Digital enhancement of publications has been a hot topic in medical communications for several years, with an increasing number of journals offering authors the option to publish enhanced features alongside their articles. The Publication Plan asked Caroline Halford, Digital Publishing Manager for Springer Healthcare, to share her insights on the use of digital features within medical publications.

Adis – Springer journals offer authors the option of publishing a wide range of digital features alongside their article. In your experience, how keen are authors on contributing digital features? How proactive do publishers need to be in encouraging their uptake?

“there has been a marked increase in author enthusiasm for digital features”

“From my Adis perspective, there has been a marked increase in author enthusiasm for digital features. When Adis first started talking to authors and funders about digital features (around 5 years ago), there was mild interest but also a reasonable level of uncertainty and reluctance – authors and funders seemed nervous to dip their toes in the water. This was mostly due to the novelty of digital additions and uncertainty around what could be done and how. However, in the last 1–2 years, we have seen a lot more interest from authors. Around 50% of conversations with authors and funders now involve interest in digital features. Adis have certainly started to receive many more submissions with digital features over the past 2 years, for both academic and industry-funded publications. Due to this increased interest, Adis now offers the service of creating digital features, such as animated abstracts and infographics, and we have received a lot of interest from authors and funders. I believe that several other publishers also now offer the same, which indicates that enthusiasm for digital features may be growing across the board.

That said, I believe that publishers still need to be very proactive in encouraging uptake. Some feedback we hear is that authors/funders don’t always know whether journals encourage them, when they can be submitted, the formats that can be published, etc. We also hear feedback that authors will only consider creating digital features if they are proactively invited to do so by publishers. Therefore, publishers need to do their part in making this information clear on journal websites and other locations (PubsHub etc). At Adis, we do this by including information on each journal website and within the Editorial Manager submission system. The Adis Rapid+ journals also email authors on manuscript acceptance to encourage the use of enhanced features, and again post-publication. Finally, we mention this on each digital feature’s Figshare hosting page, to encourage more features.  Nevertheless, we still sometimes receive questions from authors asking if we consider them, which suggests we could do even more to ensure authors are well informed.”

Which forms of digital feature are the most popular, both in terms of submission by authors and impact on readers?

“Historically, we have seen more video abstracts submitted (such as author interviews and animated abstracts) than any other feature. This may be because they are the most established feature (i.e. several publishers have been offering this service for many years) and can be relatively low-cost to produce. We are now also seeing a rise in submissions of infographics to encourage a broader readership. However, we still do receive other types of features.

In terms of impact, we haven’t seen one type of feature being significantly more effective than another feature. All types of features that we have published (video abstracts, audioslides, infographics, podcasts, animations) have received good numbers of downloads. However, I do believe that the impact of the feature can be influenced and increased by the methods by which the authors, journal and other stakeholders promote the feature.”

What do you think are the main benefits to authors in adding digital features to their publications? What do you think authors should consider when deciding which type of digital feature will add the most value to their articles?

“we know that digital features can help raise the impact and reach of articles”

“The main clear benefit to authors is that we know that digital features can help raise the impact and reach of articles, and we now have evidence from two small trials to support this. In 2017, ResearchSquare and Springer Nature analysed the metrics of 70 articles with digital features compared with a case-matched cohort of articles published without a digital feature. Data showed that articles with digital features were downloaded 88% more than those without. Adis repeated this experiment in November 2019 with 33 Adis articles with digital features, and found that these were downloaded 55% more than articles without such features. On further analysis we could see that increased impact is at least partially driven by:

1. When an article had a digital feature, authors and the publisher were more likely to share details of the feature on social media.
2. Since digital features are also often hosted on a separate platform to the article (such as Figshare, Vimeo, or YouTube), digital features and articles may benefit from this multiplatform hosting.

Of course, these are preliminary findings of a small sample size so we might want to exercise caution in interpreting the findings, but I believe it is a promising start.

