Ravinetto and Singh argue that better practices can be implemented when disseminating research findings through abstracts, preprints, peer-reviewed publications, press releases and social media

Dissemination has been defined as ‘the targeted distribution of information and intervention materials to a specific public health or clinical practice audience’,1 and as being ‘simply about getting the findings of your research to the people who can make use of them, to maximise the benefit of the research without delay’.2 Ethics guidelines concur that research stakeholders have ethical obligations to disseminate positive, inconclusive or negative results,3 in an accurate, comprehensive and transparent way4—even more so during public health emergencies.5

Traditionally, research results were first shared within the scientific community, and then ‘translated’ into lay language for policymakers and other audiences via the media, policy briefs, lobbying. Today, preprints6 and press releases7 often come first. Dissemination of research findings to research participants and communities requires contextualised approaches and have been explored elsewhere.4 Similarly, trial registries8 and data sharing are explored elsewhere in this series. Here, we navigate the challenges and opportunities presented by dissemination through peer-review publications, abstracts, preprints, press release, media coverage and social media (box 1—summary of research dissemination).

Peer-reviewed publications

Publication in peer-reviewed journals remains the benchmark dissemination modality. Independent peer-review aims to assure the quality, accuracy and credibility of reports, but does not always prevent the publication of poorly written, dubious or even fraudulent manuscripts,9 particularly if there is dearth of qualified reviewers, and/or an findings are hastily published to gain competitive advantage and visibility.10 Furthermore, researchers who are inexperienced or subject to an institutional ethos of ‘publish or perish’, may choose to publish in predatory journals with highly questionable marketing and peer-review practices.11 While target audiences may be unable to access findings if journal content is not freely accessible on the Internet, some researchers, particularly those in resource-constrained settings12 may be unable to publish their research due to resource constraints (eg, publication fees may be prohibitively high).13 Some may be poorly motivated to publish inconclusive or negative data.14 Because of such shortcomings, commentators such as Horby warn that ‘clinicians should not rely solely on peer review to assess the validity and meaningfulness of research findings’.15

For peer-reviewed publications to remain a key-dissemination modality, editors should follow the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, of the International Committee of Medical Journal Editors, and comply with the core practices of the Committee on Publication Ethics (eg, data and reproducibility, ethical oversight, authorship and contributorship, etc.). This entails going beyond a ‘checklist approach’ and subjecting manuscripts to rigorous screening and assessment. Journals should strive to select qualified independent reviewers and prioritise open-access policies. Research institutions should distance themselves from a ‘publish or perish’ culture which, together with the willingness to hide ‘unfavourable’ results, remains a major driver of unethical publication practices—which, in turn, translates to ill-informed policies and practices.16

Abstracts

Scientific conferences are valuable venues for sharing research results with peers, and getting prepublication critical feedback. Abstracts often appear in the supplement of a scientific journal, which reaches a broader audience. However, even if attendance costs are not prohibitively expensive, the selection of abstracts may be highly competitive. As a result, not all research findings—even of topical interest—are selected. Furthermore, even if selection is conducted by independent experts, the limited information contained in an abstract may mask scientific and/or ethical shortcomings in the work.

Communication via abstracts is laudable, but should be rapidly followed by peer-reviewed publications, which allows for the findings to be comprehensively reviewed by experts. When abstracts remain the sole source of information, the findings’ significance might be misunderstood, overestimated or wrongly used to guide behaviours, policies and practices.

Preprints

Preprints, that is, preliminary reports of work not yet peer-reviewed, are uploaded in dedicated free-access servers, such as https://www.medrxiv.org/. Preprints are increasingly being used by health researchers, thanks to the evolving policies of major journals that now accept manuscripts previously posted as preprints.17 Theoretically, preprints possess high value as they allow for rapid, open-access dissemination, and immediate yet informal peer-appraisal in the comments section. However, preprints also hold implicit risks. For instance, rapidity may detract from quality and accuracy; most peers will not be able to systematically invest time for the expected high-quality feedback; rushed or inexperienced readers may miss the (sometimes, small print) cautioning that preprints should not be considered established information, nor become the basis for informing policy or medical guidelines; and findings from preprints that may later be substantially revised or rejected after undergoing peer-review processes, could continue to be relied on and disseminated if, for example, they were included in scoping or systematic reviews before peer-review (the same applies to retracted peer-reviewed manuscripts).

