The 17th Annual Meeting of the International Society for Medical Publication Professionals (ISMPP) was held virtually on 12–14 April 2021. The event attracted a record-breaking number of participants with over 650 delegates attending. The theme of this year’s meeting ‘Medical communications 2.0: Creating and embracing opportunities in a time of transformation’ covered the following key topics:
- risk communication and public trust
- equity, diversity and inclusion
- forward-thinking ways of communicating virtually and digitally.
A summary of the first 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.
Opening remarks & keynote: helping patients and healthcare professionals navigate medical misinformation
Todd Parker, ISMPP 2020-2021 Chair (MedThink SciCom), and Valérie Philippon, ISMPP 2020-2021 Chair-Elect (Takeda), welcomed delegates to this year’s virtual meeting and highlighted the meeting’s themes of trust; equity, diversity and inclusion; and looking to the future of medical communications. Parker and Philippon thanked the Program Committee for their work in creating a virtual congress in the midst of the COVID-19 pandemic, while acknowledging the challenges posed globally by the crisis, including in the field of medical publications. To this end, ISMPP have donated to ‘The Meetings Industry Fund’, which provides financial assistance to industry staff affected by the global pandemic. The speakers also commended all those in the medical publishing community who have helped disseminate and advance research into COVID-19.
This year’s virtual meeting comprised a varied program of keynotes, plenaries, debates, roundtables, real time poster Q&A sessions, and a wealth of on demand online programming. To kick things off, Parker introduced Brian Southwell (RTI International), who gave a keynote speech on ‘Combatting health misinformation and restoring public trust’.
Southwell outlined that, perhaps contrary to popular belief, misinformation is not a new phenomenon, although social media and the COVID-19 pandemic have exacerbated its reach and influence.
Southwell argued that society is inherently vulnerable to misinformation, for a number of reasons:
- bias towards acceptance
- misinformation is only detected post hoc and so the population is always exposed to it to a degree (in democracies)
- drive to form connections and share hopeful, ‘good news’
- proliferation of ‘bubbles’ in which the same information is repeatedly shared among the same people.
Importantly, addressing the problem requires a shift in mindset, from blaming those who believe and disseminate misinformation, to focusing on building trust and transparency. Southwell suggests four important approaches:
- encourage compassion
- embrace translation opportunities
- learn about what people are encountering
- empower and improve information seeking.
In short, find common ground, listen to what drove the individual to misinformation, then provide reliable information once trust has been built.
Southwell has been involved in a number of such initiatives, from workshops and a white paper, to translating science and expanding its reach through community radio. We are also now starting to see the beginnings of a body of academic literature on the subject.
Finally, Southwell offered practical tips for the medical publications community:
- Publication professionals: work with authors from an early stage to develop a plain language summary and/or visual abstract.
- Authors: consider what the ’30-second summary’ of your work would be from its outset.
- Publishers: provide publicly accessible platforms, such as podcasts or websites.
Unused vaccines can’t save lives – embracing an opportunity to overcome vaccination hesitancy in the midst of a global pandemic
In the first plenary session of the meeting, which was moderated by Eugene Tombler (CMC Connect), Heidi J Larson (London School of Hygiene & Tropical Medicine), Dan Carucci (McCann Health) and Jonathan Kennedy (Queen Mary University of London) discussed vaccine hesitancy and what the industry can do to educate and mitigate the barriers to vaccination.
As noted by Carucci: “The COVID pandemic is a historical moment, and at no other time has the public had a front row seat in vaccine development”
These unique circumstances have highlighted the importance of trust and transparency, as well as education. As the risk of severe illness from COVID-19 increases with age, the benefits of vaccination may be more obvious to older people than younger age groups. Changing the narrative to address the challenges that affect younger people, such as social and economic issues, may be instrumental in improving vaccine willingness in this age group. The population must be able to make informed decisions and realise it is only through a community vaccine effort that any sense of normality can return. When asked “How do you fight vaccine misinformation?”, the panellists agreed that scare tactics do not work. Instead, listening and empathy are required, while matching the anti-vax message on all fronts with the truth. The COVID-19 infodemic occurs across all platforms and this amplification of misinformation feeds into the distrust of doctors and governments that can arise from public health crises. There is a large gap between where the public is and where health authorities and pharma present their information.
Official sources need to be more engaging online, the narrative more enticing to read and the information easier to digest and understand.
Medical communications need to adapt and different strategies developed for each age group. One such initiative aimed at younger people is TeamHalo, a collaboration of scientists from around the world, who are using TikTok and Twitter to explain vaccine development and the critical role it has in ending the pandemic. Better communication will help build relationships, gain the public’s trust, and reduce vaccine hesitancy.
