The 20th Annual Meeting of the International Society for Medical Publication Professionals (ISMPP) took place once again in Washington, DC, from 29 April – 1 May with the theme ‘Storytelling: Its Art and Power’. Incorporating stories into medical publications can clarify complex ideas, build empathy, and establish trust, ultimately dispelling stigmas and misinformation. Over 700 attendees discovered the power of storytelling to unlock greater understanding in medical communications.

A summary of the third 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 2 of the meeting.

Summaries of Day 3

Publishing reimagined and the evolution of disseminating medical research

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KEY TAKEAWAY

• With the transformative changes in journal publishing (including the move to digital formats and open access publishing), there is a need to reimagine publications while taking care to maintain quality and accurately assess their impact.

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Jonathan Patience (Taylor & Francis Group), Mark Riotto (TheResearchPost), Stephen Towers (Healthcare Consultancy Group), and Rebecca Rozich (ICON) opened Day 3 by engaging in a topical interactive session about current trends in the publication of medical research and their impact on the future of publishing.

Changes in journal publishing

In the first presentation, Patience reviewed the dramatic changes in medical journal publishing seen over the past 25 years, highlighting the:

• shift from print to electronic publishing
• declaration of open access mandates from funding organisations
• proliferation of open access journals.

While these changes have undoubtably improved accessibility and knowledge dissemination, some challenges have arisen, such as information overload, potential erosion in the quality of submissions, strain on the peer review system, threats from preprint platforms, and a rise in predatory journals. Proposals to overcome these challenges include:

• use of new formats to disseminate information to a time-poor audience
• approaches to maintain publication integrity and quality peer review
• changes to publishing revenue models to improve accessibility and speed of publication
• application of precise metrics (eg, using artificial intelligence [AI]) to focus on reaching the ‘right’ audience.

Publishing reimagined

In a thought-provoking presentation, Riotto looked at how the drive for accessibility is challenging the traditional model of publishing. He first questioned whether long-form primary manuscripts may be outdated and suggested that short forms (extenders, visual formats, etc.) may soon be reimagined as the primary publication. However, long-form papers will always be needed for scientific validation.

To expedite publication and provide a solution to funder mandates for better accessibility, Riotto went on to propose transformative agreements for new publication models, including:

• contracts with publishers that seek to shift payments away from a subscription model and towards open access publishing
• payment bundles that include both reading (subscription) and publishing (open access) under a single contract (‘read and publish’).

Maintaining quality and integrity

Subsequently, Patience deliberated how publishers can act to maintain quality and integrity in the face of increasing volumes of submissions. He proposed several responses to drivers for change:

Driver	Future response
Paper mills and unethical publication practices	More validation checks, increased editorial resource, author education, use of detection technology
AI	Education on responsible use, better AI detection
Predatory publishers	More specific journal metrics, educational campaigns, collaborative relationships with publishers
Rise in special issues	Use of guest advisors instead of guest editors, improved editorial processes, involvement of the editor-in-chief
Need for faster publication	Evolution of preprints, balance versus quality

Patience indicated that, while it remains the ‘gold standard’, peer review may be improved through measures such as reviewer training, reviewer pool expansion, reward schemes, increased editorial resource, pre-screening of manuscripts, new models of review (eg, open peer review), and ethics education.

Peer review may be improved through measures such as reviewer training, reviewer pool expansion, reward schemes, increased editorial resource, pre-screening of manuscripts, new models of review, and ethics education.

Improving metrics

In the final presentation of this session, Towers highlighted that article-level metrics have revolutionised our ability to measure the attention of, and real-time impact of publications on, a broad audience, but several challenges remain, including how to:

• determine the ‘real’ impact of publications — solutions might include use of more granular metrics and introduction of AI- or natural language processing-based text analysis to assess if a citation supports the original article
• deal with a lack of transparency, standardisation, and consistency in publication metrics scoring — solutions might include application of the EMPIRE Index and multi-stakeholder collaboration to agree on universal standards and definitions
• prevent self-promotion via manipulation of publication metrics — solutions might include use of AI to detect manipulation and reducing institutional drivers of the ‘pressure to publish’.

What do we see as the innovations over the next 5 or 10 years?

