Hi I'm Harlan Krumholz I'm a Cardiologist at Yale,
Professor of Medicine.
Hi I'm Joe Ross I'm a general Internist
and an Associate Professor at Yale.
So we have some big news to announce.
We have some big news.
It's nice finally to be able to tell the world that we're
about to launch a Preprint Server
in Clinical Medicine, Med Archive. [MedrXiv]
Can you tell me more for the people watching,
a little bit more, what is a Preprint Server?
So a Preprint Server is a platform
that enables researchers who have work in progress,
work maybe that's just about to go to peer review to be
able to post it and post it in a way that is retrievable,
archivable, searchable and to enable
the broader scientific community to see
what they're doing.
So we would typically do this in our scientific meetings.
You know,
that we have a couple of large scientific meetings
in the Cardiology year and put in abstracts
or posters and we give oral presentations
or present to our colleagues and share that information.
But it's usually sequestered among the people
who are at that meeting.
But this is an opportunity for work in progress at any
time to be able to be posted,
spread and put in a position for anyone around the world
to be able to see or read.
I think what's most exciting about it,
what we've learned from our colleagues in Math
and Physics and that people…
and even the Biological Sciences across our campus,
people have been using preprints now for years
to disseminate their research before it's gone
to a journal for peer review.
And this represents a unique opportunity for us
in clinical and medical sciences and public health
to start disseminating our research.
People probably are going to have a lot of questions
about how to do it but the process is going
to be quite similar. You're going to you know,
prepare, format your article,
you're going to submit it with an abstract.
This is for research.
People are going to include their
conflict of interest statements,
they're going to be able to include a protocol
if they pre-developed one. They're going to…
if it's a clinical trial they're going include
their registration number.
It's going to be a lot like submitting an article,
but it's before going to the journal
and it's intended to be read by others
in the scientific community.
And to be a relatively easy process.
With our partners at Cold Spring Harbor Laboratories
the group that's put up BioArchive very
successfully and with the British Medical Journal,
BMJ, that group…
although this is not going to favor any particular
journal but they worked with us to help design
this so that it could be safe.
That is we're very clear about safeguards to be sure
that as information is disseminated
it's in the public's best interest.
But but this grew out of the work that we had done
together which had showed that it often takes quite
a long time for scientists to get their work peer
review published and in the meantime other
scientists aren't necessarily aware of that work.
So people could even be repeating somebodies work,
not being able to build on it because they weren't even
aware that someone had done it.
And by making work in progress more readily available,
faster with regard to its delivery and to be able
to put it in a way that it's searchable
so you could see what's been put out there.
We thought that this might be a way to really accelerate
the clinical research enterprise.
And as you said we've seen this in so many other fields.
In fact a field that I'm working a lot in,
the big data field the machine learning field,
you simply cannot be at the top of your field if you're
depending on peer review publications.
You need to see that preliminary work,
you need to see that work in progress,
because it's teaching you something.
Even if it's even if it's not good it's teaching
you something.
It’s teaching you what people are thinking about,
what direction they're going in.
And it's a very critically important part of your
learning as you begin to develop your grants and so forth.
And I think it's gonna be a great way for people
to learn not just about the successes they've
had in research but particularly from failures.
We all know that negative research is harder to publish,
takes longer. Right?
This is a great way to disseminate that work
or the quality improvement work that we're doing at our
institution or other institutions that takes a longer
time to come out.
This is a great way to disseminate and help the rest
of the community learn from it.
And I think we knew that we were on the right track.
You know we start talking about this more than two years
ago and it's taken us time especially
because of the partners.
We were trying to design this specifically
for clinical medicine since there were other ways
that people could post preprints…
you and I both posted preprints on BioArchive
when we didn't have other options,
but that this would be a better way to do it.
But it was a matter of trying to think about
what would be a platform that would work
well for everybody?
And you may want to say a few words about the the safeguards
that we've got because what people
should know is that we've deliberated for a long time
about how to make this in a way that we would cause no harm,
but provide the possibility that research could be
done better and faster and be able to disseminate
in ways that would build stronger research in the future.
But the the safeguards are important.
Yeah. Well first of all the MedArchive as preprint
server is set up just for research.
So it's any type of research study.
Could be original research article,
it can be a systematic review,
it can be cost effectivness analysis,
but its research in the medicines and public
health sciences.
It's not intended to be used for editorials,
for commentaries, for narrative reviews,
stuff like that.
So that's actually an important safeguard right?
We're not trying to disseminate anything.
We're trying to disseminate Science to others
in the scientific community.
But as part of the submission process there's certain
requirements that have to be met.
You have to have your name on it as an author,
you should be including a research reporting checklist.
Someone's gonna take a look at it because we're looking
for submissions not just from Yale but from all
across the world.