To mitigate such risks, researchers should submit preprint manuscripts to a peer-reviewed journal as soon as reasonably possible, and transparently communicate on negative peer-review outcomes, or justify why the preprint is not being timeously submitted to a peer-review journal. Once accepted or published, researchers could remove their preprint from preprint servers or link to the final published version. The media have a duty to communicate preprint findings as unreviewed and subject to change. The scientific community should reach agreement on ‘Good Preprint Practices’ and ascribe less ambiguous terminology to preprints (eg, ‘Not peer-reviewed’ or ‘Peer-review pending’).18

Press releases, media coverage and social media

Since 2021, the dissemination of clinical trial findings by corporate press release has almost become synonymous with announcements of COVID-19 scientific breakthroughs. Therefore, it seems important to briefly contextualise the strategy underpinning such dissemination. Corporate press releases are often preceded by stock repurchasing or ‘buybacks’, that is, companies buy back part of their own stock held by executives. This increases demand for the stock and enhances earnings per share.19 Pharmaceutical or biotechnology companies typically engage in strategically timed buybacks, before press releases announcing significant research findings. Furthermore, corporates in the USA and elsewhere may employ press releases to comply with the legal requirements to disclose information that impact on their market values, and changes in their ‘financial conditions and operations’.20 Press releases are typically drafted by marketing experts and they are often first aimed at the market, and driven by corporate interests rather than social value.

For researchers, the potential to amplify scientific visibility through mass media may act as a powerful incentive to indulge in flattering but inaccurate language. Nonetheless, they have a moral responsibility to review press releases for accuracy, and to immediately make key-information including the protocol, analysis plan and detailed results, publicly available. For instance, the media briefing that announced on 16 June 2020 the life-saving benefit of dexamethasone in severe COVID-19 was followed on 26 June by a preprint with full trial results15 . In ab sence of such good practices, press releases can contain inaccuracies or overhype findings7 with major damaging downstream effects.16

The media have an equally significant impact on science dissemination: peer-reviewed publications which receive more attention from lay-press, are more likely to be cited in scientific literature.21 Perceived media credibility also impacts on dissemination: once individuals trust a media source,22 they often let down their guard on evaluating the credibility of that source. This speaks to the importance of discerning media dissemination (box 2). Journalists who cover early press releases should critically appraise them considering their limitations and potential conflicts of interest.

A call for good dissemination practices

The scientific community, health system policy-makers and regulators are the primary audience of peer-reviewed manuscripts, abstracts and preprints. These constituents should be, or become, ‘sufficiently skilled in critical thinking and scientific methods that they can make sensible decisions, regardless of whether an article is peer reviewed or not’15 ; understand that the nature of scientific knowledge is incremental and cumulative (one study seldom changes practice on its own); and also critically assess other sources, for example, pharmacovigilance, etc. Conversely, corporate press releases are aimed at influencing the market, and society as a whole—and not suited for scientific appraisal.

Irrespective of dissemination modalities, upstream information is cascaded to mainstream and social media, spreading knowledge but risk catalysing misunderstanding or overemphasis. Risks are only partially mitigated by independent quality control on the upstream information (relatively stringent in peer-review, weaker in preprints and abstracts, and virtually absent for press releases). In table 1, we summarise recommendations for good dissemination practices, aimed at researchers, research institutions, developers, medical journals editors, media, journalists, social media actors, medical opinion leaders, policy-makers, regulators and the scientific community. All these stakeholders should integrate ethics and integrity in their policies and behaviours, to ensure timely, comprehensive, accurate, unbiased, unambiguous and transparent dissemination of research findings.