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Meeting report: summary of Day 2 of the 2022 ISMPP European Meeting

The 2022 European Meeting of the International Society for Medical Publication Professionals (ISMPP) was held virtually on 25–26 January. This year, nearly 350 delegates attended the virtual meeting, which was themed ‘Advancing Our Profession: Driving Leadership and Best Practices in Medical Communications’.

For those who were unable to attend the meeting – and as a reminder of the topics covered for those who were – a summary of the second day of the meeting is provided below.

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

Summaries of Day 2

Day 2 opened with three parallel sessions that explored the peer review process, the use of digital enhancements to maximise publication impact, and patient involvement in medical publications.

The people and process of peer review: a peek behind the curtain


KEY TAKEAWAYS

  • Effective peer review is a collaboration between authors, editors, and peer reviewers. Good communication between the involved parties during the process is vital to improve the quality of published research.

Norbert Brunhuber (Vertex Pharmaceuticals) moderated the first session, which offered a view inside the ‘black box’ of journal peer review and included representation from each of the key players in the peer review process.

An author’s perspective

Kate Owen (Complete HealthVizion) described some of the common frustrations of the peer review process that can cause delays from an author’s perspective.

  • Peer review duration – Owen suggests that lead times provided by journals do not always reflect reality, and that authors are often not kept informed of any delays. Authors must frequently check the status of a submitted manuscript and chase journals for information on delays.
  • Addressing reviewers’ comments – instructions on how to adequately address comments can be lacking. This can cause delays during redrafting and potentially lead to additional rounds of revision.

While fully supportive of peer review, Owen highlights that the peer review process can make it difficult to share data in a timely manner.

An editor’s perspective

Elena Bellafante (Cell Press) explained that editors aim to select peer reviewers who can evaluate manuscripts in an unbiased fashion, a process that can be difficult in smaller research fields. Avoiding conflicts of interest is important, with editors excluding reviewers who have collaborated with the authors within the last 5 years. Bellafante explained that within reason, editors also seek to honour authors’ requests to exclude certain reviewers.

Once peer reviewers are chosen, they are asked to make assessments against several criteria, including data quality, interest to the field, and impact on future research. But ultimately, it is the editor’s decision on whether to accept or reject a manuscript and they can be rejected for a variety of reasons, including a lack of sufficient support for the conclusions or ambiguity/flaws in data interpretations. Bellafante clarified that editors can overrule reviewers’ comments and that they endeavour to provide clear guidance to authors on which points to address. Bellafante encourages authors to proactively contact editors if the major issues are unclear and explained that this is a useful approach to avoid repeated rounds of revisions.

If peer review comments are unclear, contacting the journal editor can be a useful approach to avoid repeated rounds of revisions.

A peer-reviewer’s perspective

Kathryn McGurk (Imperial College London) provided a peer-reviewer’s opinion, explaining that workload is an important consideration when deciding whether to accept peer review requests. The review itself can take at least half a day, with a moveable deadline from the journal of anywhere between 1 week and 1 month. She explained that common motivations for accepting peer review requests include improving standing with particular journals, enhancing career progression, and early access to new research.

Making the peer review process smoother

In closing, the panel members each provided their thoughts on how to improve the peer review process. Bellafante explained that there are continued efforts to improve diversity in peer review panels, but as yet, there is no industry-wide effort. To help make the peer review process smoother, authors are encouraged to suggest unbiased peer reviewers when submitting manuscripts, and to contact editors to discuss comments during revisions. McGurk highlighted the importance of including sufficiently detailed study limitations to provide balanced discussion of the research. Furthermore, she advocates effective use of supplemental material to help keep the main article clear and concise.

Digital enhancements: leveraging innovation to maximise impact


KEY TAKEAWAYS

  • Identifying the target audience for digital publication enhancements upfront and tailoring them accordingly is crucial for adding value to publications and maximising their impact.

Digital enhancements help expand reach, improve engagement and increase the impact of clinical data. This parallel session, moderated by Jan Seal-Roberts (Adis/Springer Healthcare) and Maria Haughton (integrated medhealth communication), reviewed best practices for maximising the impact of digital enhancements from publisher and industry perspectives.

