Health science research barriers and facilitators in the midst of the COVID-19 crisis: scoping review
DOI:
https://doi.org/10.18597/rcog.3788Abstract
Objective: The COVID-19 pandemic has imposed a great challenge on health research because of the pressing need to respond promptly and effectively to this crisis situation. It is important to offer a high level perspective of the main barriers and facilitators found when conducting health science studies during the COVID-19 crisis and to discuss the research initiatives suggested by global, regional or local health research authorities.
Materials and methods: A systematic scoping review was carried out. A literature search was conducted in the Medline, Cochrane Library, Lilacs and Google Scholar databases. Original research studies, review and opinion articles and editorials available in full text published in Spanish, English or Portuguese between January 2020 and May 2021 were included. Two authors working independently selected the papers and collected the data. The barriers and facilitators identified were described and organized in four categories according to the literature: sociocultural, administrative, organizational and methodological. Official documents and communications from global, regional and local health and research authorities were also included. Results are presented in narrative and table form.
Results: Overall, 26 documents were selected for data analysis and synthesis. The barriers most frequently mentioned in the literature include issues with access to participants, ethics committees paperwork, biological risk for the researchers, and lack of inter and intra-institutional coordination. On the other hand, the facilitators identified include the adoption of on-line solutions, cooperative work among research actors, and a more flexible informed consent process. Regarding the initiatives disseminated by health and research authorities, four strategies were identified: prioritization of research questions, cooperation and inclusion promotion, fight against infodemia, and strengthening of the methodological quality of the studies.
Conclusions: Continued cooperation and interoperability among institutions, countries and disciplines to facilitate future research processes is a challenge in the context of the pandemic; similarly, it is now important to maintain open science and funding of cooperative studies when other priorities emerge. Likewise, there is an evident need to develop and sustain efficient information management systems to help with decision-making. Ongoing review of the effects of the pandemic on health research practice is needed in order to gain comprehensive insights of what we need to learn as a society from this crisis.
Author Biographies
Karen Daniela Neira-Fernández, Instituto de Investigaciones Clínicas, Universidad Nacional de Colombia, Bogotá (Colombia).
Profesional en enfermería. Investigadora asociada.
Laura Gaitán-Lee, Investigadora asociada Instituto de Investigaciones Clínicas, Universidad Nacional de Colombia, Bogotá (Colombia).
Profesional en psicología.
Olga Janneth Gómez-Ramírez, Universidad Nacional de Colombia, Bogotá (Colombia).
Enfermera. Profesora asociada.
References
Organización mundial de la Salud. Coronavirus disease 2019 (COVID-19) Situation Report – 51. OMS; 2020. Disponible en: https://apps.who.int/iris/bitstream/handle/10665/331475/nCoVsitrep11Mar2020-eng.pdf?sequence=1&isAllowed=y
World Health Organization. WHO Director-General's remarks at the media briefing on 2019-nCoV on 11 February 2020. WHO; 2020. Disponible en: https://www.who.int/es/director-general/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020.
The Economist. Covid-19 data: The pandemic’s true death toll. 2021. Disponible en: https://www.economist.com/graphic-detail/coronavirus-excess-deaths-estimates.
Banco Mundial. La COVID-19 (coronavirus) hunde a la economía mundial en la peor recesión desde la Segunda Guerra Mundial. 2020. Disponible en: https://www.bancomundial.org/es/news/press-release/2020/06/08/covid-19-to-plunge-global-economy-into-worst-recession-since-world-war-ii
Organización Mundial de la Salud. World experts and funders set priorities for COVID-19 research. OMS; 2020. Disponible en: https://www.who.int/news/item/12-02-2020-world-experts-and-funders-set-priorities-for-covid-19-research
