22 March 2022

There is a growing plea for slow science worldwide. We want no more toxic publish-or-perish culture. The mental health and fulfillment of researchers, especially young ones, are in the spotlight. Slowly, the funders, the institutes, colleagues are starting to care more about these things than the number of publications in a specific time frame. In the middle of this, the COVID-19 pandemic fell like a bomb that no one saw coming. The whole world was desperate for as-fast-as-possible science while people were dying in masses. And science did provide us with real-time tracking of the virus evolution and very effective vaccines that were developed and deployed at breakneck speed. Everyone was talking about science. Under that kind of pressure and spotlight, how are we supposed to ensure the integrity of the critical work we’re doing? How did scientists make uniquely difficult decisions as funders, researchers, and on traditional and social media?

These questions were discussed in the latest Research Integrity Round on March 9. Presenter extraordinaire Jos Kole and 4 expert panelists were joined by an audience of 225 people, half of whom were PhD candidates like myself. The rest covered the entire range from bachelor’s students to senior professors.

As always, audience polls were a big part of the event, making it fun and interactive. When asked, “What is the best science (slow or fast)?” the audience tended to incline towards slow science (26%) while only 8% preferred fast science. But what the majority said was: it depends. The favorite answer of any scientist. In the pandemic context, 38 and 37% of the audience believed that the research has been “just right” or “both too fast and too slow,” respectively.

Adjusting funding methods in crisis: necessary or unacceptable?

The first panelist, representing the funding perspective, was Dr. Daniƫl Warmerdam: molecular biologist by training and current senior program manager of the COVID-19 program at The Netherlands Organisation for Health Research and Development (ZonMw).

Early in the pandemic, ZonMw created a funding scheme for COVID-19 and put out urgent calls. For these urgent calls, such as vaccine studies, ZonMw chose to take a top-down approach. Proposals could only be submitted by invitation. They wanted to pre-select the researchers with the required expertise, technical means, and critical collaborations.

This kind of top-down funding scheme might seem elitist and not very transparent. However, the crisis required urgency, established expertise, and adaptability. ZonMw, like many funders, also shortened the review process from 6-8 months to 3 months or even shorter in some cases.

The majority of the audience, through polls, agreed that deadlines can be shortened in times of crisis. What 46% didn’t agree with, and 34% was unsure about, was if funding in these times should be allocated based on competition. The scientific public appears to understand and appreciate the urgency and the need to adapt methods accordingly. This, however, does not mean that they would allow suboptimal research methods. The attendees did not support the acceptance of substandard research practices during crises.

This pandemic period had both positive and negative aspects for Daniel, his colleagues and researchers. On the positive side were being able to help patients in urgent need, getting to collaborate very closely, generous funding in the area, and making a significant impact on the daily life of society. On the other hand, negatives included the unbalanced focus on clinical research and exhausting work conditions for everyone involved (researchers, review committees, organizations).

Unexpected ethical dilemmas

Debby Gerritsen was the second presenter of the day. She is a professor in the Department of Primary and Community Care at Radboudumc. During the pandemic, she and her colleague Raymond Koopmans were asked by the ministry VWS to start a study in nursing homes during the first pandemic wave. Nursing homes closed their doors nationwide on March 20, 2020. However, shortly after, discussions started about their reopening. For that, they needed to know the possible consequences.

Can we open the nursing homes safely? This was the question Debby had to answer by planning a 3-week-long study involving 26 nursing homes in just 1 week. They were expected to report results in early June. However, the ministry decided that nursing homes could apply to reopen in late March. Restrictions were softened in early June, and by July 1, nursing homes were open. Yes, the government couldn’t wait for the scientific results that they asked for. Social pressure and politics are not always patient enough to wait for the scientific method to work its magic.

Debby and her team look back at this experience as largely positive despite disappointments and sleepless nights. While setting up and executing this study so quickly, they really got to feel the cohesive team spirit. It wasn’t about competing and publishing; it was about helping. Which, for some of us, is why we do science.

This doesn’t mean they weren’t confronted with ethical dilemmas and difficult decisions. The research team worried about potentially infecting people in the nursing homes. And it felt wrong that they could be there, while the close family was not allowed. But they felt that their work was important and urgent, so they did what they do best: ask questions and gather evidence with solid methods.