A publisher’s perspective

The use of digital publication enhancements has expanded over the last 15 years, with over 450 journals now offering digital features, some of which are mandated. The COVID-19 pandemic saw interest in digital enhancements increase overnight, prompted by a lack of face-to-face education and an overwhelming amount of content. Caroline Halford (Springer Healthcare) recommended the Medical Publishing Insights & Practices (MPIP) website for researching journals’ digital enhancement offerings, which include video abstracts, infographics, graphical plain language summaries (PLS), podcasts and slide decks.

Digital enhancements can significantly increase readership, enhance understanding, improve the quality of information, and engender trust in the authors. Halford’s best practice tips from a publisher’s perspective are to check journal processes as soon as possible during the development of a publication and to consider your audience and what you want to achieve; Halford noted that enhancements should be simple and add value to existing materials.

“There is no best digital feature – you need to provide value for your audience” – Caroline Halford.

An industry perspective

Will Gattrell (Ipsen) discussed the key challenge of digital publication enhancements from an industry perspective, namely how to optimise impact by balancing the value to readers with the cost and difficulty of development. Gattrell cited the example of video abstracts, which are highly valued and receive great reader feedback, but are costly and time consuming to develop. Conversely, making publications open access and including a PLS are both relatively easy to do and can greatly improve a publication’s impact. Ipsen are putting this approach into practice, announcing at the 2022 European Meeting a commitment to publish a PLS for all of their company-sponsored journal publications from human studies.

“Digital enhancements are not a box-ticking exercise” – Will Gattrell.

Gattrell echoed Halford’s point on considering the aim and audience for the enhancement before development and highlighted copyright status as a key consideration from an industry perspective: ensuring that the material(s) can be shown and re-purposed across other platforms means its value can be extended beyond the publication.

Halford and Gattrell summarised their joint recommendations for digital publication enhancement best practice:

  • contact the journal and engage authors before you begin
  • identify your target audience
  • understand the copyright status of your material(s)
  • ensure discoverability of your enhancement
  • monitor and assess the impact of digital enhancements and learn from the process.

Including the patient voice in medical publications


KEY TAKEAWAYS

  • Patients should be part of the publications process and a multitude of resources exist that provide guidance around how to involve patients.

Patients in publications: principles and practice

Patients may have a range of motives for being involved in medical publications, according to Richard Stephens (Patient Advocate and Co-Editor-in-Chief of Journal of Research Involvement and Engagement). They may want to change practice, spread the word about their condition, or perhaps just like to write. Challenges exist when it comes to patient involvement in publications, however, including lack of understanding of academic language and the peer review process, time constraints and the unfamiliar format of medical publications – in Stephens’ opinion, PLSs would be better structured by presenting the results and conclusions first.

Patients have opportunities for involvement in publications throughout the research pathway. They often meet the criteria for authorship, and are already authors of peer-reviewed publications across a range of journal types. However, Stephens said he would never advocate for every paper having a patient author just for the sake of having one. He highlighted that patient authorship was a two-way partnership: “It’s up to us patients to make sure we fit the criteria before we ask for co-authorship.” He closed by saying he firmly believed that the involvement of patients as authors was ‘a no-brainer’. “It’s our story. We donate data and tissues and samples and the aim of everything we all do collectively is to improve life for patients in the future, so of course we should be part of the publications process because it helps make better medicine; it helps make people better.”

“It’s our story… …so of course we should be part of the publications process because it helps make better medicine; it helps make people better” – Richard Stephens.

The pharmaceutical industry perspective: a case study

The ICMJE criteria stipulate who is eligible to be an author and are the same regardless of whether an individual is a patient or a healthcare professional. Presenting a case study on the lived experience of myasthenia gravis, Veronica Porkess (UCB Pharma) explained that to include patients in a meaningful way, she wanted to involve patients in the evidence-generation phase of research so that they can stand by the ICMJE criteria and be accountable for the work because they really understand it.

The opportunity to put this desire into practice came following calls from a group of patient advocates with myasthenia gravis on UCB Pharma’s Patient Council who wanted to address a gap in the literature with regards to patient perspectives of what it’s like to have the condition. UCB Pharma supported patients with the study, which involved the collection, discussion and consolidation of patient opinions collected from several sources: a UCB Pharma market research study, the Patient Council, and the medical literature. Two members of the Patient Council were authors of the research, which was accepted as a poster at the American Academy of Neurology Annual Meeting and subsequently published in Neurology and Therapy.

