Preprints Part I: An Era of Public Review

Jacqueline K. Owens, PhD, RN, CNE

Writer’s Camp Counselor

What is a preprint, exactly?

A preprint is a draft of a manuscript posted by authors on a public server or repository via the Internet. Preprints are typically freely accessible, and the author retains copyright. Preprints also include digital object identifiers (DOI)s.1 Although there are advantages, there are also concerns with using preprints. This article (Preprints Part I) briefly describes advantages and concerns related to preprints and discusses selected evidence about usage and early outcomes. Preprints Part II will discuss considerations for authors and editors.

Public reviewers can provide preprints feedback via freely accessible comments which discuss considerations like the rigor and validity of a research study. These reviewers declare their identity and any competing interests as part of their feedback posting. Declarations can be fact-checked by readers and editors.2 Many disciplines have dedicated preprint servers, such as medRxiv, the preprint server for health sciences; others are multidisciplinary.

The concept of a preprint was first introduced in 1961 when the National Institute of Health initiated a project known as “Information Exchange Groups.” The project ended in 3 years because some journals declined to accept these early preprints.1 The modern preprint era began with the launch of bioRxiv in 2013 by Cold Spring Harbor Laboratory, followed by medRxiv in 2019.3 Then, the COVID-19 pandemic demonstrated a shift in the dissemination of research findings. Specifically, there was a dramatic increase in preprints as a way to rapidly distribute science during this health crisis. However, this dissemination also included concerns related to rigor of review and the possibility of clinical action based on unsound science.4-6 As a result, some preprint servers have created more rigorous screening measures to deny manuscripts that can potentially endanger people or threaten public health.1,7

Preprints are not limited to any publishing model.8 For this reason, there is sometimes confusion between the concepts of preprints and “published ahead of print,” often called Early View or PAP. As opposed to preprints, manuscripts published ahead of print in refereed journals assume vetted peer review and subsequent acceptance. The aim is to publish the content in an online format ahead of print in a designated issue of the journal, meaning that it has volume, issue, and page numbers, thereby expediting time to publication and earlier dissemination of the author’s work.

Advantages and Concerns About Preprints

Advantages of preprints include providing rapid dissemination and access to new data, establishing temporal priority via a date stamp, opening science with free access to marginalized groups, fostering debate especially related to adverse or controversial outcomes that are important to discuss but may not ever be published, and increasing citations.1 Preprints are posted with the idea that anyone can offer comments and the review is not limited to scholars in the related discipline. Anonymous peer review by scholars is the industry standard, although the review by two to three experts can still fail to detect concerns in a manuscript. For example, conceptual or methodological flaws could be missed during the peer review process and may only become evident when a manuscript is formally published in a refereed journal. Unlike Early View articles that mainly seek to expedite the time to publication, posting the work to a preprint server aims to add another layer of review to improve the quality of published articles.

Misiak and Kurpas1 described controversial aspects of preprints. Preprints can lack reliable findings which allows the public to access information which could contain multiple errors and unfounded claims. This misinformation could remain until self-regulated by members of the appropriate discipline.

Although checklists are emerging to guide public reviews,9 there remain concerns with disclosure of potential author conflicts, use of suggested guidelines, and standards for data sharing and open data. For example, nursing journals are developing author guidelines related to preprints and educators have used strategies for learners to improve peer review skills.2,6,10-13 However, these guidelines are preliminary, and concerns remain regarding standards for reviewing preprints.

There may also be concerns with plagiarism. Preprints are not considered self-plagiarism because the preprint itself has not been formally published; however, preprints are a form of duplicate publication that requires the authors to update a preprint with the DOI of the published article and in the case of possible retraction. Failure to do update this information can result in “citation dilution” which is when the same content is cited twice with different DOIs. There is currently no standard procedure to ensure that authors meet this obligation. Other concerns include the possibility of confusion among public members related to the definition of a preprint versus a peer-reviewed article and the ability to discern the quality of evidence. Additionally, preprints risk information overload for both scholars and the public. It may be unclear how to retract preprints, and editorial standards may degrade without typesetting or professional editing. Research findings are beginning to address these concerns.

Selected Research Findings

To explore the general understanding of preprints, Fleerackers et al.14 asked participants to define the term (n = 1072). About one third of the participants had some understanding of the term (e.g., not yet peer-reviewed, publicly available, not yet published in a refereed journal, preliminary or uncertain scientific evidence). However, a large portion of the participants who offered mostly accurate definitions were students and their understanding differed from comments offered by participants categorized as the general public. Some participants described preprints as a part of the publication process, scientific news stories, and even complete and credible information. Because preprints are available for public comment by anyone, these findings suggest concern about public reviewers commenting when they do not understand the nature of the preprint and the potential contributions of this process to advancing the literature.

Some authors have examined the likelihood that preprints will advance to refereed journals, and if preprints are likely to be retracted. A study of preprints in medical education15 found that, between 2019 and 2022, almost half went on to formal publication in refereed journals. The open access nature of preprints expanded the audience well beyond the typical readers of medical journals, even those that share via social media outlets. However, there are concerns with this readership. Another research report, currently posted as a preprint prior to formal publication, describes a database with greater than 14,000 studies that have been withdrawn since 1991 from the preprint server ASXiv.16,17 Examples of reasons for retractions included errors related to methodology or presentation of facts, policy violations, and incomplete work, as compared to retractions by scholarly journals which are often due to academic misconduct or honest errors. The early and incomplete nature of research inherent to preprint content could be why these papers are more likely to be withdrawn versus peer reviewed studies.