Carracedo S, Palmero A, Neil M, Hasan-Granier A, Saenz C, Reveiz L. The landscape of COVID-19 clinical trials in Latin America and the Caribbean: assessment and challenges. Rev Panam Salud Pública. 2020; 44:1-5. https://doi.org/10.26633/RPSP.2020.177
UNESCO. R&D Spending by country. 2021. Disponible en: http://uis.unesco.org/apps/visualisations/research-and-development-spending/
Peters MDJ, Godfrey C, McInerney P, Baldini Soares C, Khalil H, Parker D. Chapter 11: Scoping Reviews. In: Aromataris E, Munn Z, editors. Joanna Briggs Institute Reviewer's Manual. The Joanna Briggs Institute; 2017. Disponible en: https://reviewersmanual.joannabriggs.org/
Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan—a web and mobile app for systematic reviews. Syst Rev. 2016; 5(1):210. https://doi.org/10.1186/s13643-016-0384-4
Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018;169(7):467-73. https://doi.org/10.7326/M18-0850
Verna EC, Serper M, Chu J, Corey K, Fix OK, Hoyt K, et al. Clinical Research in Hepatology in the COVID‐19 Pandemic and Post‐Pandemic Era: Challenges and the Need for Innovation. Hepatology. 2020; 72(5):1819-37. https://doi.org/10.1002/hep.31491
Meyer MN, Gelinas L, Bierer BE, Hull SC, Joffe S, Magnus D, et al. An ethics framework for consolidating and prioritizing COVID-19 clinical trials. Clin Trials. 2021; 18(2):226-33. https://doi.org/10.1177/1740774520988669
Mourad M, Bousleiman S, Wapner R, Gyamfi-Bannerman C. Conducting research during the COVID-19 pandemic. Semin Perinatol. 2020; 44(7):151287. https://doi.org/10.1016/j.semperi.2020.151287
Bierer BE, White SA, Barnes JM, Gelinas L. Ethical Challenges in Clinical Research During the COVID-19 Pandemic. J Bioethical Inq. 2020; 17(4):717-22. https://doi.org/10.1007/s11673-020-10045-4
Marcum M, Kurtzweil N, Vollmer C, Schmid L, Vollmer A, Kastl A, et al. COVID‐19 pandemic and impact on cancer clinical trials: An academic medical center perspective. Cancer Med. 2020; 9(17):6141-6. https://doi.org/10.1002/cam4.3292
Almufleh A, Joseph J. The time is now: role of pragmatic clinical trials in guiding response to global pandemics. Trials. 2021; 22(1):229. https://doi.org/10.1186/s13063-021-05165-0
Perez T, Perez RL, Roman J. Conducting Clinical Research in the Era of Covid-19. Am J Med Sci. 2020; 360(3):213-5. https://doi.org/10.1016/j.amjms.2020.06.011
Weiner DL, Balasubramaniam V, Shah SI, Javier JR, on behalf of the Pediatric Policy Council. COVID-19 impact on research, lessons learned from COVID-19 research, implications for pediatric research. Pediatr Res. 2020; 88(2):148-50. https://doi.org/10.1038/s41390-020-1006-3
Saberi P. Research in the Time of Coronavirus: Continuing Ongoing Studies in the Midst of the COVID-19 Pandemic. AIDS Behav. 2020; 24(8):2232-5. https://doi.org/10.1007/s10461-020-02868-4
Madariaga A, Kasherman L, Karakasis K, Degendorfer P, Heesters AM, Xu W, et al. Optimizing clinical research procedures in public health emergencies. Med Res Rev. 2021; 41(2):725-38. https://doi.org/10.1002/med.21749
AlNaamani K, AlSinani S, Barkun AN. Medical research during the COVID-19 pandemic. World J Clin Cases. 2020; 8(15):3156-63. https://doi.org/10.12998/wjcc.v8.i15.3156
Dron L, Dillman A, Zoratti MJ, Haggstrom J, Mills EJ, Park JJH. Clinical Trial Data Sharing for COVID-19–Related Research. J Med Internet Res. 2021; 23(3): e26718. https://doi.org/10.2196/26718
Yang Y, Li W, Zhang L, Zhang Q, Cheung T, Hall BJ, et al. The Impact of COVID-19 Pandemic on Clinical Research in China: Challenges and Progress. Front Med. 2020; 7:523. https://doi.org/10.3389/fmed.2020.00523
Ma X, Wang Y, Gao T, He Q, He Y, Yue R, et al. Challenges and strategies to research ethics in conducting COVID‐19 research. J Evid-Based Med. 2020; 13(2):173-7. https://doi.org/10.1111/jebm.12388
González-Duarte A, Kaufer-Horwitz M, Aguilar-Salinas CA. Bioethics in the COVID-19 Pandemic Research: Challenges and Strategies. Rev Investig Clínica. 2020; 72(5):4664. https://doi.org/10.24875/RIC.20000258
Bahans C, Leymarie S, Malauzat D, Girard M, Demiot C. Ethical considerations of the dynamics of clinical trials in an epidemic context: Studies on COVID-19. Ethics Med Public Health. 2021; 16:100621. https://doi.org/10.1016/j.jemep.2020.100621
