Abstract
Big data promises to spark new discoveries but may also distort clinical research. Large datasets that permit numerous analyses could increase the number of spurious findings and threaten the reproducibility and validity of clinical research. The publication of unreproducible research is incentivized by a scientific culture that rewards novelty over rigor. Introducing preprint publication to clinical research could change the culture. The first clinical preprint platform, medRxiv, allows researchers to publish working papers in advance of peer-review to more easily share preliminary findings. Preprint publishing aims to be fast and frictionless, which fundamentally changes the incentive structure of academic publishing. Preprints offer a relatively weak reward (a preprint publication) for substantially less effort than peer-review publication. By reducing barriers to publication, preprints may help encourage scientists to publish null findings, which could mitigate publication bias. By enabling scientists to share preliminary work and publish evolving versions of manuscripts, preprints may also facilitate "workshopping" of ideas and detailed methodological review. This would better reflect the iterative nature of observational research than peer-reviewed publications, which immutably document the "final" results of a study. Preprint platforms are a timely innovation that may buffer the undesired effects of big data on clinical research.