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Publishing for science or science for publications? The role of open science to reduce research waste

In an earlier issue, Chapelle et al report on "an epidemic of redundant metaanalyses."1 They show all the evidence to answer a single clinical question: Should cancer patients with venous thrombosis receive either a direct oral anticoagulant or low molecular weight heparin? Indeed, the combined data from four trials suggest a clinical benefit for direct oral anticoagulants, but this is not probably not the main reason why this letter was published in the Journal. The letter draws our attention to something different, and in the greater scheme of things, arguably more important. When the authors searched the literature to help draft a French clinical guideline on the topic, they noticed that even though there are five trials published on the topic, there are currently no less than 20 metaanalyses published. They also show that the published metaanalyses are not only numerous, but also ubiquitous and published nearly simultaneously: these 20 metaanalyses were published in 17 different journals in the span of 3 years. What can explain this? Let us first look at some reasons that are in line with a solid scientific workflow. Reproducibility and replication of research is a cornerstone of good scientific practice. The ability to repeat the activity and independently come to the same conclusions as others – or not! – is what sets science apart from mere experiencebased reasoning. Another more practical reason for more than one publication on a similar topic can be that this topic lies in multiple clinical domains, so publishing in different journals each catering those fields with their own focus might be prudent, perhaps even desirable. Also, with the arrival of additional data metaanalyses can or perhaps even should be updated, a practice reminiscent of the Cochrane approach (www. cochr ane.org) or living systematic reviews.2 But do these reasons render the conclusion of “an epidemic of redundant metaanalyses” void? No. First of all, even though science should in principle be reproducible to show the diligence of our work, it does not mean that we have to replicate everything ad nauseam. Sure, the topic in case does cover two fields (thrombosis and cancer) and not all trials were not published all simultaneously, but with 11 of the 20 reviews published within 6 months after the publication of the most recent trial it is clear that something else is going on. Are there reasons that we can think of that are less in line with a solid scientific workflow? Let's start with the situation in which multiple people came up with the same idea at roughly the same time. There are two versions of this: benign in the form of chance or malignant in the form of scooping. Sometimes the time is just right to answer a certain question and multiple people start new projects. In those cases, preregistration of research ideas is often mentioned as a method of prevention of duplicate work, but more on that later. Other reasons might be that metaanalyses are also often seen as good tool for starting researchers to get a lay of the land, ignoring that a solid metaanalysis requires highly skilled and experienced researchers in their field. Perhaps what we see here is the result of a push of the authors for a certain message. This too comes in two forms: benign when the arguments are made on behalf of patients, but less so when the argument is made for other interests (e.g., commercial ones). Either way, this is not proper science. Finally, and perhaps the most worryingly, is that what we see is an example that science projects are executed to acquire more publications for the publication’s sake, and not,

In an earlier issue, Chapelle et al report on "an epidemic of redundant meta-analyses." 1 They show all the evidence to answer a single clinical question: Should cancer patients with venous thrombosis receive either a direct oral anticoagulant or low molecular weight heparin?
Indeed, the combined data from four trials suggest a clinical benefit for direct oral anticoagulants, but this is not probably not the main reason why this letter was published in the Journal.
The letter draws our attention to something different, and in the greater scheme of things, arguably more important. When the authors searched the literature to help draft a French clinical guideline on the topic, they noticed that even though there are five trials published on the topic, there are currently no less than 20 meta-analyses published. They also show that the published meta-analyses are not only numerous, but also ubiquitous and published nearly simultaneously: these 20 meta-analyses were published in 17 different journals in the span of 3 years. What can explain this?
Let us first look at some reasons that are in line with a solid scientific workflow. Reproducibility and replication of research is a cornerstone of good scientific practice. The ability to repeat the activity and independently come to the same conclusions as others -or not! -is what sets science apart from mere experience-based reasoning.
Another more practical reason for more than one publication on a similar topic can be that this topic lies in multiple clinical domains, so publishing in different journals each catering those fields with their own focus might be prudent, perhaps even desirable. Also, with the arrival of additional data meta-analyses can or perhaps even should be updated, a practice reminiscent of the Cochrane approach (www. cochr ane.org) or living systematic reviews. 2 But do these reasons render the conclusion of "an epidemic of redundant meta-analyses" void? No. First of all, even though science should in principle be reproducible to show the diligence of our work, it does not mean that we have to replicate everything ad nauseam. Sure, the topic in case does cover two fields (thrombosis and cancer) and not all trials were not published all simultaneously, but with 11 of the 20 reviews published within 6 months after the publication of the most recent trial it is clear that something else is going on.
Are there reasons that we can think of that are less in line with a solid scientific workflow? Let's start with the situation in which multiple people came up with the same idea at roughly the same time.
There are two versions of this: benign in the form of chance or malignant in the form of scooping. Sometimes the time is just right to answer a certain question and multiple people start new projects. In those cases, preregistration of research ideas is often mentioned as a method of prevention of duplicate work, but more on that later. Other reasons might be that meta-analyses are also often seen as good tool for starting researchers to get a lay of the land, ignoring that a solid meta-analysis requires highly skilled and experienced researchers in their field. Perhaps what we see here is the result of a push of the authors for a certain message. This too comes in two forms: benign when the arguments are made on behalf of patients, but less so when the argument is made for other interests (e.g., commercial ones). Either way, this is not proper science. Finally, and perhaps the most worryingly, is that what we see is an example that science projects are exe-  [3][4][5] show that of the 10 preregistered metaanalyses, no fewer than eight proposals were submitted to Prospero, whereas at least one, and often multiple entries, for the same metaanalysis were already registered. This suggests that it is not the lack of knowledge on the efforts of others to answer the same research question that led to all these meta-analyses.
Another way to reduce redundant publications is to share research before it is peer-reviewed by publishing it on a preprint server such as medRxiv.org. Although the coronavirus disease 2019 pandemic has popularized this practice, it is only used for a small fraction of all research output. Would further adoption of this practice be a way to further reduce research waste? The data collected by Chapelle et al suggest that the time window between "received" and "published online" was short. Preprints will only prevent double work when there is a sufficiently large window between these two timepoints during which other researchers have to decide whether or not to start a new project. In

CO N FLI C T O F I NTE R E S T
The authors report no conflict of interest.

AUTH O R CO NTR I B UTI O N
Bob Siegerink: conceptualization, writing of original draft. Frits R.