Reflecting on the project, Porkess felt that it was great for the myasthenia gravis community, because it enhances understanding of the condition and its management as well as communication between doctors and patients. Notably, the Neurology and Therapy publication has the fourth highest Altmetric score of any article on myasthenia gravis despite being published relatively recently (October 2021).

The patient-authored Neurology and Therapy publication has the fourth highest Altmetric score of any article on myasthenia gravis.

Porkess made several recommendations from her experience, including:

  • get internal compliance teams on board early and keep them informed throughout
  • ensure all relevant ethics approvals are obtained at the outset; journal requirements may be more stringent than local market research rules
  • select patient authors, as for any author, based on ICMJE criteria, expertise, time/availability, level of English and confidence to offer opinions
  • provide authorship support (eg, with GPP3 and the publication development process)
  • allow sufficient time for patients to review and analyse data and manuscript drafts; they have their own work, life, and condition to manage.
Making sure the patient voice is heard

Laura Dormer (Future Science Group) highlighted some of the tools that are available to empower patients as authors.

She began by reviewing the different PLS formats, including:

  • text-only (short text summaries written in plain English with no jargon). These have the advantage of being discoverable because they can be indexed (eg, in PubMed)
  • visual (a mixture of text and graphics, eg, infographic, graphical abstract, figure). This format is a great way of conveying complex topics and is very shareable so works very well on social media
  • plain language summary of publication (PLSP). These are full-length articles, often comprising a mixture of text and visuals, summarising publications in plain language, and are peer-reviewed as a standalone article. PLSPs are linked to the original article but are independently citable and indexed and therefore have their own article metrics.
Evidence-based guidance for PLSs is emerging

Dormer then summarised some of the resources that are available to guide PLS development and patient authorship:

Patient involvement beyond PLSs

The opportunity for patient involvement in publications is evolving beyond PLSs through the emergence of patient editors, peer reviewers and advisory board members, and with the development of new article types and specialist journals.

Although it’s valuable to assess the extent to which patients are authors on publications, it isn’t easy; if patients include ‘Patient Author’ as their affiliation then patient involvement can be tracked.

If patients include ‘Patient Author’ as their affiliation, then patient involvement can be tracked.

A variety of resources exist to facilitate patient authorship, for example:

In the subsequent Q&A session, Stephens and Porkess discussed the question of paying patients for authorship. Stephens felt strongly that patient authors should be paid for their time, but Porkess felt that the pharmaceutical industry would be unlikely to change their strict position on not paying authors without relevant industry-wide guidelines.

Diversity, equity & inclusion in clinical research: implications for publications professionals


KEY TAKEAWAYS

  • Improving equity, diversity and inclusion in clinical trials will improve the reproducibility and rigour of medical research, and requires the public sector, private industry, and patients to partner in these efforts.

Nichola Gokool (Paraxel) led a panel discussion on the implications of diversity, equity & inclusion (DE&I) in clinical research for publications professionals. The panel included participants from the public and private sectors, and patient representation, with insights shared by Dr Shirin Heidari (GENDRO.ORG), Prof Kamlesh Khunti (University of Leicester), Pauline Frank (Novartis), and Sheila Khawaja (Chair of the World Alliance of Pituitary Organizations).

DE&I in clinical research has received increasing attention in the wake of the racial justice movement and as minority ethnic groups have been disproportionately affected by the COVID-19 pandemic. Because patients may respond differently to treatment, it is key that clinical trial populations are inclusive and represent the expected patient population. Additionally, ensuring that under-represented communities are able to participate in clinical trials can help reduce health disparities.

Khawaja shared her personal experience of being diagnosed with a rare disease, noting that she did not consider whether the treatment options she was given had been tested in patients like her. Prof Khunti echoed the importance of diversity in clinical trial populations. If a physician wants to persuade a patient to take a particular therapy, they require data that demonstrates safety and efficacy in that particular patient subgroup. These efforts do not start with clinical trial recruitment, said Prof Khunti; patient engagement is a decades-long investment that should be tailored and culturally appropriate, so that research is carried out ‘with’ patients rather than ‘on’ patients.

Frank suggested that the way to ensure diverse clinical trial populations is to have a diverse group of healthcare providers and investigators running those trials. She highlighted Novartis’ efforts to build trust with patients and reduce barriers for trial participation.

