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Table 1.  Preprint Policies by Category
Preprint Policies by Category
Table 2.  Median Impact Factor by Preprint Policy Category
Median Impact Factor by Preprint Policy Category
1.
MedRxiv. About MedRxiv. Accessed May 8, 2020. https://www.medrxiv.org/content/about-medrxiv
2.
Ginsparg  P.  ArXiv at 20.   Nature. 2011;476(7359):145-147. doi:10.1038/476145aPubMedGoogle ScholarCrossref
3.
Berg  JM, Bhalla  N, Bourne  PE,  et al.  Scientific community: preprints for the life sciences.   Science. 2016;352(6288):899-901. doi:10.1126/science.aaf9133PubMedGoogle ScholarCrossref
4.
Serghiou  S, Ioannidis  JPA.  Altmetric scores, citations, and publication of studies posted as preprints.   JAMA. 2018;319(4):402-404. doi:10.1001/jama.2017.21168PubMedGoogle ScholarCrossref
5.
Klebel  T, Reichmann  S, Polka  J,  et al Peer review and preprint policies are unclear at most major journals. bioRxiv. Preprint posted online January 30, 2020. doi:10.1101/2020.01.24.918995
6.
Transpose. Transpose database. Accessed May 8, 2020. https://transpose-publishing.github.io/#/
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    Research Letter
    Medical Journals and Publishing
    July 22, 2020

    Assessment of Preprint Policies of Top-Ranked Clinical Journals

    Author Affiliations
    • 1Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut
    • 2Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut
    • 3Section of General Medicine and the National Clinician Scholars Program, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
    • 4Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut
    • 5Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
    JAMA Netw Open. 2020;3(7):e2011127. doi:10.1001/jamanetworkopen.2020.11127
    Introduction

    The clinical research community has adopted the use of preprint servers, which provide outlets for preliminary reports of research that has not been peer-reviewed.1 Preprint servers support open scholarship, allow research to be disseminated quickly, offer opportunities for peer feedback before formal submission to a journal, and have been increasingly adopted by the biological, physical, and economic scientific communities.2-4 However, for preprint potential to be realized in clinical research, peer-reviewed journals must be willing to consider manuscripts that were previously posted on preprint servers (preprints) for publication. Because systematic information about contemporary clinical journal policies on preprints is lacking,5 our objective was to assess the preprint publication policies of the 100 clinical journals with the highest impact factors.

    Methods

    This cross-sectional study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline. For this study, we used InCites Journal Citation Reports (JCR) to identify journals across all fields with a 2018 journal impact factor greater than 5. We manually screened all identified journals by title and categories on JCR to find the 100 top-ranked clinical journals and included only those that publish original research.

    For each qualifying journal, we checked a succession of resources to ascertain its editorial policy on preprints: the journal website; the publisher website; the Transpose Database6; and the first 10 pages of a Google search containing the journal name and the term preprint. Once a preprint policy was located, we classified each journal’s policy by the following categories: preprints allowed (if preprints will be considered for publication), case-by-case determination (if preprints are evaluated on an individual basis), and preprints prohibited (if preprints will not be considered for publication). Data were collected on April 23, 2020. We conducted descriptive analyses using Microsoft Excel (Microsoft Corporation).

    Results

    Among the 100 top-ranked clinical journals, the median (interquartile range) impact factor was 13.7 (10.7-19.0). Most journals (86 [86%]) allowed preprints (Table 1). In contrast, 13 journals (13%) evaluated each preprint independently to determine whether to reject it on the basis of its prior preprint status (case-by-case determination). Only 1 journal (1%) had a policy that prohibited preprints (preprints prohibited). There was no association between the median impact factor and the category of preprint policy (Table 2).

