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Citation impact and social media visibility of Great Barrington and John Snow signatories for COVID-19 strategy
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  • Published on:
    From a non-scientist - practical considerations stopped the GBD rather than Twitter

    I’m prefacing this with the fact that I’m not an epidemiologist, virologist, medical scientist in any way, or healthcare worker. I’m therefore VERY hesitant to pop up and appear to be criticizing those who have spent decades in scientific research.

    I am, however, a Councillor in Local Government in the UK with some minimal scientific training (two degrees – physics and military electronic systems engineering), and was therefore a bit involved in the local response to covid (For example, the seventh suggestion by the GBD for focused protection was to offer home delivery to vulnerable people; I assisted in setting up and funding local networks to do just that from March 2020, as did councillors across the UK), so the subject under discussion had immediate impact upon us. Should there have been acceptance of the GBD, I’d have been one of those involved in trying to carry it out (albeit only in a very minor way in comparison to many others). I'm also a qualified and experienced project manager who has had to translate strategies into practice many times.

    It might therefore be of some use to give feedback from that side of things - the core of the question seemed to be "Was it Twitter that stopped implementation of the GBD rather than practical considerations." I can say that my own views of the GBD were not impacted by any Twitter publicizing (I only started reading Twitter some months ago), but because, when reading it with the view of “how wou...

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    Conflict of Interest:
    None declared.
  • Published on:
    On "weaponization," revisited
    • David H. Gorski, Professor of Surgery Wayne State University and Karmanos Cancer Institute

    I realize that I stated in my last Rapid Response (RR) [1] that it would probably be my last one, but, given Prof. Ioannidis’ most recent RR [2], I changed my mind.

    Once more unto the breach…

    It remains painfully clear that Prof. Ioannidis still does not understand the utter inadequacy of Twitter follower counts as a measure of social media impact, despite multiple patient and respectful efforts by several RR authors to educate him, most notably Gideon Meyerowitz-Katz [3]. Given all the excellent critiques of this problem with his study, I will not attempt to add mine to them. Instead, I will address something that I can address, the part of his response primarily directed at me, because it betrays a further misunderstanding of science communication that I cannot leave unanswered.

    In his most recent RR [2], Prof. Ioannidis asserts, “The best way for any scientist to ‘control’ use/misuse is to try to do better science, arriving at less biased estimates. I consider science communicators my heroes exactly because they can clarify important points, countering weaponization. They can explain why scientific papers or quotes are not aligned with conspiracy theories. Conversely, if science communicators lambast scientific papers or quotes as being aligned with such theories, they officially surrender science to conspiracy. We should dismantle conspiracy theories, not the science or scientists they misuse.” In the context of his study [4], this criticism widely...

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    Conflict of Interest:
    As he has stated in each previous Rapid Response, Dr. Gorski is the managing editor of Science-Based Medicine, a blog dedicated to discussing the use and misuse of science in medicine and has been very critical of the Great Barrington Declaration and those who helped organize the conference that resulted in the document.
  • Published on:
    A Simple Request to Professor Ioannidis: Please Address Our Concerns
    • Gavin M Yamey, Professor of Global Health and Public Policy Center for Policy Impact in Global Health, Duke University
    • Other Contributors:
      • David H Gorski, Professor of Surgery
      • Gideon Meyerowitz-Katz, Epidemiologist

    We write as a group of scientists who are concerned about ethical and methodological flaws that we have found in Professor John Ioannidis’ paper [1]. These include factual errors, statistical shortcomings, failure to protect the named research subjects from harm, and potentially undeclared conflicts of interest that entirely undermine the analysis presented. We have previously published our concerns about this study in 8 Rapid Responses authored by each of us as individuals [2-9], but since Prof. Ioannidis has declined to address them substantively, we are now writing collectively in the hope that he might consider our joint response more seriously.

    We undertake this effort because, unfortunately, the author’s Rapid Responses to our concerns and criticisms have devolved into what are inarguably personal attacks on some of us. Thus, we wish to state the issues with the study simply and directly and, once again, ask Prof. Ioannidis to address them, but this time in a more objective fashion, free of deflection and personal hostility. There is no doubt that Professor Ioannidis has been one of the foremost scientists of our times. Indeed, he is the most cited living scientist. However, as scientists we believe that we should base beliefs on facts and science over opinions, even if those opinions come from an academic as eminent as Prof. Ioannidis.

    We believe that the facts outlined below completely undermine the paper published in BMJ Open. While individual scient...