“There is no single solution—it will take the concerted, urgent action of diverse stakeholders across the public and private sectors to create a paradigm shift in health equity” – Pauline Frank.

Dr Heidari called on the industry to pay greater attention to sex and gender bias, advocating for the needs of non-binary individuals to be considered in medical research. She noted that failing to report sex and gender aspects of research “reduces reproducibility and rigour and can cause harm” and is a “missed opportunity for innovation”. Dr Heidari pointed the audience to the SAGER guidelines for further information about sex and gender equity in research.

Lastly, Simon Foulcer (Paraxel) presented a case study of how to support a client in adhering to journal requirements to report race characteristics in a manuscript. His example demonstrated that the journal requirements sparked a larger conversation about the need for increased representation in trial populations.

Research presentations


KEY TAKEAWAYS

  • Obsolescence of web references is cause for concern in the recent peer-reviewed medical literature.
  • 90% of surveyed journals required preprints to be cited in the bibliography, which is at odds with recommendations in an AMWA-EMWA-ISMPP Joint Position Statement.
  • Including a plain language summary in a publication may contribute to increased access.

In this session, ISMPP members presented findings from their own research, addressing several fascinating recent trends in medical publications and scientific communications.

Probing the obsolescence of web references in the recent peer-reviewed medical literature

Almost 30% of web references are obsolescent 3 years after publication. That was the startling finding by Benjamin Lemaire (Orange Group) and co-authors in their analysis of freely available publications published in 2018 in a subset of journals.

Almost 30% of web references are obsolescent within 3 years of publication.

The top 3 online-only or hybrid journals identified in each of the vaccine and infectious disease therapeutic areas were selected for analysis. Each of the web links cited in the 1,699 identified publications was manually checked over a 10-day period in September 2021. Approximately 6 out of 10 articles included at least one web reference in the reference list and were therefore potentially affected by obsolescence. Twenty-eight percent of web links in the identified publications were not accessible; there was little difference between journals or between types of publication (original research or review) in terms of the proportion of obsolescent references.

To determine the pace of web reference obsolescence in this dataset, Lemaire and colleagues plan to repeat the analysis next year. Given the need to continue to reference material on the web, ways to address this problem are needed and these include web archiving initiatives and the use of persistent identifiers.

Consensus among journal guidelines and the AMWA-EMWA-ISMPP Joint Position Statement (JPS) on citing preprints in medical publications

The need for rapid dissemination of research findings during the COVID-19 pandemic has driven a surge in the deposition of preprints on preprint servers such as bioRχiv and medRχiv. There is debate over the appropriateness of citing preprints in academic literature, and the AMWA-EMWA-ISMPP Joint Position Statement (JPS) recommended that preprints are cited in the same way as personal communication (ie, within the text) to distinguish them from published literature. But to what extent is this recommendation being adopted?

90% of surveyed journals required preprints to be cited in the bibliography, demonstrating weak consensus between the AMWA-EMWA-ISMPP JPS and journal guidelines.

Lisa Jolly (Parexel) and co-authors assessed citation requirements for preprints in 30 journals across a range of therapy areas. They found that 90% of the journals surveyed required preprints to be cited in the bibliography, demonstrating weak consensus between the AMWA-EMWA-ISMPP JPS and journal guidelines. Almost one-third of journals surveyed provided no guidance on citing preprints. Jolly concluded that if the recommendation of the AMWA-EMWA-ISMPP JPS is to be adopted and driven by publication professionals, dialogue with journal editors may be required. Updating the audience with recent developments on this topic, Jolly noted that the December 2021 update to the ICMJE recommendations stipulates that preprints are indicated as such in the reference list and that consideration is also given to identifying preprint citations within the text.

Do plain language summaries encourage readers to download your publication?

There has been significant growth in recent years in the number of articles published with a PLS. But do PLSs increase the impact of the associated publication? That was the question explored by Steve Winter (Springer Healthcare) and colleagues in their research. A search of open access articles with an accompanying PLS published in Adis journals between January 2018 and March 2021 identified 50 articles, which were compared with similar articles published without a PLS.

The criteria used to identify similar articles were:

  • open access
  • published in the same journal
  • published at a similar time
  • within the same disease area
  • similar trial design.

A significant difference was arbitrarily (non-statistically) defined as having 25% more (or fewer) accesses, on average, per month.

Articles with a PLS were accessed more often than similar articles without a PLS.