The public face of science – building trust
Building the public’s trust in science has always been important, but the COVID-19 pandemic has created additional urgency around this need as research is quickly churned out and consumed by the public.
Dave Andrews (Meridian HealthComms), Tom Grant (UCB Pharma), Catherine Skobe (Pfizer), and Guy Yeoman (Mallinckrodt) presented an insightful session focused on how the medical communications industry can build trust in science.
“Nothing in science has any value to society if it is not communicated, and scientists are beginning to learn their social obligations.” – Anne Roe, The Making of a Scientist (1953)
A focus on patient involvement at every stage of research – from disease area strategy to clinical trial design and publication development – is key. It is not uncommon to consider patient input at the later stages of research; for example, patient lay summaries have become increasingly popular as a way to ensure data are accessible by the public. However, patients can and should be involved at the earlier stages of research.
Additionally, it is important to involve patients with varied backgrounds and include everyone from ‘patient experts’ to lay patients and their carers. Insight can also be gleaned from patient organisations and online patient communities.
A preprint pandemic: the evolving role of preprint servers in the COVID-19 era & preprint debate – to preprint or not?
Lisa Jolly (Parexel) and Tim Koder (OxfordPharmaGenesis) moderated this thought-provoking session, with panellists from medical publishing (Joanne Walker, Future Medicine), the pharmaceutical industry (Meghan Johnson-Watson, AstraZeneca and Janet Davies, UCB Pharma) and a preprint server provider (Richard Sever, Cold Spring Harbor Laboratory Press).
Ahead of talks from the various panellists, Jolly set the scene, highlighting the huge upsurge in the use of preprints during the COVID-19 pandemic. Jolly noted that this development was welcomed by the World Health Organization as a means of rapidly sharing new research findings on the coronavirus. Over the course of the session, the panel gave their perspectives on the role of preprints in medical publishing, both in terms of the effects of the COVID-19 pandemic and more widely across the field.
Up first, Walker gave the publishers’ perspective. The COVID-19 pandemic has massively impacted the publishing process, with increased submissions and a need for rapid publication without compromising standards. Since the start of the pandemic, STM members have provided free, immediate access to COVID-19-related publications and publishers have fast-tracked the peer review and publication of these articles. Over time, as the volume of publications and HCP workload have increased, there have been knock-on delays in the review and publication of non-COVID-19-related content. Walker proposed that preprints:
- generally align to STM’s response to COVID-19
- could form part of the overall publication process, alongside congress presentations and journal publications
- provide journals with insights into ongoing research.
However, Walker also raised concerns that the medical publishing industry is not yet ready to fully embrace preprints:
- Not all publishers have clear policies. Where these are in place, requirements vary between publishers.
- <10% preprints on the medical preprint server medRxiv have received comments.
- Rapid, open access, peer reviewed publication is already available.
- There is a need for industry guidance relating to preprint servers.
Next, Johnson-Watson put forward an industry perspective. COVID-19 has had wide-ranging effects on the presentation and publication of industry-sponsored research, from condensed timings for the preparation of posters and oral presentations at congresses to delays in author input and extended peer review times for manuscripts.
Johnson-Watson agreed that in the context of the pandemic, preprints have offered benefits by enabling the rapid dissemination and wide reach of COVID-19-related data. She argued though that, in general, preprints better lend themselves to the reporting of academic and preclinical data than to the reporting of industry-sponsored clinical trial data and that, on balance, the benefits do not outweigh the concerns in the case of clinical trial data. Among the concerns listed were:
- regulatory and compliance issues
- inconsistency in journal policies
- citability of preprints
- lack of clarity on industry’s role
- difficulties in monitoring and addressing comments for items such as off-label claims, or reporting of adverse events
- potential for data misinterpretation.
Finally, Sever made the case for preprint servers, giving his perspective on the successes of bioRxiv and medRxiv.
Around 14,000 COVID-19-related preprints have been released during the pandemic, on topics ranging from virus structure, to variants, to trials of potential treatments. By comparison, most (93%) papers on SARS were not published until after the pandemic. Alongside these achievements, COVID-19 has presented new challenges for preprint servers, with increased discussion of preprints in the wider media, and additional screening procedures added to bioRxiv for COVID-19-related preprints.
Sever stressed that preprints are not an alternative to peer review, rather they are a means to uncouple dissemination of research from its evaluation. Sever argued that the current model of undertaking peer review before publication does not fit with the digital age of publishing and leads to delays in dissemination of research, subsequent advances by other researchers, and ultimately to delays in patients receiving better care.
