Clinician and PhD student, Karin Purshouse, is a longtime advocate of open access. After experiencing first-hand the positive impact of preprints for research into COVID-19 in general, and in relation to cancer in particular, she is more passionate about promoting the cause than ever.
Many medical doctors like Karin do some kind of academic study alongside their clinical work. But because of time restraints and a lack of funding for article processing charges (APCs), their research outputs often go unpublished, or get published with a significant delay and end up behind paywalls. Preprint publishing is an obvious solution, and Karin is part of a network of academics who are keen to make it more of a norm. As Karin works for the UK’s publicly-funded health service, she feels it’s particularly important for her to share any findings from her research that may prove useful to society.
Earlier this year, Karin shared a preprint on ResearchGate examining the early experience of cases of COVID-19 in patients with cancer in the cancer center where she works. The work was sparked by the changes Karin had observed happening in oncology practice since the COVID-19 outbreak, with doctors becoming anxious about giving patients chemotherapy. Seeing that the observations from her team’s experience contrasted with what others had found, Karin’s article concluded that more evidence was needed to guide safe cancer treatment during the pandemic. Her team was concerned that, in the long-term, the mortality rate from untreated or undertreated cancer may exceed that from coronavirus.
After further highlighting these concerns in a BMJ Rapid Response and sharing the preprint on the Edinburgh Cancer Informatics blog, the preprint was used as evidence by the charity Action Radiotherapy (Rapid Mini Enquiry, 27th April 2020), who gave it to a parliamentary group pleading for the UK health service to exercise caution in pausing cancer treatments.
This demonstrated to Karin firsthand the benefits of preprint publishing for scientific discourse: by communicating early on and openly what we know now, we can identify where we need more data.
In Karin’s opinion, some of the most important articles on COVID-19 have come from open access and preprint platforms like MedRxiv. Yet before the COVID-19 pandemic, her experience was that awareness of open access and preprint publishing was relatively low in the clinical community. There could be many reasons for this – busy clinical commitments, lack of preprint options appropriate for clinical research, and the value placed on PubMed-citable articles. She advises junior medical researchers to push for open science, and to ask more senior collaborators to consider open publishing formats, such as preprints and open access journals.
Karin is aware of the early nature of non-peer-reviewed content and is calling for a “culture of dynamic, active critical appraisal” in the medical community. Open peer review allows larger groups to feed in, as well as allowing clinicians to review the data for themselves as soon as it’s available. It creates a more transparent and collaborative environment, and will, at the end of the day, make progress in science happen faster.
Karin became interested in open access as a medical student. As the chair of the British Medical Association’s Medical Students Committee 2010-11 (BMA MSC), she developed a policy supporting open access that the BMA MSC passed at their annual conference in 2011. Karin qualified as a medical doctor in 2012 and commenced her medical work in a combined clinical academic post in Oxford. It was while she was on a Fulbright Scholarship at Yale University from 2014-15, doing postgraduate research into brain cancer, that Karin became more involved with other early career researchers, and joined a network driving change towards open science after attending the inaugural OpenCon Conference.
After finishing her Masters, she took up an Academic Clinical Fellowship in Oxford, which combined clinical and research training, and subsequently took up an ECAT Clinical Lectureship in Edinburgh.
In 2019, Karin paused her medical oncology residency to pursue a PhD in brain cancer research. In light of the coronavirus pandemic, Karin put her studies on pause temporarily to return to the clinical frontline. Alongside her work at Edinburgh Cancer Centre, Scotland, she has been working with the UK Coronavirus Cancer Monitoring Project to understand features or characteristics that may explain the particular risks of COVID-19 for cancer patients.
After four months of intensive clinical work, Karin has restarted her doctoral studies. Going back to full-time research with all the necessary adaptations that COVID-19 requires has been a challenge, but she welcomes the opportunity to return to her cancer studies.
