AbstractObjectiveTo assess the number, timing, characteristics, and scholarly impact of secondary publications generated using individual participant level data (IPD) from a portfolio of clinical trials shared with external investigators through a data sharing platform.DesignCross sectional study.SettingYale University Open Data Access (YODA) Project platform.ParticipantsJohnson 91%), most obtained access through data sharing platforms (n=161; 85%), primarily the YODA Project (n=157; 83%). Over time, the proportion of external publications increased steadily, exceeding 50% of all secondary publications by year 11 and thereafter. Compared with internal publications, external publications were more frequently pooled analyses (151/209 (72%) v 534/958 (55.7%); P<0.001) and involved predictive or prognostic modelling (108/209 (51.7%) v 322/958 (33.6%); P<0.001), development of statistical models or algorithms (60/209 (29%) v 114/958 (11.9%); P<0.001), and validation of existing methods, models, or risk scores (32/209 (15%) v 66/958 (6.9%); P<0.001). Compared with internal publications, external publications were published in journals with higher impact factors (median 6.7 (interquartile range 3.4-16.6) v 4.6 (2.9-10.2); P=0.002) and had higher annual Altmetric Attention Scores (median 2.1 (0.7-7.1) v 0.6 (0.3-2.3); P<0.001) but had lower annual citation counts (median 2.7 (1.1-5.6) v 3.4 (1.6-7.5); P<0.001) and were less likely to be cited in clinical guidelines (21/184 (11%) v 235/805 (29.2%); P<0.001) or policy documents (14/184 (8%) v 206/805 (25.6%); P<0.001).ConclusionsMost trials in this portfolio of clinical trials, for which IPD were available through a data sharing platform, generated secondary research by both original trial investigators and external investigators. External investigators most often accessed data through the data sharing platform, and their publications accounted for an increasingly larger proportion of secondary publications over time. These findings suggest that structured data sharing mechanisms may support additional secondary use of clinical trial data and further enhance the scientific value of clinical trials.

The General Medical Council (GMC), like many institutions today, faces a clash of values. Doctors’ freedom of speech must be protected from punitive or bad faith referrals1: if doctors fear that ethical, humanitarian, or political speech about Israel, Palestine, or Gaza will trigger regulatory scrutiny, professional witness will be constrained at the very moment moral clarity is most needed.Yet a second trust problem must be held alongside the first. If the debate is framed only as “antisemitism is being used to silence doctors,” we should not be surprised when Jewish staff and patients hear something else: that their recognition of antisemitism is itself suspect or politically motivated. That too damages trust.The task for medical institutions is not to choose between protecting speech and recognising antisemitism, but to build processes that differentiate between legitimate criticism of Israeli policy, humanitarian advocacy for Palestinians, offensive but lawful speech, professional misconduct, discrimination, and hostility...