Sever hopes that servers such as bioRxiv and medRxiv can become a central part of the publications landscape, with a role in facilitating the discovery, discussion, reproducibility and certification of research. By decoupling dissemination and peer review Sever believes that peer review will undergo reform and become more innovative and inclusive, no longer reflecting the view of a small number of individuals at a specific point in time.
Jolly closed discussions with an overview of the recent American Medical Writers Association (AMWA)– European Medical Writers Association (EMWA)–ISMPP joint position statement on medical publications, preprints and peer review. The position statement suggests:
- citing preprints as personal communications
- clearly distinguishing preprints from peer-reviewed papers
- standardising screening procedures for preprints
- use of a comprehensive checklist by reviewers.
With the scene set, Davies and Sever debated ‘To preprint or not?’ The result was perhaps reflective of the challenging nature of the issue. In a post-debate poll ISMPP delegates were split, with 44% voting ‘yes’ and 56% voting ‘no’ to preprints.
44% of ISMPP delegates voted ‘yes’ and 56% voted ‘no’ to preprints
Attendees were able to attend 1 roundtable each day of the meeting. Roundtable topics were:
- social media in medical publications
- open access: making the future bright, making the future open
- encore presentations
- plain language summaries
- case studies in ethics and standards
- optimising virtual scientific exchange in a digitally fatigued world
- optimising team structure and function
- personalised medicine should begin with gender
- digital enhancements to maximise reach and engagement
- patient engagement
- speeding publication development
- simultaneous peer review: case study.
Future-proofing your organisation with digital transformation of medical communications
Todd Parker (MedThink SciCom) led a discussion on the digital transformation of the medical communications industry, which has been accelerated during the COVID-19 pandemic. This forward-looking session discussed the concept of digital transformation, and how to identify and apply a vision within an organisation.
What is digital transformation?
Leslie Rotz (MedThink SciCom) started the session by defining digital transformation:
- Digitisation: conversion of analogue/physical information to digital format.
- Digitalisation: use of digital technologies to enable or improve business models and processes.
- Digital transformation: process of using digital technologies to create new – or modify existing – business processes, culture, and customer experiences to meet changing business and market requirements.
As such, digital transformation is a coordinated change, with effort diffused through various structural and cultural aspects of a business.
Digital transformation is a coordinated change, with effort diffused through various structural and cultural aspects of a business.
Rotz stressed the importance of forward planning, by first defining the needs, establishing the vision (which involves collaboration with colleagues and leadership), developing a plan, before finally implementing the plan. Indeed, when embarking on a novel initiative, you are by definition the first to do it, so the engagement of all stakeholders such as Regulatory and Legal up-front is critical.
How has digital transformation been implemented during COVID-19?
Dheepa Chari (Pfizer Oncology) gave an industry publications perspective of implementing digital transformation during the last year. There were many drivers for transformation, such as information overload as the world moved online, changes in content consumption (eg devices), emerging audiences (eg patients), and new technology and platforms becoming available.
Chari described a paradigm shift in the digital journey, from a multichannel approach with fragmented communication lacking a single strategy, to an omnichannel approach with a centralised strategy and a 360 view of the physician/patient experience.
This resulted in increased consistency for the user, increased alignment with their needs, and appropriate targeting of the audience.
Looking ahead, Chari touched on the interest in using artificial intelligence (AI) to generate insights from activities. An example was using Natural Language Processing, which takes information from the literature, social media, congress activities, etc and gives actionable insights such as patterns, gap identification, landscape analyses, and even hypotheses. Other initiatives included enhancing the accessibility of content to align with audience needs, through for example, plain language summaries or promotion on social channels.
It was emphasised that digital transformation comes with challenges, and requires cross-functional training for optimal roll-out – upskilling across soft skills, technical skills, and latest technologies is essential for success.
Neil Adams (Karger Publishers) presented the publishers’ perspective. During the pandemic, publishers realised the need to communicate research:
- as quickly as possible
- with improved quality
- while managing increased quantity
- by transparent delivery
- in convenient formats
- for diverse audiences.
Digital solutions are now available for many aspects of the manuscript workflow, from journal selection (or assessment of alignment with journal requirements [eg through Penelope.ai]), submission (which may involve technology to help with language editing), and even manuscript peer review (eg the use of ‘select crowd review’ by Filestage). AI is also becoming an increasingly useful tool. For example, Artificial Intelligence Review Assistant (AIRA) is being trialled by Frontiers to assist in peer review, and Quertle can support literature searches.
