Preprints: An underutilized mechanism to accelerate outbreak science

Johansson, Michael A.; Reich, Nicholas G.; Meyers, Lauren Ancel; Lipsitch, Marc

Preprints also bring new challenges to outbreak responses [3] . By definition, preprints are not peer reviewed prior to posting. While preprint posting is common practice in fields such as physics and statistics, it is a new concept to many scientists in public health and even more so to public health officials, the press, and the public, all of whom may be seeking the latest information during epidemics. Until preprints are broadly recognized as pre-peer review manuscripts, they may be misinterpreted as peer-reviewed research. On the other hand, peer review faces its own challenges of subjectivity, bias, transparency, and speed [1, 7, 8] . Peer review is an integral component of scientific communication, but it does not intrinsically guarantee the quality of science. Moreover, peer review is particularly challenging during major outbreaks when the most qualified reviewers are also immersed in urgent research. Preprint posting may help mediate this process, providing an opportunity for broad and immediate community input that is not subject to the limits of traditional peer review [4] [5] [6] . Assuring ethical review, participant confidentiality, recognition of preprints as pre-peer review manuscripts, and finding mechanisms to enable transparent, open feedback will be essential to limiting possible negative impacts and maximizing the benefits of preprints for outbreak responses. Immediate, open access to research prior to peer review raises the possibility of misinterpretation and the misuse of science in critical decision making when lives are at stake, but it also permits early and open criticism, discussion, and consideration of findings that may save lives.