    Discussion

    This cross-sectional study of preprint policies among the 100 clinical journals with the highest impact factors suggests that clinical journals are broadly supportive of considering clinical research preprints for publication. After classifying each journal according to the content of its preprint policies, we found that 86% of these journals allow for submitting articles previously posted as preprints. Our findings show that prohibitive journal preprint policies are in the minority, suggesting that clinical research journals are willing to consider manuscripts previously published on preprint servers. As a result, clinical researchers may feel less concerned that posting a manuscript on a preprint server will disqualify it from publication by a journal. However, the 13 journals whose policies were classified as case-by-case represent a potential barrier to researchers’ trust that manuscripts posted as preprints will be considered by clinical journals.

    This study was limited to a search of publication policies at a single point in time, although journals may change their policies on preprints as preprint posting becomes more common. The COVID-19 pandemic has demonstrated the advantages of preprints, especially for rapid dissemination of information during a global health crisis, as well as the dangers that they may pose in disseminating false information. Preprints aim to bring expediency and transparency to clinical research, and current journal policies suggest that the community is open to their use.

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    Article Information

    Accepted for Publication: May 11, 2020.

    Published: July 22, 2020. doi:10.1001/jamanetworkopen.2020.11127

    Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2020 Massey DS et al. JAMA Network Open.

    Corresponding Author: Harlan M. Krumholz, MD, SM, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, One Church Street, Ste 200, New Haven, CT 06510 (harlan.krumholz@yale.edu).

    Author Contributions: Ms Massey had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

    Concept and design: Massey, Wallach, Ross, Krumholz.

    Acquisition, analysis, or interpretation of data: All authors.

    Drafting of the manuscript: Massey.

    Critical revision of the manuscript for important intellectual content: All authors.

    Statistical analysis: Massey.

    Supervision: Krumholz.

    Conflict of Interest Disclosures: Dr Wallach reported grants from the US Food and Drug Administration (FDA) and the Laura and John Arnold Foundation outside the submitted work. Dr Ross reported grants from FDA, Johnson and Johnson, the Medical Devices Innovation Consortium, the Agency for Healthcare Research and Quality, the National Institutes of Health/National Heart, Lung, and Blood Institute, the Laura and John Arnold Foundation, the Centers for Medicare and Medicaid Services, and Medtronic, Inc. outside the submitted work. Dr Krumholz reported personal fees from UnitedHealth, IBM Watson Health, Element Science, Aetna, Facebook, Siegfried & Jensen Law Firm, Arnold & Porter Law Firm, Martin/Baughman Law Firm, and the National Center for Cardiovascular Diseases, Beijing; is the cofounder of HugoHealth and Refactor Health; contracts from Centers for Medicare & Medicaid Services through Yale New Haven Hospital; and grants from Medtronic, the FDA, Johnson and Johnson, and the Shenzhen Center for Health Information outside the submitted work. Drs Ross and Krumholz are founders of medRxiv, a preprint server for the health sciences; they receive no financial compensation for their roles. No other disclosures were reported.

    References
    1.
    MedRxiv. About MedRxiv. Accessed May 8, 2020. https://www.medrxiv.org/content/about-medrxiv
    2.
    Ginsparg  P.  ArXiv at 20.   Nature. 2011;476(7359):145-147. doi:10.1038/476145aPubMedGoogle ScholarCrossref
    3.
    Berg  JM, Bhalla  N, Bourne  PE,  et al.  Scientific community: preprints for the life sciences.   Science. 2016;352(6288):899-901. doi:10.1126/science.aaf9133PubMedGoogle ScholarCrossref
    4.
    Serghiou  S, Ioannidis  JPA.  Altmetric scores, citations, and publication of studies posted as preprints.   JAMA. 2018;319(4):402-404. doi:10.1001/jama.2017.21168PubMedGoogle ScholarCrossref
    5.
    Klebel  T, Reichmann  S, Polka  J,  et al Peer review and preprint policies are unclear at most major journals. bioRxiv. Preprint posted online January 30, 2020. doi:10.1101/2020.01.24.918995
    6.
    Transpose. Transpose database. Accessed May 8, 2020. https://transpose-publishing.github.io/#/
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