The Landscape of Medical Literature in the Era of COVID-19: Original Research Versus Opinion Pieces

Ethics and Academic Discourse, Scientific Integrity, Uncertainty, and Disinformation in Medicine: An American College of Physicians Position Paper

Respect for the scientific process and a diversity of views; open discourse and debate based on principles of ethics, best available evidence, and scientific inquiry and integrity; and an understanding of evidence gaps and uncertainty and how to communicate about them are important values in the advancement of science and the practice of medicine. Physicians often must make decisions about their recommendations to patients in the face of scarce or conflicting data. Are these characteristics of medicine and science widely understood and effectively communicated among members of the profession and to patients and the public? Issues of scientific integrity are longstanding, but COVID-19 brought them to the forefront, in an environment that was sometimes characterized by communication missteps as guidance came and went-or changed-quickly. Today, is open debate flourishing? Have some debates shed more heat than light? Are people losing confidence in science and medicine? In health care institutions? The American College of Physicians explores these issues and offers guidance in this position paper.

The impact of COVID-19 on global health journals: an analysis of impact factor and publication trends

BACKGROUND

COVID-19 has affected research productivity across all areas of knowledge. Current evidence suggests that COVID-19 has had a blockbuster effect on journal impact factors (JIFs) and publication trends, while little is known on global health journals.

METHODS

Twenty global health journals were included to analyse the impact of COVID-19 on their JIFs and publication trends. Indicator data, including numbers of publications, citations, articles with different types, etc, were extracted from journal websites and Web of Science Core Collection database. The JIFs from 2019 to 2021 were simulated for longitudinal and cross-sectional analyses. Interrupted time-series analysis and non-parametric tests were applied to assess whether COVID-19 had decreased non-COVID-19 publications from January 2018 to June 2022.

RESULTS

In 2020, 615 out of 3223 publications were COVID-19 related, accounting for 19.08%. The simulated JIFs of 17 out of 20 journals in 2021 were higher than those in 2019 and 2020. Notably, 18 out of 20 journals had a decrease in their simulated JIFs after excluding COVID-19-related publications. Moreover, 10 out of 20 journals decreased their monthly numbers of non-COVID-19 publications after the COVID-19 outbreak. For all the 20 journals as a whole, after the COVID-19 outbreak in February 2020, the total number of non-COVID-19 publications significantly decreased by 14.2 compared with the previous month (p=0.013), and since then, on average, the publications had decreased by 0.6 per month until June 2022 (p<0.001).

CONCLUSIONS

COVID-19 has impacted the structure of COVID-19-related publications, the JIFs of global health journals and their numbers of non-COVID-19 publications. Although journals may benefit from increased JIFs, global health journals should avoid relying on a single metric. More follow-up studies including more years of data with a combination of metrics should be conducted to generate more robust evidence.

How did COVID-19 affect medical and cardiology journals? A pandemic in literature

BACKGROUND AND AIMS

The spreading speed of the COVID-19 pandemic forced the medical community to produce efforts in updating and sharing the evidence about this new disease, trying to preserve the accuracy of the data but at the same time avoiding the potentially harmful delay from discovery to implementation. The aim of our analysis was to assess the impact of the COVID-19 pandemic on medical literature in terms of proportion of COVID-19-related published papers and temporal patterns of publications within a sample of general/internal medicine and cardiology journals.

METHODS

We searched through PubMed scientific papers published from 1 January 2020 to 31 January 2021 about COVID-19 in ten major medical journals, of which five were in general/internal medicine and five in the cardiology field. We analyzed the proportion of COVID-19-related papers, and we examined temporal trends in the number of published papers.

RESULTS

Overall, the proportion of COVID-19-related papers was 18.5% (1986/10 756). This proportion was higher among the five selected general/internal medicine journals, compared with cardiology journals (23.8% vs 9.5%). The vast majority of papers were not original articles; in particular, in cardiology journals, there were 28% 'original articles', 17% 'review articles' and 55.1% 'miscellaneous', compared with 20.2%, 5.1% and 74.7% in general/internal medicine journals, respectively.

CONCLUSIONS

Our analysis highlights the big impact of the COVID-19 pandemic on international scientific literature. General and internal medicine journals were mainly involved, with cardiology journals only at a later time.

Publication Non Grata: The Challenge of Publishing Non-COVID-19 Research in the COVID Era

Objectives: We aimed to determine publication trends in leading clinical research journals (impact factor >20) during the rise of the coronavirus disease 2019 (COVID-19) pandemic and to check for an increase in publication times of non-COVID-19 original research articles.

Methods: We collected publication data from five print-based medical journals and one online journal--JAMA: The Journal of the American Medical Association, The Lancet (Lancet), The New England Journal of Medicine, Annals of Internal Medicine, The BMJ (BMJ), and BMC Medicine (BMC Med)--for the December 2019 through May 2020 period. We categorized each article as either "COVID-19-related" or "non-COVID-19-related". When available, we further extracted data on submission-to-acceptance dates and acceptance-to-publication dates for original research articles for the January through July 2019 and January through July 2020 periods. We compared the time from submission to publication for non-COVID-19 original research articles during the two periods and tested for statistical significance with a one-tailed Wilcoxon rank-sum test.

Results: We found that non-COVID-19-related articles began decreasing in volume as COVID-19-related articles increased. In BMJ and Lancet, the COVID-19-related articles began overtaking the non-COVID-19-related articles in number during April and May 2020. However, COVID-19-related primary research articles only began consistently appearing in journal issues during May 2020. Only BMJ and BMC Med publicly recorded complete data regarding their publication timelines. After removing outliers, we found that the mean time from submission to publication for articles published in BMJ from January through July 2019 was 204 days (median: 194 days; IQR: 163-236), and from January through July 2020 was 223 days (median: 218 days; IQR: 177-261) (p=0.04). In BMC Med, the mean time from submission to publication from February through July 2019 was 153 days (median: 150 days; IQR: 123-181), and from February through July 2020 was 163 days (median: 157 days; IQR: 132-191) (p=0.06). 

Conclusion: We discovered a steadily increasing trend in the percentage of COVID-19-related articles and a concomitant decreasing trend in the percentage of non-COVID-19-related articles published in high-impact print journals during the period from December 2019 through May 2020. For non-COVID-19-related articles published in BMJ, we found a statistically significant increase upon comparing the submission-to-publication times for the period from January through July 2020 with the submission-to-publication times for the period from January through July 2019.