So someone's gonna be taking a look at
everything that comes in and make sure
it's not gibberish,
make sure it's not offensive content and then it's gonna be
going out to the broader community including
affiliates, some of whom may be affiliated with Yale,
some in the broader community who are gonna be
looking at each paper and saying “Yep this is in my field,
this is a research study.”
They're not going to be evaluating the quality
of it or providing a review like you might
be doing for a journal,
but they're going to be saying “yes
this is a representation of a scientific study
and it should go out to the broader community.”
After that if there is any concern,
when that person reviews that paper,
it's going to come to our Leadership Council
and to an Editor, a Medical Editor… could be BMJ…
who are going to take a close look,
and particularly in the early phase,
be cautious about ensuring that we're not
disseminating work that could be misinterpreted or put public
health decision making at risk.
And so in that case we may decide that some papers
shouldn't come out as a preprint but instead
should go to the peer review process before
they're disseminated.
Yeah. I mean if someone made a wild claim about
a cancer cure or wanted to say that measles vaccines
caused some untoward effects,
given the hot button issues and the concerns about how
the public might take that on,
we might say that might be best put through peer review before
it's disseminated in this way.
But we do hope that there'll be a broad range of papers
that would accrue this way.
And one of the things we thought was this is a good
way for researchers who want establish
provenance of the work,
for people who are doing timely work like in quality
improvement or policy evaluation and there is the opportunity
for peer review once it's been posted so people
can post comments.
It just needs to be understood as work
in progress that people are then interacting
with and the belief here is that this is going
to ultimately drive better at the end.
It's meant to be complementary to peer review not to replace
peer review and that it enables that preliminary
information and science to be distributed
and disseminated while the peer review,
the official peer review in the journals is taking place.
It's also a great opportunity for people
who are preparing their grant applications to be able
to describe their work in progress or their
preliminary pilot data and be able to reference out to it.
So the NIH know….
I think that’s a great point. So no I mean finish…
I mean I think it's a great idea.
We knew we were on the right track to when the NIH
came and said “in your grants you can cite a preprint”.
So it means,
if my grant is going in next week and I finally
have accumulated all my stuff.
I don't have the space in the paper to put
all the preliminary stuff but I've got a paper,
I can post it on the preprint server and simply reference it.
And the other thing that we've found
that was interesting was that many of the funders
are tacking in this direction.
Gates and Zuckerberg and others are saying “when you finish
we want you to post on a preprint server,
because we want the world to start commenting on this.”
It's going to be important people
recognize it as pre peer review, preliminary…
but we don't want wait two years for this to get out there.
Because again,
they recognize that the mere fact of sharing the information,
however preliminary, stimulates thinking,
stimulates creativity,
gets people in a mode to think about well
what would be next or was that real or do
I need to verify that?
Or even as it's going through the process,
and then there'll be this additional benefit
when something eventually does get peer reviewed
and not everything will need to go through
that but some will,
it'll be an opportunity to compare.
Well what evolution did that science go through?
From the time it was first put on and we will be able to show,
people may have multiple versions of preprints.
They may have preprinted and improved it and improved it.
And we can link it to the peer review publication
so that the entire journey of a of a scientific
contribution can be tracked.
I mean it's an it's an incredibly
exciting time and BioArchive went from a very small
server used by very few people to now they're getting
thousands of submissions every month.
So and we're learning so much from our colleagues
at Cold Spring Harbor Labs who'd established Bio Archive
who get you know really….
Biologist colleagues are telling us they couldn't
imagine without it now because it's accelerating…
What we hope by the way,
is that this really be seen as a community resource.
The contribution here is trying to build a better
scientific enterprise.
One that can be taken advantage of for all.
It's Cold Spring Harbor Labs, BMJ, Yale co-founders.
But we want no one to see this as ours.
We want this to be for the community.
And so anyone who's interested should contact
us or become part of it. We want people to submit.
We want people to become part of this effort and no
one should feel like it's one or the other,
in the end this should be seen as MedArchive
in that there are lots of people who are supporting
it and that it's helping things get better.[00:10:13.29]
So when's your first submission?
Tomorrow. [laughs]
Me too!
And I will say in the last year since we've started
this effort I've put in a lot of preprints and I've
had a great experience with it. I mean lots of rapid feedback.
It hasn't impeded our ability to publish in peer view.
It's made us better. And it's also more exciting.
You finish this, you submit to peer review,
you're actually getting immediate feedback
from the community by having your preprint up….
It’s right out there for people to be able to do.
We're going to begin accepting submissions right away.
And then the the server itself,
Med Archive we'll be open and live starting on June 25th.
June 25th is when it will be live.
Med Archive .org. [MedrXiv.org]