Objective The posting of clinical research reports on preprint servers prior to peer review increased dramatically during the SARS-CoV-2 pandemic.1 However, little is known about the fate of preprint reports after submission to a peer-reviewed journal. This study investigated Annals of Internal Medicine’s experience with submissions available as preprints submitted during the first 21 months of the pandemic to address the following questions: (1) what was the acceptance rate of these submissions? and (2) after publication, how often did the preprint server note the published article?

Design Data on all submissions from March 1, 2020, through January 21, 2022, that appeared on preprint servers were collected. Editorial decisions (reject without external review, reject after external review or statistical review, and accepted for publication) were reported. Finally, for those submissions that the journal did not publish but for which it did perform a statistical review, a Google Scholar search was performed to determine subsequent publication in another indexed journal. Results Of all manuscripts submitted between March 1, 2020, and January 21, 2022, a total of 362 manuscripts were posted in a preprint archive prior to submission to Annals of Internal Medicine. Of these, 337 manuscripts (93.6%) were rejected, 23 manuscripts (6.3%) were published, and 2 manuscripts were pending final decision. Additionally, 247 manuscripts (68.2%) were rejected without external review and 115 manuscripts (31.8%) were sent for peer review. Of those sent for peer review, 34 manuscripts (29.5%) progressed to statistical review. Of those sent for statistical review, 11 manuscripts (32.4%) were rejected after statistical review. A Google Scholar search showed that 2 manuscripts rejected after statistical review were published in other journals. Among manuscripts published to preprint servers, a link to the peer-reviewed, published version was provided on the server for 13 manuscripts (56.5%). Acceptance and rejection rates were comparable to submissions that did not appear on a preprint server.

Conclusions There are theoretical advantages to posting non–peer-reviewed preprints of clinical research, particularly during public health crises, such as a pandemic. However, subsequent vetting and publication in peer-reviewed journals can help to avoid dissemination of misinformation. Unfortunately, a large proportion of submissions posted as preprints were not found suitable for publication in a clinically influential, peer-reviewed journal. When published, the preprint archive did not always acknowledge the subsequently published article.

Reference 1. Cabanac G, Oikonomidi T, Boutron I. Day-to-day discovery of preprint-publication links. Scientometrics. 2021;126(6):5285-5304. doi:10.1007/s11192-021-03900-7

Conflict of Interest Disclosures Christine Laine is a member of the Peer Review Congress advisory board but was not involved in the review or decision for this abstract. No other disclosures reported.