Who’s Guarding the Gate? The Reach of Prereviewed Emerging Science and Implications for Family Medicine Education

Abstract

Background and Objectives: Online publication of prereviewed manuscripts disseminates research simultaneously to scientists, clinicians, and patients, enabling the media and public to act as scientific reviewers for studies that are not yet endorsed by the scientific and clinical community. This study describes the reach of prereview literature and frames it within the pursuit to teach evidence-based medicine. Methods: In this deductive content analysis, the primary unit of analysis was the individual preprint manuscript submitted to the medRxiv preprint server during the emergence of the COVID-19 pandemic. The coding scheme included study design, negative or positive findings, dissemination status (whether it was withdrawn from the server or eventually published), and three levels of reach: user engagement, news media coverage, and social media engagement. Results: Prereviewed manuscripts describe a variety of study methods. Dissemination status was significantly related to abstract views, manuscript views, news coverage, and social media exposure. Studies with negative findings had higher counts of abstract views, manuscript views, and news coverage, but no significant relationships were detected. Conclusions: Results demonstrate that not only are scientists publishing negative findings, but that those studies reach a wide audience. Notably, eventually-withdrawn manuscripts, potentially containing incomplete or uncertain science, is reaching the public domain. Increasingly, family physicians will need to critically appraise emerging literature before it is peer reviewed, whether they encounter it in their own searches or when a patient presents information they found before an appointment.