The remaining unknowns: A mixed methods study of the current and global health research priorities for COVID-19

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Abstract

Introduction

In March 2020 the World Health Organisation (WHO) released a Global Research Roadmap in an effort to coordinate and accelerate the global research response to combat COVID-19 based on deliberations of 400 experts across the world. Three months on, the disease and our understanding have both evolved significantly. As we now tackle a pandemic in very different contexts and with increased knowledge, we sought to build on the work of the WHO to gain a more current and global perspective on these initial priorities.

Methods

We undertook a mixed methods study seeking the views of the global research community to i) assess which of the early WHO roadmap priorities are still most pressing; ii) understand whether they are still valid in different settings, regions or countries; and iii) identify any new emerging priorities.

Results

Thematic analysis of the significant body of combined data shows the WHO roadmap is globally relevant, however, new important priorities have emerged, in particular, pertinent to low and lower-middle income countries (less resourced countries), where health systems are under significant competing pressures. We also found a shift from prioritising vaccine and therapeutic development towards a focus on assessing the effectiveness, risks, benefits and trust in the variety of public health interventions and measures. Our findings also provide insight into temporal nature of these research priorities, highlighting the urgency of research that can only be undertaken within the period of virus transmission, as well as other important research questions but which can be answered outside the transmission period. Both types of studies are key to help combat this pandemic but also importantly to ensure we are better prepared for the future.

Conclusion

We hope these findings will help guide decision making across the broad research system including the multi-lateral partners, research funders, public health practitioners, clinicians and civil society.

Summary box

What is already known?

The WHO produced a roadmap that set out the research priorities following a meeting in February, just before COVID-19 was declared a Pandemic. Now, at this point in the evolution of this novel disease across the world, and almost 6 months later, it is important to assess whether these priorities remain and if research teams in all countries across the globe agree that these are the most important question that need to be tackled within their health care setting and communities, both to mitigate this outbreak and to learn for next time.

What are the new findings?

Over 3,000 healthcare workers and researchers contributed to this research and their data tells us that across the globe there has been a shift in priorities and new questions have emerged, particularly from low-resourced settings. For example, there is a strong call for evidence on the relative effectiveness and optimal implementation of public health interventions in varied global settings, for social science studies to guide how to gain public trust and mitigate myths, to understand the impact on already present diseases within communities, and to explore the ethics of research within a pandemic.

What do the new findings imply?

The WHO roadmap is globally relevant, however, our findings also provide insight into the temporal nature of these research priorities, highlighting the urgency of research that can only be undertaken within the period of virus transmission, as well as other important research questions but which can be answered outside the transmission period. Both types of studies are key to help combat this pandemic but also importantly to ensure we are better prepared for the future.

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  1. SciScore for 10.1101/2020.06.24.20138198: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    These written comments were imported into NVivo qualitative data analysis package and we undertook a pragmatic thematic content analysis.
    NVivo
    suggested: (NVivo, RRID:SCR_014802)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).


    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Limitations of our approach include the fact that we built the questions to align with the original WHO broad priority headings, this would have inherently focussed the survey respondents around the largely biomedical focus of these priorities and this meant that some headings (for example the animal human interface) had relatively few suggested priorities while others (for example social sciences in the outbreak response) had much larger numbers. We also retained the original order of priorities from the WHO Research Roadmap and the AAS survey and this may have influenced the ranking given by respondents. The workshops however were open and purposefully invited researchers to make whatever comments they wanted in regard to where current research priorities lie, beyond the scope of the WHO Research Roadmap. Therefore, taken together we suggest that these data support the importance of the WHO Research Roadmap approach and highlight where funders and researcher should be placing emphasis as well as identifying potential new areas that should be tackled within this pandemic. Consideration of both immediate and long-term priorities is important to address this specific pandemic and to better prepare for the future. There are studies that need ongoing transmission, at a high enough rate to answer the question they set. These might be essential for this pandemic, for example clinical trials to determine the efficacy of drugs or vaccines, or address questions to guide future outbre...

    Results from TrialIdentifier: No clinical trial numbers were referenced.


    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.


    Results from JetFighter: We did not find any issues relating to colormaps.


    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a protocol registration statement.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.