To pre-print or not to pre-print

After covering funding and methodology, the following agenda point was publishing. Marcel Olde Rikkert, the third presenter, is a professor of Geriatrics and the coordinator of Radboudumc Alzheimer Centre alongside his role as editor-in-chief of The Dutch Journal of Medicine (NTvG).

Marcel told us how NTvG fulfilled an information gap in the early phases of the pandemic, especially for the Dutch professionals and public. Everyone was hungry for even the tiniest information. So, they introduced a COVID-19 section in the journal and reached a vast readership. With around 300 articles published and some getting more than 10.000 reads, it is clear to see the hunger.

Marcel is, in general, satisfied with the quality of publications. Of course, they made difficult decisions and published some studies that they normally wouldn’t publish while doing a much-quicker-than-normal review. Thankfully, there were no retractions necessary.

In the panel discussion that followed, the hot topic was pre-print servers such as bioRxiv and medRxiv. Both Marcel and Saskia Middeldorp emphasized the importance of pre-print servers. Especially in times of crisis, publishing on a pre-print server allows for an open international review process. It is not to replace peer-review; 85% of the audience disagreed that peer-review was an outdated method for crises. A similar number of people objected to applying less strict quality control for publishing in urgent situations.

Still, pre-prints are the quickest way to share knowledge that is up for critical scrutiny. Most pre-print papers later get published in peer-reviewed journals, maybe with some corrections. Particularly with randomized controlled trials that take a long time to fully report, pre-prints are incredibly valuable in sharing interim results quickly and helping the field. Again, science in crisis ends up being not about citations, personal careers, and praise, but rather about helping people.

A scientist’s challenge with the wild world of media

The last presentation of the session was from Prof. Saskia Middeldorp. She’s the head of the Internal Medicine department at Radboudumc and a thrombosis expert whose advice is sought by the media. After starting with conflict of interest disclosures, in true RIR spirit, she took us to the Twitter world. Saskia uses Twitter for research dissemination and discussion, patient education, and conversations on feminism in research and society. Twitter can be a great source of scientific information. As she says, and I agree as an avid Twitter user, it is where we get the quickest information before they end up in our inboxes.

When the thrombosis reports related to the AstraZeneca vaccine started emerging, and the vaccine’s use was paused in the Netherlands, Saskia reposted and commented, rather harshly, on a tweet about this vaccine side effect. The tweet exploded in minutes. She was getting phone calls constantly and had to drop everything else that day to deal with this unexpected media crisis. The communication office of the Radboudumc was very supportive and helped her get her narrative straight, says Saskia.

She attended talk shows, news programs and saw first-hand how tricky it is to deal with media professionals. As Saskia experienced, media often tries to put words into the mouths of not-media-educated scientists, and we shouldn’t let that happen.

This insane period had many benefits on the impact she was having, the opportunity for patient education on the sensitive topic of vaccine hesitancy, and widespread attention for the field of thrombosis. Her media presence also helped her get introduced to Radboudumc very quickly. On the other hand, media presence is a serious time investment. Let’s not forget Saskia is still a department head, physician, researcher, and supervisor. Another drawback is constantly getting asked off-topic questions and dealing with Twitter trolls.

Panelists Marcel Olde Rikkert and Saskia emphasized the importance of media training for researchers. Saskia argues that even if someone is never going to be on TV, media training will help them in various ways as a scientist who frequently needs to give presentations. What is her final media advice? Determine your voice, use strong opinions wisely, stay open to changing perspectives, make use of communication teams, and prepare for a wild ride.

One word to wrap up: reflection

In the end, panelists were asked to summarize what they’ve learned that day in a tweet-length statement. The common thread in all the answers was the importance of ‘reflection.’ Looking back at ourselves and others critically, reflecting on what we learned, and putting these into good use preparing for the next possible crisis.

Fast science is not necessarily a threat to research integrity, and slow science is not always better. The trick is to acknowledge the urgency, adapt methods in a way that doesn’t compromise the quality of the work, and be willing to learn from mistakes and challenges. Only then we can help and make the best of a nightmare situation like the pandemic we’ve been through.


Blog by Ozlem Bulut

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