Another main benefit to authors is that a digital feature gives authors a tool to help disseminate their research to a wide audience, in a ‘snackable’ format that is easy to understand and digest. Anecdotally, we know that healthcare professionals are increasingly too busy to keep up to date with literature, and are looking for shortcuts to learning (aren’t we all?). We also know that many readers prefer to learn through audiovisual means. And we know that images/visuals capture more attention on social media than pure text. By creating a digital feature to accompany a full-length manuscript, authors are equipping themselves with a tool to ensure that their research is easily understood, quickly digested, and can be screen-shot and shared on social media; that should drive more traffic to the article. I have seen several historic examples where Adis digital features have been disseminated within educational packages alongside the full text manuscript to help inform healthcare professionals in a time-efficient way. The full text manuscript should always be available with the feature so that readers can ‘deep dive’ into the data, but, the digital feature can be a valuable ‘entrée’ into the data.

When considering which type of digital feature will add most value to their article, in my experience the most impactful features have been instances where the feature complements findings of the article, and the authors have been able to use that feature to help a wider audience understand the data. For example:

• For key Phase III data authored by a leading expert, a video of the author presenting the trial results with accompanying slides is incredibly impactful in replicating the feel of attending a congress and watching the results being presented ‘live’ (https://link.springer.com/article/10.1007/s12325-017-0626-4 – click ‘Enhanced content’ link to view digital feature).
• For surveys or pooled analyses, where there is a wealth of data to distil, infographics have historically performed well by translating data into visuals that can be easily understood by many (https://link.springer.com/article/10.1007/s12325-016-0431-5 – click ‘Enhanced content’ link to view digital feature).
• For complex data (such as articles with novel trial designs, or reviews of drugs with a novel mechanism of action), animated abstracts have been successful in making the data more understandable by the peer reviewers and readers (https://link.springer.com/article/10.1007/s40265-019-01120-1 – click ‘Additional information’ link to view digital feature].
• For articles with patient authors or describing patient experience, a video discussion with the patient and scientific/medical co-authors can help to bring the patient perspective to life (https://link.springer.com/article/10.1007/s40120-017-0087-3 – click ‘Enhanced content’ link to view digital feature).

In my opinion, the secret is to create a feature that best helps to communicate the data in a clear, balanced, and meaningful way.”

Some digital features such as animations and mechanism of action videos can be expensive and time-consuming to develop. How can return of investment (ROI) be measured so that authors and funders can understand their value?

“ROI can be measured in different ways, such as downloads, citations, reach to specific audience types, increased understanding, Altmetrics/social media discussion, or perhaps influencing clinical practice. I would encourage authors and funders to decide on which ROI measurements are important to them and to put measures in place to capture these. Some tools that can be effective in measuring ROI include:

• Measuring downloads from the journal platform (and wherever else the article/digital feature is hosted).
• Monitoring Altmetrics such as social media shares is also a good measure of ROI – especially to capture any debate or commentary on the feature.
• Monitoring citations can help to measure if the feature and article have been read and utilized to support systematic reviews and/or other research projects.
• Our health economics and outcomes research articles are often cited in NICE (the UK National Institute for Health and Care Excellence) submission packages, and this enables us to measure whether our research has influenced prescribing decisions.
• Adis digital features are hosted on Figshare, where the download and citation information is visible.

Authors and funders should try to publish digital features in a way that means that downloads, shares, and cites can be easily viewed and measured.”

 

“To maximise ROI, we encourage publishers, authors and funders to utilise the digital feature as much as possible”

“To maximise ROI, we encourage publishers, authors and funders to utilise the digital feature as much as possible.  I would recommend publishing digital features with a journal that commits to using social media to share digital features, and encourage authors to advertise the presence of their articles and digital features on their own social media accounts too (within the publisher’s permitted copyright rules, of course). For more targeted exposure, video abstracts can be hosted on conference exhibition booths, attached to posters via QR codes, or within an eprint. They can also be used in press releases (we have seen success in this method of dissemination), and can be distributed to healthcare professionals via educational newsletters, websites or other tools, to ensure that the feature reaches the appropriate audience. ROI from these methods can be measured by views, reach, or by asking viewers to complete a simple survey to check understanding and possible clinical impact. Publishers use a range of copyright licences for digital features; therefore authors and funders must always check the copyright license of the feature and speak to the publisher about how the feature can be used within legal limits.”

What challenges do you think are commonly encountered in the publication of digital features and how these might be prevented or overcome by authors?