Considering this question in an interactive discussion, the panellists stated that they expect the following innovations in publishing in the near future:

• greater interactivity – expanded use of visual and digital publications, and extenders
• increased collaboration among stakeholders over publishing models
• growth of open data initiatives
• consolidation of business models, including expansion of journal ‘families’
• better use of storytelling
• journals taking a more curatorial role over publications
• more initiatives to counter ‘bad actors’ to improve trust in publications.

Metrics on the horizon: how do we measure success of publications in a rapidly evolving technological world?

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KEY TAKEAWAY

• Employing AI technologies and a data-driven approach to publication insight generation can help to broaden the reach and impact of medical publications.

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The theme in this parallel session was the evolving landscape of metrics for measuring success in medical publications. Tomas Rees (Oxford PharmaGenesis),  Jim Streeter (Envision Pharma Group), and Kimberly Della Penna (Johnson & Johnson) explored different methods for evaluating success and discussed the potential for new technologies to impact on publication planning strategies.

Rees began by outlining the array of different metrics that have found use in medical publications. Reflecting on over a decade’s experience with publication metrics, he explained how different metrics can measure different aspects of engagement with a publication, but that some metrics were more valuable than others. For example, citations from credible sources are typically given more credence than social media shares. Furthermore, while different metrics can offer different types of insight, not all metrics are directly actionable. Rather than being used as performance targets, the purpose of publication metrics is to assess alignment between a publication and its overall goal.

In the next part of the session, Streeter elaborated on how the massive amount of data being collected on publications can be leveraged to inform decision making and improve the impact of publications. The emergence of AI as a tool will offer opportunities to analyse these ‘big data’ to generate meaningful publication insights. However, Streeter saw existing AI models as a starting point on which further bespoke functionality would need to be built to interpret and utilise data for specific use cases.

“The layers that go on top of these AI models are going to become very important so that we can get the right data at the right time.” – Jim Streeter

Real-time data was another concept that Streeter saw as crucial to understanding how people engage with publications. For example, understanding how long someone spends viewing a specific graph or section of text could be used to gauge their comprehension of the publication. Analysis in real-time could also allow content to be adapted more quickly and targeted or re-aligned to suit a specific type of user or a specific demographic. Acknowledging that there were privacy considerations involved with collecting and analysing information at a patient or healthcare professional level, Streeter described the importance of understanding and defining what constitutes an ethical approach for this type of insight generation.

Emphasising the need to incorporate data science and AI into everyday workflows, Streeter summarised that we are ready to start using these data-driven approaches to make better decisions about how we create, distribute, and measure the impact of our publications.

“We hear about AI, the amount of data that’s coming and really the value it’s going to bring so that we can make better decisions with our publications.” – Jim Streeter

End-to-end patient involvement

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KEY TAKEAWAY

• Patient involvement in the development of medical treatments is an exciting new frontier that offers excellent value for all stakeholders but is dependent on strict guidance and a clear understanding of the roles and responsibilities of patients.

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In this parallel session, Jasmine Malone (Open Health) introduced a varied panel of speakers, Robert Greene (patient advocate, HungerNdThirst Foundation), Behtash Bahador (CISCRP), and Hamish McDougall (SAGE Publications), to discuss key elements of end-to-end patient involvement in clinical development.

The importance of end-to-end involvement from the patient’s perspective

Greene provided his personal perspective on the importance of patient involvement throughout the drug development process and treatment landscapes. He began by reminding the audience that patients are individuals, which means that one patient is not necessarily representative of the full population. Despite this, Greene explained that patients provide unique insights and experiences that can enhance the relevance and reach of research and publications. Ensuring information is accessible, understandable, and reflective of real-world experience is the best way to build transparency and trust; provision of fair and ethical compensation when engaging patients was also noted as a critical factor.

Several ways to increase patient involvement were highlighted, such as training programmes and communications strategies created with patient involvement as a core starting element, advisory panels at the patient or patient advocacy group level, and encouraging collaborations between patients and groups such as pharma companies and medical publishers for the co-creation of materials.

Ensuring information is accessible, understandable, and reflective of real-world experience is the best way to build transparency and trust.

