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 attendees. The theme of this year’s meeting was ‘Medical communications 2.0: Creating and embracing opportunities in a time of transformation’.

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.

You can also read our summaries of Day 1 and Day 3 of the meeting.

Opening remarks & poster winner announcement

Kirsten Parr (CMC Connect) and Amy Foreman-Wykert (Amgen) welcomed attendees to the second day of the virtual meeting. Gary Burd (Caudex and ISMPP Abstract Committee Chair) then announced the meeting’s poster winners:

• Best original research: Gattrell et al. Comparison of the carbon costs of in-person and virtual conferences – lessons from the coronavirus pandemic (encore).
• Best practice: Lobban et al. Guidance for patient engagement in plain language summaries: where are we?
• Best visual communication: Blumson et al. Digital innovation in clinical trials: use of wearable technology to monitor activity (encore).
• Publication star – joint winners:
  • McKinnon et al. A review process for scientific publications to protect the privacy of clinical study participants (encore).
  • Gattrell et al. Comparison of the carbon costs of in-person and virtual conferences – lessons from the coronavirus pandemic (encore).

Keynote: writing for equity & inclusion: the role of empathy in medical communications

Catherine Skobe (Pfizer) introduced the day’s keynote speaker, Stacy Robison (CommunicateHealth Inc), who spoke powerfully on writing for equity and inclusion. Robison first clarified the importance of empathy in healthcare, citing benefits such as improved:

• health and outcomes
• medication adherence
• patient satisfaction.

Highlighting the power of empathy, Robison put to attendees that “feeling seen and heard makes people more likely to listen to and follow a recommended course of action.”

An attendee poll confirmed that concerns around needing to sound smart, accurate and professional can lead to a lack of empathetic writing in medical communications. Robison challenged this, asserting that empathetic writing is, by its nature, more specific and accurate.

Inclusive language is a key feature of empathetic writing and Robison described several tangible ways in which medical publication professionals can increase its use. Key features of inclusive language are that it:

• acknowledges diversity
• conveys respect
• is sensitive to difference
• promotes equal opportunities.

Put simply, “inclusive language is about making space.”

Increasing empathy in medical writing

Robison empowered attendees to increase empathy in their own writing with some pointers:

• General principles:
  • Before writing: consider your reader but also your own positionality – how does this compare to that of your reader(s)?
  • When writing: be transparent and specific. Avoid stereotypes and the passive voice. Use person-first language (unless identity-first is preferred by the community you are describing).
• Race and ethnicity:
  • Be specific and do not use ‘othering’ terms such as minority or non-white.
  • A debate is ongoing regarding the capitalisation of ‘white’, with many now arguing that it should not be capitalised.
• Sex and gender:
  • Only mention this if relevant.
  • Be specific as to whether you are referring to sex (biological) or gender (social), and if possible, be specific regarding the biological sex characteristic to which you are referring (eg ‘people who menstruate’).
  • Use a person’s correct pronouns and if these are not known, use singular ‘they’. This is now an accepted approach in many style guides. If not accepted, re-word or alternate between ‘he’ and ‘she’ by paragraph.
  • Avoid terms such as opposite sex, born/biologically [male/female], identifies as ‘x’ and instead, say different sex, assigned [male/female] at birth or is ‘x’.

Advocating for inclusive language

Robison also encouraged attendees to open discussions with others in the industry, such as peer reviewers, on the use of inclusive language.

In doing so, its use and reach can be extended. Finally, Robison reminded attendees of the opportunity before them: “Your words have the power to make space”.

Equity, diversity and inclusion – defining a roadmap for our profession

The next 2 sessions focused on equity in medical communications. Skobe introduced the topic by recapping the call to action prepared by ISMPP members and published in the MAP Newsletter, which discussed the need to improve equity, diversity and inclusion within medical communications and the wider healthcare community. Skobe then moderated an insightful panel discussion between Beryne Odeny (PLOS), Angela Sykes (Pfizer), Chris Winchester (Oxford PharmaGenesis) and Durhane Wong-Rieger (Canadian Organization for Rare Disorders) which examined 4 next steps towards achieving these goals.

1. Advocate for diversity in clinical trial representation.

“We know that selectivity perpetuates health inequalities.” Beryne Odeny (PLOS)

Diversity in clinical trials expands the generalisability of findings and provides an opportunity to better understand treatment responses across wider groups of people. This is both scientifically and ethically important.

“Patients need to see themselves reflected in clinical trials.” Durhane Wong-Rieger (Canadian Organization for Rare Disorders)

2. Invite authors and presenters from diverse backgrounds and perspectives.

When people see research that is contextually appropriate, it is more likely to be disseminated, implemented, and incorporated into best practice. To achieve this, patients need to be involved in all stages of scientific research – not just at the publication stage.

