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The implications of open access publishing for the medical community
ARTICLE IN PRESS Evidence-Based Healthcare & Public Health (2005) 9, 371–373
www.elsevier.com/locate/ebhph
EDITORIAL
The implications of open access publishing for the medical community Open access publishing could create a freely accessible information resource with benefits for all aspects of the delivery of healthcare, from where to channel resources for research to engaging a wide range of stakeholders in health policy debates. However, how much this potential can be realised will vary between communities, depending on how much the publishing model is embraced. The main challenge to open access is the transition of funding from subscription-based publishing to this new publishing model. Open access journals have emerged as an alternative to the traditional publishing model. In the new model, accepted articles are made available online without charge at the point of publication, and readers can then use such articles without seeking permission.1 This differs from the traditional model of scientific publishing in which readers are charged to view content, creating an economic barrier to information, and where readers must request permission to use an article, limiting or slowing down scientific progress. In recent years, subscription fees for scientific journals have risen faster than inflation, and have become too high for some individual users and libraries.2,3 Not all audiences can afford to access information, and it has been argued that this may impede scientific progress.4 Two of the leading open access publishers, BioMed Central and Public Library of Science (PLoS), cover the costs of publication by levying a charge on every article accepted after peer review. This is referred to as the ‘author-pays’ model, although the term is inaccurate as in the majority of cases the author’s institution or funder pays the fee. The ‘article processing charge’ model has gained endorsement from major funding bodies, such as the Wellcome Trust, the National Institutes of Health, and the Howard Hughes Medical Insti-
tute, as well as major research institutions worldwide.5 Evidence-based research and practice will benefit as more articles are made available through open access publishing. Evidence-based medicine seeks to improve patient care by formulating effective solutions based on integrating clinical expertise with evidence from the published literature.6 This is more likely to succeed if academic and clinical communities have easy access to the most recent research results and analyses.6 Open access journals provide this ‘easy access’, enabling rapid and simple searching of the literature.7 Similar benefits are available for evidence-based health policy. Certain features of the policymaker’s world have impeded the development of strong, productive partnerships between researchers and policy-makers. These include the timing of decision-making, limited political windows of opportunity, the need for urgent information, and the imperative to respond rapidly.8 With increasing concern and debate about whether it is possible to deliver such policy,9 open access publishing can serve the particularly valuable purpose of placing timely research in the ‘inboxes’ of policy analysts and decision-makers – research that can then be accessed by anyone without restrictions. The adoption of open access publishing is dependent on a transition of funding, from the costs incurred by traditional publishing to those of open access. The costs of open access can be seen as the final cost incurred as part of a research project. In high-income countries and medical specialities with large research funds this transition is already taking place. As the scientific literature becomes an easy access public resource, duplication of research may fall, resulting in more effective use of resources. It could also help create
1744-2249/$ - see front matter & 2005 Elsevier Ltd. All rights reserved. doi:10.1016/j.ehbc.2005.09.007
ARTICLE IN PRESS 372 a culture of multi-national and interdisciplinary collaboration, as readers can access articles published in subject areas they did not previously have subscription access to. This has the potential for more effective sharing of ideas and information, so driving research forward. Low-income countries may have the most to gain from the new publishing model. They are currently under-represented in the literature, however access to the main body of current research provides a valuable information resource, which (imperialistic overtones notwithstanding) could serve as an important educational tool for research and practices.10 As the majority of research carried out in these communities is done on relatively low budgets, current article processing charges, waived by BioMed Central and PLoS, are otherwise prohibitive to these authors. However, open access journals can also be run on a low budget with either government or society-based central funding of the costs, taking the costs away from the individual researcher. As such