Some studies examine the content of preprint versus final published papers. For example, Davidson et al.4 compared the effect estimates between preprints and articles published in refereed journals related to 109 randomized clinical trials (RCTs) conducted during the COVID-19 pandemic. They found there was “some concern” regarding the risk for bias for 8% of the RCTs. Nine trials had at least one outcome where a discrepancy led to a minor difference in the effect estimates. Six trials had one or more outcomes missing and 14 had one or more outcomes added in the later published journal article. The authors found changes in effect estimates for 8% of the RCTs but did not find changes in statistical significance or any of the conclusions in the final published versions. From this data collection, the authors emphasized the need to read both a preprint and final published paper.

Conclusion

Informal conversations in my role as an editor have indicated that many authors receive little or no feedback on the preprints they have submitted. However, with the increased focus on public availability of funded research and the growth of this process since the COVID-19 pandemic, preprints are likely here to stay. Early research has begun to both formally identify advantages, areas of concern, and suggest potential safeguards. This research is useful to inform both authors and editors. Considerations for each of these parties will be discussed in Part II of this series on preprints.

References

  1. Misiak M, Kurpas D. Supporting open science: Advances in clinical and experimental medicine and preprints Advances in Clinical and Experimental Medicine. 2024; 33(10): 1045–1068. doi:10.17219/acem/193956
  2. Avissar-Whiting M, Belliard F, Bertozzi SM, Brand A, Brown K, Clement-Stoneham G, et al. Recommendations for accelerating open preprint peer review to improve the culture of science. PLoS Biology. 2024; 22(2): e3002502. doi:10.1371/journal.pbio.3002502
  3. Hindle S, Sever R. Preprints as tools to advance careers. Nature Reviews Cancer. 2024; 24(9): 591-592. doi:10.1038/s41568-024-00718-2
  4. Davidson M, Evrenoglou T, Graña C, Chaimani A, Boutron I. Comparison of effect estimates between preprints and peer-reviewed journal articles of covid-19 trials. BMC Medical Research Methodology. 2024; 24(1): 9. doi:10.1186/s12874-023-02136-8
  5. Lu E, Kumar A, Chidambaram V, et al. Preprints: Are they precedents or expedient substitutes for peer-reviewed journal publications? The American Journal of the Medical Sciences. 2024; 368(1): 80-82. doi:10.1016/j.amjms.2024.03.017
  6. Richter FC, Gea‐Mallorquí E, Mortha A, Ruffin N, Vabret N. The preprint club. EMBO Reports. 2023; 24(6): e57258. doi:10.15252/embr.202357258
  7. Watson C. Rise of the preprint: How rapid data sharing during COVID-19 has changed science forever. Nature Medicine. 2022; 28(1): 2-5. doi:10.1038/s41591-021-01654-6
  8. Neiman M, Bagley RK, Paczesniak D, Singh-Shepherd S. Development, implementation and impact of a new preprint solicitation process at Proceedings of the Royal Society B: Biological Sciences. 2021; 288(1954): 20211248. doi:10.1098/rspb.2021.1248
  9. Turoman N, Heyard R, Schwab S, Furrer E, Vergauwe E, Held L. Using an expert survey and user feedback to construct PRECHECK: A checklist to evaluate preprints on covid-19 and beyond. Published online August 30, 2022. doi:10.31222/osf.io/nb928
  10. Ide K, Koshiba H, Hawke P, Fujita M. Guidelines are urgently needed for the use of preprints as a source of information. Journal of Epidemiology. 2021; 31(1): 97-99. doi:10.2188/jea.je20200506
  11. Pickler RH. Publishing preprints. Nursing Research. 2019; 68(5): 337-338. doi:10.1097/nnr.0000000000000378
  12. Benjamin J, Wanjalla CN, Gaddy JA, Kirabo A, Williams EM, Hinton A. Reimagining bioRxiv and preprint servers as platforms for academic learning. Journal of Cellular Physiology. 2024; 239(7): e31234. doi:10.1002/jcp.31234
  13. Sever R. Preprint review should form part of PhD programmes and postdoc training. Nature News. January 17, 2023. Accessed May 15, 2025. https://www.nature.com/articles/d41586-023-00085-2
  14. Fleerackers A, Ratcliff CL, Wicke R, King AJ, Jensen JD. Public understanding of preprints: How audiences make sense of unreviewed research in the news. Public Understanding of Science. 2024; 34(2): 154-171. doi:10.1177/09636625241268881
  15. Maggio LA, Costello JA, Artino AR. Describing the landscape of medical education preprints on medRxiv: Current trends and future recommendations. Academic Medicine. 2024; 99(9):981-986. doi:10.1097/acm.0000000000005742
  16. Singh Chawla D. WithdrarXiv database of 14,000 retracted preprints launches. Nature. 2025; 637(8046): 530. doi:10.1038/d41586-025-00011-8
  17. Delip R, Young J, Dietterich T, Callison-Burch. WithdrarXiv: A large-scale dataset for retraction study. Accessed May 15, 2025. https://arxiv.org/html/2412.03775v1

Author: Jacqueline Owens

Edited and Reviewed by: Jenny Chicca and Leslie H. Nicoll

Copyright © 2025 Writer’s Camp and Jacqueline Owens. CC-BY-ND 4.0

Citation: Owens J. Preprints Part I: An Era of Public Review. The Writer’s Camp Journal, 1(3):10 doi:10.5281/zenodo.17476019

 

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