3. Develop plain language summaries (PLS).

PLS that are developed with health literacy in mind can improve the accessibility of scientific data for patients. PLS should be culturally sensitive – are translations appropriate for the audience? Does your PLS use informal jargon that has been translated, distorting the message you are seeking to communicate? Consider seeking patient input when developing PLS.

4. Encourage open access publishing.

The ability to access information without cost is important for fostering an inclusive environment in scientific research, to ensure that individuals are not ‘locked out’ due to their socioeconomic status, geographic location, role, or other factors. Open access can help to improve inclusivity.

Equity and excellence

This session, moderated by Jill Wund (Oxford PharmaGenesis), continued discussions on the importance of equity, diversity and inclusion with contributions from expert panellists Sue-Ann Chen (Pfizer), Jackie Goldschmidt (Pfizer) and Charlotte Shyllon (Transforming Words). Shyllon highlighted that having a diverse workforce ensures a mix of talent, skills, backgrounds and experiences, improves creativity and fosters innovation. In turn, this enhances the reputation of the employer and drives further diversity. Chen added that diversity and inclusion are needed for a globally representative workforce, and result in highly engaged employees, leading to greater productivity.

Diversity and inclusion are needed for a globally representative workforce, and result in highly engaged employees, leading to greater productivity.

The panellists highlighted the benefits of mentoring those from minority populations. A mentor can:

• provide access to their network, allowing new connections to be made
• offer an additional support system to that provided by a manager or team
• share information, knowledge, and experience
• help build confidence
• help create opportunities.

Looking specifically at the life sciences, the panellists noted that while some pharmaceutical companies do have equality, diversity and inclusion policies in place, there is still a way to go to achieve these goals. The key role of leadership endorsement and support in driving change was highlighted.

While some pharmaceutical companies do have equality, diversity and inclusion policies in place, there is still a way to go to achieve these goals.

Shyllon noted that an organisation does not have to be large to drive change. She recommended that companies start by listening to their staff to find out which issues are important to them and to make sure programmes are sustainable in the long term.

To reduce bias when hiring, the panellists recommended that:

• employees review job descriptions to check for gender bias, for example
• bias training for hiring managers should be considered, to increase awareness of the issue
• using blinded CVs should be considered, to avoid name discrimination.

The experts suggested that when recruiting within medical communications, employers should seek talent from different backgrounds and look beyond the traditional sources.

The future of scientific writing and journal articles – with user experience (UX) design

Jason Gardner (CMC Connect) opened the session by giving a brief history of scientific journals, from the first journals appearing in the 17th century to accessing journals online today. Gardner highlighted that the amount of scientific information available now can be overwhelming. He introduced Mike Morrison (Michigan State University) to give his perspective as a UX Designer on overcoming barriers to disseminating scientific information.

“Murder the PDF!”

Morrison noted that the current process of reading scientific articles is inefficient and walked the audience through an example of how this could be improved. Morrison suggested 5 ‘revolutions’ that could be implemented:

1. “Murder the PDF!” –  making articles HTML only and open access removes restrictions due to print requirements (such as page and data limits). It also facilitates automatic updates and empowers users to include more interesting elements within the article (such as videos or embedding code).
2. Crowdsourcing, to allow open post-publication peer review.
3. Using structured content for machine readability.
4. Implementing responsive design to make articles easy to consume and optimal for any device.
5. Considering UX to improve efficiency.

“Applying UX principles to science could massively accelerate progress.” Mike Morrison (Michigan State University)

UX writing – what can we do to progress?

Next, Morrison described UX recommendations for writing, referring attendees to further information at User.com and the Nielsen Norman Group. Following UX design principles, articles should be:

• accurate
• complete
• skimmable
• efficient (conversational).

Morrison noted that change has to be driven by scientific publishers, calling on them to encourage use of bullet points, try statement headings to expand on the traditional Introduction, Methods, Results, and Discussion (IMRaD) structure, and make science free to consume.

Presenting data – let your data be the star

Orla Weir (CMC Connect) rounded up the session with an overview of visual considerations for data in articles, noting that “your data should tell the story.” Weir emphasised considering the basics: the purpose, clarity and message of the data. She explained some interesting ways to improve how data are presented, including:

• enabling the audience to interrogate the data
• making datasets interactive
• simplifying formats to visually communicate (for example, through infographics).

Oral presentations

Burd chaired this session looking at 2 areas routinely encountered by publication professionals: copyright permissions and PLS.

