But scientists and journalists are increasingly worried that the studies proposed and presented are not ready for "prime time". In fact, many are not studies at all, but subjective conclusions based on data and methods that remain hidden and therefore difficult to validate. Never before has full and immediate transparency been more important, and never before has the scientific image around Covid-19 been so opaque.
What difference does the source make?
Press releases, preprinted articles and published articles all have different purposes and have different weights for scientists and journalists.
A press release "is there to make your institution, your client, your great researcher, your product, your pharmaceutical company and its products, as beautiful as possible, hoping that this press release will convince journalists to write about it ". Gary Schwitzer explained to CNN. Schwitzer is a longtime health journalist and editor, and the founder of HealthNewsReview.org. Because it's written by whoever is promoting the product, it's almost never negative, said Schwitzer.
Traditionally, preprinted articles have been articles that researchers and academics publish on preprinted servers for peer review before submitting their study to a journal. During this pandemic, the profiles of at least two of them - medRxiv (pronounced med-archive), for health sciences, and bioRxiv (pronounced bio-archive), for biology - were considerably elevated. . "Pre-print servers are much, much larger than they have ever been in areas related to Covid - in other words, in the life sciences, in clinical medicine. just not an actor before that, "said Dr. Ivan Oransky. tell us. Oransky is the co-founder of RetractionWatch.org, vice president of editorial at Medscape and professor of medical journalism at New York University.
A study published in a credible scientific journal is - in theory - the complete final version. To be published here, a study must go through a process called peer review. Kate Grabowski, assistant professor in the department of pathology at Johns Hopkins University, calls the peer review process "multiple independent eyes" on paper. While peer review is by no means foolproof, it generally reflects the expertise of many people in a particular area who do not necessarily have a "dog in the running".
"I think it is so useful to detect potential errors that are largely unintentional, and also to just improve the science. Usually when we submit articles they are like drafts and can then be refined [several times] until they are much better, "said Grabowski. She described the process as" iterative ".
But the past few months have shown that the road to solid science can be full of potholes, speed bumps, blind spots, and hairpin turns. If you are not careful, sometimes this road can lead you straight from a cliff.
Here are several recent examples from history that precedes science:
HYDROXYCHLOROQUINE: By now, you've probably heard of hydroxychloroquine, an antimalarial. But, you may not have known that when President Trump touted his benefits, there was a preprinted report from French researchers originally published online on March 20. This study involved only 42 patients, and was criticized for confusing data, poor protocols, and not clearly taking into account all of the patient's results, according to the Oransky Retraction Watch website. On April 3, the International Society for Antimicrobial Chemotherapy - the company that publishes the newspaper in which the newspaper was supposed to publish - published a notice saying that "the article does not meet the standards expected of the Society".
On May 11, another study on hydroxychloroquine appeared on medRxiv. Nine days later, the study was withdrawn. The abstract now contains a statement saying, "The authors have withdrawn this manuscript and do not wish it cited. Due to the controversy over hydroxychloroquine and the retrospective nature of their study, they intend to revise the manuscript after peer review. "
Unfortunately, none of this has stopped the hype about the drug, leading to critical shortages for patients who use it for the effective treatment of lupus and rheumatoid arthritis. As further published research on the drug finally began to emerge, it was shown to work neither prophylactically nor as a treatment for Covid-19, and its side effects were found to be potentially dangerous for some patients. The US government now has a stock of 63 million doses.
DEXAMETHASONE: More recently, the results of the study on dexamethasone, a commonly used steroid drug, were first published by a press conference, frustrating researchers who wanted to see the reliable data on which this good news was based. Harvard health expert Dr. Ashish Jha tweeted: "First - it is now a feature of this pandemic that most of the results have been made public via a press release with little data to provide context. true. "The problem is that by the time we hear about these results in the public, we should have the confidence to say that it is true. Unlike hydroxychloroquine, the results of the dexamethasone study seem Mortality has been reduced by a third in patients on respirators, according to the preprinted early study published the following week, but again we have yet to see if that withstands the rigors of the review. by peers.
