Joint Position Statement: Guidance on Medical Publications & Pre-Prints by AMWA, EMWA & ISMPP

During the COVID-19 health crisis, medical researchers have felt significant pressure to publish relevant findings as quickly as possible. A danger is that the rush to publish could lead to the misleading, incomplete, or inaccurate publication of data that can directly inform critical medical or health decisions. Further, if the threshold of publication oversight is lowered, it may become a precedent that cannot be easily reversed, potentially eroding standards and causing the public to lose trust in medical science. The American Medical Writers Association (AMWA), the European Medical Writers Association (EMWA), and the International Society for Medical Publication Professionals (ISMPP) published a Joint Position Statement (JPS) on 31 March 2021, in the peer-reviewed journal Current Medical Research and Opinion (CMRO) – emphasizing that having a pre-publication review is essential and asserting that the integrity of published scientific and medical research must be protected. The statement also provides recommendations aimed to resolve the dilemma between speed and quality of published research.

The statement highlights an important issue, witnessed recently during the pandemic, that could undermine public trust in scientific and medical research, that is bypassing the conventional high standards of peer-review in a hurry to get the research published and released to the potential readers. No doubt the process of review is laborious and time-consuming, yet it is the hallmark of science that safeguards the reliability and validity of the published research. Though the benefit of accelerated publications is undeniable, the harms associated with it cannot be neglected. Therefore, the JPS made several recommendations and provides a checklist to ensure that minimum standards of pre-publication vetting can be met, thereby limiting the chances of poor-quality publication.

The president of AMWA, Gail Flores, believes that Medical communicators, including writers, editors, and those involved in quality control, play a critical role in ensuring that clinical and scientific data are published and disseminated accurately and clearly. In a rush-to-publish environment, all stakeholders in the scientific and clinical research communities and the press must ensure that the public have correct and actionable information from which to make health and medical decisions.

The JPS highpoints the role of professional medical writers and scientific communicators in accelerating the publication process. Medical writers and scientific communicators may facilitate not only enhancing the content quality but also speeding up the writing process along with limiting the likelihood of retraction because of misconduct.

Therefore, they need to have proper access to resources such as the clinical study report, source data, and every other relevant document, including statistical outputs and patient narratives. In addition, through their training, medical writers and communicators should be involved in the development of editing and referencing standards, and support peer review through critical analysis of the quality of the manuscript.

The JPS addresses the challenges with preprints, which are sometimes neither revised nor fully published. Preprints, once posted online, are available to the public and all sorts of media to comment and reflect upon. If the information is misleading or wrong, even after the preprint is retracted, it could have done irreparable damage already. To alleviate this potential problem, the three organizations suggested that preprints should be cited in the manner of personal communication, it should explicitly mentioned that the source is a preprint, the preprints should be watermarked as not peer-reviewed, and pre-publication vetting processes should be conducted and made mandatory for all server hosts. Moreover, they call for standards developed by all stakeholders involved.

The issues with post-publication peer review and their potential solutions are similar to those proposed for preprints, but an additional recommendation was that the publication is indexed by mainstream bibliographic databases {if applicable) once it has been fully peer-reviewed.

Moreover, the JPS highlights the concern with the conventional peer-review process: the lengthy review process, which may delay the dissemination of relevant research findings. This problem is further accelerated due to the unavailability of good and qualified reviewers during a health crisis. To limit the duration of review and accelerate research dissemination, they recommended that the authors should always submit rejection comments to the second-choice journals with itemized rebuttals and updates to the manuscript. Furthermore, the journal's editorial board should accept or request such portable peer-review; commercial back-end services could speed up the peer-review, as well as the formation of a rapid response team of reviewers. The publishers should standardize formatting requirements, offer fast-track options, and consider incentives for reviewers to expedite the process.

The JPS also provides recommendations for all formats, which include quality control, and training in peer review. Firstly, publication guidelines and other guidelines, such as from the Committee on Publication Ethics (COPE), and checklists should be followed responsibly. Secondly, all involved parties (authors, reviewers and editors) should be trained in the nature or technical aspects of the peer-review process to adequately vet the manuscript. Thirdly, it is the responsibility of medical journalists to raise awareness of their audience to the differences between preprints and pre-publication peer-review.

In short, the JPS recognizes the significant advantages and disadvantages of all publication models. The recommendations, if followed properly, can aid in accelerating the peer-review and publication process, and importantly can help to limit the harms that can come from disseminating unvetted information. Click here to see the full Joint Position Statement.

ACKNOWLEDGMENT

This place was reviewed by representative of AMWA, EMWA and ISMPP including ShariRager and Dikran Toroser, AMWA, Beatrix Does and Art Gertel, EMWA; and Anna Geraci, ISMPP on behalf of the AMWA-EMWA-ISMPP Joint Position Statement on Medical Publications and Peer Review Writing Committee.