journals are open access, they can be included in services such as PubMed Central and Google Scholar, integrating them with the mainstream literature. As a result, journals published in low-income countries, and hence their authors, will be able to compete for audiences on an international scale. At present, restricted internet access is a limiting factor of open access in these countries;11 however the internet is by far the cheapest, most effective way to carry information into and distribute it within these countries. Similarly there are benefits for medical specialties whose research funds are limited. The traditional publishing model was based on circulating print copies of journals. Their costs were often so high that journals with small circulations were never likely to succeed,12 effectively making that community ‘invisible.’ Open access publishing gives these communities the best chance they have ever had to be noticed. To embrace open access publishing, it is important for researchers in both low-income countries and communities to engage with funders and opinion leaders and understand the unprecedented benefits potentially available to them. Open access publishing extends the possibility of democratic participation and global learning. Health sector reforms continue around the world; as policy discussion papers and draft legislation are tabled, policy analyses can be readily published in open access journals and disseminated to a wide range of stakeholders, enabling immediate debates to occur. While the publication and dissemination of research itself does not lead to
EDITORIAL policy change, it could enable more effective policy lobbying.13 Given the similar tools and approaches to health sector reform being adopted in both developed and developing countries, open access publishing can also be important in forging global links between researchers, policy-makers, and activists, so that the lessons from reform efforts can readily shared. Health reform debates across different countries have the potential to become informed by more extensive and better quality evidence. For instance, open access national/regional journals, such as Australia and New Zealand Health Policy, have an immediate global readership, facilitating international exchange. A recent, small survey of BMJ authors concluded that editors of open access journals needed to do more to reassure researchers of their quality.14 There is no doubt that one of the challenges facing editors of open access journals is that many researchers still see ‘online-only’ journals as inferior to journals with print versions. This perception is probably consolidated by the fact that open access journals are young and hence many still await an impact factor. There is, however, no inherent reason why an online-only journal should be inferior–the medium of distribution does not in any way confer the quality of the editorial processes. To our minds, there is no doubt that open access publishing offers many benefits to evidence-based healthcare and policy-making. While the business model continues to be explored, we have no doubt that it is here to stay, and that communities should find ways to embrace it.
Acknowledgements We would like to thank Matthew Cockerill (BioMed Central, London, UK) for critical reading of the draft manuscript.
References 1. Bethesda Statement on open access publishing. Available at; http://www.earlham.edu/peters/fos/bethesda.htm 2. Delamothe T, Smith R. Open access publishing takes off. BMJ 2004;328:1–3. 3. Clarke MT. Open sesame? Increasing access to the medical literature. Pediatrics 2004;114:265–8. 4. Eisen M, Brown P. Should the scientific literature be privately owned and controlled? Nature web debates. Available at: http://www.nature.com/nature/debates/e-access/Articles/ Eisen/htm
ARTICLE IN PRESS EDITORIAL 5. Which funding agencies explicitly allow direct use of their grants to cover article-processing charges? Available at: http://www.biomedcentral.com/info/authors/apcfaq#grants 6. Craig JC, Irwig LM, Stockler MR. Evidence-based medicine: useful tools for decision making. MJA 2001;174:248–53. 7. http://www.pubmedcentral.nih.gov/about/intro.html. 8. Choi BCK, Pang T, Lin V, et al. Can scientists and policymakers work together? J Epidemiol Community Health 2005; 59:632–7. 9. Lin V, Gibson B, (eds). Evidence-based Health Policy: Problems and possibilities. Melbourne: Oxford University Press, 2003. 10. King R, Tamber PS. Is open access to medical research literature relevant to low-and middle-income countries. Natl Med J India 2004;17:121–4. 11. Satyanarayana K. Open access publication in biomedical research: implications for developing countries. Indian J Med Res 2004;120:67–9. 12. Tamber PS, Godlee F, Newmark P. Open access to peerreviewed research: making it happen. Lancet 2003;362: 1575–7. 13. Gibson B. From Transfer to Transformation: Rethinking the Relationship between Research and Policy. PhD thesis, Australian National University, 2003. 14. Schroter S, Tite L, Smtih R. Perceptions of open access publishing: interviews with journal authors. BMJ 2005; 330:756.
