVID-19 pandemic has affected this. This article examines these questions through a review of relevant literature published from 2018 onwards-particularly literature relating to the COVID-19 pandemic-as well as seminal articles outside the search dates. We find that research that explicitly examines journalists' engagement with open access publications or preprints is scarce, with existing literature mostly addressing the topic tangentially or as a secondary concern, rather than a primary focus. Still, the limited body of evidence points to several factors that may hamper journalists' use of these outputs and thus warrant further exploration. These include an overreliance on traditional criteria for evaluating scientific quality; concerns about the trustworthiness of open research outputs; and challenges using and verifying the findings. We also find that, while the COVID-19 pandemic encouraged journalists to explore open research outputs such as preprints, the extent to which these explorations will become established journalistic practices remains unclear. Furthermore, we note that current research is overwhelmingly authored and focused on the Global North, and the United States specifically. We conclude with recommendations for future research that attend to issues of equity and diversity, and more explicitly examine the intersections of open access and science journalism.

Promoting diversity and overcoming publication barriers in Latin American neuroscience and Alzheimer's disease research: A call to action

Alzheimer's disease (AD) is a global health issue. Because AD is a condition demanding effective management, its socioeconomic burden is immense and threatens the health systems of both low- and middle-income (LMIC) and high-income (HIC) countries. However, while most of the HICs are increasing their budget for AD research, the situation is different in LMICs, and resources are scarce. In addition, LMIC researchers face significant barriers to publishing in international peer reviewed journals, including funding constraints; language barriers; and in many cases, high article processing charges. In this perspective, we discuss these disparities and propose some actions that could help promote diversity, and ultimately translate into improved AD research capacity in LMICs, especially in Latin American and Caribbean countries.

HIGHLIGHTS

Researchers in low- and middle-income countries (LMIC) face increasing difficulties such as financial constraints, language barriers, and article processing charges.Publication fees, in particular, can be a significant barrier in the process of publication and equal access to scientific information.Publication fee equalization initiatives by publishing companies could reduce the scientific inequality that disadvantages researchers in LMICs.

Preprints in Health Professions Education: Raising Awareness and Shifting Culture

A preprint is a version of a research manuscript posted by its authors to a preprint server before peer review. Preprints are associated with a variety of benefits, including the ability to rapidly communicate research, the opportunity for researchers to receive feedback and raise awareness of their research, and broad and unrestricted access. For early-career researchers, preprints also provide a mechanism for demonstrating research progress and productivity without the lengthy timelines of traditional journal publishing. Despite these benefits, few health professions education (HPE) research articles are deposited as preprints, suggesting that preprinting is not currently integrated into HPE culture. In this article, the authors describe preprints, their benefits and related risks, and the potential barriers that hamper their widespread use within HPE. In particular, the authors propose the barriers of discordant messaging and the lack of formal and informal education on how to deposit, critically appraise, and use preprints. To mitigate these barriers, several recommendations are proposed to facilitate preprints in becoming an accepted and encouraged component of HPE culture, allowing the field to take full advantage of this evolving form of research dissemination.

Publishing Identifiable Patient Photographs in Scientific Journals: Scoping Review of Policies and Practices

BACKGROUND

Publishing identifiable patient data in scientific journals may jeopardize patient privacy and confidentiality if best ethical practices are not followed. Current journal practices show considerable diversity in the publication of identifiable patient photographs, and different stakeholders may have different opinions of and practices in publishing patient photographs.

OBJECTIVE

This scoping review aimed to identify existing evidence and map knowledge gaps in medical research on the policies and practices of publishing identifiable photographs in scientific articles.

METHODS

We performed a comprehensive search of the Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, CINAHL with Full Text, Database of Abstracts of Reviews of Effects, Ovid MEDLINE, and Scopus. The Open Science Framework, PROSPERO, BASE, Google Scholar, OpenGrey, ClinicalTrials.gov, the Campbell Collaboration Library, and Science.gov were also searched.

