Open Medicine: a peer-reviewed, independent, open-access (OA) general medical journal


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A powerpoint presentation by Dr. A. Palepu to our LIBR534 class on April 8th, 2010.

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  • Introductions – Anita
  • Provide some idea of what we will discuss; format; “tag-team” presenters – Anita
  • Open medicine arose within a context – Anita
  • The history of conflict in medical journal publishing is linked to big pharmaceutical companies and their influence – Anita
  • Some medical journals suffer from political kinds of interference in what they publish – Anita
  • Came to a head in 2006 at the CMAJ – Anita
  • The crux of the matter was the Plan B story, John Hooey, etc. – Anita
  • Dean’s slide -
  • So what’s the problem? The biggest problem with older publishing models is how they limit access to research and knowledge – Dean
  • Here’s an overview to some of the highlights of the conflicting influences that are of concern – Anita
  • Within the last decade, much of the paradigm around scholarly publishing changed because of the rise of the web; and easy access to information of various kinds; proprietary control continues, however – Dean
  • Web 2.0 is also a heavy influence now in how medical journals publish – Dean
  • Might be useful to go over in some detail what OA is here – Dean OA is the free, immediate and permanent access to the full text of research articles online; And that includes access to anyone, anywhere and at any time; Important to mention monographs vs. journal articles; scholars write for impact not money; but what we are talking about is primarily open access to the journal article So why is OA important? It removes barriers to accessibility and use, so linked with the notion of OA is unrestricted distribution and remix of content; no sense limiting the dissemination or ‘repurposing’ of knowledge because this is one of the ways that it is refined and improved; we also believe that it is important that authors retain the ownership and copyright and not sign those over to publishers; finally, open access includes the ability to self-archive, which Stevan Harnad calls the “green” road to Open Access.
  • Who benefits when a medical journal is completely open and free to access? – Dean
  • One of the key issues for us was what type of Creative Commons license we would adopt - Anita
  • Ideas breed More access to information- more ideas which are a source of wealth in the information age Richard Smith, The Trouble with Medical Publishing
  • Apart from the fact that we are open access, what is Open Medicine? – Anita
  • We have a number of core values that grow out of our values, experiences and belief systems. – Anita
  • The actual production of the journal is guided by a number of principles. - Dean
  • We of course are committed to making some changes at Open Medicine, such as… - Anita
  • Open Medicine: a peer-reviewed, independent, open-access (OA) general medical journal

    1. 1. A peer-reviewed, independent, open-access (OA) general medical journal Open Medicine Anita Palepu MD, MPH Co-editor, Open Medicine Professor of Medicine Department of Medicine University of British Columbia April 8, 2010 for LIBR534, SLAIS
    2. 2. <ul><li>Scholarly publishing model </li></ul><ul><ul><ul><li>Challenges (and conflict) in biomedicine </li></ul></ul></ul><ul><ul><ul><li>Publishers’ & Drug companies influence </li></ul></ul></ul><ul><li>What is open access (OA)? </li></ul><ul><ul><ul><li>How did we get here, circa 2008? </li></ul></ul></ul><ul><li>Open Medicine (OM) </li></ul><ul><ul><ul><li>Where we are and hope to go </li></ul></ul></ul><ul><ul><ul><li>Medical librarian-physician collaboration </li></ul></ul></ul>Roadmap
    3. 3. <ul><li>Conflict between publishers and editors </li></ul>A recurring theme
    4. 4. <ul><li>“ The pharmaceutical industry showed us that the advertising dollar could be a two-edged sword, a carrot or a stick. If you ever wondered whether they play hardball, that was a pretty good demonstration that they do.” </li></ul><ul><li>- Robert Fletcher, then-editor of Annals </li></ul>1992                                                                                                                                         
    5. 5. <ul><li>Editor fired by AMA for fast tracking report about what college students considered as “ having sex “ </li></ul><ul><li>Coincided with President Clinton's “I did not have sex with that woman” </li></ul><ul><li>Justification: Lundberg “Swayed from science and medicine into politics.” </li></ul>1999
    6. 6. <ul><li>Editor Jerry Kassirer forced out because he objected to publisher’s use of editors’ credibility to market content editors hadn’t reviewed </li></ul>1999
    7. 7. 2006