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    Conflict of Interest:
    Gavin Yamey is a former editor of the BMJ. He was editor of two of John Ioannidis' papers in PLOS Medicine, and he wrote a feature about Ioannidis for the BMJ. He has written articles, including in TIME, in support of public health measures to curb COVID-19 (including widespread vaccination; masks; test, trace, isolate, and support; distancing; workplace and school safety measures; and ventilation of buildings). He was a co-author of a Lancet correspondence, “Scientific consensus on the COVID-19 pandemic: we need to act now” (Lancet 2020;396:E71-E72) that was the basis for the Jon Snow Memorandum. In a legal case in which 7 rural Manitoba churches and 3 individuals argued that Manitoba’s public health measures violated their charter rights, an argument supported in court by GBD author Jay Bhattacharya, Yamey provided unpaid scientific guidance to the legal team that argued in support of public health measures; the judge, Court of Queen's Bench Chief Justice Glenn Joyal, ruled that the public health measures were reasonable limitations on the group's charter rights in the context of the Covid-19 pandemic. Yamey has been critical of the GBD, including in an article in TIME.

    David Gorski is managing editor for the Science-Based Medicine blog, where he and other bloggers have been very critical of the Great Barrington Declaration.

    Gideon Meyerowitz-Katz has signed neither the Great Barrington Declaration nor the John Snow Memorandum and has no financial conflicts of interest. He has, however, publicly critiqued both statements on twitter, and has made several public statements pointing out factual errors in the Great Barrington Declaration. He has also been personally attacked both by Professor John Ioannidis and signatories to the Great Barrington Declaration. Finally, her is the owner of both large glasses and a cat.
  • Published on:
    Fourth set of replies

    I thank Helling, Meyerowitz-Katz (second comment) and Yamey and Gorski (third comments). I learned a lot in this exchange.
    Meyerowitz-Katz is probably less critical of my work than I am myself. I acknowledged face and construct validity limitations in Twitter metrics. Indeed, number of followers are a surrogate. However, the difference between the two compared groups is extraordinary. Following his comments, I collected also data on number of tweets. Differences are immense: 20 JSM key signatories versus only 2 GBD signatories exceed 6000 tweets each. The top-10 (26900 to 177900 tweets per scientist) are all JSM key signatories. The JSM key signatories unleashed almost a million tweets, roughly 10-fold higher than GBD signatories. Even adding AIER and GBD accounts (25600 and 579 tweets, respectively), the difference remains enormous. Other social media platforms are worth exploring, but access to data is problematic, as Altmetric has also witnessed. Regardless, the stated primary aim of the paper was not to “evaluate the social media visibility of signatories, as denoted by Twitter followers”, but “to examine whether the prevailing narrative that GBD is a minority view among experts is true”: the paper provides strong evidence that this is untrue. Both GBD and JSM are supported by many stellar scientists. The Twitter analysis offers one potential explanation why GBD was dismissed as “unscientific nonsense” by Meyerowitz-Katz (...

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    Conflict of Interest:
    As in the original paper: "The author has signed neither of the two documents and has many friends, collaborators and other people who he knows and he admires among those who have signed each of them. JPI has previously published that he is very skeptical about signature collection for scientific matters (BMJ 2020;371:m4048). He has no personal social media and he believes that the fact that his citation indices are extremely high only proves (when compared against his self-acknowledged vast ignorance) that these indices can occasionally be very unreliable. JPI congratulates all the thousands of signatories (of both documents) for their great sense of social responsibility."
  • Published on:
    Scientific Inadequacies Unaddressed

    I thank Professor Ioannidis for his kind response. However, it appears not to have engaged with the central arguments I have raised and does not address the issue that many of the statements made in this paper are factually mistaken.

    The first point is regarding Twitter. Prof Ioannidis eschews social media, and thus may be unaware of this, but 'followers' are, at best, a surrogate measure for impact (1). Having a large number of followers on Twitter is no guarantee of interaction with tweets, nor does it measure how many people have actually viewed the tweets. Twitter prioritizes viewing through an opaque algorithm, meaning some accounts with 100,000s of followers receive little attention while others with very few receive large amounts. Previous research has shown that simple follower counts contribute only a modest fraction of the total ‘impact’ of each account on Twitter: “topological measures such as indegree [follower counts] alone reveals very little about the influence of a user” (2). It is factually incorrect to ascribe greater Twitter "firepower" to the authors of the JSM, as even a cursory analysis shows that despite having fewer Twitter users in the group, the GBD authors have had a greater reach by far. For example, the GBD link is still being shared on Twitter several times an hour, while the JSM link is shared at most once a week (3,4).

    Prof Ioannidis is likely correct in that this is because the GBD was more accessible to n...

