Undoubtedly, the COVID-19 pandemic has had a major impact on medical communications. Journals have faced the pressure of receiving vast numbers of COVID-19-related submissions, there has been an increased demand for research to be openly available, and the popularity of preprints has continued to grow due to the need for rapid access to new data. Changes have not only affected publishers, with medical congress organisers needing to adapt their traditional face-to-face events to virtually-attended versions. Following her contribution to the 2021 European Meeting of the International Society for Medical Publication Professionals (ISMPP), The Publication Plan spoke to Lucy Turner, Global Publications Director, Oncology at AstraZeneca. We found out more about the medical communications challenges she has faced as a result of COVID-19, and what long-lasting effects she expects the pandemic to have.

 The COVID-19 pandemic may have delayed clinical trials and, consequently, the availability of data. In addition, some medical congresses have been postponed or cancelled and journal publication processes have slowed. Have you experienced any significant delays to the publications you oversee at AstraZeneca? Have you needed to update your publication plans to account for these factors?

“With the pace of oncology research, we’re used to managing complexity in our publication planning, but the impact of COVID-19 added another layer. We had to re-evaluate all of our publication plans and adapt in a very fluid and changeable environment. Discussions focused on whether data should be redirected to another congress, held for the rescheduled event or prioritised for manuscript publication in lieu of congress presentation. Furthermore, we needed to understand how the prioritisation of COVID-19-related publications could impact journal timelines and how author engagement in the publication process might be impacted by COVID-19 commitments. Plans were reworked multiple times as the landscape changed and we started to get clearer answers to these questions.

Plans were reworked multiple times as the landscape changed.

Some abstracts did cycle through cancelled or postponed congresses in the first half of the year before being presented in a virtual format, and flexibility in some congress deadlines actually helped us with some rapid data disclosures. In some instances, we found that going straight to manuscript publication was the more guaranteed route to expedited dissemination, and in most cases, journals maintained their rapid review timeframes for time-sensitive research, which was remarkable given the increased pressure on peer reviewers. Overall, we didn’t encounter any significant delays.”

Authors occupied with COVID-19-related work may have been unable to contribute promptly to publications of time-sensitive research, an issue identified by ISMPP and addressed in their guidance for publication professionals. During the last year, what challenges have you encountered due to this problem and how have you managed to overcome them?  

“The ISMPP guidance was very helpful here and gave us a framework to keep time-sensitive research publications on track in the event that an author was unresponsive because of COVID-19-related responsibilities. In our interactions with authors, our overarching principle is to be mindful and conscientious: making sure we are efficient in our communications and adapting timelines as much as possible to give authors more time to contribute (even if this meant we had to work quicker on our side). We did have some investigators decline authorship invitations outright as a result of their COVID-19-related commitments.”

Preprints have proliferated during the COVID-19 pandemic as a vehicle for rapid research dissemination, although concerns have also been raised about potential issues with credibility and misinformation, given the lack of peer review. What is your perspective on the role of preprints, particularly for communicating time-sensitive information?

“Peer review is a critical step for maintaining the integrity of scientific and medical advances across the board and particularly for industry-sponsored clinical trial data, given the potential for informing patient care. Rigorous standards throughout the whole process are of paramount importance to avoid misunderstanding and misinterpretation.

Rigorous standards throughout the whole process are of paramount importance to avoid misunderstanding and misinterpretation.

Furthermore, a peer reviewed publication is essential for our interactions with regulators. With many journals offering rapid publication tracks, we have good mechanisms in place for communicating time-sensitive information in a peer reviewed format. I think we need to see consistent standards in terms of transparency and disclosure across preprint platforms, including how these are moderated and monitored, and an understanding from regulators and journals on their perspectives before we could see adoption of preprint dissemination for our datasets.”

Recent interviewees on The Publication Plan have discussed the importance of reporting negative data and data sharing. Given AstraZeneca’s membership of Open Pharma, how are you approaching the open science movement? With the increased push for open science, and the calls for open access to COVID-19-related research to be extended to other topics, how has your outlook evolved as a result of the pandemic?

“We are supportive of an open access publishing model and open access options are included in discussions with authors on target journals. However, a requirement to publish via unrestricted open access routes only would currently limit an author’s choice of journal. Many publishers have made COVID-19 research available open access without an embargo period, an important step in ensuring equitable access to research that could support the global response. In addition, publishers agreed to make content accessible in machine-readable formats to support data mining. It would be great to see publishers continue to provide this level of accessibility as standard, with better open access models for pharma-sponsored research.”

Due to restrictions on travel and events, many congresses had to move from a traditional face-to-face meeting to a virtual setting. In your experience, what have been the main challenges with the change in congress format, and how can such issues be addressed?

“To me, the challenges boil down to engagement – with the event, with the data, with peers – and what we need to make sure is that the infrastructure and approaches are in place to encourage this.

A poster crammed full of text had limitations in a poster hall with the author present, but…without the option for face-to-face author interaction, it just is not going to resonate.

A poster crammed full of text had limitations in a poster hall with the author present, but on a phone or tablet screen being viewed on the go without the option for face-to-face author interaction, it just is not going to resonate. Research presented at the 2020 European Meeting of ISMPP (Helson R et al. Curr Med Res Opin 2020;36(Suppl.1):23­–33) has shown us that healthcare professionals want a simplified approach to posters, with congresses also advocating for this (eg the American Society of Clinical Oncology (ASCO) provided a poster template based on the #betterposter campaign). Therefore, we have focused on reforming our poster layouts to have a clearer structure, less text and improved visualisation of results. Including audio/video and Q&A options also ensures that the author’s voice and the level of debate experienced in face-to-face events are not lost.

