ISMPP 2021: transformation and evolution

This year’s ISMPP theme was: ‘creating and embracing opportunities in a time of transformation’. Here we report on some of the discussions.

A call to arms in the fight against misinformation

It’s difficult to make informed decisions about health when constantly inundated by misinformation and false reports. Misinformation around vaccines has been particularly noticeable through the ongoing COVID-19 pandemic, refuelling historic public mistrust in vaccines.

Now, more than ever, medical publishing professionals must engage in the battle against misinformation. But understanding is key – only once we understand someone’s perspective can we really start to convince them of the facts. Then we can work together to promote open science, educate scientists to become better communicators and equip audiences with the right skills to become critical readers.

Transparency is key

As Anne Roe explained in 1953, “nothing in science has any value to society if it is not communicated”. The pharma industry needs to work towards

• mandating open access,
• breaking down data sharing barriers,
• ensuring summary data are available in clinical trial registries, and
• publishing negative trial data in a timely fashion.

Furthermore, patient lay summaries (PLS) – especially for vaccine trials – may be a useful tool for transparently disclosing information to the public. However, we should be cautious of PLS in preprints because these have not been peer reviewed and may even contribute to the spread of misinformation.

Diversity, equity, and inclusion

The importance of these themes to the medical communications industry has been nicely summarised in a recent article in the MAP newsletter. It’s vital that patients, especially those from marginalised and underrepresented groups, feel empowered to take ownership of their health.

PLS may help promote health equity by making medical information more readily accessible to patients, caregivers, healthcare professionals (HCPs) and researchers. Using simple and inclusive language that patients will understand and identify with is particularly important when developing PLS. Therefore, it is essential that non-experts are invited to review them.

Inclusive language is accurate language. It is important to acknowledge diversity, convey respect and be sensitive to differences between people in all publications, not just PLS. Unfortunately, little attention has been paid to the positive impact of PLS thus far, and few journal articles offer an associated PLS, or the summary ends up hidden in the supplementary information with little to no visibility.

Furthermore, pharmaceutical companies have been reluctant to develop PLS for fear of them being misconstrued as promotional materials. Lastly, as well as not being clear on how to review PLS, pharmaceutical company employees are also not clear on whether commercial or medical functions are responsible for developing these summaries. It seems that industry-wide guidance on developing PLS is required.

Authorship diversity

Authorship diversity can substantially enhance a publication as different people can make valuable contributions through drawing on their own unique experiences. Perhaps the authorship algorithm tool – due to be rolled out on the ISMPP website in Q3 2021 – will help quantify author contributions, leading to more diverse author lists.

Regrettably, there are still many barriers that prevent underrepresented groups publishing their research. It was therefore recommended that we, as medical publishing professionals, should provide technical and submission support to help these individuals communicate their data.

Diversity in clinical trials

A diverse clinical trial population ensures that studies are more representative of the whole patient population, enabling researchers to better understand the wide spectrum of treatment outcomes. Furthermore, clinical trials may be the only opportunity for patients from disadvantaged communities to receive the treatment they need. Although more and more journals are now requesting inclusivity/diversity forms upon manuscript submission, many communities are still unwilling to participate in clinical trials, highlighting the importance of medical communications professionals reaching out to disengaged communities and building trust.

Inclusion

A good way to engage with the disengaged is to include patients in every step of the process. This can go a long way in fulfilling the mantra ‘no decision about me without me’. There is also a trend towards increased patient participation at scientific and medical conferences. In fact, some conferences are now starting to reserve seats specifically for patients. The benefits of such participation are numerous; social media analytics have shown that patients play an essential role in data dissemination, not just to other conference attendees, but also to a broader audience. Interestingly, new patient-reported outcomes were discovered just from talking to patients at a rheumatology conference. A recent study also showed that patient participation can reduce the number of study protocol amendments and improve trial adherence and retention.

