Citation: LaFlamme M, Bosurgi R (2022) Facilitating preprint sharing in the health sciences. PLoS Med 19(6): e1004051. https://doi.org/10.1371/journal.pmed.1004051

Published: June 21, 2022

Copyright: © 2022 LaFlamme, Bosurgi. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Funding: The authors are each paid a salary by the Public Library of Science, and wrote this editorial during their salaried time.

Competing interests: The authors have declared that no competing interests exist.

Earlier this year, a study of the effects of heterologous boost immunization against COVID-19 was published in PLOS Medicine [1]. The study reports that, for individuals previously receiving one dose of the adenovirus-vectored Convidecia vaccine, a booster vaccination with a different protein-subunit-based vaccine is well tolerated and stimulates an enhanced immune response. These findings contribute to a broader base of evidence about how different COVID-19 vaccines can be optimally and safely deployed [2]. Yet this study is also notable because it was the first PLOS Medicine article whose authors opted in, at the point of submission, to sharing a preprint of their manuscript through an expanded partnership with the preprint server medRxiv.

But are preprints a good fit for the health sciences? With the launch of arXiv in 1991, it was physics researchers who created a public online repository for unpublished manuscripts rather than circulating them privately via email or, before that, postal mail. In the years that followed, parallel efforts popped up in other fields, including a repository for clinical research created by BMJ in 1999 and later shuttered due to low usage [3]. As preprint sharing in the life sciences has increased over the past decade, an extensive debate has unfolded about applying this practice to medical research, given the risks of propagating erroneous information that stands to have an impact on human health [4]. Still, as the benefits of preprint sharing (and the reality that peer review is no panacea for error) are weighed, journal policies on preprints have become more progressive; by 2020, 85 of the 100 top-ranked clinical journals joined PLOS Medicine in agreeing to consider submissions that had previously been posted as a preprint [5]. There is also clear evidence that the COVID-19 pandemic led to an uptick in preprint sharing by health science researchers, with as many as 5,000 COVID-19 preprints posted in a single month at its peak [6]. As these numbers stabilize and as attention turns to next steps, the time has come for PLOS Medicine to take a more proactive role in facilitating this open science practice.

More recently, the journal has expanded its partnership with medRxiv to make preprint sharing even easier for PLOS Medicine authors. As of January 6, 2022, authors completing a full submission to the journal have been given the option to have PLOS forward their manuscript to medRxiv for posting as a preprint [7]. This offering builds on the success of a similar arrangement with bioRxiv involving six other PLOS titles, which has resulted in more than 9,000 authors opting in to have their life science manuscripts forwarded to bioRxiv at the point of submission. Services like this, which center author choice and focus on lowering barriers to participation, have proven to be effective methods for accelerating the uptake of open science.

In the context of the health sciences, PLOS has particularly emphasized the importance of responsible preprint sharing. Indeed, four years ago the editors of PLOS Medicine articulated a set of principles for the early sharing of research with implications for human health [8]. These included transparency in reporting, clarity about the role of a preprint versus a peer-reviewed journal article, and responsibility for safety. Today, we are confident that PLOS Medicine’s expanded partnership with medRxiv satisfies each of these principles. The journal’s own standards for reporting align with medRxiv’s requirements for funding sources, competing interests, and ethics approvals to be declared, as well as clinical trials to be registered. Each preprint posted on medRxiv bears a prominent notice alerting readers to the manuscript’s peer review status, and a link to the published article is automatically added once it becomes available. Each preprint is also screened by researchers with related expertise to ensure that posting will not pose a risk to patients or public health.