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    Conflict of Interest:
    I have signed neither the Great Barrington Declaration nor the John Snow Memorandum and have no financial conflicts of interest. I have, however, publicly critiqued both statements on twitter, and have made several public statements pointing out factual errors in the Great Barrington Declaration. I have also been personally attacked both by Professor John Ioannidis and signatories to the Great Barrington Declaration. Finally, I am the owner of both large glasses and a cat.
  • Published on:
    On "weaponization"
    • David H. Gorski, Professor of Surgery Karmanos Cancer Institute and Wayne State University

    I thank Prof. Ioannidis for his second response (1) and am gratified that, as much as he disagrees with me, he considers me a talented science communicator. Although I am even more honored to realize that someone of Prof. Ioannidis' prominence is not only aware of the humble blog for which I serve as managing editor (2) but is sufficiently familiar with posts containing my much longer critique of his Kardashian index study (3) and that of one of my co-bloggers of some of his—shall we say?—less temperate assertions about the pandemic (4), to the point of having done actual word counts for both posts (5, 6), I am nonetheless disappointed to have to note that his response would seem to validate at least some of my criticisms (7, 8) of his study (9) and his prior responses (5, 6). Also, given that he has criticized one of my bloggers for "conspiracy theories," I feel the obligation to respond to defend him—and, of course, myself—for having used his blog post in my previous response (8).

    What seems to have raised Prof. Ioannidis' ire the most was my observation about his having repeated a narrative that was an early conspiracy theory during the pandemic, which he described as facilitating weaponization of his words by linking him with conspiracy theories. I would counter that conspiracy theorists do not need me in the least; they were doing an outstanding job of "weaponizing" Prof. Ioannidis' words without my input, thanks to Prof. Ioan...

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    Conflict of Interest:
    Dr. Gorski is managing editor for the Science-Based Medicine blog, where he and other bloggers have been very critical of the Great Barrington Declaration.
  • Published on:
    Obvious conflict of interest

    Mr Ioannnidis is close to the initiators of the Great Barrington initiative. He uses biased data and false logic to pursue yet another attempt at confusing the public on the scientific consensus regarding covid19 prevention and control.

    Conflict of Interest:
    None declared.
  • Published on:
    Third set of replies

    I thank Meyerowitz-Katz, Rigby, Nurse and Grant for their comments, Gorski for his second comment and Bak-Coleman for his third comment.
    Meyerowitz-Katz offers valuable insights. In-depth analyses of GBD and JSM scientists in diverse social media platforms is an excellent idea. Nurse and Grant also make astute suggestions on this issue. A collaborative effort may be launched, since Gorski and Bak-Coleman also make similar points in passim. Collectively the team has superb complementary expertise. Such studies could also perform in-depth content analyses and interviews of scientists, and then IRB approval is indispensable. I also fully agree that pre-pandemic social media activity and rate of growth during the pandemic deserve attention. Probably GBD has a more steep increase over time than JSM; this may associate also with increasing acceptance of its proposals. The pandemic exploded social media presence for many scientists (e.g. Jay Bhattacharya: no Twitter account in April 2021, 81,000 followers in November 2021, 170,000 in February 2022). Analyses should separate social media presence of organizations. Organizations serve too many purposes to fix them to one or the other document. Moreover, comparing dissemination of the 2 main documents across non-Twitter social media is biased: GBD attracted signatures also from the general public (close to 1 million signatures to-date), while JSM remained focused to experts. Given this different outlook, unsurprisingly GBD...

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    Conflict of Interest:
    As stated also in the original paper “The author has signed neither of the two documents and has many friends, collaborators and other people who he knows and he admires among those who have signed each of them. JPI has previously published that he is very skeptical about signature collection for scientific matters (BMJ 2020;371:m4048). He has no personal social media and he believes that the fact that his citation indices are extremely high only proves (when compared against his self-acknowledged vast ignorance) that these indices can occasionally be very unreliable. JPI congratulates all the thousands of signatories (of both documents) for their great sense of social responsibility.”
  • Published on:
    It Is Not “Divisive” to Criticize Science Misinformation
    • Gavin M Yamey, Professor of Global Health and Public Policy Center for Policy Impact in Global Health, Duke University

    In the latest response to his growing number of critics [1], Professor Ioannidis forcefully defends his record and continues to suggest that having signed neither the Great Barrington Declaration (GBD) nor the John Snow Memo (JSM), he is in an objective position. In a previous response [2], Professor Ioannidis has selectively quoted from interviews and events that occurred in the spring of 2020 to make a case that he has not lobbied for the positions espoused by the GBD and thus argues that he has no undeclared conflicts of interests. This is unfortunate, as there is evidence of his views at the more relevant time (the fall of 2020, when both the GBD and JSM were published).