Demonstrating the value of end-to-end patient involvement

Bahador opened his presentation by defining patient involvement as “collaboration with patients in their communities to understand and address their needs across all stages of medicinal product development”. He showed the EUPATI model of patient involvement, which describes opportunities for working with patients beginning at the early stages of research design all the way through to the communication of trial results post-approval. To assist with this, there are established standards, frameworks, and guidance for patient engagement in research and development processes. The development of clinical trial lay summaries was held up as an example of where patient input is crucial in determining what information from clinical study reports patients are interested in and how to effectively communicate trial results to them. Bahador went on to explain how patient engagement has led to improved study cycle times, better retention in studies, increased patient satisfaction and, ultimately, better health outcomes for patients. Regulatory bodies like the US Food and Drug Administration (FDA) and the UK’s National Health Service (NHS) are also now emphasising the importance of patient involvement in setting research priorities, identifying key endpoints, and designing trials. Community engagement initiatives such as developing culturally relevant resources, conducting surveys to gather feedback, and mobile education initiatives aimed at increasing awareness and understanding of clinical research were also highlighted as important tools for increasing patient involvement.

Patient engagement has led to improved study cycle times, better retention in studies, increased patient satisfaction and, ultimately, better health outcomes for patients.

Opportunities and best practices for patient involvement in publications

The final presentation in the session was given by McDougall, who provided a publisher’s perspective on best practices in patient involvement. He offered several insights, beginning with the observation that because patient involvement in publications offers many advantages for publishers, it is crucial they do not lose sight of patients’ diverse experiences and challenges during the process. Currently, there are 2 primary roles for patients in the publications landscape: peer reviewers and authors. Patients can contribute to peer review by ensuring plain language and accessibility, especially for language-oriented publications. Patients can also be involved as authors, but it is essential they fit authorship criteria and are provided with adequate guidance and support. Patient perspective articles or journals provide valuable qualitative information, particularly in areas with limited quantitative data; however, McDougall reiterated that guidance is needed to ensure patients understand their responsibilities, can avoid ethical issues, and feel empowered to be involved throughout the process. Other best practice approaches for involving patients include recognising diverse levels of experience and providing fair compensation.

Because patient involvement in publications offers many advantages for publishers, it is crucial they do not lose sight of patients’ diverse experiences and challenges during the process.

Guided poster tour

Plain Language Summaries was the theme for the guided poster tour on Day 3, with 4 featured posters:

• AI’s might vs human prowess in crafting plain language summaries
• Cracking the code: how discoverable are plain language summaries?
• Readability of plain language summaries (PLS): are they getting better?
• Standalone plain language summaries of publications: a 5-year trend analysis

Keynote: Generative AI: practical strategies to increase productivity

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KEY TAKEAWAY

• Generative AI (GenAI) is changing the way we work and can dramatically increase productivity, but its effective adoption requires behavioural change.

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Conor Grennan (NYU Stern School of Business), who delivered an interactive keynote session on GenAI, started by posing a question: given that the GenAI tool ChatGPT is accessible and has no learning curve, why is it difficult to master? The answer, he suggests, is that it requires behavioural change.

What is ChatGPT replacing?

ChatGPT reached 1 million users 3 days following its launch, much faster than streaming services such as Netflix and Spotify. However, Grennan explained that while it is obvious to our brains that Netflix replaces videos and Spotify replaces CDs, it is unclear what ChatGPT is replacing. He highlighted the need to “break down the paradigm that ChatGPT is the same as a search engine”, assumed because its interface resembles that of Google search.

It is obvious to our brains that Netflix replaces videos and Spotify replaces CDs; it is unclear what ChatGPT is replacing.

Focus on needs, not use cases

Grennan pointed out that the use of AI tools is already widespread (take spellcheckers, for example), but they are running in the background. He likened the potential of GenAI to that of electricity: although electricity is an integral part of everyday modern life, it is easiest to explain its benefits using specific examples, such as lightbulbs. So instead of considering use cases for GenAI, Grennan stressed the importance of considering what needs exist.

Perfect prompting

“Forget prompt engineering – just talk to ChatGPT like a human!” This was Grennan’s top tip at the start of his live demonstration of how ChatGPT can help with tasks such as:

• explaining something in different ways for different audiences, using the example prompt: “Can you explain immunotherapy to three different people, giving me a short script for each – the three people are: an MIT PhD in science, an elderly farmer and a 10-year-old obsessed with monster trucks”
• drafting emails
• coming up with creative ways to introduce new employees to company culture
• strategising (eg, identifying the steps involved in starting a new company).