    8. 8. <ul><li>Canadian Pharmacists Association complained about a CMA news article on Plan B </li></ul><ul><li>Publisher told CMAJ editors to withhold article because “investigative reporting isn’t scientific research” </li></ul><ul><li>Clear interference with editorial autonomy </li></ul><ul><li>Prioritized relationship with a collegial professional body over best interests of patients </li></ul><ul><li> full/174/7/945 </li></ul>Plan B – ‘Morning after pill’
    9. 9. <ul><li>News report about &quot;two-tier Tony” published online </li></ul><ul><li>ordered off website by publisher, who published more supportive revision after firing editors </li></ul><ul><li>prioritized political relationship over fair reporting of Minister’s record </li></ul><ul><li>original and revised versions at </li></ul>Honourable Tony Clement
    10. 10. <ul><li>“ Need for a fresh approach” </li></ul>Reason for firing the editors
    11. 11. <ul><li>“ Irreconcilable differences” </li></ul>Reason for firing the editors
    12. 12. <ul><li>Effective governance depends on the integrity of both parties (publisher/editor) </li></ul><ul><li>An editor who doesn't share the values of the association/publisher is vulnerable to loss of autonomy </li></ul><ul><li>A truly independent journal cannot exist within traditional publisher-editor relationship </li></ul>Editorial Independence
    13. 13. Scholarly publishing model? Palepu - Giustini – BCLA Conference April 2008
    14. 14. <ul><li>Much scientific knowledge privately-owned, controlled </li></ul><ul><li>Author loses ownership as copyright signed over to publisher </li></ul><ul><li>Billions of taxpayer research funding seen by small fraction of intended audiences </li></ul><ul><li>Annual subscription cost for Brain Research is ~$24,000 </li></ul>Older models limit access Palepu - Giustini – BCLA Conference April 2008
    15. 15. <ul><li>High profile drug trial can earn up to $1m in reprint sales </li></ul><ul><li>Market leader Elsevier earns profits of $681m/yr Euros in 2006 with margins of 40% on its core journal business </li></ul><ul><li>Medical publishing the fastest growing sub-sector of media industry for past 15 years </li></ul>Restricted access drives big profits
    16. 16. <ul><li>Impedes global research </li></ul><ul><li>Contributes to knowledge gap in developing countries </li></ul><ul><li>Hampers capacity building and collaboration </li></ul><ul><li>Clinicians, patients and health policymakers can’t make decisions based on all the available information </li></ul>Restricted access does harm
    17. 17. Their goal is to fool most of the doctors most of the time – should we help them do it?
    18. 18. <ul><li>PLoS Medicine June 2006 </li></ul>
    19. 19. <ul><li>Driving a $9 billion/year drug industry </li></ul><ul><li>Accounted for US$448 million of medical journal revenue in 2003 </li></ul><ul><li>Medical journals are now dependent on revenue from pharmaceutical and medical device advertising </li></ul>Pharmaceutical Advertising
    20. 20. <ul><li>In 1996, 5 of 6 physician organizations raised 10% or more of their total annual revenue from pharmaceutical advertising in affiliated medical journals </li></ul><ul><li>In 2004, advertising in AMA publications constituted 15% of total AMA revenues </li></ul><ul><ul><li>AMA generated US$40.7 million from advertising, more than twice the US$17.5 million from subscriptions </li></ul></ul>Ads in Journals
    21. 21. <ul><li>&quot;The highly cited articles published in JCE&M discuss the application of your company's therapeutic products in the treatment of various endocrine disorders.” </li></ul>Medical Marketing and Media (MMM) May 2002 a four-page advertisement for the Endocrine Society, which publishes the Journal of Endocrinology and Metabolism Courting Pharmaceutical Advertisers
    22. 22. <ul><li>&quot;You'll be amazed at what a week in New England can do&quot; </li></ul><ul><li>&quot;Once a week, your advertising message is delivered to physicians who make decisions and influence the decisions of others&quot; </li></ul><ul><li>&quot;The place to be for important news, important readers, important prescribers” </li></ul><ul><li>&quot;Place your ad in the New England Journal of Medicine and make our relationship with the medical community yours.” </li></ul>Medical Marketing and Media (MMM) October 2000 and November 2003 Courting Pharmaceutical Advertisers
    23. 23. <ul><li>NEJM 2007 advertising rate card: </li></ul><ul><li>&quot;To help you determine physicians’ reading and prescribing habits, NEJM conducts independent market research and subscribes to PERQ/HCI Focus. </li></ul><ul><li>To learn how this research can benefit your product’s marketing efforts, please contact your Regional Sales Director or visit our website,; </li></ul>Readers Surveys
    24. 24. <ul><li>No requirements to demonstrate greater efficacy as condition of advertising </li></ul><ul><li>As a service to advertisers, side-by-side advertising of competing drugs is avoided: </li></ul><ul><ul><ul><li>“ Competitive products are separated by no fewer than four pages for primary indication only, as reflected in the ad content.” </li></ul></ul></ul><ul><ul><ul><li>(Annals of Internal Medicine) </li></ul></ul></ul>Who do our Journals serve?
