key: cord-0882342-v8vegody authors: Papes, Dino; Jeroncic, Ana; Ozimec, Elizabeta title: Redundancy and methodological issues in articles on COVID‐19 date: 2020-06-07 journal: Eur J Clin Invest DOI: 10.1111/eci.13301 sha: f1dfd42866922767be52a560b3c3ccde37ecb95d doc_id: 882342 cord_uid: v8vegody Despite the seriousness of the current pandemic, logical and critical thinking, common sense and method remain the mainstay of biomedicine. Unfortunately, the panic caused by the disease has led many to abandon those principles. Some scientists have used the situation to publish substandard articles that would never get published in normal times as journals publish quickly (and gain citations), without proper review and level of criticism. This situation has been used by medical equipment manufacturers and pharmaceutical industry as well, to promote publication of biased sponsored articles. disease has led many to abandon those principles. Some scientists have used the situation to publish substandard articles that would never get published in normal times as journals publish quickly (and gain citations), without proper review and level of criticism. This situation has been used by medical equipment manufacturers and pharmaceutical industry as well, to promote publication of biased sponsored articles. It seems that anything related to COVID-19 goes during this pandemic. In the aftermath, months from now, the same authors and journals will probably publish corrections and retrospectives recognizing the mentioned issues and justifying them with the need for rapid spread of information that was necessary to fight the virus. In a recent comment on the article by dr. Ioannidis 1 , we have discussed the issue of redundancy in scientific research and reporting 2 . Redundant research usually denoted duplicate studies that present already published data. In a broader sense, any study or review can be considered redundant (not required, unnecessary) if it is without clinically significant or useful result, and such outcome could have been foreseen prior to carrying out the study. Redundant research is published just for the sake of publishing. Although this is not a new problem 3 , this pandemic has created a very rich soil for such studies. There are several reasons, intentional and unintentional, why redundant publications occur. Intentionally, redundant studies are mostly done to further careers (because of publication pressure), to favour industry or simply because funds are available to do them. The overgrowing publishing industry is certainly encouraging it which is obvious from the growing number of reviews and meta-analyses 4 . This article is protected by copyright. All rights reserved usually powered to detect whether the difference in blood loss (measured in millilitres) was statistically significant, but not powered enough to detect whether this difference was actually clinically significant (was there an increase in blood transfusion rate). In this research, we aimed to evaluate the trend in the number of publication on COVID-19, quantify publication redundancy and determine methodological issues in publications on COVID-19. In order to do this, we searched LitCovid 5 (a curated literature hub), identified and collected information about publications on COVID-19 indexed in Pubmed. The information on publication type and country of origin was obtained from MEDLINE records. All articles found in LitCovid were included. On May 10 there were 11,130 publications in Pubmed, with around 25% originating from China (Table) . The weekly rise in the number of publications continued to approximate an exponential function 2 . By reviewing the published material, one can determine that the majority of articles are of low quality, repetitive, hastily written, methodologically flawed and highly biased. Although the problem of hyperpublication has been recognized 6-8 , specific issues have not yet been addressed. We have determined three main issues in COVID-19 publications: 1) Non-evidence based information/recommendation. For example, the risk of spreading COVID-19 during laparoscopic surgery, that has been given much significance, although it is in fact negligible. A very unrealistic laboratory model of HIV virus spreading in surgically created vapour 9 has been accepted as fact and used as an argument 10 without noticing that it had been refuted 11 . When assessing the risk of disease spread through surgical vapour, splashed blood and evacuated artificial pneumoperitoneum, the presence of viable viral particles is constantly being equalized with infection risk 10 This article is protected by copyright. All rights reserved scan findings in COVID-19 from non-COVID pneumonias with the aid of AI, but the majority of the non-COVID pneumonias were bacterial, and such CT findings are much easier to differentiate 13 . Suggestions that chest CT scan should be used for screening or even added to standard preoperative work-up are irresponsible, have no scientific basis and risk exposing numerous patients to unnecessary radiation 12, 14, 15 . 2) RCTs should provide a supplemental file that would contain a summary of relevant data, properly formatted, to enable faster systematic reviews and meta-analyses; This article is protected by copyright. All rights reserved 3) both statistical and clinical significance criteria should be clearly defined, critically assessed and approved before conducting and publishing a study with journals being more critical and selective when publishing RCTs, systematic-reviews and meta-analyses. Journals, databases and hubs should enable up-and down-voting of publications to filter most useful ones; 4) through development of a special journal devoted to publishing RCT protocols that would also serve as a forum to discuss methodologically insufficiencies. Currently, a vast quantity of useless and biased data is being intentionally and unintentionally poured into the pool of evidence-based medicine, diluting it to such extent that finding relevant and true information will soon become very difficult, if at all possible. Often, low-quality or false information are obscured by being embedded in lengthy texts and supplementary material, or wrapped in technical terms (machine learning, neural network, Bayesian statistics) which hinder potential criticism, since most physicians are probably not well acquainted with them. Good examples are various useless predictive models for COVID-19 that have been hastily developed by advanced methods and will, of course, never be used 19 . To account for this, future medical students should be formally trained in mathematics/logic, computer science and statistics so they could critically asses each information and claim they are being served, do their own research and analysis, and improve the methods of data retrieval and synthesis in their favour. Of course, there have been and there will be bigger problems than redundancy in publications, but at some point, this issue requires to be addressed. This article is protected by copyright. All rights reserved Article and specific design type such as Review, the publication was counted as a specific design type. Coronavirus disease 2019: the harms of exaggerated information and non-evidence-based measures Redundancy in reporting on COVID-19 Seventy-five trials and eleven systematic reviews a day: how will we ever keep up The Mass Production of Redundant, Misleading, and Conflicted Systematic Reviews and Meta-analyses Waste in covid-19 research Methodological challenges of analysing COVID-19 data during the pandemic A publishing pandemic during the COVID-19 pandemic: how challenging can it become? Human immunodeficiency virus-1 (HIV-1) in the vapors of surgical power instruments Minimally Invasive Surgery and the Novel Coronavirus Outbreak: Lessons Learned in China and Italy Risks to surgeons and patients from HIV and hepatitis: guidelines on precautions and management of exposure to blood or body fluids SARS-CoV-2 pandemic and pediatric endoscopic surgery Accepted Article This article is protected by copyright. All rights reserved 13. Laghi A. Cautions about radiologic diagnosis of COVID-19 infection driven by artificial intelligence Intercollegiate General Surgery Guidance on COVID-19 UPDATE | The Royal College of Surgeons of Edinburgh Chest CT as a screening tool for COVID-19 in unrelated patients and asymptomatic subjects without contact history is unjustified Compassionate Use of Remdesivir for Patients with Severe Covid-19 A trial of lopinavir-ritonavir in adults hospitalized with severe Covid-19 Critically ill patients with COVID-19 in Hong Kong: a multicentre retrospective observational cohort study Prediction models for diagnosis and prognosis of covid-19 infection: systematic review and critical appraisal This article is protected by copyright. All rights reserved