The COVID-19 pandemic has undoubtedly affected the medical communications industry, presenting unexpected challenges but also creating opportunities for change and innovation. Following his presentation at the 2021 European Meeting of the International Society for Medical Publication Professionals (ISMPP), The Publication Plan talked to Chris Brooks, Publication Lead at AstraZeneca, to learn more about the impact of the pandemic on medical publications and to find out how he sees his role evolving in the future.

 In your role as Publication Lead, you liaise with multiple parties, such as internal medics, authors, medical affairs teams, and agencies. Each of these groups will likely have different motivations and priorities. How do you manage to ensure that all of these stakeholders work together as a cohesive team?

“It’s most certainly a challenge, particularly when you’re new to a team or, as happens so often, colleagues in the various teams you work with are changing. Building relationships with each of the various groups is imperative; it really helps to get to know how they work and what exactly it is that they need or expect from you, as well as who you need to approach to get what you need for publications. Bringing these groups together for regular publication team meetings is one of the simplest ways of keeping everyone informed of plans and progress whilst also giving them a platform to provide input themselves. In addition, I think it’s important that the publications function is included in meetings hosted by other groups. There have been numerous occasions during these meetings where I have heard important snippets of information about studies, results, plans or strategic updates that impact publications. Attending meetings also allows me to provide publication updates or gain clarity on important topics.”

Building relationships with each of the various groups is imperative.

The COVID-19 pandemic has raised many challenges, leading to rapid adaptations across industries in response. In your experience, what have been the main impacts on the medical communications sector?

“I have two answers to this, purely based on the fact I have simultaneously worked on products both in and outside the COVID-19 space.

Firstly, with respect to COVID-19-specific activities, the pace of work has been incredible. I think everyone is abundantly aware of how quickly vaccines have been developed, tested, and approved, but what probably goes a little more unnoticed among the headlines is the fact that all of the other aspects have had to keep pace with the condensed clinical development timelines. Publications is just one tiny cog, and obviously an important one, in the enormous machine that develops a product and brings it to market. Just like everyone else in this effort, publications professionals have had to adapt to move at light speed. Publication timelines for developing and reviewing drafts have often been measured in hours rather than days, whilst timelines for developing manuscripts can be counted in days rather than weeks. These timelines have meant that the idea of submitting to a congress, something that has always been the norm, has been almost unthinkable for the delays it might cause to disseminating data.

The idea of submitting to a congress, something that has always been the norm, has been almost unthinkable for the delays it might cause to disseminating data.

The urgency required to share results has really brought preprints to the fore during the pandemic. For the most part, I think the use of preprints has been good, but it does come with challenges. They are an incredible resource for distributing important science in a rapid fashion, but we must remember that preprints have not undergone peer review when released.

Beyond COVID-19-related publications, I think the biggest impact of the pandemic has been the rise of the virtual congress. First and foremost, the societies organising the meetings have had to change their entire model, which is no small task, but the benefit is that a global audience can access the content so much more easily than they could before. For medical communications, it has presented its own fair share of challenges as we seek the best way to engage with a virtual audience across the many different platforms used by congresses.”

Have you faced any particular challenges or seen any positive outcomes or strategies emerge in response to the unprecedented situation caused by COVID-19?   

“The rapid shift to a virtual environment for congresses was an immediate challenge but I think it’s fair to say that we probably think of it as normal now. The level of innovation has been incredible and has shown what we can do when faced with a new challenge. It’s something that will have to continue to evolve because I think the virtual aspects of these congresses are here to stay.

The level of innovation has been incredible and has shown what we can do when faced with a new challenge.

With the speed at which COVID-19-related content has been delivered, I genuinely think we’ve learnt a lot about what is actually within the realm of possibility. However, this does come with the caveat that it’s not a pace that is sustainable over the long term.

By far and away the most significant positive impact I’ve experienced through the entire pandemic is an even keener awareness of the real, human impact of our work. What we’re doing – however small a part we play – is helping to improve and save lives every day, sometimes on a global scale.”

What we’re doing – however small a part we play – is helping to improve and save lives every day, sometimes on a global scale.

Over the last year, many medical congresses have taken place as virtual events allowing digital elements, while journals are increasingly offering enhanced digital features alongside articles. Which additional digital options do you think have the most value in ensuring that research has the widest reach and impact possible?

“From a congress perspective, it is hard to say as each one offers a vastly different package. There have been some great examples of infographic posters – some have downloadable content whereas others may have embedded video. There are so many possibilities now, depending on the congress. It’s difficult to say which option has the most value because each poster has its own story to tell, but the most basic option allowing the presenting author to record a presentation of their content for people to view on-demand is incredibly powerful – anything you can do on top of that is only going to add value.

