The "under review" status pill and when a moderator applies it — a second dataset

The "under review" status pill and when a moderator applies it — a second dataset Writing it up because I had to work it out twice and would rather nobody else did.

I have seen SURPASS-4 (Lancet, 2021) cited in support of a claim I do not think it supports, twice this month, so I would like to work through what it actually shows.

My reading is that the trial is sound for its own question and is being stretched to answer a different one. I might be wrong about that, which is why this is a topic rather than a correction.

What I would like from this discussion: someone who disagrees with me to say why, with the section of the paper they are relying on.

Peer review as a filter: published papers have survived a review process that rejects many submissions. Preprints have not. Neither guarantees correctness, but publication history is a difference worth noting.

Unrefereed work is not worthless. A great deal of it survives review substantially unchanged. It is also the case that the version appearing in a journal frequently has different numbers, and the changes are not random — they tend to be in the direction of a smaller effect and a more careful claim.

Picking up the opening post: that is the part I would want checked first.

For anyone arriving from a search: the marked solution above is the direct answer, and the replies underneath it add the caveats that make it safe to use.

Two things before anyone answers the substance.

First, the context in the first post is clear and specific. Second, the question is framed so that an answer can actually address it. Both are the norm here and both matter more than they sound.

Always label it as a preprint in any discussion. A preprint is not a published trial and it is not settled knowledge. Use it for hypothesis generation and for understanding emerging evidence, not for drawing definitive conclusions.

I read post #5 twice before replying, because I had assumed the opposite.

Server repositories: medRxiv for medicine, bioRxiv for biology. Preprints on these servers are time-stamped and have DOIs even if they are later published elsewhere. Citing the preprint with its DOI is appropriate while noting it is unpublished.

This follows post #5 rather than contradicting it.

What changes between preprint and publication: authors respond to reviewer comments, re-analyse data, correct errors found in peer review, and sometimes report different results from updated analyses. The published version is not the same as the preprint.

Check whether it was later published: searching for the preprint's first author and keywords in PubMed might find a published version. The published version is the stronger citation if it exists.

Discussing preprints in this community: bring them in for early discussion, label them clearly as preprints, invite peer critique, and be prepared for the discussion to differ if the paper is later published differently.

I disagree with the reply above, and I think the disagreement is substantive rather than terminological.

The distinction being drawn does not survive when you look at the published data for this specific question. I would be glad to be shown wrong on this, because the version I am arguing against is more convenient.

Worth separating two things that post #8 runs together.

Do not build anything on a preprint that you would mind rebuilding: if the preprint later changes substantially in revision or shows different results when published, your reasoning based on the preprint needs to be revised.

Preprints for speed: some important preliminary findings are posted as preprints to disseminate quickly. That speed is useful but comes at the cost of not yet having survived peer review. The trade-off is real.

Check whether it was later published: searching for the preprint's first author and keywords in PubMed might find a published version. The published version is the stronger citation if it exists.