We have focused on reforming our poster layouts to have a clearer structure, less text and improved visualisation of results.

We also need to keep pace with changes in conference attendee profiles and information needs, and ensure publications are accessible. Plain language summaries were increasingly adopted in 2020 and research has shown these are a desirable feature of congress presentations (Helson R et al. Curr Med Res Opin 2020;36(Suppl.1):23–33; Pyke E et al. Reform and enhancement of scientific posters: what was the extent of innovation in 2020? Oral presentation at the 2021 European Meeting of ISMPP). We are working to utilise these findings and are piloting some new approaches this year.”

What are the advantages of holding a virtual meeting in place of a traditional congress? Are there any elements of a virtual congress that you feel have been particularly successful or have provided opportunities for digital innovation?

“The advantage is that congresses are now more accessible than they were. Before COVID-19, if you wanted to actively take part in a congress, you had to commit at minimum a weekend, the cost of a plane ticket/hotel and rearrange your home life. Now, you can attend from home or the office instead and still have the opportunity to see and discuss the latest research as it breaks. Virtual congresses have raised standards with a mix of live and on-demand content, to mitigate scheduling and timezone issues, which has helped to ensure audiences could access data of interest while balancing day-to-day distractions.

But, with these virtual platforms, there are inherent challenges in achieving the same level of engagement you would see with a face-to-face audience free of day-to-day distractions. We have had to embrace digital innovation to try to meet this challenge. Audio/video for presentations of all formats, quick-take formats, infographic enhancements and reformed poster layouts have all come to the fore. Making better use of QR codes to link to supplementary material in the same way you would a manuscript, and making sure authors are available and able to engage in virtual Q&A sessions, for example, are also important considerations. While I do think this period has accelerated the adoption of novel, digital formats across a typically cautious industry, there’s more that we can do.

While I do think this period has accelerated the adoption of novel, digital formats across a typically cautious industry, there’s more that we can do.

I look forward to continuing to evolve approaches, further discussion and guidance on digital innovation in ISMPP forums and also seeing what congresses and journals will offer moving forward.”

You have noted that virtual formats allow broader congress attendance, but maintaining audience engagement is a challenge. How do you think this can be addressed?

“We all really got behind virtual formats, but I don’t think we have nailed the best way to ensure engagement.

We all really got behind virtual formats, but I don’t think we have nailed the best way to ensure engagement.

It is a lot easier to tune out of a virtual congress compared with if you’re sat in an auditorium or walking a poster hall. As mentioned, the data have to be presented in a format that is complete but also accessible and quickly understandable. You also have to ensure engagement between authors and the audience, which has mainly been approached through pre-recorded presentations followed by live or text-based Q&A formats. Some congresses, such as the European Society for Medical Oncology (ESMO), have initiated monthly virtual plenaries with the objective of accelerating research disclosure in more focused, shorter meetings and I am interested to see the impact of new approaches like this.

Metrics from the congresses would really help us to understand audience engagement, but these have not been available to date. The platforms and formats that really foster speaker/audience engagement will do well in the future.”

Over the past year, social media platforms have seen increasing use as a venue for debating findings presented at virtual congresses. Have you seen this trend with research that you are involved with? How can pharma best engage with discussions on social media to promote accurate interpretation of research?       

“Yes, we have definitely seen social media play a stronger role as a vehicle for sharing and debating our scientific research. It has stepped in to replace the poster halls and lunch queues as the venue for discussion. The challenge is that the research can be shared widely and out of context – perhaps one figure or slide being picked up – leading to misunderstanding or misinterpretation amongst a broader audience, including the general public.

In terms of pharma engagement with social media, that’s something that needs renewed focus industry-wide.

In terms of pharma engagement with social media, that’s something that needs renewed focus industry-wide. It is where the conversations are taking place.”

What do you think medical congresses will look like in the future, once group gatherings and travel resume? Do you feel most will revert to the traditional format, or would you like to see a greater virtual offering as standard in the years to come?

“I would very much like to see greater virtual offerings as standard. The switch to virtual has made medical congresses and research more accessible. You don’t have to be able to travel across the globe to access and discuss the latest scientific advances with peers – you can do that from anywhere. I would hate to see that disappear and I think we would all be poorer for it. A hybrid approach would be ideal.”

Finally, has the COVID-19 pandemic brought about any improvements to your standard ways of working? Do you think that any of your experiences over the past year will have a lasting impact on how you go about your work in future? 

“It has accelerated us embracing digital innovation and enhanced publication features and has really made us focus on audience needs. While we had been working to build these in to our publication planning, the events of the past year have made it imperative that we embrace new approaches to ensure our research reaches the right audience at the right time. We’ve been really encouraged by the new approaches we are seeing from some congresses and publishers. I hope this period of innovation will continue.”

Lucy Turner is Global Publications Director, Oncology at AstraZeneca. You can contact Lucy via lucy.turner@astrazeneca.com. All views are Lucy Turner’s own and are not meant to represent any official views of AstraZeneca.

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