The 2021 European Meeting of the International Society for Medical Publication Professionals (ISMPP) was held virtually on 26–27 January. This year, over 300 delegates attended the engaging meeting themed ‘Collaboration, connectivity and change: A holistic view of the scientific communications environment in 2021’.

A summary of the second day of the meeting is provided below to benefit those who were unable to attend the meeting, and as a timely reminder of the key topics covered for those who did.

A summary of the first day of the meeting can be found here.

Needs, expectations and the future of scientific communications: what do our key stakeholders really think?

Day 2 kicked off with a panel discussion on the future of medical communications and what industry stakeholders need from publications professionals to ‘stay ahead of the curve’, as opening speaker Eleanor Raynsford (OPEN Health) described. Moderated by Anne Clare Wadsworth (Envision Pharma Group), the panel members were:

• Danie du Plessis (Kyowa Kirin International plc.)
• Christopher Brooks (AstraZeneca)
• Luke Mircea-Willats (Takeda)
• James Read (MSD)
• Chien-Chia Chuang (Sanofi)

A main topic of discussion was patient-centric communication, which has been a key theme at this meeting. The COVID-19 era has expedited the digital evolution and increased the demand for data, but the issue of misinformation has led to a ‘social media infodemic’ according to a recent Nature article. Social listening will be important to understand how to effectively communicate science to a lay audience. Mircea-Willats also acknowledged the reputation of pharma and advised using patient advocacy groups to communicate with patients to help improve trust.

The COVID-19 era has expedited the digital evolution and increased the demand for data, but the issue of misinformation has led to a ‘social media infodemic’.

Read cautioned against keeping patient-focussed materials separate from other publications and instead advised seeing patients as the destination for data, rather than an add-on. The notion of involving patients at an early stage through patient advisory boards and publication steering committees was reiterated (a topic that was also discussed during the session, ‘Patient engagement in publications’ on Day 1 of the meeting).

It was clear from the panel that using multichannel communications was an important factor in helping move publications beyond print that will also allow for tailored data dissemination, with Brooks referencing the ‘snacking culture of healthcare professionals (HCPs)’. Journals with enhancements such as podcasts, visual abstracts and video summaries have a clear advantage in making data stand out through the noise, but du Plessis noted that high-impact print journals still have their place.

Non-clinical data were discussed, with Chuang focussing on the advantages of real-world data and the increased use of patient-reported outcomes as clinical trial endpoints. Read meanwhile asked audience members to consider the nature of what a publication is in a big data environment and envisioned datasets being layered using artificial intelligence, but warned that there would be challenges in maintaining quality when dealing with such vast amounts of data. Read noted that:

“Simplicity of science is excellence of science”

It was noted that publications professionals need to upskill in the following three areas:

• Interpreting and communicating non-clinical data (eg real-world evidence, patient reported outcomes).
• Writing for a lay audience and using social listening to understand patient influencers. Chang asked for writers to imagine the patient with a quote from William Butler Yeats, “Think like a wise man, communicate in the language of the people”.
• Maintaining the quality of publications whilst handling the pressure to communicate more data at a quicker pace, particularly with the advent of big data.

There can be a tendency for publications to exist in a silo, but it is clear that pharma companies consider medical affairs and publications as an integrated group. The panel outlined the need for publications professionals to act as advisors for this cross-functional collaboration. A key shift will be from ‘publication planning’ to the broader and strategic ‘data dissemination planning’, which should start earlier to optimise efficiency. Although pharma can be slow to adapt, the audience was reminded that compliance is an essential function to protect companies, and the right attitude can encourage communications, rather than act as an obstacle.

Keynote: ableism in medical research and impact on health equality

Becca Wilson (University of Liverpool) gave an impactful keynote focused on the importance of inclusion, and the need to include disabled individuals in clinical trials to prevent research findings from being biased towards a healthier population.

Pre-existing conditions are often considered exclusion criteria in clinical trials, even if the condition would have little bearing on the treatment being tested or the trial outcomes. As disability often correlates with other inequalities (eg poverty and unemployment), exclusion of disabled individuals from a trial can mean that the study population is not representative of the general population.

Numerous studies show that disabled people are underrepresented, absent or their status is even unknown in medical research.

Wilson emphasised the need for targeted recruitment of disabled individuals into clinical trials, and to consider the unique barriers and motivations that may impact this population’s participation. For instance, traveling to a trial site may be too exhausting or difficult for a disabled individual.