    25. 25. <ul><li>Political relationships vs. best interests of patients & health policy </li></ul><ul><li>Medical publishing fastest growing sub-sector of media industry for past 15 years </li></ul><ul><li>Elsevier earned 693 m pounds in profit 2009 with 44% of this profit derived from core journals </li></ul><ul><li>Revenue from pharmaceutical “clients” vs. best evidence gained by research </li></ul><ul><li>High-profile drug trials earn millions in reprint sales </li></ul><ul><li>Profit vs. interests of global health progress </li></ul>Publishing, politics & profits
    26. 26. <ul><li>In 21 st century, we are information-rich </li></ul><ul><li>Easier to access ‘medical evidence’ & exchange information, communicate </li></ul><ul><li>Less expensive to publish online </li></ul><ul><ul><ul><li>Fast, or instantaneous </li></ul></ul></ul><ul><li>Global reach </li></ul><ul><ul><ul><li>Includes developing countries, global health issues </li></ul></ul></ul><ul><li>Web 2.0 requires two-way ‘social’ interaction, feedback mechanisms </li></ul>The web changes everything Palepu - Giustini – BCLA Conference April 2008
    27. 27. Palepu - Giustini – BCLA Conference April 2008
    28. 28. <ul><li>Scholarly research freely-available </li></ul><ul><li>Free, immediate access to anyone, anywhere </li></ul><ul><li>Scholars write for impact, not money </li></ul><ul><li>OA removes barriers to access & use </li></ul><ul><li>Unrestricted distribution & remix </li></ul><ul><li>Author retains ownership & rights to attribution </li></ul><ul><li>Papers deposited in online public archive </li></ul><ul><li>- from Bethesda OA Principles 2003 </li></ul>What is open access? Palepu - Giustini – BCLA Conference April 2008
    29. 29. <ul><li>Taxpayers, policy makers, government </li></ul><ul><li>Clinicians, reseachers, </li></ul><ul><li>Teachers & students, libraries, librarians </li></ul><ul><li>Learning organizations, universities </li></ul><ul><li>Developing nations </li></ul><ul><li>“ We recently become a supporter of Open Medicine… </li></ul><ul><li>Providing open access to peer-reviewed research has become a critical issue for the academic community. It affects the way in which research is funded, created, shared and archived. We articulated an open access statement on our website to express our strong support for this shift in scholarly communication.” </li></ul><ul><li>Tony Horava, Collection Librarian, University of Ottawa </li></ul>Who benefits from OA? Palepu - Giustini – BCLA Conference April 2008
    30. 30. Palepu - Giustini – BCLA Conference April 2008
    31. 31. <ul><li>“ If you have an apple and I have an apple and we exchange these apples then you and I will have each one apple. But if you have an idea and I have an idea and we exchange these ideas, then each of us have two ideas.” </li></ul><ul><li>- George Bernard Shaw </li></ul>Free, unrestricted access
    32. 37. PLoS Image
    33. 38. Re-mix
    34. 39. <ul><li>Peer-reviewed, independent, open-access general medical journal </li></ul><ul><li>Examines issues relevant to health and clinical medicine in Canada and internationally </li></ul><ul><li>A newer model of scholarly publishing </li></ul><ul><li>Unique venture, interdisciplinary group with qualified medical librarian </li></ul><ul><li> </li></ul>What is Open Medicine?
    35. 40. <ul><ul><li>Openly-accessible, worldwide </li></ul></ul><ul><ul><li>Authors retain copyrights </li></ul></ul><ul><ul><li>Achieve publishing excellence </li></ul></ul><ul><ul><li>Maintain editorial autonomy </li></ul></ul><ul><ul><li>Fiscal & political independence </li></ul></ul><ul><ul><li>Local community and international engagement </li></ul></ul><ul><ul><li>To know our community </li></ul></ul><ul><ul><li>Be technologically-innovative </li></ul></ul>Our core values @OM Palepu - Giustini – BCLA Conference April 2008
    36. 41. <ul><li>Open source software is used </li></ul><ul><ul><ul><li>Willinsky’s Open Journal Systems (OJS) </li></ul></ul></ul><ul><ul><ul><li>Public Knowledge Project – SFU Library & UBC </li></ul></ul></ul><ul><ul><ul><li>Development of ideas and code </li></ul></ul></ul><ul><ul><ul><li>Use Drupal for OM blog </li></ul></ul></ul><ul><ul><ul><li>XML conversion for later NLM indexing </li></ul></ul></ul><ul><li>Peer review, copy editing, layout </li></ul><ul><ul><ul><li>Weekly teleconference meetings </li></ul></ul></ul><ul><ul><ul><li>Internal editors’ wiki </li></ul></ul></ul>OM journal production Palepu - Giustini – BCLA Conference April 2008
    37. 42. <ul><ul><li>407 submissions since April 2007 </li></ul></ul><ul><ul><li>200 submissions peer-reviewed </li></ul></ul><ul><ul><li>Days to peer review ~35 d </li></ul></ul><ul><ul><li>Published 81 articles </li></ul></ul><ul><ul><ul><li>Acceptance rate ~25% </li></ul></ul></ul><ul><ul><ul><li>Registered website users: 3833 </li></ul></ul></ul>OM submissions – 2010
    38. 43. Open Medicine – the future <ul><li>http:// / </li></ul><ul><li>Develop stronger ties to global research community, medical practitioners and libraries </li></ul><ul><li>Inclusion in MEDLINE indexing (Accepted in PubMed) </li></ul><ul><li>Develop business & economic models/ deal with sustainability issues </li></ul><ul><li>Improve production efficiency </li></ul><ul><li>Fundraising & development process </li></ul><ul><li>Website redesign </li></ul><ul><li>Utilize more web 2.0 tools and multimedia </li></ul><ul><li>Encourage social aspects of web and interactivity </li></ul>