Our Research is Completed: is There an Ethical Way to Disseminate its Findings?

Full of suggestions, this article turns the spotlight on what should be strictly pursued to timely, clearly and transparently disseminate all findings of health and medical research to the people who can make use of them. To this aim, it maintains that all research stakeholders should integrate ethics and integrity principles in their institutional dissemination policies and personal belief systems

By Raffaella Ravinetto

Institute of Tropical Medicine, Antwerp, Belgium (Twitter: @RRavinetto) 

Our Research is Completed: is There an Ethical Way to Disseminate its Findings?

 

All findings of health and medical research, whether positive, inconclusive or negative, should be timely, clearly and transparently disseminated to the people who can make use of them[1],[2]. This, in order to inform policies and practices, and to maximize the social value and benefit of the research without delay”[3]. In a paper recently published in the BMJ Evidence Based Medicines[4], Jerome A Singh and myself reflected on the ethics challenges faced not only by researchers, but also by other concerned stakeholders, when it comes to disseminating research findings. In particular, we looked at the challenges and opportunities of peer-review publications, abstracts, pre-prints, press-releases, and media and social media coverage. Dissemination of research findings to the research participants and communities is at least equally important, but it requires different modalities and contextualized approaches.

Herein, I present an overview of our reflection and call from the publication in the BMJ Evidence Based Medicine, which is available open access at Responsible dissemination of health and medical research: some guidance points | BMJ Evidence-Based Medicine.

The main modalities of dissemination

Publishing in peer-reviewed journals remains the benchmark dissemination modality. However, it is not exempt from shortcomings and weaknesses[5], particularly if there is lack of qualified reviewers, and/or if researchers are subject to a ‘publish or perish’ institutional culture. Furthermore, independent researchers or those in resource-constrained settings may be unable to publish their research due prohibitively high publication fees[6]. Before peer-review publication, scientific conferences provide adequate platforms for sharing research results with peers. However, the limited information contained in a conference abstract will not allow reviewers to identify all potential scientific and/or ethical shortcomings of the concerned work.  Preprints, i.e. preliminary reports of work not yet peer-reviewed, are more and more frequently uploaded in dedicated free-access servers, such as https://www.medrxiv.org/[7]. They allow for rapid, open-access dissemination, accompanied by informal peer-appraisal; but rushed readers may miss the cautioning  that they are not peer-reviewed, thus not suitable yet to inform policy or medical guidelines.

The scientific community, health system policy-makers, and regulators are the primary target of  peer-reviewed manuscripts, abstracts, and pre-prints. Conversely, corporate press-releases for early dissemination of (in particular) clinical trial findings, primarily aim at influencing the market. They are drafted by marketing experts, and are often preceded by stock repurchasing, i.e. companies buy back part of their own stock held by executives, thus increasing demand for the stock and enhancing earnings per share.[8]

Last, irrespective of the initial dissemination modality, upstream information is cascaded to mainstream and social media, helping to spread valuable knowledge, but also risking to catalyze misunderstanding or overemphasis on marginal, unsignificant or inaccurate findings.

A call for good dissemination practices

In our paper in the BMJ Evidence Based Medicine, we drafted some recommendations for good dissemination practices. They are aimed at researchers, research institutions, developers, medical journals editors, media, journalists, social media actors, medical opinion leaders, policy makers, regulators, and the scientific community. For instance, researchers, research institutions and developers (including pharmaceutical companies) should publish all results, including those that are negative or inconclusive, and they should do it in open access journals when possible. They should also ensure that conference abstracts, pre-prints and press-releases are (rapidly) followed by a peer review publication – and if this does not happen, be transparent on why this does not happen. Research institution should avoid fostering an explicit or implicit ‘publish or perish’ culture. Medical journals should adopt fair prices for open access publication; rigorously ensure compliance with the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals of the International Committee of Medical Journal Editors (ICMJE), beyond a formal “checklist approach”; and comply with the core practices of the Committee on Publication Ethics (COPE). As we advocated for elsewhere, the scientific community as a whole should agree on “good pre-print practices”, and on a less ambiguous terminology, e.g. not peer reviewed”[9]. There is also a key-responsibility of journalists and key-opinion leaders to critically appraise any dissemination modality (and press-releases in particular) for ethics, science and possible bias, and to communicate accordingly, whether in mainstream media or in personal social media feeds.

In summary, in order to ensure timely, comprehensive, accurate, unbiased, unambiguous, and transparent dissemination, all research stakeholders should integrate ethics and integrity principles in their institutional dissemination policies and personal belief systems.

 

REFERENCES

[1] World Medical Association. Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013; 310: 2191–94.

[2] Council for International Organizations of Medical Sciences (CIOMS). International ethical guidelines for health-related research involving humans. 4th ed. Geneva: Council for International Organizations of Medical Sciences (CIOMS); 2016 Nov. Accessed on 21/04/2022 at: https://cioms.ch/shop/product/international-ethical-guidelines-for-health-related-research-involving-humans/

[3] National Institute for Health Care and Research. “How to disseminate your research”. Version 1.0, January 2019. Accessed on 21/4/2022 at https://www.nihr.ac.uk/documents/how-to-disseminate-your-research/19951

[4] Ravinetto R, Singh JA. Responsible dissemination of health and medical research: some guidance points. BMJ Evidence-Based Medicine Epub ahead of print 2.9.2022; doi:10.1136/bmjebm-2022-111967

[5] Smith MJ, Upshur REG, Emanuel EJ. Publication ethics during public health emergencies such as the COVID-19 pandemic. Am J Public Health. 2020; 110:947–8.

[6] Ellingson MK, Shi X, Skydel JJ, et al. Publishing at any cost: a cross-sectional study of the amount that medical researchers spend on open access publishing each year. BMJ Open 2021; 11: e047107. 7

[7] Massey DA, Opare MA, Wallach JD, Ross JS and Krumholz HM. Assessment of Preprint Policies of Top-Ranked Clinical Journals. JAMA Network Open. 2020;3(7): e2011127

[8] Sorkin AR, Karaian J, Gandel S, de la Merced MJ, Hirsch L, and Livni E. Biden Renews Pushback Against Stock Buybacks. 28 March 2022. https://www.nytimes.com/2022/03/28/business/dealbook/biden-stock-buybacks.html.

[9] Ravinetto, R., Caillet, C., Zaman, M.H. et al. Preprints in times of COVID19: the time is ripe for agreeing on terminology and good practices. BMC Med Ethics 2021;  22 (106).