Monday, July 2, 2012

Boycotting Elsevier and the Open Access Debate -- What does this mean for patients, residents, and surgeons?

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Have you ever read a journal article online? Unless you have an academic affiliation, you likely faced a paywall. In an era of pubmed central, google scholar, facebook, and twitter, rapid access to any study is felt to be a right. What should you know about the debate between authors and publishers on open access to research?

Earlier this year, scientists throughout the world started a boycott of the scientific journal publisher Elsevier. At this point, 8966 scientists have joined the boycott -- refusing to publish, referee, or participate in editorial boards for Elsevier journals. These scientists argue that Elsevier and other publishers are overcharging for individual journal subscriptions, mandating libraries to purchase journals in bundles, and supporting measures that restrict the free exchange of information.

In recent years, peer-reviewed, open access journals have emerged as a viable option for publishing scientific studies. Unfortunately, few online open access journals have the same tradition, reputation, or prestige as many print journals. The Public Library of Science (PLoS) is a leader in peer-reviewed, open access publishing and was founded in 2000. PLoS ONE, the main online publication for PLoS, has gained great popularity among scientists for rapid, peer-reviewed publications. PLoS ONE publishes original research within science and medicine independent of subject area. PLoS ONE articles are indexed and archived in PubMed, MEDLINE, PubMed Central, Scopus, Web of Science, Google Scholar, the Chemical Abstracts Service (CAS), EMBASE, AGRICOLA, PsycINFO, Zoological Records, FSTA (Food Science and Technology Abstracts), GeoRef, and RefAware, as well as being searchable via the Web of Knowledge.

Although readers can have easy, rapid access to current research, open access publishing comes at a cost. Publishing in PLoS ONE and many other online, peer-reviewed, open access journals is not free for authors. Currently, PLoS ONE charges $1350 per article. Fee discount or waivers are available to some authors. Publishing fees can be as high as $5000 per article, such is the case for Cell Reports.

Journal publishing is a business, a billion dollar business. Over one-third of revenues are profit for many of the major medical journal publishers. Instead of charging authors, readers can face hefty charges in the current business model for medical journals. We can argue in circles about authorship, ownership, fair use, and how much a manuscript is worth. I don't know the answer. I do know that distribution of any information (medical, news, etc.) costs something. Even information spread by word-of-mouth costs time. Also, distribution of information is not always fair. Open access and traditional publishers compete for readership. For example, de-indexing of BMJ.com by Google last month resulted in significant drop in online readership. David Payne, editor of BMJ.com, openly discussed the importance of Google indexing and search engine optimization for their business.

So, what about surgical literature?

Open access journals specializing in surgery are limited. Currently, the directory of open access journals lists only 91 journals with the surgery as the subject, 21 published in the United States and 13 in the United Kingdom. Searching PLoS ONE, so far 316 articles have been published on the subject of surgery. Some publishers, such as Springer, now offer a open access option for its print journals including Annals of Surgical Oncology. For research funded by the National Institutes of Health, publishers will make manuscripts available on the National Library of Medicine's PubMed Central within a year of publication. For example, many studies in the Annals of Surgery are available free for online access six months after printing in the journal.

The majority of research published today in surgery is not freely available online. Also, to publish in a major surgery journal typically requires releasing the copyright of the manuscript to the publisher. Importantly, open access publishing options are available to surgeons; however, the readership is currently small.

In an ideal world, results of all medical research, published or not, would be freely available to the public, researchers, and clinicians. Unfortunately, the distribution of information is not free. Open access doesn't mean free--at least for the author. So, the next time you face a paywall, think about the cost of information, boycotting scientists, and the emerging business of online, open access publishing.

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