    In late 2020, the White House coronavirus czar was Dr Scott Atlas, a colleague of Professor Ioannidis at Stanford. The appointment was controversial because of Dr Atlas’s lack of experience with infectious disease control. It is a matter of record that President Trump held a roundtable in August 2020 that included Atlas and two GBD authors, Jay Bhattacharya and Martin Kulldorff [3, 4]. This was a secret meeting; details about it were only made public a year later, thanks to the work of the Select Subcommittee on the Coronavirus Crisis [3]. The day after this meeting, President Trump described his strategy as "sheltering those at highest risk, especially the elderly, while allowing lower risk Americans to safely return to work and to school...they have to get back to work," a strategy t...

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    Conflict of Interest:
    Gavin Yamey is a former editor of the BMJ. He was editor of two of John Ioannidis' papers in PLOS Medicine, and he wrote a feature about Ioannidis for the BMJ. He has written articles, including in TIME, in support of public health measures to curb COVID-19 (including widespread vaccination; masks; test, trace, isolate, and support; distancing; workplace and school safety measures; and ventilation of buildings). He was a co-author of a Lancet correspondence, “Scientific consensus on the COVID-19 pandemic: we need to act now” (Lancet 2020;396:E71-E72) that was the basis for the Jon Snow Memorandum. In a legal case in which 7 rural Manitoba churches and 3 individuals argued that Manitoba’s public health measures violated their charter rights, an argument supported in court by GBD author Jay Bhattacharya, Yamey provided unpaid scientific guidance to the legal team that argued in support of public health measures; the judge, Court of Queen's Bench Chief Justice Glenn Joyal, ruled that the public health measures were reasonable limitations on the group's charter rights in the context of the Covid-19 pandemic. Yamey has been critical of the GBD, including in an article in TIME.
  • Published on:
    Scientific Inadequacies in Social Media Analysis

    In this paper, the primary ambition is stated as: "Here, an analysis is being performed to try to evaluate the scientific impact and the social media visibility of the key signatories who have led the two strategies… Concurrently, an additional analysis evaluated the social media visibility of signatories, as denoted by Twitter followers ". However, the methodology used is clearly inadequate for this stated purpose, with the ultimate consequence that the paper is largely meaningless as an analysis of social media visibility.

    A key limitation not noted in this study is that the author has chosen to use a metric designed for one of the smallest social media platforms in the world. While precise figures may be opaquely calculated due to commercial interests, Twitter reported 192 million monetizable active users in 2020 (1), and according to the data aggregation website Statista has a total of 436 million 'active' users as of October 2021 (2). This is in stark contrast to other social media sites such as Facebook (2.9 billion users) Youtube (2.3 billion users) and even newer platforms such as Telegram (550 million users) Snapchat (538 million users) and Tiktok (1 billion users) (2).

    On examining other social media sites, the inadequacy of using only metrics derived from Twitter becomes immediately apparent. Facebook shares can be analyzed freely through several websites linked to the API (3,4), and these show that the URL for the Great Barring...

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    Conflict of Interest:
    I have signed neither the Great Barrington Declaration nor the John Snow Memorandum and have no financial conflicts of interest. I have, however, publicly critiqued both statements on twitter, and have made several public statements pointing out factual errors in the Great Barrington Declaration. I have also been personally attacked both by Professor John Ioannidis and signatories to the Great Barrington Declaration.
  • Published on:
    Response to Prof. Ioannidis
    • David H. Gorski, Professor of Surgery Barbara Ann Karmanos Cancer Institute at Wayne State University

    I thank Prof. Ioannidis for his response. Although I am honored that someone of Prof. Ioannidis' prominence is aware of the blog for which I serve as managing editor—even so flatteringly noticing the word count of my blog post about his study (1).

    Unfortunately, it is difficult for me not to notice that in his responses (the first of which he referred me to so pointedly) (2, 3), Prof. Ioannidis continues to show no indication that he understands the massive conceptual flaw at the heart of his analysis: The Kardashian index was meant as a joke. He even responds, "The Twitter presence of many signatories is loud (even if laudable) regardless of whether number of followers is expressed as absolute count, k-index, log10, square root, or sinφ. Twitter influence on public perception of science, media, and policy is large, an elephant in the room that needs better study. An elephant is an elephant regardless of whether one presents his weight in kilograms or in pounds" (3) This comparison not only mistakenly represents Twitter as the be-all and end-all of social media influence—leading me to suggest that at all costs he stay away from Tik Tok—but also falsely equates using a satirical measure for an inappropriately serious purpose with a simple choice between commonly accepted units of measure. Indeed, this failure to recognize the K-index as satire on the part of Prof. Ioannidis and the peer reviewers would seem to me to reinforce Neil Hall's very poin...

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    Conflict of Interest:
    Dr. Gorski is managing editor of Science-Based Medicine, the medical blog so kindly mentioned by Prof. Ioannidis. He and one other blogger there have been very critical of the Great Barrington Declaration.
  • Published on:
    Bak-Coleman: Final thoughts

    Dr. Ioannidis has responded to a request to disclose the statistical tests used to compute p-values by calling them a superfluous " focus on statistical testing." Given that such a simple request was met with deflection and hostility, it is difficult to see how further discussion will be productive or advance scientific knowledge in any meaningful way.