The four key pillars of patient involvement are as follows:

1. Accommodation: the patients’ personal commitments are considered, alongside medical, nutritional, accessibility and financial requirements.
2. Co-designing: the conference organisers collaborate with patients to set the themes and objectives of the meeting.
3. Engagement: patients are included in the audience and have speaker roles.
4. Education/mentorship: patients receive training and support on how to collaborate with partners and researchers.

Digital engagement: a virtual reality

HCPs are starting to engage more with patients in the digital space. A recent study reported that 82% of clinical trial professionals have adopted virtual trial technologies due to the pandemic.

Prescription Digital Therapeutics (PDT) is a new and exciting field of research. These supply evidence-based therapeutic interventions via high-quality software applications to prevent, manage or treat a medical disorder or disease. With individual patient data at their fingertips, HCPs may be able to optimise treatment in real time to improve healthcare outcomes; this may be particularly helpful for chronic conditions.

The development of PDTs could bring about big changes in our industry. The medical affairs process for these can be very different from the traditional approach, so there is a real need to start thinking about the audience, the treatment modality, how to integrate this into clinical practice, what evidence might be needed in addition to safety/efficacy data and what might be the key barriers preventing prescriber uptake.

Virtual meeting engagement

Digital engagement is also important to consider in the context of medical and scientific meetings. Due to the ongoing COVID-19 pandemic, many congresses made the switch to a virtual format. And those that did reported their highest level of attendance ever, including the ISMPP 17th Annual Meeting.

Attendance might be up – especially by patients – because barriers associated with attending an in-person meeting, such as travel and accommodation, are removed. But engagement at these virtual meetings was generally quite low. As hybrid scientific and medical conferences are seemingly here to stay, we must ask ourselves, how can we stimulate those ‘hallway conversations’ at virtual meetings?

Perhaps quick-fire Q&A rounds and poster contests could help make these meetings more interactive? Or maybe we need to ensure the speaker’s expertise is fully and effectively communicated to the audience, e.g.:

• Setting the stage: compelling presentation delivered using clean backgrounds, front lighting and good sound quality.
• Preparing the presenter: rehearsals, good posture and good voice projection will help with enunciation and delivery.
• Ensuring a good presenting experience: speaker engages with the audience and panellists, and has a contingency plan in case anything goes wrong.

From AI to UX

Further digital transformations also appear to be on the horizon. For example, it may not be long until large-scale artificial intelligence (AI)-assisted analytics are used as a basis for literature reviews and clinical development.

Furthermore, with the rise of preprints, traditional journal articles as we know them may also be a thing of the past, with many even calling for the application of user experience (UX) design principles to the structure and format of online journal articles. This could mean making articles accessible only via HTML and enabling live updates to be made following continuous rounds of peer review, potentially signalling the end of the print journal. Structured journal articles could also enable machine readability, paving the way for things like automatic literature reviews.

It is important that we as industry professionals are prepared for the next wave of technological advancements. Both people and processes will need to be ‘up-skilled’ so that we are able to fully capitalise on the benefits of these new technologies. Finally, we will also need to assess the real-world impact of these digital enhancements; while standard quantitative metrics exist (views, downloads, etc.), qualitative metrics have been difficult to establish and require additional commitment and development. Advances such as web-based platforms and AI may provide new opportunities for the development of relevant qualitative and quantitative metrics, which may be valuable in assessing the impact of traditional publications, as well as newer digital outputs.

2021 and beyond

This year’s ISMPP meeting predicted a move towards returning to ‘normality’ in the wake of the COVID-19 pandemic, whilst retaining the current remote models of communication, resulting in a hybrid approach that will bring its own challenges. There will be continued pressure on pharmaceutical organisations to involve patients in all aspects of the drug development process and publish faster with more open access. Digital will also continue to be an important aspect, with the ongoing evolution of scientific posters and the long-term changes in author engagement.

ISMPPP is the International Society for Medical Publication Professionals. Their 17th Annual Meeting took place virtually on 12–14 April 2021 and had a recordbreaking attendance of 650 delegates.

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