When the preprint revolution started with the launch of arXiv – a scientific online repository – in August 1991, it sent a jolt through the scientific community. Many perhaps considered it a “rogue mission” to sidestep peer-review – a critical process in the conventional journal submission system.

However, the idea is not a recent one. A similar, albeit long-forgotten attempt, was made in the 1960s by the National Institutes of Health (NIH), but it turned out unsuccessful. Today, despite both sides of the arguments revolving around the preprint controversy, things seem to be well under way at arXiv and the site is still up and running – surpassing 1 billion downloads, and still counting.

Can preprint be advantageous to scientific research?

Recently, Stanford researchers made a breakthrough by successfully developing an algorithm that offers diagnoses based on the interpretation of X-ray images. The algorithm, called CheXNet, can diagnose as many as 14 types of medical conditions. In just over a month, CheXNet had outperformed four Stanford radiologists in diagnosing pneumonia accurately. This is just one of the many findings published on arXiv. Since its launch, arXiv has inspired the growth of similar sites across numerous disciplines, gradually changing the landscape of scholarly publication. Hundreds of journals have now allowed posting on preprint servers prior to publication.

The rapid dissemination of research findings is clearly one of the primary advantages argued by the advocates of preprint, since based on the conventional journal submission system, it can take months and sometimes up to years before a manuscript can be officially published. This also helps researchers maintain their enthusiasm. “Publishing can be such a long process that all the excitement is usually sucked out of your work by the time it appears,” laments Stephen Royle, a cell biologist at the University of Warwick in Coventry, United Kingdom. He adds, “Getting the paper out when you are still excited about it is an amazing feeling.”

The ability to disseminate a study quickly would also allow other researchers in the field to be “in the know” of recent developments in the field, which could prove beneficial in the long run. Needhi Bhalla, Associate Professor of Molecular, Cell & Developmental Biology at the University of California Santa Cruz wrote in her article, “The ability to let other scientists know of recent developments in one’s lab so that they can rapidly build and expand upon those developments will promote more rapid progress in a field than the fits and starts that often accompany the peer review process for journals.” The article was featured in Molecular Biology of the Cell.

In her article, Bhalla also brought forth other advantages of the preprint system such as the ability to establish priority of discovery, which recognises an individual’s work as one of the pioneers of a particular finding. Preprints also help to demonstrate productivity and scholarly contributions to a field, while a manuscript is undergoing peer review and vetting prior to publication in a journal. In addition, it provides additional opportunities to disseminate one’s work to individuals without journal subscriptions.

Is the medical community ready to hop on the preprint bandwagon?

Preprints can encourage productivity and scholarly contributions to a field, while a manuscript is undergoing peer review.
Preprints can encourage productivity and scholarly contributions to a field, while a manuscript is undergoing peer review.

The idea of preprint as the future of scientific research has received a huge share of criticisms ever since its inception. Nonetheless, when the concept extends to the clinical domain, a rather distinct kind of apprehension rises among members of the medical community.

This was the reaction displayed after Yale cardiologist Harlan Krumholz presented the plan to launch a preprint server specialising in clinical research results, named MedArXiv, at the Eighth International Congress on Peer Review and Scientific Publication. The plan invited a mixed response – the primary concern being that this would lead to patients trying treatments on their own before findings are reviewed or vetted. Howard Bauchner, editor-in-chief of the Journal of the American Medical Association (JAMA), expressed that he was “surprised” that Krumholz did not bring up potential risks to patient health of publishing unreviewed papers in his talk.

Steven Goodman, epidemiologist and associate dean of clinical and translational research at Stanford University in Palo Alto, proposed that one way to do it in a careful manner would be to start small, in just a single field of medicine. Krumholz, however, does not seem to find the idea appealing. “I would not want to restrict who can use it,” he said.

Whether or not the medical community will embrace preprint still remains to be seen. Despite the preprint being seen as challenging the status quo in the realm of journal publication, expecting the demise of peer-review any time soon is perhaps a bit far-fetched. Nonetheless, in the midst of the controversy surrounding the preprint revolution, researchers should not overlook the importance of adhering to the core values and upholding the integrity of research at all times. MIMS

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