Healthcare organisations should also consider the accessibility of their communications and digital literacy of their audiences. This has become particularly important during the COVID-19 pandemic. It was recommended that public advisors should be enlisted to make healthcare communication more accessible, and that it should:

• be multi-format
• use pictorial representation of concepts, where applicable
• use alt-text and captions.

Disabled individuals also appear to be underrepresented within the scientific research field. While 19% of the general population in the UK identifies as disabled, just 4% of academic, research and teaching staff do. Wilson suggested that disability confident schemes and unconscious bias training could help avoid discrimination that happens during the hiring process.

Wilson recommended that disabled individuals are involved in conversations regarding inclusivity: “Nothing about us, without us”.

How professional practices are evolving and what might stick?

Tom Grant (Willow Medical Communications) led an interesting discussion expanding on a key theme of ISMPP EU 2021 – the changing practices we have seen in scientific communications as a result of COVID-19. The restrictions of 2020 drove digital innovation to enable continued scientific exchange in the absence of face-to-face meetings. The panel discussed what we have learned, and how the priority changed from direct replacement of traditional formats to thoughtful incorporation of digital solutions into strategic communication plans in 2021 and beyond.

Medical publishing

Joanne Walker (Future Science Group) focused her presentation on the digital advances we have seen in medical publishing in 2020.

Normally, congresses are the prime time for data release, and pharmaceutical companies have had to make difficult decisions on when, where, and how to present their key data.

Communications professionals have had to re-think how to present posters in this new format, and there has been a rapid uptake in simplified virtual posters with digital enhancements. Walker hopes that this digital innovation will carry through to the full publications, as authors and funders have experienced the benefits. Indeed, publishers have also been active in providing new platforms, such as citable video (eg Video Journal of Biomedicine) and podcast (eg Adis) content. Walker also discussed a publication innovation that has gained much attention during 2020, Plain Language Summaries of Publications. These summarise in simple language any type of publication, from clinical trial protocols to Phase 3 results, and are considered an acceptable secondary publication type per International Committee of Medical Journal Editors (ICMJE) criteria, allowing them to exist as standalone, peer-reviewed, open-access articles without copyright issues.

Challenges of virtual meetings

From the meetings perspective, Lucy Turner (AstraZeneca) discussed the challenge of communicating with medical audiences during 2020.

In theory, virtual formats allow more flexible and broader attendance than extended congresses in centralised locations; however, audience engagement is a major issue.

Virtual attendees have more day-to-day distractions, may not be using the optimal devices, may not be inclined to navigate to all content, and are less likely to ask questions or join debates. Many different virtual platforms were used across the industry with varying degrees of success in fostering discussion, and often social media became the chosen platform for debate and sharing content. We are also learning how travel restrictions might change attendee choices, for example choosing congresses within their own time zone or more specialist congresses. This might present opportunities, for example considering encore presentations at more varied congresses. Turner believes that there are benefits to both face-to-face and virtual formats, especially as we continue to learn how to optimise their use, and expects future events to involve hybrid formats incorporating the best of both.

Mark Handforth (3Sixty Event Consulting) joined the panel discussion to give his perspective on the future of events. Although we have seen great innovation and success in virtual events and there have been amazing environmental benefits from the reduction in international travel, it is clear that governments perceive live events as key for economic recovery post-COVID-19. Additionally, Handforth noted that in his experience, HCPs are eager to return to live meetings, and it is important that content providers adapt to their needs and wishes. As such, Handforth believes that events will return to the traditional congress format, but the industry will need to continue to innovate and incorporate digital solutions to make sure that the information being distributed across all channels is clear and sustained in this era of information overload.

Implementing digital innovations

Adam Jeffery (Cello Health) described the changes he had seen in the uptake of digital content by HCPs. Even before COVID-19, HCPs considered educational websites as their most important source of information. This was further solidified in 2020, and within 6 months of lockdown MedThority (an independent medical education website) experienced a 70% increase in access, with metrics showing deep engagement. Despite limits on travel, most users accessed information on mobile devices, and still preferred bitesize content. Jeffery emphasised that:

while digital tactics need to be a priority for pharmaceutical companies, they need to be thoughtfully implemented with the audience at the heart of the communication plan.

Jeffery estimated that 2020 pushed digital innovation forward 5 years, and the medical communications community needs to embrace this shift by understanding how implementing a HCP-centric model using metrics to guide their content will optimise value and engagement.

Member research oral presentations

Assessment of the abuse of preprint articles for the sensationalisation of news in the COVID-19 era

Kicking off this session, Graham Allcock (Spirit Medical Communications Group Ltd) presented research looking into how COVID-19-related preprints have been disseminated in the media – an important topic considering the potential negative impact non-robust scientific findings can have on health. Allcock et al used the Talkwalker social listening tool to analyse online UK news articles from March to August 2020 that cited preprints posted on medRxiv.