373 Charlotte Hubbard Assistant Editor, BioMed Central, Middlesex House, 34–42 Cleveland Street, London W1T 4LB, UK
Pritpal S Tamber Editorial Director for Medicine, BioMed Central, London, UK
Vivian Lin Professor of Public Health, School of Public Health, La Trobe University, Bundoora, Australia
Liz Furler Managing Editor, Australia New Zealand Health Policy
Stephen Duckett Professor of Health Policy and Dean of Health Sciences, La Trobe University, Australia
www.elsevier.com/locate/ebhph
EDITORIAL
The implications of open access publishing for the medical community Open access publishing could create a freely accessible information resource with benefits for all aspects of the delivery of healthcare, from where to channel resources for research to engaging a wide range of stakeholders in health policy debates. However, how much this potential can be realised will vary between communities, depending on how much the publishing model is embraced. The main challenge to open access is the transition of funding from subscription-based publishing to this new publishing model. Open access journals have emerged as an alternative to the traditional publishing model. In the new model, accepted articles are made available online without charge at the point of publication, and readers can then use such articles without seeking permission.1 This differs from the traditional model of scientific publishing in which readers are charged to view content, creating an economic barrier to information, and where readers must request permission to use an article, limiting or slowing down scientific progress. In recent years, subscription fees for scientific journals have risen faster than inflation, and have become too high for some individual users and libraries.2,3 Not all audiences can afford to access information, and it has been argued that this may impede scientific progress.4 Two of the leading open access publishers, BioMed Central and Public Library of Science (PLoS), cover the costs of publication by levying a charge on every article accepted after peer review. This is referred to as the ‘author-pays’ model, although the term is inaccurate as in the majority of cases the author’s institution or funder pays the fee. The ‘article processing charge’ model has gained endorsement from major funding bodies, such as the Wellcome Trust, the National Institutes of Health, and the Howard Hughes Medical Insti-
tute, as well as major research institutions worldwide.5 Evidence-based research and practice will benefit as more articles are made available through open access publishing. Evidence-based medicine seeks to improve patient care by formulating effective solutions based on integrating clinical expertise with evidence from the published literature.6 This is more likely to succeed if academic and clinical communities have easy access to the most recent research results and analyses.6 Open access journals provide this ‘easy access’, enabling rapid and simple searching of the literature.7 Similar benefits are available for evidence-based health policy. Certain features of the policymaker’s world have impeded the development of strong, productive partnerships between researchers and policy-makers. These include the timing of decision-making, limited political windows of opportunity, the need for urgent information, and the imperative to respond rapidly.8 With increasing concern and debate about whether it is possible to deliver such policy,9 open access publishing can serve the particularly valuable purpose of placing timely research in the ‘inboxes’ of policy analysts and decision-makers – research that can then be accessed by anyone without restrictions. The adoption of open access publishing is dependent on a transition of funding, from the costs incurred by traditional publishing to those of open access. The costs of open access can be seen as the final cost incurred as part of a research project. In high-income countries and medical specialities with large research funds this transition is already taking place. As the scientific literature becomes an easy access public resource, duplication of research may fall, resulting in more effective use of resources. It could also help create
1744-2249/$ - see front matter & 2005 Elsevier Ltd. All rights reserved. doi:10.1016/j.ehbc.2005.09.007
ARTICLE IN PRESS 372 a culture of multi-national and interdisciplinary collaboration, as readers can access articles published in subject areas they did not previously have subscription access to. This has the potential for more effective sharing of ideas and information, so driving research forward. Low-income countries may have the most to gain from the new publishing model. They are currently under-represented in the literature, however access to the main body of current research provides a valuable information resource, which (imperialistic overtones notwithstanding) could serve as an important educational tool for research and practices.10 As the majority of research carried out in these communities is done on relatively low budgets, current article processing charges, waived by BioMed Central and PLoS, are otherwise prohibitive to these authors. However, open access journals can also be run on a low budget with either government or society-based central funding of the costs, taking the costs away from the individual researcher. As such journals are open access, they can be included in services such as PubMed Central and Google Scholar, integrating them with the mainstream literature. As a result, journals published in low-income countries, and hence their authors, will be able to compete for audiences on an international scale. At present, restricted internet access is a limiting factor of open access in these countries;11 however the internet is by far the cheapest, most effective way to carry information into and distribute it within these countries. Similarly there are benefits for medical specialties whose research funds are limited. The traditional publishing model was based on circulating print copies of journals. Their costs were often so high that journals with small circulations were never likely to succeed,12 effectively making that community ‘invisible.’ Open access publishing gives these communities the best chance they have ever had to be noticed. To embrace open access publishing, it is important for researchers in both low-income countries and communities to engage with funders and opinion leaders and understand the unprecedented benefits potentially available to them. Open access publishing extends the possibility of democratic participation and global learning. Health sector reforms continue around the world; as policy discussion papers and draft legislation are tabled, policy analyses can be readily published in open access journals and disseminated to a wide range of stakeholders, enabling immediate debates to occur. While the publication and dissemination of research itself does not lead to
EDITORIAL policy change, it could enable more effective policy lobbying.13 Given the similar tools and approaches to health sector reform being adopted in both developed and developing countries, open access publishing can also be important in forging global links between researchers, policy-makers, and activists, so that the lessons from reform efforts can readily shared. Health reform debates across different countries have the potential to become informed by more extensive and better quality evidence. For instance, open access national/regional journals, such as Australia and New Zealand Health Policy, have an immediate global readership, facilitating international exchange. A recent, small survey of BMJ authors concluded that editors of open access journals needed to do more to reassure researchers of their quality.14 There is no doubt that one of the challenges facing editors of open access journals is that many researchers still see ‘online-only’ journals as inferior to journals with print versions. This perception is probably consolidated by the fact that open access journals are young and hence many still await an impact factor. There is, however, no inherent reason why an online-only journal should be inferior–the medium of distribution does not in any way confer the quality of the editorial processes. To our minds, there is no doubt that open access publishing offers many benefits to evidence-based healthcare and policy-making. While the business model continues to be explored, we have no doubt that it is here to stay, and that communities should find ways to embrace it.
Acknowledgements We would like to thank Matthew Cockerill (BioMed Central, London, UK) for critical reading of the draft manuscript.
References 1. Bethesda Statement on open access publishing. Available at; http://www.earlham.edu/peters/fos/bethesda.htm 2. Delamothe T, Smith R. Open access publishing takes off. BMJ 2004;328:1–3. 3. Clarke MT. Open sesame? Increasing access to the medical literature. Pediatrics 2004;114:265–8. 4. Eisen M, Brown P. Should the scientific literature be privately owned and controlled? Nature web debates. Available at: http://www.nature.com/nature/debates/e-access/Articles/ Eisen/htm
ARTICLE IN PRESS EDITORIAL 5. Which funding agencies explicitly allow direct use of their grants to cover article-processing charges? Available at: http://www.biomedcentral.com/info/authors/apcfaq#grants 6. Craig JC, Irwig LM, Stockler MR. Evidence-based medicine: useful tools for decision making. MJA 2001;174:248–53. 7. http://www.pubmedcentral.nih.gov/about/intro.html. 8. Choi BCK, Pang T, Lin V, et al. Can scientists and policymakers work together? J Epidemiol Community Health 2005; 59:632–7. 9. Lin V, Gibson B, (eds). Evidence-based Health Policy: Problems and possibilities. Melbourne: Oxford University Press, 2003. 10. King R, Tamber PS. Is open access to medical research literature relevant to low-and middle-income countries. Natl Med J India 2004;17:121–4. 11. Satyanarayana K. Open access publication in biomedical research: implications for developing countries. Indian J Med Res 2004;120:67–9. 12. Tamber PS, Godlee F, Newmark P. Open access to peerreviewed research: making it happen. Lancet 2003;362: 1575–7. 13. Gibson B. From Transfer to Transformation: Rethinking the Relationship between Research and Policy. PhD thesis, Australian National University, 2003. 14. Schroter S, Tite L, Smtih R. Perceptions of open access publishing: interviews with journal authors. BMJ 2005; 330:756.
373 Charlotte Hubbard Assistant Editor, BioMed Central, Middlesex House, 34–42 Cleveland Street, London W1T 4LB, UK
Pritpal S Tamber Editorial Director for Medicine, BioMed Central, London, UK
Vivian Lin Professor of Public Health, School of Public Health, La Trobe University, Bundoora, Australia
Liz Furler Managing Editor, Australia New Zealand Health Policy
Stephen Duckett Professor of Health Policy and Dean of Health Sciences, La Trobe University, Australia