1. My new paper with @kimmelmanJ is out at @ScienceMagazine. “Pandemic Research Exceptionalism” is the idea that the urgency of a crisis warrants lowering #research standards. We argue against this view. #researchEthics #medicine #publicHealth https://science.sciencemag.org/cgi/doi/10.1126/science.abc1731

2. “Although crises present major logistical and practical challenges, the moral mission of research remains the same: to reduce uncertainty and enable caregivers, health systems, and policy-makers to better address individual and public health.”

3. #Pandemics pose daunting practical and logistical challenges for science. But the problems that #randomization, concurrent controls, and meaningful clinical endpoints address don’t disappear just because this is a crisis.

4. Some evidence now is not always better if it increases #uncertainty, makes providers and patients reluctant to join studies with randomization and concurrent controls and misleads #caregivers and #healthsystems into squandering scarce resources.

5. Many lives are at stake in a pandemic, but matters are always urgent for desperately ill patients and when #equipoise exists, well-designed studies do not make patients worse off but do generate the information that care givers and health systems need...

6. ... to discharge their social responsibilities. I’ve written about #equipoise in public health emergencies in several places, including here: https://www.cmu.edu/dietrich/philosophy/docs/london/london-social-value-equipoise-epidemic.pdf

7. Researchers normally have broad discretion over the questions they ask and the methods they use. But, as we argued here: https://science.sciencemag.org/content/336/6081/544.summary the goal of an effective ethical and oversight system is to align stakeholder interests with the production of a public good.

8. The feasibility of high-quality research in a public health emergency hinges on the ability of stakeholders to make exceptional efforts to cooperate and collaborate. To work outside normal academic silos rather than to reduce the quality of studies.

9. Public health crises reveal shortcomings that are present in research even in normal circumstances. We are witnessing a deluge of studies on similar clinical hypotheses, duplicating effort, making inefficient use of time and resources, that risk generating false positives by..

10. ...by chance. But research ethics and regulation lack a mechanism for dealing with these system- or “portfolio-level” concerns. @KimmelmanJ and I write about those deficiencies at length here.
. https://twitter.com/alexjohnlondon/status/1168854774034382848?s=21 https://twitter.com/AlexJohnLondon/status/1168854774034382848