The panel encouraged the audience not to be afraid to fail, as these are novel initiatives that require optimisation. Small pilot studies are very useful for testing a novel project, and it is important to pause along the way to continually re-evaluate the needs and whether they are being addressed. Their practical guidance was to:
- Speak to internal and/or external stakeholders to define unmet needs and pain points.
- Determine the best approach for your organisation, and develop a supported rationale to obtain buy-in.
- Enhance focus through ruthless prioritisation (do one thing well).
- Identify 2 stakeholders as potential advocates, and partner with them throughout the journey.
Metrics, analytics and effective storyboarding
“Inevitably, if you work in publications, someone is going to ask you for metrics, it’s like death and taxes…” Dianne Barry (Vertex Pharmaceuticals)
Publication metrics requests are commonplace but can be time-consuming to address. Metrics reporting tools can save time and provide valuable insight, but require careful upfront consideration. Dianne Barry (Vertex Pharmaceuticals), Jason Villalobos (3vue) and Robert Wright (Sanofi) explored the practicalities and pitfalls of metrics reporting with custom analytics platforms in a panel discussion moderated by Elizabeth Crane (Envision Pharma Group).
Important practical considerations for kicking off a metrics project were discussed:
- Establishing a thorough understanding of the end user and their true needs – a seemingly simple request for time from start-to-publish metrics could reveal a more complex desire to understand efficiency of publication processes.
- Getting comfortable with your raw data source and how it maps to your desired metrics, and identifying and addressing issues such as inconsistent data entry or missing fields.
- Establishing an effective collaboration with internal partners such as IT and external agencies, ensuring all are on the same page regarding scope and technical language.
A roadmap to success
The panel outlined an agile, iterative process for platform development, emphasising the importance of tackling such a large, complex project in small, clearly defined phases and allowing sufficient time for end-user testing to help drive further evolution – don’t try to run before you can walk! Appropriate data and project documentation combined with user training at roll-out is also key.
Looking to the future
Trends to watch out for include the impact of AI on the generation of reach metrics, use of metrics to assess resourcing, geoanalytics, and self-service options to meet different needs for different end users. Increased capability for assessing strategic alignment of tactics, both within publications and across the broader med affairs sphere, via use of data lakes and interconnected analytics was also discussed as an exciting possibility.
Patient engagement in a post-COVID world
Alex Morton (NucleusX Consulting) and Gerard Mortimer (Synaptik Digital) explored how COVID-19 has altered the patient engagement space, and what that means for the future.
It’s clear that COVID-19 has impacted every step of the patient journey, from screening to post-discharge care. Even treatment methods have evolved to include virtual elements. For example, some 15 digital applications for mental health have been reviewed and approved by the UK National Health Service (NHS). The uptake of telehealth has skyrocketed, as has the adoption of virtual clinical trial technologies. In a study by ERT, 82% of clinical trial professionals reported adopting virtual trial technologies due to the pandemic, including:
- electronic patient-reported outcomes
- central nervous system assessments
- electronic diaries.
Mortimer predicts the benefits of this shift towards remote and virtual trials will ensure their longevity; not only do patients have improved access to virtual trials, they are also more likely to adhere to protocols, can be recruited more quickly, and are able to generate their own data in real time. These advantages are, however, counterbalanced by a lack of face-to-face support and reassurance.
Morton discussed the critical need for high-quality patient information. Never before has the majority of the public so closely followed and scrutinised the drug development process. Morton identified social media as a “primary battleground” where people take sides and share information, which includes a great deal of misinformation. He called for medical communications professionals to help “cut through the noise” by creating clear, evidence-based, and searchable information for patients in the right formats. Furthermore, both speakers highlighted the role pharma need to play in optimising patients’ online experience and in the “fight against misinformation”. Crucially, future patient communication strategies will need to consider those without the digital skills essential to daily life – recently reported to be 22% of people in the UK.
Morton noted that: “The pharmaceutical industry and drug development have been put under the microscope on a global scale.”
Public interest in pharma and healthcare is at an unprecedented high. This session suggested we capitalise on that interest; if patients have the information and tools they need, they can feel empowered and supported by pharma, rather than suspicious of it. Morton and Mortimer agreed that the future of patient engagement will involve a hybrid model, with many COVID-19-accelerated innovations here to stay.
Morton concluded: “Healthcare and pharma have done a lot of hard work in adapting to this situation. It’s now up to us to continue that work and keep improving patients’ lives, trying to innovate and improve solutions, and ensure patient engagement gets stronger and stronger.”
Tips for effective manuscript writing and feedback
This session, which was opened and chaired by Amy Foreman-Wykert (Amgen), focussed on the different stages of manuscript preparation. The 2 speakers, Lisa Humphries (Amgen) and Katherine Molnar-Kimber (Kimnar Group), provided key strategic tips on how to improve efficiency and productivity during manuscript development.