“I believe the main challenges have fallen into several categories:

1. 1. Confusion over which journals allow digital features. If the information is not available on the journal website or instructions for authors, it’s worth checking journal databases such as PubsHub or contacting the journal directly. If in doubt, I would always recommend speaking to the journal directly
   2. Confusion over formatting. I have heard of examples where a video abstract has been painstakingly created, only for the publisher to reject it because it is 3 seconds longer than the accepted format. This challenge seems to be often connected with communication breakdown between authors and publishers.  I encourage authors to check journal instructions for authors before beginning the creation of a digital feature. If there is insufficient information, try to speak to the publisher directly and gain as much clear information about formatting as possible. As a belt-and-braces approach, look at previously published digital features within the journal. This will give authors a sense of what is possible within the journal
   3. Having to make costly amendments to video abstracts following peer review. To prevent this scenario, ask the journal if they would be prepared to peer review a script and storyboard of a video, rather than the final video. Many journals offer this option, and this allows the script/storyboard to be ‘approved’ by the journal before the video is filmed, and reduces the potential for major (and potentially expensive) changes being needed to the video itself.
   4. Submitting a digital feature to a journal that does not peer review them. For some authors/funders, creating non-peer reviewed digital features is fine, but to others it is a deal-breaker and prevents features from being distributed for educational purposes. I would encourage authors and funders to verify with the journal if digital features are peer reviewed beforehand, to avoid any confusion or disappointment.
   5. The risk of creating a feature for an article that is subsequently rejected.  If the next journal does not accept digital features, the feature might be ‘wasted’. To avoid this scenario, many journals now accept and encourage digital features to be submitted after the manuscript has been accepted. I would recommend asking your chosen journal if they allow this option. This will mean that production of the digital feature can begin once the authors know that the article will be published.
   6. The risk that adding a feature after article acceptance will slow down the final publication (i.e. to allow the article and feature to be published simultaneously). It is always worth verifying if adding a digital feature will slow the publication of the article down. However, many journals now allow features to be added post-publication of the article. It is definitely worth speaking to the journal to ask about this possibility.
   7. Lack of time, resource and budget to create a digital feature. I would encourage funders to partner with their medical communications agency to decide the most efficient way to publish a digital feature. Also bear in mind that not every manuscript necessarily needs a digital feature – therefore, time and budget should be spent wisely. Several publishers (including Adis) can now create digital features for authors and funders in a cost-effective manner. This can be a convenient option since the publisher can manage the preparation of the script, video and peer review (alongside a medical communications agency if needed). I would encourage authors and funders to speak to publishers and ask for details about how they can assist.”

What role can medical communications professionals play in the creation and promotion of digital features?

“In the same way that medical communications professionals have assisted in the publication of manuscripts, they can play a pivotal role in the creation and promotion of digital features. In my experience, medical communications professionals have excellent scientific experience and creativity to help look at the manuscript data and decide which feature would be most helpful to support the findings of the manuscript. They are also best placed to help ensure that the feature is a fair and balanced representation of the manuscript (which is ultimately what publishers are looking for). Their technical tools are often invaluable in creating the feature – I have seen several impressive examples of infographic posters, animated abstracts and audioslides created by medical communications agencies. They also do brilliant work in their liaison with the publishers. Sometimes the process of publishing a feature involves significant conversation with the publisher in deciding what is possible, how to submit the feature, and what admin is required to facilitate publication. In my experience, authors are incredibly busy and rarely have the time, patience and resource to achieve this alone. For the digital features that Adis have created for authors and funders, and also for the digital features that we have received, medical communications professionals have done a great job in facilitating the publication process. Finally, they can play a crucial role in using their creativity to roll-out viable communications plans that use the article and digital features to their maximum potential.”

The use of digital features in medical communications has gained traction over the last 5 years. How do you think the field will evolve? In your view, will the inclusion of digital features become more common or will the type of features offered by journals change?

“It’s difficult to predict the future, but I believe that both of these options are possible. It is likely that the inclusion of digital features alongside manuscripts will become more common – we are already seeing this happen, with more publishers offering this opportunity and more authors submitting features. It is also highly likely that scientific congresses will start to encourage digital features alongside presented data. We have seen this happen already at ESMO 2019, with many authors presenting video abstracts to complement their poster presentations. I believe that the types of features offered by journals may broaden out to include different formats and features; such as using interactive tools to enable readers to analyse and interpret the raw data.”

Caroline Halford BA/BS is Digital Publishing Manager at Springer Healthcare. You can contact Caroline via caroline.halford@springer.com

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