{"id":49895,"date":"2021-03-23T07:40:04","date_gmt":"2021-03-23T06:40:04","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=49895"},"modified":"2021-03-23T09:00:06","modified_gmt":"2021-03-23T08:00:06","slug":"publish-the-protocol-for-the-uk-sars-cov-2-human-challenge-study-now","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2021\/03\/23\/publish-the-protocol-for-the-uk-sars-cov-2-human-challenge-study-now\/","title":{"rendered":"Publish the protocol for the UK SARS-CoV-2 human challenge study now"},"content":{"rendered":"<p class=\"standfirst\"><span style=\"font-weight: 400\">Publishing protocols while a trial is being conducted rather than afterward has unique value, particularly for SARS-CoV-2 challenge studies, say Josh Morrison and Charles Weijer<\/span><\/p>\n<p><!--more--><span style=\"font-weight: 400\">On 17 February, the British government <\/span><a href=\"https:\/\/www.gov.uk\/government\/news\/worlds-first-coronavirus-human-challenge-study-receives-ethics-approval-in-the-uk\"><span style=\"font-weight: 400\">announced<\/span><\/a><span style=\"font-weight: 400\"> that the first <\/span><a href=\"https:\/\/hvivo.com\/the-human-challenge-programme\/\"><span style=\"font-weight: 400\">SARS-CoV-2 human challenge study<\/span><\/a><span style=\"font-weight: 400\"> had received approval from a research ethics committee. The challenge study, it said, was \u201cdue to begin in the next few weeks.\u201d We, as co-authors, <\/span><a href=\"https:\/\/www.bmj.com\/content\/371\/bmj.m4258\"><span style=\"font-weight: 400\">disagree<\/span><\/a><span style=\"font-weight: 400\"> on whether these studies should be conducted, but what we do agree on is that the full study protocol for any SARS-CoV-2 challenge study should be published now.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Support for publishing scientific protocols has broad consensus: a <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/31450958\/\"><span style=\"font-weight: 400\">review of high impact studies<\/span><\/a><span style=\"font-weight: 400\"> reveals that 82% of those reviewed eventually made their protocols available. Science is a collaborative endeavor, and sharing methods makes future research easier to conduct. Moreover, access to protocols finalized before a study begins helps to improve the end result by specifying hypotheses, design, outcome measures, and analysis plans in advance to avoid <\/span><a href=\"https:\/\/www.cochranelibrary.com\/cdsr\/doi\/10.1002\/14651858.MR000031.pub2\/full\"><span style=\"font-weight: 400\">unwarranted changes to design or analysis<\/span><\/a><span style=\"font-weight: 400\"> and <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/15161896\/\"><span style=\"font-weight: 400\">selective reporting of outcomes<\/span><\/a><span style=\"font-weight: 400\">.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Real time transparency\u2014publishing protocols while a trial is being conducted rather than afterward\u2014has unique value, particularly for SARS-CoV-2 challenge studies. The philosopher <\/span><a href=\"https:\/\/www.youtube.com\/watch?v=XWwTYy9k5nc\"><span style=\"font-weight: 400\">Onora O\u2019Neill <\/span><\/a><span style=\"font-weight: 400\">argues that trustworthiness is more important than trust. <\/span><a href=\"https:\/\/www.theguardian.com\/commentisfree\/2020\/nov\/26\/pandemic-earn-trust-facts-vital-covid\"><span style=\"font-weight: 400\">David Spiegelhalter<\/span><\/a><span style=\"font-weight: 400\"> believes her view is key to fostering public trust during the covid-19 pandemic. He says, \u201ctrust happens when people show honesty, reliability and competence, presenting evidence in ways that make it accessible, intelligible, useful and easily assessed (meaning you can check the workings for yourself, if you so wish).\u201d\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">The early publication of study protocols is a verifiable public commitment to conduct the study as planned and thus evinces trustworthiness. It also provides an opportunity for the scientific community to better understand and digest these studies, which will, in turn, allow for better communication with the public. Openness with the protocol may allow experts to spot potential gaps and areas for improvement in the study plan, and thus improve safety for healthy volunteers. Seeing the plan for the study ahead of time may reduce the opportunity for sensationalist coverage if something goes wrong.