Almost two-thirds of articles (31 of 50) with a PLS were accessed significantly more often than those without a PLS. Significantly higher average numbers of accesses per month for articles with a PLS compared with articles without a PLS were seen for ophthalmology (100% [4/4 articles]), rheumatology (75% [9/12]), oncology (75% [3/4]) and diabetes (60% [6/10]) therapy areas.

These preliminary results suggest that for an open access article, inclusion of a PLS may contribute to increased access to the publication. Winter and colleagues conclude that more research is needed to confirm this link and contextualise other factors that may influence the popularity of articles with and without a PLS.

Keynote – Let’s redesign the publication process for better dissemination


KEY TAKEAWAYS

  • Replacing journal submission forms with machine-readable documents may shorten the submission-to-publication process and reduce open access fees.

The second keynote address of the meeting was given by Mike Morrison, User Experience Developer, Work Psychologist, and the founder of the #betterposter campaign. Drawing from his background as a User Experience Designer, Morrison looked at possible ways to shorten the submission-to-publication process.

Morrison noted that open access fees are generally high, often around $3,500 per article. In the last couple of years, many journals accelerated the publication of COVID-19 related research and made it freely available. The changes made by publishers helped researchers to tackle the pandemic, but the publication process and consequent advances for other diseases remains slow.

“There is a moral imperative to lower the cost of publishing” – Mike Morrison.

Morrison stressed that there is a moral imperative to lower the cost of publishing and suggested 2 substantial changes to the publication process that could dramatically reduce publications fees:

  1. crowd source post-publication peer review
  2. replace manuscript submission forms with machine-readable documents.

Acknowledging that the first option would be a huge shift from current practice, Morrison’s presentation focused on the second option, which could be more easily achieved.

Morrison described the way that manuscripts are currently submitted to journals – a Microsoft Word document is uploaded, and information, such as author details, title, key words, and the abstract are also entered into fields of an online submission form. It is necessary for the information to be extracted in this way, so that the publisher can distribute it appropriately to different parties, such as peer reviewers, type setters, and databases like PubMed. Their software cannot read the Word document, so the information must be manually extracted, which is time consuming and costly. In addition, should the manuscript be rejected, the author will likely need to restyle the Word document and complete another submission form for an alternative journal. This inefficient process wastes time, costs money and causes a gridlock in the publication process, ultimately making information less accessible.

Morrison’s solution is robots – software that can automatically translate the Word document into a machine-readable code that is compatible with the publisher’s administrative systems. This would save the author and publisher time, which in turn would result in reduced open access fees, and greater dissemination of information. Such software could be created as a plug-in for Word and other word processing tools and could be used in a similar way to reference manager software tools like EndNote, or the existing heading style formatting feature in Word – instead of selecting a heading style, authors would tag text as a certain type of information (abstract, key words etc) as shown in Morrison’s mock-up below.

 

Morrison felt that such software would not be difficult to develop; the biggest obstacle would likely be reluctance by publishers to adopt a new system rather than any technical barriers. Looking beyond manuscript submissions, Morrison described how other key details of an article such as outcomes, and the study population, could be tagged in a machine-readable format, which could lead to improved data linking and searchability.

Tomorrow’s technology today: how precision medicine and AI are reshaping medical communication


KEY TAKEAWAYS

  • Artificial intelligence (AI) is a powerful and necessary tool to optimise knowledge and insight extraction from the growing body of medical literature and Big Data, but care needs to be given to the human design that underpins it.

The last plenary session of the meeting explored the use of AI, natural language processing (NLP) and machine learning (ML) to aid medical publication professionals in the extraction of knowledge and insight from the scientific literature, and concluded with a look at the role of precision medicine in shaping tomorrow’s healthcare.

Artificial intelligence

Matt Lewis (MEDiSTRAVA) began with a broad overview of how AI, NLP and ML are already contributing to the medical publishing industry. NLP can be used to identify gaps in the medical literature or for automated lexicon development, while AI was highlighted as a tool for following sentiment analysis of social media, as demonstrated in a member research presentation at last year’s European Meeting of ISMPP using Talkwalker to detect preprint citations in UK news articles. Lewis also pointed to the role of conversational AI and ‘Chatbots’ to facilitate medical science liaison interactions. ML has been most recognisably impactful in improving the accurate screening of medical images and has the potential to engage in literature mining for deeper insights.

