Science at Warp Speed: Medical Research, Publication, and Translation During the COVID-19 Pandemic.

"Failure to Manage Competing Interests So far, we have portrayed the scientific process as a depersonalized one in which ideas are (more or less effectively) generated, tested, and either discarded or taken up by people who are concerned only about generating high quality knowledge and promoting health and well-being. The reality, however, is that all those involved in biomedical research, publication, and translation (including researchers, journal editors, and clinicians) have multiple competing obligations and are embedded in a complex web of financial and non-financial interests, such as the desire to earn money, create product opportunities, pursue intellectual projects, and achieve professional recognition and career advancement. All of these stakeholders are also susceptible to cognitive biases that can lead them to overvalue innovative technologies (“optimism bias”), and to be swayed by industry marketing, and by pressure from patients, the public, and governments to address urgent unmet needs (Chan 2012; Taylor 2013). These competing interests can sometimes be benign and easily managed, but they can also introduce biases that distort research, publication, policymaking, and practice and, at times, even motivate outright fraud. For these reasons, there are many checks and balances in place to manage competing interests in biomedical innovation. These include both the general scientific and journal review processes described above and other processes that are designed to directly address competing interests such as preregistration of research studies (to avoid reporting/publication biases), disclosure of competing interests, and independent auditing processes (Lipworth 2019). When biomedical innovation is sped up, these checks and balances can be undermined and competing interests are far less likely to be picked up or navigated in nuanced and sophisticated ways. To make matters worse, science tends to be sped up in precisely those circumstances in which stakes are highest and competing interests are the most powerful. As described above, when health emergencies arise, there is often “big money” at stake and strong political pressures (in some cases, focused on particular interventions, as evident in Donald Trump’s personal endorsement of hydroxychloroquine (Mahase 2020)). As a result, those who are the first to make, disseminate, and use new discoveries are likely to reap considerable fame and fortune. Another compounding factor is that it is easier for undeveloped methods (which, as discussed above, are often used in emergency situations) to be manipulated without detection for personal or professional gain (Lipworth 2019). The precise nature and effects of competing interests in the Surgisphere study remain to be determined, but there is emerging evidence that there might have been significant commercial interests at play, stemming primarily from the fact that one of the study’s lead co-authors (Dr Supan Desai) is founder and CEO of Surgisphere. While such ties to any company can be problematic for a researcher, journalists have subsequently uncovered findings suggesting that Desai and his companies have behaved with questionable integrity both in other research and in their cooperation with investigations following the Lancet publication (Davey, Kirchgaessner, and Bosely 2020); Mehra, Ruschitzka and Patel 2020; Ledford and Van Noorden 2020; Davey 2020). It is important for these emerging findings to be critically interrogated and for conceptual and moral distinctions to be made between commercial interests, competing interests, misconduct, and corruption. It seems very clear, however, that competing interests need to be investigated in the Surgipshere case."

"National Health and Medical Research Council"