Are copyright permissions required for using modified published figures in biomedical journal articles? A survey

The first presentation looked at the tricky issue of when permissions do and don’t need to be sought when modifying figures for publication. Saurabh Gagangras (Cactus) presented the results of a survey of ISMPP members and medical publication professionals in which participants were shown 6 pairs of figures and asked whether copyright permissions would be required to publish the modified version.

The results revealed a lack of consensus and widely divergent opinions on when copyright permissions are needed, highlighting an unmet need for clear and comprehensive guidance.

Discussions focused on how such guidance could be developed, acknowledging that there was currently no obvious roadmap. Regardless, Gagangras noted that a multi-stakeholder approach including publishers, authors and publication professionals would be important for developing workable guidelines.

PLS of publications: diverse stakeholders identify key opportunities to accelerate uptake

Attention then turned to PLS. Despite widespread enthusiasm and demand for PLS, only a small proportion of publications are currently accompanied by a PLS. On behalf of the ISMPP PLS Perspectives Working Group, Jason Gardner (CMC Connect) and Dawn Lobban (Envision Pharma Group) described efforts to investigate PLS development processes and identify key considerations, barriers and opportunities for their use.

The Working Group has engaged with nearly 30 stakeholders globally, including patients and pharmaceutical industry, publishing and medical publication professionals. The findings have highlighted that patients are not a target audience for PLS, but the target audience.

Patients are not a target audience for PLS, but the target audience.

Key issues considered included:

• involvement of people skilled in plain language writing
• need for a quality assessment checklist (along the lines of the CONSORT checklist)
• PLS always being freely accessible and linked to the original publication.

The barriers to widespread use of PLS were discussed, including the skills, time and resources required for their development. However, it was noted that with the large investment that goes into a research study, it makes little sense to ‘save’ a little time and money when communicating the results.

The Working Group is continuing to engage with the stakeholders, discussing each of the topics in more detail, and plans a manuscript, other communications and lobbying to accelerate PLS uptake.

How to succeed in cross-collaboration: the SCARF® model for Medical Affairs

Cathy Kirk and her colleagues, Patricia Butler, Brian Falcone and Richard White (all Oxford PharmaGenesis) introduced the SCARF® model, devised by The NeuroLeadership Institute, as a tool to improve communication and collaboration. The NeuroLeadership Institute describes the SCARF® model as “a brain-based framework designed to enhance self and social awareness and improve the quality of daily interactions”. Kirk explained that SCARF® encompasses 5 social domains (Status, Certainty, Autonomy, Relatedness and Fairness) that can trigger either a reward or threat response in the brain. As with a physical threat, a social threat can activate the ‘fight or flight’ response with adrenaline and cortisol released into the bloodstream. Emotions can take over and leave you seeing red or being in the ‘red zone’. In contrast, a reward can leave you feeling much more open and relaxed or in the ‘green zone’.

The SCARF® model can be used to analyse how we are working and communicating with each other. This can help to foster productive collaborations and avoid disputes:

• Status – acknowledge the importance of each role.
• Certainty – clarify what will happen or the next steps.
• Autonomy – allow input and choice (if possible).
• Relatedness – help all sides to feel included.
• Fairness – treat everyone fairly.

At the current time, remote working can enforce feelings of isolation and make people more sensitive to threat triggers, while virtual activities can make it harder to pick up on signals that people are feeling uncomfortable or disengaged. Kirk recommended that attendees think about each aspect of SCARF® before meetings and use the model to communicate more effectively and promote positive interactions.

Powering insight generation: practical application of new artificial intelligence (AI) tools to mine the scientific literature

This session explored the role of AI in evaluation of the scientific literature, with a focus on real life examples and the practicalities of adopting an AI-based approach to facilitate publication planning.

The road travelled so far

Jennifer Ghith (Pfizer) began the session by outlining the role of AI in overcoming challenges in analysing the ever-growing volume of scientific literature. Misconceptions still exist regarding AI, which encompasses multiple tools designed to accomplish specific, discrete tasks, not a single magic bullet. Ghith underscored the importance of ensuring AI approaches are grounded in a robust scientific question and noted the need to build connections and facilitate communication between the data analytics community, internal colleagues, and healthcare professionals (HCPs). Ghith finished with a review of progress since the 2019 ISMPP Annual Meeting:

AI is already in use for literature and gap analyses, with exciting prospects for the future.

AI tools for literature analysis

Kim Wager (Oxford PharmaGenesis) highlighted the various stages of literature analysis where AI tools can be used, including initial searches, data extraction and analysis, and noted the importance of selecting the right tool for each task. Wager contrasted lexical search tools (such as PubMed) with semantic searching using natural language and touched on the technologies underlying text mining capabilities. Carrot2 was presented as an example: it uses clustering algorithms to group PubMed search results into common themes, providing immediate insights into key topics. Wager concluded by encouraging attendees to start exploring the existing AI tools available for literature analysis.