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">The <\/span><a href=\"https:\/\/www.bmj.com\/content\/371\/bmj.m4058\"><span style=\"font-weight: 400\">publication of protocols<\/span><\/a><span style=\"font-weight: 400\"> for randomized controlled trials of SARS-CoV-2 vaccines bears this out. Pressure for publication of study protocols increased after the poor <\/span><a href=\"https:\/\/www.nytimes.com\/2020\/09\/13\/science\/coronavirus-vaccine-trials.html\"><span style=\"font-weight: 400\">public communication<\/span><\/a><span style=\"font-weight: 400\"> of a pause in a trial to investigate a serious adverse event. Unfortunately, in this instance, protocol publication as a response to public criticism seemed defensive. The World Health Organization\u2019s 7 <\/span><a href=\"https:\/\/cdn.who.int\/media\/docs\/default-source\/blue-print\/hcs-who-ag_meeting-report_09feb2021.pdf?sfvrsn=fb65ebff_5&amp;download=true\"><span style=\"font-weight: 400\">December meeting<\/span><\/a><span style=\"font-weight: 400\"> on SARS-CoV-2 challenge studies emphasized the importance of preventing these studies from contributing to vaccine hesitancy. This makes it imperative to think carefully about how an adverse event in the trial would be managed and communicated to the public. Given that the hVIVO and Imperial College London study team has publicly <\/span><a href=\"https:\/\/www.sciencemuseumgroup.org.uk\/blog\/coronavirus-should-we-infect-young-people-with-covid-19\/\"><span style=\"font-weight: 400\">committed to publishing the protocol<\/span><\/a><span style=\"font-weight: 400\"> at some point, it makes sense to do it beforehand rather than as a response to any potential issue that may arise.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Human challenge studies can advance the frontiers of medicine, but they raise the specter of past abuses such as <\/span><a href=\"https:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673602117971\/fulltext\"><span style=\"font-weight: 400\">wartime experiments<\/span><\/a><span style=\"font-weight: 400\"> involving the exposure of prisoners to infectious agents. Evading public scrutiny is not a solution. Instead, these studies should be treated as an opportunity to enact and publicly demonstrate our highest moral standards. This is best achieved by aiming to conduct challenge research not as an exercise in meeting the necessary requirements to receive ethics committee approval, but, rather, as a chance to think carefully about what the ideal policies for medical research should be and then attempt to make these studies models of such behavior.<\/span><\/p>\n<p><span style=\"font-weight: 400\">By all accounts, the volunteers who wish to participate in these studies are doing so out of a sincere desire to help humanity. We, as a scientific community, owe it to them to do the same. Publishing scientific protocols for SARS-CoV-2 challenge studies in advance is one meaningful way of meeting that moral commitment.<\/span><\/p>\n<p><em><span style=\"font-weight: 400\"><strong>Josh Morrison<\/strong> is the executive director of 1Day Sooner, an advocacy group for research participants, including those in covid-19 challenge studies. <a href=\"https:\/\/twitter.com\/1daysooner?lang=en\">@1daysooner<\/a><\/span><\/em><\/p>\n<p><em><span style=\"font-weight: 400\"><strong>Charles Weijer<\/strong> is a bioethicist and professor at Western University in London, Canada. <a href=\"https:\/\/twitter.com\/charlesweijer?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor\">@charlesweijer<\/a><\/span><\/em><\/p>\n<p><span style=\"font-weight: 400\"><strong>Competing interests<\/strong>: <\/span><span style=\"font-weight: 400\">JM is employed as the executive director of 1Day Sooner, a nonprofit organization that advocates on behalf of volunteers for a covid-19 human challenge trial. CW receives consulting income from Cardialen, Eli Lilly &amp; Company, and Research Triangle Institute International.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Publishing protocols while a trial is being conducted rather than afterward has unique value, particularly for SARS-CoV-2 challenge studies, say Josh Morrison and Charles Weijer [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2021\/03\/23\/publish-the-protocol-for-the-uk-sars-cov-2-human-challenge-study-now\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":66,"featured_media":49897,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[223],"tags":[],"class_list":["post-49895","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-guest-bloggers"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Publish the protocol for the UK SARS-CoV-2 human challenge study now - 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