    This paper serves as a powerful testament to how highly-cited scientists are not beholden to even the most basic standards of scientific research. They needn't follow ethical norms, disclose conflicts of interest, consider the validity of metrics, or even report which analysis they used.

    They are free to publish numerically-glazed opinions in prestigious venues intended to house knowledge. For the rest of us, there's Twitter.

    Conflict of Interest:
    None declared.
  • Published on:
    The Fallacy of Equating Citation Data with Scientific Qualkity or Impact

    The paper by Ioannidis is fatally flawed by the assumption that citation counts and Twitter activity correlate with scientific quality or health and policy impact. No hypothesis has been presented to support this. Opportunities to publish at scale will be influenced by length of career, and by other academic commitments. Reasons for high citation of papers may be to challenge or seek more clarity as much to commend or build on them. This point has been demonstrated in a peer reviewed paper which contrasted the examples of publication of contentious views gaining high citations, while a research finding which quickly got applied in practice had a single publication (1); the high-cited author eventually had his licence to practice withdrawn, while he who led to many lives being saved globally had no profile. Ioannidis seems to confuse noise and twittering with good grounding and integrity of evidence.

    (1) Rigby M. Citation Analysis in Health Care Sciences - Innovative Investigation or Seductive Pseudo-science?; Methods Inf Med 2014; 53(06): 459-463, DOI: 10.3414/ME14-05-0004

    Conflict of Interest:
    None declared.
  • Published on:
    Reply to Gorski, Dahly, Pimenta and to second comments by Yamey and Bak-Coleman

    I thank Gorski, Dahly, and Pimenta for their criticism and Yamey and Bak-Coleman for their second round of comments. As already stated, I signed neither GBD nor JSM, my study did not aim to elevate or downgrade one or the other narrative, and I congratulate all GBD and JSM signatories. The 443 signatories from GBD include 4 scientists with whom I have co-authored, and 3 with Stanford affiliation. The respective first 443 signatories of JSM include 5 scientists with whom I have co-authored, and 15 with Stanford affiliation. I have co-authored COVID-19 scientific papers with both GBD and JSM signatories (more with the latter). I have more close ongoing collaborators and friends in JSM than GBD. According to Scopus I have 6590 co-authors and probably >200 have signed GBD or JSM. I have learned from both JSM and GBD colleagues and I thank them all for sharing their wisdom.

    As I did in my original paper, I applaud Pimenta again for his amazing work. Additional studies of engagement, impressions and reach would be very useful to perform. Pimenta defends fervently but needlessly some of the JSM main points, since my paper attacked neither JSM nor GBD. It only showed that both lists include many stellar scientists and that JSM had overwhelming Twitter presence. This is emphatically obvious also in the Twitter reception of my paper.

    Gorski apparently submitted his rapid response and his 7591 words long blog in his sciencebasedmedicine.org website before seeing my...

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    Conflict of Interest:
    As stated also in the original paper “The author has signed neither of the two documents and has many friends, collaborators and other people who he knows and he admires among those who have signed each of them. JPI has previously published that he is very skeptical about signature collection for scientific matters (BMJ 2020;371:m4048). He has no personal social media and he believes that the fact that his citation indices are extremely high only proves (when compared against his self-acknowledged vast ignorance) that these indices can occasionally be very unreliable. JPI congratulates all the thousands of signatories (of both documents) for their great sense of social responsibility.”
  • Published on:
    Time for the science Kanyes to stop harassing the science Kardashians
    • Matthew S Nurse, PhD researcher Australian National University
    • Other Contributors:
      • Will J Grant, Associate Professor

    Time for the science Kanyes to stop harassing the science Kardashians

    This study doesn't adequately measure what it seeks to measure and may instead harmfully discourage people from engaging with the stakeholders of science.

    We share many of the concerns presented by other rapid reviews, but we contribute to the discussion by critiquing this study from a science communication perspective, which we would argue is the most appropriate domain for this kind of study.

    The study aims to measure whether it is scientific citations or social media metrics that influence the apparent perception that one group of scientists' policy responses to COVID-19 are more supported by credible scientists compared to another group's.

    We could point to concerns about the precision and measurement of the outcomes under investigation. The description of "perceptions" (presumably an attitudinal concept) or "dominant narrative" or “prevailing narrative” (presumably a relative measure of message prevalence) are never defined or measured in this paper. Instead, there is an assumption that the number of Twitter followers axiomatically leads to such attitudinal or message prevalence outcomes. As science communication researchers, we wish it were so easy.