Big data insights

Bob Schijvenaars (Digital Science) gave an overview of an AI-based project that aimed to identify biomarkers of potential interest using Dimensions data, which links publications to related outputs such as grants, patents, and policy documents. Mentions and co-mentions of biomarkers were identified and used to build a network of potential biomarker relationships.

Trends such as an increasing rate of mentions over time could help to identify areas of potential interest for further analysis. Schijvenaars demonstrated some of the interactive visualisations used to explore data of this size and complexity, while noting that static plots may be more suitable for publications.

The path forward

Dheepa Chari (Pfizer) closed the session by outlining key factors to consider when deciding to implement an AI-based approach:

• Ensure your goals for the project are grounded in a clear business objective and a well-defined scientific question.
• Understand and educate on the technical basics of your desired approach, including any field-specific terminology, to ensure effective communication internally and with HCPs.
• Define a coordinated, long-term strategy and integrated approach for investment in AI and commit to sharing learnings.

Chari reflected on developments since 2019, noting that availability of tools has increased, so ongoing focus is needed on education and ensuring appropriate use. At the same time, the value proposition for AI has strengthened, with clear cost-effectiveness versus a manual approach. Understanding of AI capabilities has also increased, and Chari urged attendees to continue sharing best practice and to articulate the value of successful approaches.

Real-world impact: how pharma and publishers are using digital enhancements to maximise reach and engagement

The final session, moderated by Elvira D’souza (Cactus Communications), involved a panel of representatives from publishing and pharmaceutical industries. The panel discussed the changing landscape of data dissemination and best practices and challenges encountered with publication of digital enhancements.

The changing landscape of data dissemination

Peter de Jong (Wiley) summarised the key results of a survey of 827 HCPs, highlighting that increasingly, HCPs learn about new medical information through digital platforms (eg social media) rather than via traditional approaches (eg attending conferences).When HCPs were asked where they learn about newly published scientific/clinical research, the most common response (22%) was from societies/journals via email, websites or social media.

The survey also showed that HCPs’ content preferences are evolving. When asked about their preferred format of references to support clinical decision making, 31% stated full text articles, but 9% and 15% chose infographics and videos, respectively.

While full text manuscripts are still fundamental to guiding decision making, there is an increasing desire for bite-sized summaries of key information and engaging digital enhancements.

Publication professionals, the pharmaceutical industry, publishers and societies need to work together to meet this need.

Best practices for digital enhancements

Hetal Patel (Boehringer Ingelheim) outlined best practice recommendations for planning, execution and compliance for digital enhancements.

For planning:

• Understand how your target audience consumes data.
• Define objectives, intended impact and relevant journals/conferences offering enhancements.
• Align all stakeholders early in publication development.

For execution:

• Be innovative; stay away from brand colours.
• Set up a process for managing enhanced content alongside the main publication.
• Leverage the publisher’s offerings to disseminate content.

For compliance:

• Articulate how, when and where the enhanced content will be used.
• Share examples of enhanced content from publishers.
• Invite compliance teams to educational events.

Challenges faced during delivery of digital enhancement projects

Rekha Rao (Amgen) highlighted some of the challenges that need to be overcome when working on digital enhancements.

From a compliance perspective, it was noted that, currently, there may be insufficient guidance on what is allowed. Copyright license preferences of authors and pharmaceutical companies (in terms of the use of digital enhancements) also need to be considered and aligned with the licenses available from potential target journals.

From a process perspective, there may be a lack of understanding about the development and publication of digital pieces, but it is vital that alignment with authors is obtained.

From a budget perspective, digital enhancements increase the cost of publications, so considering the benefits of the piece and whether it may have additional internal uses will add value. While metrics (such as the number of views or downloads) provide valuable information, limited data demonstrating the effectiveness of enhanced content in guiding clinical decision making are available. More research is needed in this area.

Limited data demonstrating the effectiveness of enhanced content in guiding clinical decision making are available. More research is needed in this area.

What does the future hold for digital enhancements?

D’souza brought the session to a close highlighting that the requirement for digital enhancements is likely to continue to grow in the future and should be embraced by all stakeholders. Full adoption of digital enhancements will require rethinking of policies and workflows by pharmaceutical companies, medical writing agencies and publishers.

The requirement for digital enhancements is likely to continue to grow in the future and should be embraced by all stakeholders.

You can also read our summaries of Day 1 and Day 3 of the meeting.

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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.

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With thanks to our sponsor, Aspire Scientific Ltd

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