Of the 555 news articles citing medRxiv:

• 234 did not indicate that the data were from a preprint
• 202 did not link through to the preprint
• 383 were based on source articles that were not published as of 1 October 2020
• 5 were based on preprints that were subsequently withdrawn.

Nearly 30% of the news articles were published on Nature and The BMJ, and were therefore aimed at scientifically literate audiences who would be aware of peer review processes and the robustness of preprints.

Among the traditional news media, a couple of tabloids were responsible for many of the articles, which were typically sensationalised.

In one case, rollout of a national story to local newspapers meant one preprint became the basis of 121 news articles. Furthermore, there were around 1.5 million posts, likes and shares of these news stories on Twitter and Facebook over the study period. Allcock concluded that despite the risks of the unverified and potentially unbalanced scientific data discussed in preprints, they have led to significant numbers of new stories and social media attention during the COVID-19 pandemic.

Impact of COVID-19 pandemic on medical congresses

Valerie Philippon (Takeda) presented an analysis of changes to medical and scientific congress formats due to COVID-19, covering March to December 2020. DataVision and congress websites were used to extract information on 102 congresses of interest to Takeda (including 25 neuroscience, 21 immunology and 16 gastroenterology congresses).

Results showed that:

• 22 congresses were cancelled, 28 were postponed and 52 were held in an exclusively virtual format.
• The majority of congresses changed to a virtual format for every subject area (except rare metabolic diseases, where 7 of 10 congresses were postponed).
• Congresses were cancelled in all subject areas apart from oncology and haematology (for which 15 congresses were analysed in total).
• One small US immunology congress was postponed for a few weeks but did take place in-person.

A key learning from the study was how quickly conferences took the opportunity to enhance their virtual platforms to offer digital enhancements: 51 virtual congresses offered a virtual scientific programme including e-posters and oral posters, while 12 congresses gave presenters the chance to include digital enhancements. 11 congresses held dedicated poster sessions facilitating an interactive experience between poster presenters and attendees. Even among the 22 cancelled congresses, 8 provided the option for posters to be uploaded to a virtual library.

Do traditional key opinion leaders (KOLs) and digital opinion leaders (DOLs) exist in the same or different communities?

Next, Andy Shepherd (Envision Pharma Group) presented an investigation undertaken as part of the ongoing efforts of the ISMPP Social Media & Web-Based Metrics Working Group. The research examined overlap between traditional KOLs and DOLs, individuals recognised as experts within specific online channels.

Restricting their analysis to one field (atrial fibrillation) and one online platform (Twitter), Shepherd et al identified 20 traditional KOLs based on their 10-year publication record in PubMed-indexed journals (weighted by author position, high-impact journal publications and authorship of national/international guidelines). Early-career ‘rising stars’ were also identified. DOLs were ranked using Symplur, analysing their Twitter influence specific to atrial fibrillation.

Findings showed that KOLs and DOLs form two distinct but overlapping groups. Most KOLs were not particularly active in the Twitter space (they may have been established in the field prior to the rise of social media), although 2 did have substantial Twitter activity. DOLs had distinctly higher Twitter activity than the KOLs, but publication activity overlapped – possibly since the methodology selected for active researchers. ‘Rising stars’ had much higher Twitter activity than traditional KOLs, but only one had been separately identified as a DOL.

The influence of DOLs was dynamic and could change rapidly, even around particular congresses or events.

Shepherd closed by noting that given the ongoing circumstances, medical communications professionals might benefit from a greater understanding of digital initiatives to enhance opportunities for identifying and engaging with appropriate experts in the digital space.

Reform and enhancement of scientific posters: what was the extent of innovation in 2020?

Ben Clarke (AMICULUM Limited) presented an analysis of innovations in poster formats and poster enhancements, examining posters from 6 sessions at the virtual 2020 congresses of the European Society for Medical Oncology (ESMO), the American Society of Clinical Oncology (ASCO) and the European Hematology Association (EHA).

Of 371 evaluable posters, 174 declared industry funding. Of these, 99 acknowledged medical writing support (none of the 197 posters without industry funding declared medical writing support).