    While one reviewer queried this assumption, it is disappointing that it was not fully addressed. As noted by that reviewer, "The author attempted to examine a group of scien...

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    Conflict of Interest:
    None declared.
  • Published on:
    Yamey: Reply to Ioannidis
    • Gavin M Yamey, Professor of Global Health and Public Policy Center for Policy Impact in Global Health

    I am grateful to John Ioannidis for replying to my rapid response, but I do not agree with him when he says that I have misrepresented his study. I also believe he has failed to address my two original concerns: (1) along with a group of GBD signatories, he lobbied the Trump administration, yet he failed to declare this competing interest, and (2) his paper demeans, belittles, and humiliates named scientists and yet he did not seek ethics review. I also am very concerned indeed that the author has not described the GBD's competing interests (he merely says, " GBD leaders have repeatedly denied conflicts of interest"). He merely takes the GBD, who he is allied with, at face value.

    I'd like to more fully explain my three concerns.

    1. THE AUTHOR'S LOBBYING EFFORTS, ALONG WITH GBD SIGNATORIES

    It is a matter of public record that Prof Ioannidis worked with three GBD signatories, one of who was an author of the GBD, to lobby the Trump Administration, as described in a March 2020 investigative report, titled "An Elite Group Of Scientists Tried To Warn Trump Against Lockdowns In March." [1]

    The author of the investigation, Stephanie Lee, writes that: "John Ioannidis’s controversial studies claim that the coronavirus isn’t that big a threat. Before the Stanford scientist did any of them, he wanted to take that message to the White House."

    Lee notes:

    "Stanford University scientist John Ioan...

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    Conflict of Interest:
    Gavin Yamey is a former editor of the BMJ. He was editor of two of John Ioannidis' papers in PLOS Medicine, and he wrote a feature about Ioannidis for the BMJ. He has written articles, including in TIME, in support of public health measures to curb COVID-19 (including widespread vaccination; masks; test, trace, isolate, and support; distancing; workplace and school safety measures; and ventilation of buildings). He was a co-author of a Lancet correspondence, “Scientific consensus on the COVID-19 pandemic: we need to act now” (Lancet 2020;396:E71-E72) that was the basis for the Jon Snow Memorandum. In a legal case in which 7 rural Manitoba churches and 3 individuals argued that Manitoba’s public health measures violated their charter rights, an argument supported in court by GBD author Jay Bhattacharya, Yamey provided unpaid scientific guidance to the legal team that argued in support of public health measures; the judge, Court of Queen's Bench Chief Justice Glenn Joyal, ruled that the public health measures were reasonable limitations on the group's charter rights in the context of the Covid-19 pandemic. Yamey has been critical of the GBD, including in an article in TIME.
  • Published on:
    And for the right reasons
    • Darren L Dahly, Epidemiologist and Statistician University College Cork

    I am reminded of Doug Altman's seminal paper, The Scandal of Medical Research, published in the British Medical Journal almost 30 years ago. It begins:

    "We need less research, better research, and research done for the right reasons."

    (https://www.bmj.com/content/308/6924/283)

    I believe these are the most important words ever written about our field. They are also the most ignored. If asked for evidence of the latter, I would start by highlighting this paper, published under that same BMJ banner, and from which nothing of scientific substance can be learned. The bar remains entirely too low.

    Conflict of Interest:
    None declared.
  • Published on:
    Elevating pettiness, downgrading science

    The BMJOpen has published a 'paper' by a close friend and supporter of Great Barrington authors, that attempts to measure 'social media influence' by Twitter followers (ignoring an entire field of data science that studies engagement, impressions and reach) in correlation to scientific impact (using an equally flawed citation count metric) combined into an index that was published and later confirmed to be, an actual joke. It's called the Kardashian Index, in order to say what exactly?
    That letting millions of people become infected with COVID-19 when a vaccine was only a month or two away was actually a good idea? That shutting away approximately 30% of the population for an indeterminate amount of time was both feasible and ethical? That natural infection would confer lasting immunity (it didn't)? Or that variants wouldn't arise as a consequence of widespread infection (they did?). And all of these good ideas would've been gladly received by the global scientific community and it's decision makers, nearly 100% of which completely ignored these ideas as the nonsense they were, if not for a group of 30 scientists on Twitter?

    Is that really what the BMJ, the British Medical Journal, thought was a scientific and academically rigorous concept? Did they even read any of the references? Such as when the Kardashian Index 'author referred to his own work as "just a bit of fun"?

    These discussions wer...