Similarly, for journals, I think one of the simplest and most impactful things to offer is a short presentation of the results in some form of audio format.

For journals, I think one of the simplest and most impactful things to offer is a short presentation of the results in some form of audio format.

We know that there is so much competition for attention nowadays, so the option of being able to listen to an audio description of research findings offers a time-saving alternative for someone who would ordinarily have to sit down and read the full paper.”

For many authors, the journal impact factor continues to be a key consideration when selecting a target journal for their manuscript. What do you think are the most important aspects to look at when discussing journal options – is the impact factor a relevant metric?

 “It’s so hard to get away from it. I often joke that I’ve never attended a kick-off call where The Lancet, The Journal of the American Medical Association (JAMA) or The New England Journal of Medicine (NEJM) hasn’t been mentioned, but in reality it’s not far from the truth. You can never overlook these options – they are fantastic journals and there is a good reason that it’s difficult to publish in them, especially as the likes of NEJM are offering such fantastic digital add-ons to some of their publications right now.

That said, if you don’t have ground-breaking, pivotal phase 3 data that the big journals are going to be excited to get hold of, I really think there is a need to think a little more carefully. This is especially true if it’s a strategically important publication for which you want maximum exposure. Publication timelines can come into it as well; aiming too high can increase the time it takes for an article to get accepted as a single rejection can delay publication by weeks or months. Sometimes, the lower impact factor journals are the ones that offer more options for publication enhancements such as video abstracts, voiceovers, and podcasts that can help the article gain greater attention.

In all, I think it’s a delicate balance and one that needs open discussion and agreement with the author group from the outset.”

Open access publishing is actively promoted by some pharma companies, and others mandate that all research they fund is published open access. How important do you think open access publishing is and if there is not already a policy in place at AstraZeneca, is this something that you envision being implemented in the future? 

“I’m a big fan of open access publishing, having started out many years ago working for a publisher. It’s been fantastic seeing all of the publishers making COVID-19 publications open access to further research efforts globally and facilitate the spread of peer reviewed articles to stave off misinformation.

It’s been fantastic seeing all of the publishers making COVID-19 publications open access to further research efforts globally and facilitate the spread of peer reviewed articles to stave off misinformation.

Whilst open access publication is not mandated at AstraZeneca currently, I can envisage circumstances where such a policy might be introduced one day. At the same time, it would be fantastic to see this approach taken for all publications across pharma regardless of the sponsor.”

There have been calls for information to be made more accessible to patients, for example via plain language summaries. Do you feel that plain language summaries should be considered for publication alongside all research articles and how achievable would this be in practice?

“Absolutely yes! I’ve made a concerted effort on the publications I’ve worked on over the past year to develop some form of plain language summary.

I’ve made a concerted effort on the publications I’ve worked on over the past year to develop some form of plain language summary.

Within AstraZeneca, one of our core values is to put patients first, but in publications we don’t see patients which means it can be very easy to focus on the immediate deliverable. That makes it important for us to remember those who actually took the time to participate in the studies that provide our data, and are those who are ultimately going to be impacted by our outputs.

We also need to consider that we’re in an age where a patient can simply type a few words into a search engine to access a mass of information about their condition. Ultimately, patients are going to be consumers of our content so we need to be mindful of that. Plain language summaries are a quick win right now, but I think this is an area that will evolve rapidly over time in an effort to make sure that patients are well informed with accurate and reliable information, should they choose to access it.”

 Finally, how do you see the role of a Publication Lead evolving in the future?

 “I was on a panel discussion recently and one of the comments I heard on this subject was that the role is becoming more attuned to what could be described as a ‘Scientific Communications Specialist’. It’s a concept that resonated with me quite strongly, and I interpret it to mean that the Publications Lead will come to have a greater influence on how science is communicated beyond the development of strategy and execution of publications.

There are a number of other things that will come to the fore over time as well. Previously, I mentioned the increasing need to consider the patient in our work and that there is potential for growth in this area. I think we’re all aware that there are competing demands on the time and attention our audiences have available to read our content. As such, we need to think carefully about how we adapt what we deliver to meet their needs. Digital aspects of publications are going to become more important over time in an effort to garner attention and make it easier to connect and engage with our content, but there has to be a balance because the traditional publication is still central to delivering the science.”

Chris Brooks is Publication Lead at AstraZeneca.

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