“Forget prompt engineering – just talk to ChatGPT like a human!” – Conor Grennan

Solving the biggest problems

Grennan explained that while ChatGPT’s first answer to a question may be short and simple, further prompting can provide exactly the right information needed. Therefore, users need to go deeper, since continuing to ask about individual details will lead to better answers. To mitigate against AI ‘hallucinations’, Grennan advised double checking ChatGPT outputs, particularly when precision was important.

Double check everything if you need precision – ChatGPT is better as a reasoning tool than a knowledge tool.

The future intersection of medical affairs and publications – are you ready for it?

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KEY TAKEAWAY

• A cross-functional working relationship between publications and medical affairs will be essential for navigating the rapidly changing publications landscape.

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Gary Lyons (Avalere Health) presented an interesting and engaging session, which began with an emphasis on the increasingly important role that medical affairs plays in the delivery of content in what is now a rapidly evolving landscape. It was reasoned that the increased complexity of the current landscape is being driven by digital technology, the emergence of omnichannel strategy, and utilisation of modular content. During his presentation, Lyons covered the 4 key components on the path to engagement: audiences, content, channels, and capabilities.

Audiences

Lyons emphasised the importance of considering multiple audiences when developing a publication, including experts, specialists, communities, patients, and patient advocates. He explained that we should not expect the information to trickle down this cascade of potential audiences, but, instead, content should be developed to reach out to a broader audience.

How an audience prefers to receive content was also highlighted as a key consideration, as there has been an increase in demand for information to be delivered digitally. Despite this increase in demand, a digital divide exists between the preference for digital delivery and the actual availability of information and data via digital channels.

We should not expect the information to trickle down the cascade of potential audiences, but, instead, content should be developed to reach out to a broader audience.

Content

In the next part of the session, content was discussed, with an emphasis on the growing need for conciseness. To achieve this, Lyons recommended that digital features and enhanced publication content should be considered when possible.

Channels

Connecting the dots between different channels to create a journey of engagement should be a key aim in the development of all publications. It is therefore important to consider all content that is being created alongside a publication, such as training slide decks and enhanced publication content, and how these channels can be connected.

Connecting the dots between different channels to create a journey of engagement should be a key aim in the development of all publications.

Capabilities

Two key points were outlined in this section of the presentation: the growing need for modular content and the future role of AI in supporting publications. Modular content was described as a way of fragmenting content into smaller pieces that can be pre-approved and then used for future engagement. Thinking of ways to use content in a more fragmented way can help increase the speed and flexibility of future content development and delivery, especially when requested at short notice.

Lyons suggested that AI may have a supporting role to play in publication development, highlighting 3 specific points at which AI could be utilised:

• kick off calls, to produce a summary of meeting discussions
• post-draft development, to help with data checks, CONSORT checklists, and proofreading
• post-submission, to assist with creation of enhanced publication content.

To navigate the ever-changing and increasingly complex publications landscape, there will be a need to embrace omnichannel planning, utilise modular content, and find ways to use AI to help drive content creation and improve efficiency.

Towards patient-friendly electronic product information (ePI)

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KEY TAKEAWAY

• Current product information (PI) is not fit for purpose – moving to ePI provides an opportunity to link to patient-friendly materials providing medical information in plain language.

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Panellists Chris Winchester (Oxford PharmaGenesis), Trishna Bharadia (patient advocate, The Spark Global), Behtash Bahador (CISCRP), Catherine Skobe (Pfizer), and Christopher Rains (CPR BioPharma Consulting) shared their thoughts on the journey towards patient-friendly ePI.

The evolution of product information

Winchester kicked off the session by outlining the journey towards digital transformation of PI. Although paper PI is still very much alive, it is widely unread, and recent years have seen a transition away from the paper format. Winchester elaborated, explaining how we are currently in the PDF PI era and edging towards the digital era, where PI could be tailored towards indication, patient information preferences, and the background of the reader. The clear shift in the FDA’s perspective on PI since the first half of the 20^th century signals that what was once considered a back-covering exercise is now regarded as an integral part of motivating better health outcomes.

Are current product information leaflets fit for purpose?

Discussing the evolving perspective on ePI and the role of publication professionals, Bharadia noted that PI leaflets have made some progress towards becoming patient friendly in the UK, but in other countries, such as the US, they are far from being suitable. She stressed the importance of the patient as the intended audience and that the current ‘one size fits all’ approach is suboptimal, given the variation in health literacy among patients.

What is driving the digitisation of product information?