Key findings included:

• 25% of posters used reformed layouts, mostly through featuring prominent conclusions (around one quarter featured a prominent figure).
• Reformed posters were most prevalent at ASCO, which provided a reformed poster template (ESMO did not provide a template; EHA provided a non-reformed template).
• Industry-sponsored posters with medical writing support were most likely to use a reformed layout.
• Around 6% of posters (mostly industry-sponsored) used an infographic style.
• Only 8/371 posters included social media handles; only one of these was on an industry-sponsored poster.
• ASCO allowed presenters to provide both audio and video recordings. Half of ASCO posters had video narrations, mostly featuring the static poster, although some videos did use zooming or slides.
• Around 30% of posters included QR codes – these were featured on 8 times more posters with versus without industry funding. QR codes often linked to PDFs of the poster, but some industry-sponsored posters also linked to poster supplements, plain language summaries or videos.

Overall, findings suggested that use of poster innovations and enhancements was linked to industry sponsorship and medical writing support.

Clarke also noted that proactive promotion by congress organisers may increase uptake of innovative formats.

Awareness of journal credibility, publication practices and predatory journals: findings from a company survey

Next up, Nisha Sheikh and Anna Popova (Ipsen) presented a survey of Ipsen employees to assess awareness and identify knowledge gaps related to journal credibility, predatory journals and good publication practice, important topics to consider, given that predatory publishing remains commonplace.

Between 26 August and 11 September 2020, a 12-item anonymised questionnaire was circulated across functions and received 260 responses (17% response rate). The majority of respondents were from research and development, local medical affairs, or global medical affairs, with two-thirds having looked online for medical information as part of their job and over one-third having authored congress publications or manuscripts. 12% had been approached by an online journal to submit an article (a common practice of predatory journals).

When assessing the credibility of information from medical journals, nearly 75% considered the authors/author credentials or the journal name, and nearly 65% looked at journal listing in a medical database (such as PubMed). Impact factor, journal listing in a medical database and the experiences of fellow authors were most frequently considered when planning to submit a manuscript.

In terms of good publication practice, 76% of respondents could identify >3 good practices from a list, but many also selected intentionally misleading answers.

For example, 67% believed publication charges should be disclosed after submission and 23% expected to be notified of article acceptance within a week of submission. In addition, 13% believed that medical writing support did not need to be acknowledged.

75% of respondents were able to identify negative repercussions of publishing in an untrustworthy or predatory journal, although they were unable to identify all of the drawbacks of doing so (including the possible lack of peer review, publication alongside poor-quality articles and lack of discoverability).

Surprisingly, 66% of respondents (including some authors of congress or journal publications) had not heard of predatory journals, illegitimate journals, deceptive journals or pseudojournals.

Awareness of resources related to good publication practice and predatory journals was extremely low: over two-thirds had not heard of any of the resources listed. For example, only 19% were aware of ICMJE recommendations.

These findings have led to Ipsen producing an infographic to aid identification of predatory journals and to plan internal training sessions to increase awareness.

 Using social media to drive engagement with scientific posters

Finally, Alison Lovibond (BOLDSCIENCE Ltd) looked at how Twitter, the most popular social media platform for medical congresses, can be used to raise awareness and enhance engagement with posters at virtual congresses. Lovibond et al asked ‘How is social media being used to create engagement with scientific posters, and is it replacing live interactions for online congress posters?’ They compared the live 2019 ASCO and ESMO congresses with the online counterparts in 2020, using the social media monitoring tool Tweet Binder to quantify original tweets (not retweets) using the official congress hashtag over an 8-day period around each congress. Tweets were filtered for inclusion of ‘poster’.

The authors found that despite posters being the most frequent presentation type at the congresses, only 2–4% of tweets mentioned posters. Overall, there were fewer tweets at online congresses compared to their live counterparts, with 40% and 22% reductions in tweets at ASCO and ESMO, respectively.

Posters were particularly left behind in terms of social media attention, with 57% and 49% fewer poster tweets at online versus live congresses for ASCO and ESMO, respectively.

Analysing poster tweet content:

• 4–30% contained URLs to access the poster.
  • Many URLs were for congress platforms – while these can be enduring, they are only accessible to congress attendees; linking to external platforms would widen access.
• Poster images were more frequent at live than online congresses.
  • At live congresses, images were often social-focused (depicting the poster and presenter). Images for online congresses were data-focused (depicting the poster content or key findings), providing an opportunity to build engagement with the science.

Optimising tweet content and reach could increase engagement with posters – which might be particularly important for online congresses lacking in-person interaction.

To this end, Lovibond shared 8 tips for effective tweeting to increase impact of congress posters:

• include an active learning statement so the tweet is educational
• include hashtags
• mention fellow tweeters by name, to increase dissemination
• focus on key takeaways
• don’t clutter the content
• include an external and enduring link to the full presentation
• share a #twitterposter GIF
• increase the number of followers on your account.