Planning and initiation
- Consider the desired impact of the publication, the audience and potential target journals.
- Establish the author list and key contacts.
- Set up an ideal timeline working backwards from the target date.
- Organise a project kick-off call to align on the content, roles and responsibilities, review processes, timelines and target journal.
- Consult target journal and reporting guidelines early in development. Visit the Equator Network website to find the relevant reporting guidelines.
- Consult the target journal checklist for peer reviewers (if available).
- Initially develop a comprehensive outline including all sections required by the target journal, developing the results section first.
- Establish processes for formatting and styling, quality control, version control and reference management.
- Consider search engine optimisation to make your publication easier to find.
- Explain the evolution of tasks for reviewers at each stage of manuscript development.
- Provide guidance in the manuscript for the reviewers to help achieve actionable comments.
- Be solutions-focused: provide suggestions where appropriate.
- Inspect before replacing a word or phrase rather than using global replace.
Business Meeting, Financial Report
The outgoing Chair of the ISMPP Board of Trustees, Todd Parker (MedThink SciComm) opened this session with updates on the 5 prioritised areas of focus for the Board in 2020: education, expansion, evolution, extension, and efficiency. Parker highlighted the Education and Expansion task forces’ examination of the educational needs of ISMPP members, including the development of an Educational Needs Assessment survey designed to ensure that ISMPP’s educational initiatives are aligned with members’ requirements. He mentioned the recent news that ISMPP has assumed organisational leadership of Medical Publishing Insights & Practices (MPIP) and highlighted their useful Enhanced Publication Options Navigator (EPON) tool. Parker closed by noting that while there remain challenges ahead, there is a sense of hope for the future and ISMPP will be there to help navigate the ever-changing medical publications landscape.
Secondly, we heard from ISMPP Treasurer Courtney Leo (Pfizer). Leo outlined ISMPP’s finances over the past year, noting that despite the challenges of pivoting to virtual formats, all of the 2020 ISMPP meetings and the 2021 European Meeting were profitable. With increased virtual meeting attendance and Certified Medical Publication Professional (CMPP) recertifications, ISMPP maintains a healthy financial position with strong financial reserves and procedures.
ISMPP President and CEO Rob Matheis then gave the presidential address, referring to the recent update in the MAP Newsletter in which he discussed the successes of ISMPP members and the society in rising to the challenges presented by COVID-19. Matheis noted that:
- ISMPP is evolving on an organisational level to bolster administrative capabilities and maximise the ability to meet members’ needs, with new ISMPP Operations Project Manager and Director of Membership and Community roles being fulfilled by Wendy Hazard and Suzanne Fraga, respectively.
- ISMPP membership continues to grow year-on-year despite COVID-19, with a total of 1,818 members as of 31 March. Most members are from industry/agency backgrounds, with academia and Contract Research Organisations identified as key areas for membership growth.
- ISMPP are working to better address the specific needs of individual members, for example utilising member engagement tools (such as PropFuel) to help focus communications.
- The Educational Partnership between ISMPP and the University of Florida College of Pharmacy continues, and advocacy and outreach activities are growing globally.
Matheis also mentioned several ISMPP society and member initiatives:
- the recent AMWA-EMWA-ISMPP joint position statement on medical publications, preprints and peer review
- progress on the ISMPP Authorship Algorithm (discussed on day 3 of the meeting)
- the Good Publication Practices (GPP)4 guidance, which is progressing rapidly and should be submitted for publication by end of this summer
- future ISMPP meetings – the 2021 Asia Pacific Meeting of ISMPP (which will take place virtually in September) and ISMPP West, currently planned to take place live in Irvine, CA on 21–22 October.
Next up, Laura Carlson (Chair of the ISMPP Certification Board; Envision Pharma Group) gave an update on the CMPP programme. Carlson noted that there are nearly 1,500 CMPPs at present, with expansion seen into the Asia Pacific region and Europe. Aiming to meet the needs of CMPPs during COVID-19, online self-study opportunities have been significantly expanded. Notably, the CMPP credential has gone digital, making achievements easier to track and share, and a new and improved credit tracker has simplified the recertification process. The CMPP Mentor Program has also been launched to support those considering certification, with resource development ongoing. Finally, Carlson reminded us of the 1 August application deadline for the September CMPP exam.
Closing the session, Parker thanked departing Board members and introduced Valérie Philippon (Takeda) as the new Chair. Philippon noted that there are brighter days ahead and that she is excited to embark on the next year.
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