The challenge of preprints for public health The challenge of preprints for public health

"Despite disagreements over whether this form of publication is actually beneficial or not, its advantages and problems present a high degree of convergence among advocates and detractors. On the one hand, preprint is beneficial because it is a quicker way to disseminate scientific content with open access to everyone; on the other hand, the lack of adequate vetting, especially for peer reviews, increases the risk of disseminating bad science and can lead to several problems 2. The dissent lies in considering to what extent possible risks overcome possible benefits (or vice versa).

The argument about this rapid dissemination has strong supporting evidence. A study on preprint publication showed that preprint are published on average 14 months earlier than peer-reviewed journal articles 1. This is expected considering that the time-intensive process of peer reviews and revising manuscripts is totally bypassed. However, in this strength lies its very fragility: how to assure that this shorter process will not compromise the quality of the publication?

ASAPbio (Accelerating Science and Publication in Biology) 3 is a group of biology researchers that promotes preprint publication and has produced a number of studies that attempt to allay concerns about its quality, claiming, for example, that published articles previously submitted to a preprint server did not show relevant changes for its publication 4. Authors from this group have argued that the current approaches to evaluate research and researchers hold back a more widespread adoption of the preprint methodology 5, which would explain its relatively small participation on the general panorama of scientific publication.

Despite claims to the contrary, however, there are examples of poor studies published as preprints, which caused undesirable consequences in public health. Two methodologically flawed studies about a protective effect of tobacco smoking against COVID-19 (one of which has an author with known connections with the tobacco industry), for example, increased the commercialization of tobacco products in France and Iran 6 and a virology study that erroneously stated that the SARS-COV-2 virus had “HIV insertions” fueled conspiracy theories about the former virus being a bioweapon, which lingered on even after the preprint was removed from the server due to its egregious errors 7. Studies have found that much of the public discussion and even policy was indeed driven by what was published in preprints rather than in scientific journals 7,8,9,10, thus, quality issues are a major cause of concern.

On the other hand, similar errors have been observed within traditional publishing; the publication of a poor quality paper with undisclosed conflicts of interest in one of the most prestigious medical journals, The Lancet, which became the trigger for the contemporary wave of anti-vaccine activism, is a major, and regretful, example. Understanding to what extent this problem is likely to occur with or without gatekeeping mechanisms is necessary...."