Preprints first caught my eye in May 2020. As a human factors researcher who has researched wearables for several years and owned a few (remember the Jawbone UP?) my interest was piqued by a Washington Post headline, “Wearable tech can spot coronavirus symptoms before you even realize you’re sick” (Fowler, 2020). The wearable mentioned in the Post article, the Oura ring, must have already been developed before COVID-19 reached the U.S. and a novel application was developed for the existing hardware. Physical and digital prototypes go through iterative design and development processes and while the process can be rushed, speed comes at the expense of quality (e.g., Cyberpunk 2077). Quality is paramount when developing an application for monitoring individual and public health during a pandemic. The initial findings Fowler referenced were reported in preprint form. Preprints are scholarly works posted by researchers before the manuscripts have undergone peer review. Scientific research must be developed over time, much like hardware and software. Studies take months and even years to design, develop, pilot, collect and analyze data, interpret findings, and report the results. Peer review, the process of the scientific community evaluating research for its scientific soundness and practical and applied merit, takes additional months. Preprints are a way for scientists and researchers to put their (unvalidated) findings into the world, thus making sure nobody else can gain credit for the work. No industry standard exists for preprints. Do “initial findings” contain the results of two study participants or 200? Work-in-progress papers have been presented at academic conferences for years. Technical reports are another avenue for quickly reporting research. Why are preprints, which are posted online for the world to consume before peer review has vetted the work, necessary for researchers to make sure no one else receives credit for their work?
People may rely on news headlines and information gained through word-of-mouth for health advice. There’s a lot of money to be made. Newspapers need headlines to drive subscriptions, tech startups need investment capital, and researchers need funding. The financial incentives reinforce the people involved until the echo chamber increases sales. The preprint problem is magnified when journalists, who are also looking to not get scooped, take the initial findings and generate headlines that may be contradictory to the final, validated results. What happens if a study that’s initially reported as a preprint is found to be invalid? Is the preprint pulled from the internet? Does the news media issue a retraction? Will future researchers who are looking to develop and test hypotheses be able to distinguish between a preprint and a peer reviewed study? Some article repositories are taking steps to address this issue by clearly labeling which articles are preprints, such as medRxiv (https://www.medrxiv.org/). The following cautionary statement is prominently displayed on medRxiv’s homepage (emphasis medRxiv’s): Caution: Preprints are preliminary reports of work that have not been certified by peer review. They should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information. This is a good first step; however, it is incumbent on journalists and news outlets to responsibly report information. For example, a reporter could state that research into using wearables to aid in early COVID-19 diagnoses is ongoing while also refraining from mentioning any features or capabilities of devices that have not been validated.
The results of the first Oura studies are promising. Maybe the Oura ring and similar devices can detect the symptoms of COVID-19 before most people would otherwise spot them, but we don’t know yet. Validation takes time. In the meantime, wash your hands, wear a mask, and physically distance as much as you can. Relying on an unvalidated, non-FDA approved device for disease prevention and detection may lead some people to have a false sense of security when their wearable does not, in fact, indicate they may be ill. This false sense of security could then lead to infecting others. The scientific community can more clearly indicate that preprints are not to be used for individual or organization-level health guidance, as medRxiv has done. Scientists and researchers can choose to not cite preprints in their work, since the issue of what happens when a preprint is invalidated and retracted is still unclear. Companies and institutions can choose to not use preprints as a basis for hiring, promotion, and tenure. The issue of whether researchers should use information reported in preprints as a foundation upon which to scaffold scientific theories needs to be answered. We stand on the shoulders of giants, but without a firm footing we risk regressing down a slippery slope.
What are your thoughts on preprints? Let us know, below!
Fowler, G.A. (2020 May 8). Wearable tech can spot coronavirus symptoms before you even realize you’re sick. The Washington Post. https://www.washingtonpost.com/technology/2020/05/28/wearable-coronavirus-detect/
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