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Will research preprints improve healthcare for patients?

BMJ 2018; 362 doi: (Published 24 September 2018) Cite this as: BMJ 2018;362:k3628


Sharing science at today’s pace: an experience with preprints

  1. Harlan M Krumholz, Harold H Hines Jr professor of medicine and public health12,
  2. Joseph S Ross, associate professor of medicine and public health1 2,
  3. Catherine M Otto, J Ward Kennedy-Hamilton endowed chair in cardiology3
  1. 1Yale Schools of Medicine and Public Health, New Haven, CT, USA
  2. 2Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT, USA
  3. 3Division of Cardiology, University of Washington, Seattle, Washington, USA
  1. Correspondence to: H M Krumholz harlan.krumholz{at}, C M Otto cmotto{at}

Early publication of research findings without peer review could speed up knowledge dissemination and changes to clinical practice, argue Harlan M Krumholz and Joseph S Ross. But Catherine M Otto worries that publication without that quality control has the potential to confuse and cause harm

Yes—Harlan M Krumholz, Joseph S Ross

Preprinting in the clinical sciences, with appropriate safeguards, should be welcomed: it accelerates knowledge dissemination and reduces non-reporting and waste in research, while promoting transparency. Preprints could also improve the safety of clinical action based on preliminary work, by making the full data and description public and avoiding the hearsay of presentations at scientific meetings, internet postings, and media interviews. Many other disciplines already use preprints; in physics, for example, preprint posting has existed alongside formal journal publication for more than 20 years.

Peer review slows scientific communication

Progress in medicine relies on the prompt communication of research findings. the results of many clinical trials are never reported or only reported years after trial completion.123 Delays in publication can cause harm as scientists work without knowing what others have done or found.45 Moreover, for public health emergencies, when rapid communication is essential, preprint servers can immediately disseminate study findings globally, fostering scientific exchange.6

Peer review, while performing an essential function, can slow scientific communication. Peer review journals will continue to play a role in constructively scrutinising and editing clinical research, ensuring that findings are disseminated in a manner to best inform clinical care. However, peer review impedes the rapid dissemination of scientific knowledge, holding up the information until it becomes a published product—which in some cases can take years. By contrast, research shared on a preprint server enables and accelerates the sharing of pre-peer reviewed findings in a way that timestamps the contribution, makes it widely available, and provides the ability to comment …

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