Dipanwita Das (Sorcero) focused on the combination of AI with linguistics to generate ‘language intelligence’. NLP is a tool already embedded in our everyday lives through its use in autocomplete search fields and autocorrect tools. Beyond this, publication professionals may benefit from NLP-based AI applications such as Contrastive Text Generation to search for emerging consensus in the literature; Natural Language Inference which can review the literature and examine author conclusions; and Natural Language Understanding for mining publications for personalised treatment insights.

Tomas Rees (Oxford PharmaGenesis) examined some further practical applications of AI. Platforms such as Semantic Scholar are designed to retrieve the most relevant publications for a search term, operating in a similar way to PubMed’s best match feature. Additionally, Semantic Scholar uses AI-based auto-summary software to generate one-sentence publication summaries termed TLDRs (too long, didn’t read), and there are other automated summarising tools, such as Scholarcy and SciencePod, which provide condensed summaries of publications. Citation Coupling could aid reference selection, while AI can be used to automatically apply and score the risk of bias in studies captured in a systematic literature review. Rees presented examples of using AI in research projects, including Named Entity Recognition to highlight text of interest, potentially aiding tasks such as abstract screening during systematic literature review (a concept presented in detail in an accompanying poster at this year’s meeting); Natural Language Query tools to probe for definitions of search terms that can be used to compile a consensus lexicon; and bigram (paired-word) text analysis to generate insight into the concepts most commonly associated with a particular medical term or product.

“AI is only as impartial as the information inputted by its human designers” – Tomas Rees.

Importantly, while AI may be viewed as a tool to overcome human cognitive bias, the presenters noted that AI is only as impartial as the information inputted by human designers into the underlying algorithm. Equally, when using a tool to examine a research question, the AI output is still determined by the researcher’s hypothesis generation and validation. The importance of ensuring medical equity was emphasised, where diversity and inclusivity needs to be represented in AI model data sets. AI will also continue to be limited by issues such as accessibility and paywalls, and the need for data to be in a machine-readable format.

Precision medicine

Alice Choi (McCann Health Medical Communications) introduced some of the hot topics in precision medicine, including next-generation sequencing and genomics, wearables, and image screening. ML and data mining are seen as key tools for exploiting the increasingly complex Big Data generated from these technologies, as has been showcased in projects such as LungMap. The scientific communication of precision medicine will need to consider the non-traditional collaborative partners involved, as well as educating traditional stakeholders, such as clinicians, regulators, and payers on the nature of the clinical evidence generated by these technologies. Choi examined some of the barriers to uptake of precision medicine, including the lack of a centralised system for finding precision medicine trials, and bioethical considerations such as equal access, patient anonymity, and justification of large investment for smaller patient groups.

Mingyu Liang (Center of Systems Molecular Medicine, Medical College of Wisconsin) presented his experience as a researcher in the field of molecular systems medicine and its use in precision medicine. Molecular systems medicine aims to bridge the gap between the uncertain significance of genetic sequences and the difficulty of identifying or quantifying environmental or lifestyle impact on health. Liang emphasised the critical need to educate medical practitioners so they are AI-ready and can act as medical innovators.

Poster awards & closing remarks


Eleanor Raynsford (OPEN Health) presented the final session of the meeting. Raynsford thanked the abstract review committee, which this year evaluated a record-setting 49 abstract submissions and 45 posters. She congratulated this year’s poster prize winners:

  • Most reflective of meeting theme: Characterization of the medical publication landscape in digital health during the 2010–2020 period – Lindsey Weedon, Frank Biegun, Matt Gooding, Emma Reynolds and Laura McGovern.
  • Best original research: Measuring open access to pharmaceutical company-supported articles – an improved and semi-automated method – Elin Bevan, Tim Koder, Valerie Philippon, Slavka Baronikova, Larisa Miller, William Gattrell and Tomas Rees.
  • Most innovative digital poster format or enhancement: Current trends in pharmaceutical industry-affiliated medRxiv and bioRxiv preprints – Susan Wieting, Samuel Bestall, Kim Wager and Valerie Philippon.

In closing, Raynsford thanked all of the speakers for their insightful and thought-provoking contributions to the meeting, and noted that registration is now open for the 18th Annual Meeting of ISMPP, to take place on 9–11 May 2022 in Washington, DC.

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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