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    Conflict of Interest:
    I am one of the named Kardashian Indices of the JSM authorship, and am also disappointed at how low my Kardashian score is.
  • Published on:
    Is this incredibly subtle satire?
    • David H. Gorski, Professor of Surgery Barbara Ann Karmanos Cancer Center at Wayne State University

    It is very puzzling how someone of Prof. Ioannidis' stature could so lower himself as to write such a methodologically flawed a manuscript. However, to me its methodological flaws, which have been well covered by other Rapid Responses, are completely overshadowed by a far more glaring problem, a conceptual one at the heart of the very premise of the manuscript. The Kardashian index was conceived as satire. If you do not believe me, look no further than to Neil Hall himself, who, having been tagged in Tweets about Prof. Ioannidis' article, took to Twitter to say that the Kardashian index was "a dig at metrics not Kardashians. It’s like taking a quiz to see what character from Game of Thrones you are and finding out you’re Joffrey Baratheon. It doesn’t matter - it’s not a real test. Thankfully," adding that "the tells that the entire premise is satire could not be made more obvious." (https://twitter.com/neilhall_uk/status/1492259823114723329)

    Indeed, various points in his paper (https://genomebiology.biomedcentral.com/articles/10.1186/s13059-014-0424-0), Hall's "tells" include passages like:

    1. "I had intended to collect more data but it took a long time and I therefore decided 40 would be enough to make a point. Please don’t take this as representativ...

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    Conflict of Interest:
    Dr. Gorski has been known to be very critical of the Great Barrington Declaration. He is also the managing editor of Science-Based Medicine (sciencebasedmedicine.org), a blog
  • Published on:
    Bak-Coleman: Reply to Ioannidis

    I welcome Professor Ioannidis’ engagement on these issues. The response however falls short on several points and raises additional concerns.

    Ethical: Professor Ioannidis is correct that many papers make use of Twitter and other publicly available sources of data. However, he is mistaken in the assertion that as a result, such work does not need to be reviewed by an IRB (my own research is a case in point). IRBs exist in order to safeguard the rights of human subjects, and the decision about whether an IRB is required critically must rest with an IRB rather than with individual scientists conducting research.

    Professor Ioannidis argues that IRB approval should not be required to publish publicly searchable information in a deanonymized context. This is a dangerous position to take. A researcher using this standard could publish, for instance, the sleuthed addresses, family members, places of work, and identities of political dissidents or victims of hate crime. In this particular case, Dr. Ioannidis indirectly ascertained non-use of Twitter, a decision that was made in a reasonably private context. No reasonable definition of consent to participate in the Twitter portion of the study could be applied for these signatories. Given the inflamed nature of the discussions around these issues, the potential for signatories of either to experience further negative attention on social media as a result of their Twitter accounts being publicly identified and linked...

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    Conflict of Interest:
    None declared.
  • Published on:
    Typo

    In composing my response, I have a typo regarding the Kardashian Index. When someone does not use twitter, it goes to zero not infinity.

    Conflict of Interest:
    None declared.
  • Published on:
    In reply to Sheldrick, Bak-Coleman and Yamey

    I thank Sheldrick, Bak-Coleman and Yamey for their constructive criticism. As stated clearly in the paper, the main analysis focuses on the key signatories of both documents: All the key signatories are included without random sampling. As the paper already explains in detail, since thousands of additional people signed each document, a few randomly selected signatories from the longer lists were also explored. Random numbers were generated in Excel. There was no power calculation for this secondary analysis. The paper already explains that this secondary analysis deserves caution, since only 443 GBD signatories were listed by name when the two documents were accessed online in April 2021.
    The Twitter data represents information readily retrieved by a Google search by anyone. The notion of requiring IRB approval to report the results of searching Google or free publicly available databases (e.g. citation databases) contradicts the practice of hundreds of thousands of published papers reporting on such searches without IRB approval. Moreover, contrary to what Bak-Coleman asserts (“failure to disclose the author's well-documented history of interaction (co-authorship, affiliations, debate, etc..) with the named signatories—positive and negative”), my disclosures clarified explicitly that “The author has signed neither of the two documents and has many friends, collaborators and other people who he knows and he admires among those who have signed each of them...

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    Conflict of Interest:
    As stated also in the original paper “The author has signed neither of the two documents and has many friends, collaborators and other people who he knows and he admires among those who have signed each of them. JPI has previously published that he is very skeptical about signature collection for scientific matters (BMJ 2020;371:m4048). He has no personal social media and he believes that the fact that his citation indices are extremely high only proves (when compared against his self-acknowledged vast ignorance) that these indices can occasionally be very unreliable. JPI congratulates all the thousands of signatories (of both documents) for their great sense of social responsibility.”
  • Published on:
    Conflicts of interest & ethical concerns
    • Gavin M Yamey, Professor of Global Health and Public Policy Center for Policy Impact in Global Health

    In addition to the major methodological flaws that have been highlighted in the rapid responses from Kyle A Sheldrick and Joseph B. Bak-Coleman, I believe there are two deeply problematic aspects of this paper.

