When COVID-19 hit Edinburgh, Karin Purshouse didn’t hesitate to put her doctoral studies on hold and join fellow physicians on the front lines.
“People have asked me if I was keen to go back to clinical work. I was desperate to go back,” says Purshouse, a clinical and academic cancer doctor at the University of Edinburgh. “You feel that’s your purpose. That’s what I was trained to do. You don’t want your colleagues to be struggling without you.”
Along with healthcare providers around the world, the Wellcome Trust PhD fellow is seeing the need for fast-tracked guidance on the virus and patient treatment. She is turning to preprints for the information, not having the luxury to wait for an article to appear months later in a traditional journal.
“Preprint articles hosted by the likes of Medrxiv or ResearchGate are being widely used by clinical teams all around the world as their outlet of choice for the latest information,” says Purshouse. “What’s become really apparent during COVID is that, for clinicians, open research is particularly vital and achievable. We’ve seen a complete change in how clinical research has been shared.”
Purshouse maintains that open peer review is the best way for people to judge for themselves what to extract from a piece of work since clinical research involves many variables — depending on different health care systems and demographics. While there has been some concern about quality control with preprints, Purshouse counters that major errors and limitations have been identified in a small number of high-impact, peer reviewed articles and there is an advantage with transparency.
“I think we should look at research differently — as a piece of work that will have caveats, which is true whether the peer review process is at the beginning or the peer review process is ongoing. Pre-prints make that open and clear” says Purshouse.
Within her specialty as an oncologist, Purshouse is participating in another massive collaborative project (the UK Coronavirus Cancer Monitoring Project) searching for answers about the impact of COVID-19 on cancer patient care. “That’s another example of this openness that we are seeing and I hope is the future,” says Purshouse, whose husband is an emergency room resident.
About 10 years ago as a medical student, Purshouse became involved with SPARC’s student program and later attended OpenCon to learn more about open access with other early career researchers. The experience inspired her to help develop an open access policy for the British Medical Association. When Purshouse later became a Fulbright Scholar, she proposed the organization explore an open access policy as well.
Now, in a clinical setting, Purshouse says merely discussing preprints during the global pandemic is pushing the open agenda forward. “Our department is regularly summarizing and sharing appraisals of the most up-to-date evidence, and this has highlighted that much of the key research is first being published in pre-print format. The clinical community is having a conversation about how we share clinical research in a way we’ve not seen before – that in itself is advocacy” says Purshouse.
Many of her colleagues were simply not aware of open access prior to the pandemic, but Purshouse says this has been a “watershed moment” to educate and come to realize its value. Some information, for instance, on how hospitals are operating differently to accommodate coronavirus patients may not interest a journal, yet clinicians would benefit from sharing best practices.
Practitioners are so crunched for time to get the latest research, Purshouse says that this crisis has illuminated the utility of preprints and she’d welcome the chance to write about its impact
“I think it’s important that we learn the lessons. I don’t think we will ever go back – or should go back,” she says. “Preprints should be the dream for clinicians. You don’t have to pay to publish it, and you don’t have to wait to read it. That’s pretty powerful. The key now is starting a dialogue about how pre-prints can drive up publishing quality as part of an open peer review process.”