Becker G, Martin T, Sabo AN, Bertrand F, Hutt A, Ayme-Dietrich E, et al. Impact of the COVID-19 pandemic on clinical research in hospitals: observational study in the first epicenter of the epidemic during the general lockdown in France. Eur Rev Med Pharmacol Sci. 2021; 25(2):1158-1162. https://doi.org/10.26355/eurrev_202101_24686
Cagnazzo C, Besse M-G, Manfellotto D, Minghetti P, Cazzaniga S, Cottini L, et al. Lessons learned from COVID-19 for clinical research operations in Italy: what have we learned and what can we apply in the future? Tumori J. 2021; 107(1):6-11. https://doi.org/10.1177/0300891620977916
Sohrabi C, Mathew G, Franchi T, Kerwan A, Griffin M, C Del Mundo JS, et al. Impact of the coronavirus (COVID-19) pandemic on scientific research and implications for clinical academic training – A review. Int J Surg. 2021; 86:57-63. https://doi.org/10.1016/j.ijsu.2020.12.008
Singh JA, Bandewar SV, Bukusi EA. The impact of the COVID-19 pandemic response on other health research. Bull World Health Organ. 2020;98(9):625-31. https://doi.org/10.2471/BLT.20.257485
Bhatt A. Clinical trials during the COVID-19 pandemic: Challenges of putting scientific and ethical principles into practice. Perspect Clin Res. 2020; 11(2):59. https://doi.org/10.4103/picr.PICR_77_20
Hashem H, Abufaraj M, Tbakhi A, Sultan I. Obstacles and Considerations Related to Clinical Trial Research During the COVID-19 Pandemic. Front Med. 2020; 7:598038. https://doi.org/10.3389/fmed.2020.598038
Ibrahim H, Kamour AM, Harhara T, Gaba WH, Nair SC. Covid-19 pandemic research opportunity: Is the Middle East & North Africa (MENA) missing out? Contemp Clin Trials. 2020; 96:106106. https://doi.org/10.1016/j.cct.2020.106106
Reyes M. Research in the Time of COVID-19: Challenges of Research Ethics Committees. J ASEAN Fed Endocr Soc. 2020;35(1):29-32. https://doi.org/10.15605/jafes.035.01.07
Pepper MS, ChB M, Burton SG. Research in COVID-19 times: The way forward. In Pract. 2020;110(8):3.
Caicedo-Rosero ÁV, Estrada-Montoya JH. Barreras geográficas de acceso a los servicios de salud oral en el departamento de Nariño, Colombia. Rev Gerenc Polit Salud. 2016;15(31): 146-174. https://doi.org/10.11144/Javeriana.rgyps15-31.bgas
Cochrane. Coronavirus (COVID-19) - Cochrane resources and news. 2021. Disponible en: https://www.cochrane.org/our-evidence/coronavirus-covid-19-resources
Centers for Disease Control and Prevention. CDC Science Agenda for COVID-19, 2020-2023. Building the Evidence Base for Ongoing COVID-19 Response. CDC; 2021. Disponible en: https://www.cdc.gov/coronavirus/2019-ncov/science/science-agenda-covid19.html#print
Organización para la Cooperación y el Desarrollo Económicos. Medidas políticas clave de la OCDE ante el coronavirus (COVID-19): Por qué la ciencia abierta es esencial para combatir el COVID-19. OECD; 2020. Disponible en: https://www.oecd.org/coronavirus/policy-responses/por-que-la-ciencia-abierta-es-esencial-para-combatir-el-covid-19-f3b83813/
Organización Mundial de la Salud. Coronavirus disease (COVID-19) pandemic. 2021; Disponible en: https://www.who.int/emergencies/diseases/novel-coronavirus-2019
World Health Organization, Cochrane. The COVID-NMA initiative: A living mapping and living systematic review of Covid-19 trials. 2021. Disponible en: https://covid-nma.com/
Boutron I, Chaimani A, Meerpohl JJ, Hróbjartsson A, Devane D, Rada G, et al. The COVID-NMA Project: Building an Evidence Ecosystem for the COVID-19 Pandemic. Ann Intern Med. 2020;173(12):1015-7. https://doi.org/10.7326/M20-5261
Food and Drug Adminstration. FDA Guidance on Conduct of Clinical Trials of Medical Products during COVID-19 Pandemic. Guidance for Industry, Investigators, and Institutional Review Boards [Updated on March 21]. FDA; 2020. Disponible en: https://www.fda.gov/regulatory-information/search-fda-guidance-documents/fda-guidance-conduct-clinical-trials-medical-products-during-covid-19-pandemic
Pan American Health Organization. Entender la infodemia y la desinformación en la lucha contra la COVID-19. PAHO; 2020. Disponible en: https://iris.paho.org/bitstream/handle/10665.2/52053/Factsheet-Infodemic_spa.pdf?sequence=16
How to Cite
Downloads
Published
Issue
Section
Funding data
-
Universidad Nacional de Colombia
Grant numbers 202010033085
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