    The first is that the author has not declared his own lobbying efforts and his affiliation with the signatories of the Great Barrington Declaration (GBD). As the science reporter Stephanie Lee described in her detailed feature for Buzzfeed News, John Ioannidis gathered a group of scientists together, who lobbied the Trump Administration against using a circuit-breaker lockdown (1). Three of these scientists (Jay Bhattacharya, David Katz, and Michael Levitt) were original signatories of the GBD, and one of these three (Jay Bhattacharya) co-authored the GBD.

    It is unclear to me why John Ioannidis did not mention his lobbying efforts, nor did he mention his affiliation with these GBD signatories. The study tries to show that the GBD signatories were somehow superior to the scientists who signed the JSM, and so I cannot understand why the author failed to mention these conflicts of interest.

    The second problem is that he specifically names scientists, including me, with the purpose of demeaning and belittling them. Is this ethical? None of the scientists who were demeaned and belittled gave their consent to be publicly humiliated in this way, and nor did the author ask an ethics review committee to approve this study.

    References
    1. L...

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    Conflict of Interest:
    Gavin Yamey is a former editor of the BMJ. He was editor of two of John Ioannidis' papers in PLOS Medicine, and he wrote a feature about Ioannidis for the BMJ. He has written articles, including in TIME, in support of public health measures to curb COVID-19 (including widespread vaccination; masks; test, trace, isolate, and support; distancing; workplace and school safety measures; and ventilation of buildings). He was a co-author of a Lancet correspondence, “Scientific consensus on the COVID-19 pandemic: we need to act now” (Lancet 2020;396:E71-E72) that was the basis for the Jon Snow Memorandum. In a legal case in which 7 rural Manitoba churches and 3 individuals argued that Manitoba’s public health measures violated their charter rights, an argument supported in court by GBD author Jay Bhattacharya, Yamey provided unpaid scientific guidance to the legal team that argued in support of public health measures; the judge, Court of Queen's Bench Chief Justice Glenn Joyal, ruled that the public health measures were reasonable limitations on the group's charter rights in the context of the Covid-19 pandemic. Yamey has been critical of the GBD, including in an article in TIME.
  • Published on:
    Editor's Note

    BMJ Open thanks the authors of the posted responses for their comments. We have alerted the author of the article to these comments and asked him to respond.

    It has been noted that the peer review and previous versions of the article were not posted, as is standard practice for the journal. This was the result of an error in the production process. We are actively working to resolve the error. While we are continuing to experience technical problems posting the peer review using the usual links, as a temporary solution we have provided the peer review history and previous versions as a data supplement, which will be replaced by the standard format in due course.

    Conflict of Interest:
    I am the Editor in Chief of the journal.
  • Published on:
    The absence of basic but vital information makes this paper uninterpretable and unpublishable

    This article is dependent on random sampling of non-randomly ordered lists. Despite this it fails to even mention what random sampling method was selected nor what software was used to implement this method. The list of "randomly" selected signatories generated by this unnamed method is not given in the article itself, however the data availability statement refers to a "public, open access repository" although the repository is not named and no link is given, so perhaps this is available somewhere?

    No sample size calculation is given, and the selection of 30 is not justified within the method or discussion in any way.

    This paper frankly fails to meet minimum standards in describing how the research was actually conducted.

    It is unclear to me what merits of the paper led to its selection for publication, although this lack of clarity is partially driven by the failure of BMJ Open to publish any reviews in violation of their stated policies.

    Conflict of Interest:
    None declared.
  • Published on:
    Ethical, Conceptual, Statistical, and Presentational Issues

    This paper has several ethical, conceptual, statistical, and presentational issues. From an ethical standpoint, it is somewhat surprising that the author declares no human subjects are involved. Bibliometric data is widely established as public data, and some IRBs hold the same is true of data gathered from public accounts on Twitter (here, follower counts). However, the author explicitly investigates whether named individuals choose to use Twitter by searching for a linked account through google. Decisions about whether or not to use Twitter are reasonably private. There is no reason to believe someone who has chosen not to use Twitter has consented to their presence in a study on social media use. For these reasons review by an IRB seems warranted.

    Other ethical challenges may arise from a failure to disclose the author's well-documented history of interaction (co-authorship, affiliations, debate, etc..) with the named signatories—positive and negative. An IRB may have taken those relationships into consideration when deciding (for instance) whether it was appropriate to explicitly name scientists. Alternatively, reviewers and readers alike may have found these important context when interpreting the paper as a whole.

    Conceptually, the author acknowledges the limitation that: “​​Both citation indices and Twitter followers have limitations in face validity and construct validity as measures of impact.” Yet the paper’s conclusions are based entirely...

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    Conflict of Interest:
    None declared.