How a few poorly designed COVID-19 studies may have contributed to misinformation in Brazil: the case for evidence-based communication of science.

© Author(s) (or their employer(s)) 2021. Reuse permitted under CC BY. Published by BMJ. INTRODUCTION The emergence of SARSCoV-2 in the end of 2019, an aetiologic agent responsible for the SARS plunged the world into an unprecedented sanitary crisis. Papers on COVID-19 have been fasttracked since then. Accelerated time from submission to publication and qualitative changes in peer review, associated with empirical evidence that duplicate and implausible clinical trials have been carried out during the pandemic, could perhaps imply lower quality of peer review in COVID-19 research. Accumulating empirical evidence has also been indicating the pandemic era output to be less reliable than its prepandemic counterpart. 10–14 A systematic review to evaluate the methodological quality of COVID-19 peerreviewed clinical studies compared with historical controls found methodological quality scores to be lower in COVID-19 articles across all study designs. Meanwhile, data sharing practices remained largely unchanged during the first year of the pandemic. 14 With no mandates of data sharing in place for COVID-19 studies, the reproducibility of these data on COVID-19 is yet to be independently verified as well. However, more efficiency in scientific publication did manifest in accelerated publication, journals tearing down their paywalls for their COVID-19 output, an increased usage of life and medical sciences preprint servers to increase speed and transparency, not to mention the intense international collaboration that resulted in the development of multiple highefficacy vaccines within the first year of the pandemic. On the other hand, some pratices that reduce the reliability of clinical trials may have gained some traction during 2020, such as executing underpowered studies with small samples, multiplicity of trials testing ideas with low prior probability of being true, forgoing blinding to test interventions 11 14 17–20 and incomplete reporting of findings, which was already an issue before the pandemic. 21 To what extent that has dominated the general output in medical interventions for COVID-19 and how much of it turned into actual clinical pratice is something that has not yet been thoroughly assessed and is, thus, still open for debate. 14 Notwithstanding, it is likely that poor science, even if it being the exception within an overall output, when carelessly amplified within a context of sanitary crisis and political polarisation, may be consequential, as it has been the case of the now infamous hydroxychloroquine (HCQ) study, that strengthened a trend in nonevidencebased interventions for COVID-19 and divided the Brazilian medical community to this date. 24 The mechanism of how that type of misinformation plays out in the current media environment is the topic of interest of this brief communication as disseminating scientific findings through press releases and press conferences but without timely access to the study nor to its data has also gained some traction in 2020 in Brazil. 14 25 Below, we briefly discuss how a small set of exceptionally poorly designed studies disseminated through the press, weeks or months before publication and without access to the data sets used to generate these studies for a more thorough assessment, played into a cycle of misinformation in Brazil in the first year of the pandemic. And, to conclude, we suggest a programme of scientific investigation aimed to properly examine and address coright.