Rains explained that, as it stands in the EU, ePI must be identical to paper PI, and paper PI must also be provided. Consequently, each year, 500,000 tonnes of carbon dioxide and 11 billion gallons of water are needed to produce the 100 billion paper PI leaflets printed.

Bahador stated that the high appetite for plain language materials and increased patient engagement is certainly a driver in the digitisation of PI. Moreover, results from a recent Global Perceptions and Insights Survey revealed that sharing more information in understandable terms drives trust and matters to patients.

Each year, 500,000 tonnes of carbon dioxide and 11 billion gallons of water are needed to produce the 100 billion paper PI leaflets printed.

How can ePI best meet the needs of patients and other audiences?

Suggestions for how ePI can best meet patients’ needs from Skobe and Bharadia included:

• ePIs should contain links to publications and, most importantly, plain language summaries. This can facilitate understanding of scientific jargon, reaping benefits such as increased medication compliance.
• ePI development should involve the intended audience, including patients and patient organisations, such as the Patient Information Forum.

How can publications and medical communications professionals get involved in optimising ePI?

Rains urged publications professionals to work closely with cross-functional teams, including regulatory/labelling colleagues, in the journey towards optimised ePI. Publication teams are already creating content in different formats for different audiences (eg, plain language summaries of publication). Linking these materials to product labels offers the perfect opportunity to see them used in settings beyond journal publications.

Wrapping up the discussion, the panel issued a call to action, suggesting publications professionals leverage the momentum behind the current focus on patient-centric materials to ensure regulatory teams are aware of the patient-centric materials they produce.

Publications professionals can leverage the momentum behind the current focus on patient-centric materials to ensure regulatory teams are aware of the patient-centric materials they produce.

Hot topics and meeting highlights

Bringing the 20^th Anniversary Meeting of ISMPP to a close, Jenny Ghith (Pfizer), Tomas Rees (Oxford PharmaGenesis), Jason Gardner (Real Chemistry), Richard Davis (ApotheCom), and Rob Matheis (President and CEO, ISMPP) reflected on the hottest topics and highlights from the meeting.

Storytelling

The panel promoted the important role of medical communications professionals as storytellers, emphasising the need for different storytelling approaches for different outputs. Ghith saw the role of medical writers as ‘inventors’ with the task of bridging the gap between different stakeholders and leveraging storytelling across teams.

“We are all storytellers, but we just maybe don’t realise it. Everything we do is about telling stories.” – Tomas Rees

Artificial intelligence

Ghith described how we have passed the initial ‘hype’ phase for AI applications in medical communications and now find ourselves in the ‘trough of disillusionment’, where we will meet and take on the challenges and limitations of AI after the initial period of excitement. For Rees and Gardner, a key take-home message was that human input was essential for successful implementation of AI tools. While AI can analyse data and identify patterns, it cannot provide insight on the key question of why the data are what they are. Matheis felt that connecting and feeding AI systems with appropriate context would ensure relevant and usable outputs, while Davis reiterated the importance of understanding the distinction between GenAI and other (non-generative) types of AI.

AI is a tool that can enhance human intelligence, not replace it.

Patients

A key theme emerging from this year’s sessions on patient involvement in medical communications was that patients’ voices must be integrated into discussion about AI, ensuring their concerns and needs are addressed throughout the process. Gardner stressed the importance of non-traditional outcomes to make sure the patient voice is incorporated into medical communications. Reflecting on the session on ePI, Rees thought that there was an opportunity to address the accessibility of product information, using ePI tools to generate more patient-friendly materials. Considering how often patients are required to make active healthcare decisions, Matheis felt there was a need to be mindful of what information was available to patients and how it was presented to them – and this all comes back to a need for effective storytelling.

“We have to be mindful that as we put medical information out there, patients are making decisions for themselves – they have different needs and different ways of processing information – it all comes full circle to storytelling.” – Rob Matheis

Publishing metrics and insights

Rees finished with the hot topic of publishing metrics and insights, noting the increasing interest in metrics due to the need to show the value of what we do as medical publications professionals. He thought that current metrics did not always capture a publication’s true impact, so he was encouraged by the level and direction of discussions surrounding metrics and excited by the progress to be made by the ISMPP Social Media & Web-based Metrics Committee on metrics in the near future.

Every publication has its own goal, so there’s a need for increased sophistication about how we measure achievement of that goal.

Why not also read the summaries of Day 1 and Day 2 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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