As medical research continues to evolve, so do publication platforms.
The traditional peer review publishing model has operated in much the same way since its inception in the 18th century: Authors submit their research, anonymous reviewers critique the work, and the manuscript is ultimately either rejected or deemed worthy of publication. In the latter case, the work often goes through several revisions before being accepted by the journal.
This process ensures the integrity of the published research, but lengthy delays in publication due to the review and revision process have led critics to search for alternative avenues for disseminating research results.
“About 30 years ago, a physicist who was trying to figure out how to get comments on his work started taping [his papers] outside of his office door for people to come by and provide feedback,†recounted Harlan Krumholz, MD, of Yale University and Yale New Haven Hospital. “With the advent of the internet, the idea evolved first to sharing papers using email, and eventually to the creation of arXiv.â€
The preprint server arXiv is operated and maintained by staff at Cornell University in Ithaca, New York, and encompasses articles in the fields of physics, mathematics, computer science, quantitative biology, quantitative finance, statistics, electrical engineering, systems science, and economics.1 In 1991, arXiv launched as a central repository mailbox where scientists could upload their papers and colleagues could access the files from any computer. As of July 2020, it hosts more than 1.7 million submitted papers.
Following the model of arXiv, several other servers have emerged for sharing research results prior to publication in a peer-reviewed journal, including bioRxiv (a preprint server for the biological sciences operated by Cold Spring Harbor Laboratory) and ChemRxiv (a platform operated by five national chemistry professional societies).
“Preprint publishing started in fields where it can take years to get work published,†said Nancy Berliner, MD, of Brigham and Women’s Hospital and Dana-Farber Cancer Institute, and Editor-in-Chief of the American Society of Hematology’s Blood journal. “It was a way of establishing priority for the person who was first to put something out there, so they can take credit for it without waiting for it to be published by a journal months to years later. If such papers are then submitted, peer-reviewed, and published, the authors may have benefited both from suggestions made while on the server and also by having been established as the first investigators to report the work.â€
Preprint publishing was slower to take hold in the area of medical literature, in part because of the perception that erroneous, non–peer-reviewed information might influence patient care. However, in June 2019, Cold Spring Harbor Laboratory, The BMJ, and Yale University partnered to launch medRxiv, a preprint server for medical, clinical, and health sciences research.2 MedRxiv is the latest in a group of free online archives designed to display and distribute unpublished scientific manuscripts.