In closing, Lovibond noted that if there are multiple #twitterposters at a congress, virtual ‘poster walks’ can be followed. This allows users to skim the educational content, absorbing key messages and helping to increase engagement further.

CMPP update

Laura Carlson (Engage Scientific Solutions) began this session by providing an update on the number of Certified Medical Publication Professionals (CMPPs), which currently stands at nearly 1,500, spanning 24 countries across 4 continents. The majority of CMPPs are located in the UK and North America, but numbers in the Asia Pacific and European regions are growing. As in many other sessions throughout the meeting, Carlson discussed the impact of the COVID-19 pandemic, noting the resulting drive towards digital and virtual activities. This shift has led to greater flexibility for education and communication:

• CMPPs now receive digital badges from ISMPP rather than printed certificates, allowing their achievement to be shared and tracked more easily.
• Online learning opportunities have also expanded, with a range of self-study activities now offered.
• The online credit tracker has been improved, making it easier to track credits and record progress. This improvement was made in response to the increasing number of individuals choosing to recertify their CMPP qualification via credits rather than sitting an exam, due to the current situation.

Carlson went on to highlight the role of CMPP mentors in supporting less experienced individuals with examinations and providing recertification and career guidance, and encouraged professionals to consider volunteering for this role. Carlson concluded the session by noting upcoming key dates including the next certification exam taking place in March 2021.

Year in review

In her review of 2020, Fiona Plunkett (Articulate Science) looked back to the start of the year, when the ICMJE updated its guidance around author disclosures to encourage increased transparency. Under the new guidance, authors are asked to disclose all relationships, allowing the reader to judge whether they represent a conflict. Plunkett noted that these updated recommendations align with Good Publication Practice (GPP)3 guidelines. Plunkett went on to discuss some of the changes that have resulted from COVID-19, such as the increased number of people working from home and the move from face-to-face congresses to virtual events. With traditional poster boards at congresses no longer a feasible way to share research, the format had to change. Plunkett noted that many congresses encouraged such change and referred to the new poster concepts presented by Mike Morrison at the 2020 Annual Meeting of ISMPP.

One COVID-19-related challenge that medical communication professionals are likely to have faced during 2020 was that of unresponsive authors. ISMPP released official guidance to address this issue in March 2020. Plunkett noted that 2020 saw a drop in journal submissions by women, likely due to increased caring responsibilities due to the pandemic. The issue of gender inequality was one of the topics covered in a call to action in The MAP newsletter, an article which Plunkett encouraged all attendees to read.

There was a rise in the use of preprints in 2020, reflecting the need to rapidly share research, and a higher use of social media and digital platforms as a means of accessing information, rather than traditional print sources. While preprints may allow research to be disclosed more rapidly, Plunkett highlighted the importance of maintaining good publication practice, going on to note that a number of COVID-19 related papers have been retracted. One high-profile retraction from The Lancet caused the journal to amend its requirements so that all authors who access data are named in the signed declaration. Plunkett noted that this requirement is also captured in GPP3 guidance.

Other key events for ISMPP during the last year included the launch of:

• COMPASS, a weekly newsletter
• ISMPP Connect, a platform that enables discussions between ISMPP members
• InformED podcast.

Plunkett concluded on a hopeful note, acknowledging the achievement of developing COVID-19 vaccines, which are currently being rolled out.

ISMPP update

Valerie Philippon (Takeda) shared some of the key events that we can look forward to in the coming year:

• further information on the ISMPP Authorship Algorithm will be shared at the 2021 Annual meeting of ISMPP
• ongoing development of GPP4
• continued work of the ISMPP Plain Language Summary Perspectives Working Group
• new content will be available on InformED, the ISMPP Podcast, from February 2021
• ISMPP’s new learning management system, providing online and on-demand educational content, will be launched in February 2021

Philippon noted that ISMPP has recently assumed organisational leadership of Medical Publishing Insights & Practices (MPIP) and encouraged attendees to check out the organisation’s Enhanced Publication Options Navigator, a new tool to provide authors and publication professionals with detailed journal information. Philippon concluded the session by reminding attendees that the 17^th Annual Meeting of ISMPP will be held as a virtual event on 12–14 April 2021, and will focus on the theme ‘Medical communications 2.0: creating and embracing opportunities in a time of transformation’.

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Written as part of a Media Partnership between ISMPP and The Publication Plan, by Aspire Scientific, an independent medical writing agency led by experienced editorial team members, and supported by MSc and/or PhD-educated writers.——————————————————–

With thanks to our sponsor, Aspire Scientific Ltd

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