MODERN: Moderna, one of the companies in the highly competitive race to produce a coronavirus vaccine, unleashed a frenzy on Wall Street after sending out a press release on what some saw as exaggerated partial results from phase 1 of its trial. At the time, Dr. Peter Hotez, a leading expert on infectious diseases and vaccine development at Baylor College of Medicine, told CNN that he found the results of Moderna's press release "uninterpretable" . "It did not contain any data," he said. "So basically - it's an opinion. It was a twist and an opinion." When CNN asked it to respond, Moderna issued a statement saying, "The company has worked in cooperation with NIAID to properly characterize the interim data provided by NIAID. From the trial at a later date."
The Moderna vaccine was developed in partnership with the National Institute of Allergies and Infectious Diseases of the National Institutes of Health, led by Dr. Anthony Fauci. Fauci has often cited the speed at which the vaccine was introduced in phase 1 trials. "It is massively the fastest that has ever been done," he said. He added, "Since we have to do it as quickly as possible without sacrificing security or scientific integrity, the federal government partnered with several of these companies and said," Guess what? We are going to go fast and we "We are going to assume that we are going to be successful. And if we do, we have saved several months. And if we don't, the only thing we have lost is money." But it is better to lose money than to lose lives by delaying the vaccine. "
Fauci is optimistic about the potential vaccine but was also disappointed with the rapid publication of the results. "I didn't like it," he told STAT News. "What we would have preferred to do, quite frankly, is wait until we have the data for all of phase 1 - what I hear is quite similar to the data they showed - and publish it in a good log reputation and show all the data. But the company, when they looked at the data, like all the companies, they said, "Wow, this is exciting. Let's put out a press release. ""
In fact, when it comes to the vaccine race, despite all the talk you've heard from Moderna or the University of Oxford or Operation Warp Speed, or having billions of doses from here at the end of the year, remember: we only saw this study published in The Lancet. That's all. We must remember to temper our hopes and our enthusiasm with the facts we have.
I include these examples because they show how different parts of the process can break down.
"Trying to do science through a press release, without supporting it, either with a traditional newspaper or a pre-publication ... has universally led to misunderstandings and has no place in science. Biotechnology does it because "They write for their shareholders, they write for their investors, but this is done in a way that ignores their impact on public health and must stop," said Hotez.
In other words, frustrated researcher James Heathers in a tweet: "Science by press release is just promise with dusted numbers. GIVE. WE. THE. GOD. PAPER."
Whiplash for Health News Consumers
When this happens - and especially when errors are revealed or documents removed - public confidence is eroded and people begin to doubt science.
"It's like a boost," said Oransky. "I would be really confused."
But these days, that boost has become almost inevitable, because science is advancing in both directions in this Covid way of life.
Adding to the boost and confusion is just the large number of studies coming out. According to Grabowski, who based his estimate on the NIH iSearch COVID-19 portfolio, about 35,000 articles have been collected to date on the subject - and they keep coming.
To master them all, Grabowski heads a team of about 50 researchers from Johns Hopkins University at the Novel Coronavirus Research Compendium, which organizes and reviews emerging research. She estimates that they examine between 1,500 and 2,000 articles per week and have examined more than 10,000 in total. As you can imagine, some are garbage and others are gems.
"I would say there are certainly some excellent studies that are being done in a very short time," said Grabowski. "It's really amazing to see science evolving at this rate. I don't think we've ever seen anything like this before."
Buyer and seller, beware
All of the experts said it was great news that so much research was being done, despite the fact that much of the work is emerging through press releases and pre-prints.
"The fact that scientists get jobs earlier so other scientists can work on them and that we may be able to learn things faster - it's a good thing," said Oransky. "The fact that we treat it all the same as if everything had been ... subjected to the same level of control - that's the problem."
Schwitzer advises journalists and those who disseminate information to take the time to get it right. "I'm just reminding people to slow down. Much of what we do, reporting breathlessly at breakneck speed, doesn't need to be relentlessly flagged at breakneck speed," he said. he said, adding, "Words count and data counts."
So what does all this mean for you? "I think that someone who reads, watches, watches, listens should never make a decision on the basis of a single report he has read, whether it be a study or a report on a study, "said Oransky. "Especially if this report does not put all of the above into context and does not explain what we still do not know."