RESULTS

After screening the initial 15,949 titles and abstracts, 98 (0.61%) publications were assessed for eligibility at the full-text level, and 30 (0.19%) publications were included in this review. The studies were published between 1994 and 2020; most had a cross-sectional design and were published in journals covering different medical disciplines. We identified 3 main topics. The first included ethical aspects of the use of facial photographs in publications. In different clinical settings, the consent process was not conducted properly, and health professionals did not recognize the importance of obtaining written patient consent for taking and using patient medical photographs. They often considered verbal consent sufficient or even used the photographs without consent. The second topic included studies that investigated the practices and use of medical photography in publishing. Both patients and doctors asked for confidential storage and maintenance of medical photographs. Patients preferred to be photographed by their physicians using an institutional camera and preferred nonidentifiable medical photographs not only for publication but also in general. Conventional methods of deidentification of facial photographs concealing the eye area were recognized as unsuccessful in protecting patient privacy. The third topic emerged from studies investigating medical photography in journal articles. These studies showed great diversity in publishing practices regarding consent for publication of medical photographs. Journal policies regarding the consent process and consent forms were insufficient, and existing ethical professional guidelines were not fully implemented in actual practices. Patients' photographs from open-access medical journals were found on public web-based platforms.

CONCLUSIONS

This scoping review showed a diversity of practices in publishing identifiable patient photographs and an unsatisfactory level of knowledge of this issue among different stakeholders despite existing standards. Emerging issues include the availability of patients' photographs from open-access journals or preprints in the digital environment. There is a need to improve standards and processes to obtain proper consent to fully protect the privacy of patients in published articles.

A Synthesis of the Formats for Correcting Erroneous and Fraudulent Academic Literature, and Associated Challenges

Academic publishing is undergoing a highly transformative process, and many established rules and value systems that are in place, such as traditional peer review (TPR) and preprints, are facing unprecedented challenges, including as a result of post-publication peer review. The integrity and validity of the academic literature continue to rely naively on blind trust, while TPR and preprints continue to fail to effectively screen out errors, fraud, and misconduct. Imperfect TPR invariably results in imperfect papers that have passed through varying levels of rigor of screening and validation. If errors or misconduct were not detected during TPR's editorial screening, but are detected at the post-publication stage, an opportunity is created to correct the academic record. Currently, the most common forms of correcting the academic literature are errata, corrigenda, expressions of concern, and retractions or withdrawals. Some additional measures to correct the literature have emerged, including manuscript versioning, amendments, partial retractions and retract and replace. Preprints can also be corrected if their version is updated. This paper discusses the risks, benefits and limitations of these forms of correcting the academic literature.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10838-022-09607-4.

Pearls of wisdom for aspiring physician-scientist residency applicants and program directors

Postgraduate physician-scientist training programs (PSTPs) enhance the experiences of physician-scientist trainees following medical school graduation. PSTPs usually span residency and fellowship training, but this varies widely by institution. Applicant competitiveness for these programs would be enhanced, and unnecessary trainee anxiety relieved, by a clear understanding of what factors define a successful PSTP matriculant. Such information would also be invaluable to PSTP directors and would allow benchmarking of their admissions processes with peer programs. We conducted a survey of PSTP directors across the US to understand the importance they placed on components of PSTP applications. Of 41 survey respondents, most were from internal medicine and pediatrics residency programs. Of all components in the application, two elements were considered very important by a majority of PSTP directors: (a) having one or more first-author publications and (b) the thesis advisor’s letter. Less weight was consistently placed on factors often considered more relevant for non-physician-scientist postgraduate applicants — such as US Medical Licensing Examination scores, awards, and leadership activities. The data presented here highlight important metrics for PSTP applicants and directors and suggest that indicators of scientific productivity and commitment to research outweigh traditional quantitative measures of medical school performance.

Adjusting the use of preprints to accommodate the 'quality' factor in response to COVID-19

Preprints are typically crude precursors of peer-reviewed papers that are placed almost immediately, save for some superficial screening, on an open-access repository to allow the information to reach readers quickly, circumventing the long-drawn process typically associated with processing in peer-reviewed journals. For early-career researchers who might be enthusiastic about obtaining some recognition for their efforts, or wanting open and public input about their work, preprints are certainly a useful publication choice. However, if health-related data and information have not been carefully scrutinised, they may pose a risk and may even serve as a source of public health misinformation. Surging growth and competition among preprint servers, coupled with a massive volume of COVID-19-related preprints, mainly on bioRxiv and medRxiv, as well as select indexing now being tested on PubMed, suggests that preprints are being increasingly used in the biomedical sciences. Stronger and more robust ethical policies are needed to screen preprints before they are released to the public, and even if this implies a slight delay in publication, it may increase academics' trust in this form of scientific information and communication. Clear and stringent ethical policies need to be urgently introduced by ethics groups such as COPE and the ICMJE, whose many member journals allow preprints to be posted before traditional peer review. Stringent ethical guidelines that treat misconduct equally in preprints and peer-reviewed papers will boost the integrity of academic publishing.