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Choosing to be an Open Access Journal [videorecording] Palepu, Anita 2010-10-19

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2689-Palepu_Anita_Open_Medicine.wmv [ 152.14MB ]
2689-Palepu_Anita_Open_Medicine.pdf [ 2.43MB ]
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Choosing to be an open access journalOpen MedicineAnita Palepu, MD, MPHScientist, CHEOSProfessor of Medicine, UBCCo-editor and Founder of Open Medicine• Editorial interference• Pharmaceutical advertising• Impact of internet on publishing• What Open Medicine has been able to Roadmapachieve• What you can doRecurring ThemeConflict between publisher and editor is a recurring themeRobert Fletcher : “The pharmaceutical 1992industry 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”• Editor George Lundberg fired by the AMA for fast tracking a report describing what college students considered 1999"having sex“• Coincided with President Clinton's assertions that he “did not have sex with that woman” • Justification: Lundberg “Swayed from science and medicine into politics.”Editor Jerry Kassirer forced out because he objected to publisher’s use of 1999editors’ credibility to market content editors hadn’t reviewed2006• Canadian Pharmacists Association complained to CMA about a news article on Plan B • Publisher instructed editors to withhold article on grounds that investigative reporting isn’t Plan Bscientific research• Clear interference with editorial autonomy• Prioritized relationship with a collegial professional body over best interests of patients• Effective governance depends on the integrity of both parties (publisher/editor)• An editor who doesn't share the values Editorial Independenceof the association/publisher is vulnerable to loss of autonomy• A truly independent journal may not be able to exist within traditional publisher-editor relationshipCurrent Model of Publishing• Medical knowledge is privately owned and available in a timely way only to those who can pay• Authors lose ownership of their work when sign over copyright to the publisherCurrent model restricts access• Billions of dollars of taxpayer research funding research seen by small fraction of the intended audience– Cost of annual subscription to Brain Research is ~$24,000The journal crisis• High profile drug trial can earn up to $1m in reprint sales• Market leader Elsevier earns adjusted operating profits of $693m/yr Euros in Restricted access drives big profits2009 with margins of 35% on its core journal business• Medical publishing the fastest growing sub-sector of media industry for past 15 years• Impedes global research• Contributes to knowledge gap in developing countries• Hampers capacity building and Restricted access does harmcollaboration• Clinicians, patients and health policymakers can’t make decisions based on all the available informationTheir goal is to fool most of the doctors most of the time – should we help them do it?• PLoS Medicine June 2006PLoS Med 3(6): e130. doi:10.1371/journal.pmed.0030130• Driving a $9 billion/year drug industry• Accounted for US$448 million of medical journal revenue in 2003Pharmaceutical Advertising• Medical journals are now dependent on revenue from pharmaceutical and medical device advertising• In 1996, 5 of 6 physician organizations raised 10% or more of their total annual revenue from pharmaceutical advertising in affiliated medical journalsAds in Association Journals• In 2004, advertising in AMA publications constituted 15% of total AMA revenues– AMA generated US$40.7 million from advertising, more than twice the US$17.5 million from subscriptionsIn 1995, 12% of journal editors reported conflicts between advertisers’ Ads in Association Journalswishes and editorial decisions, and 21% reported that they had no control over advertisements"The highly cited articles published in JCE&M discuss the application of your company's therapeutic products in the treatment of various endocrine disorders.”Courting Pharmaceutical AdvertisersMedical Marketing and Media (MMM) May 2002 a four-page advertisement for the Endocrine Society, which publishes the  Journal of Endocrinology and Metabolism• "You'll be  amazed at what a week  in  New England can do" • "Once a week, your advertising message is delivered to physicians who make decisions and influence the decisions of others" Courting Pharmaceutical Advertisers• "The place to be for important news, important readers, important prescribers”• "Place your ad in the New England Journal of Medicine and make our relationship with the medical community yours.”Medical Marketing and Media (MMM) October 2000 and November 2003NEJM 2010 advertising rate card: FREE MARKET RESEARCH“NEJM conducts independent market research to track physicians’ reading Readers Surveysand prescribing habits and makes this information available to advertisers free of charge. NEJM also subscribes to Nielsen, FOCUS.” • The NEJM sold 929,400 reprints of the “Vioxx trial”- most to Merck• More than one for every physician Post-Publication Marketing and Reprint Salesin the USA• Revenues generated were ~$700,000 - conservatively for the NEJM• Little space devoted to covering health issues of developing world given that editors must prioritize– What will sell ads and reprintsCurrent model driven by profit motive– Audiences who can afford to buy:• Pharmaceutical and medical device advertisers• Physicians in wealthy nations• Revenue from pharmaceutical “clients” vs. research-based best medical practiceCurrent model creates conflict• Political and collegial relationships vs. best interests of patients and health policy• Profit from publications vs. best interests of progress in global health• In 21st century, we are information-rich• Easier to access ‘medical evidence’ & exchange information, communicateThe web changed everything• Less expensive to publish online • Fast, or instantaneous• Global reach• Includes developing countries, global health issues• Web 2.0 requires two-way ‘social’ interaction, feedback mechanisms• Subscription fees made sense before Internet• Printing, binding, and mailing each additional paper copy cost additional amountOpen access publishing• Online publishers have one-time fixed cost– Cost of 2 readers = cost of 2000 readers– Why charge all 2000 readers?Removes barriers to access: • Free, immediate access onlineRemoves barriers to usageWhat is open access • Unrestricted distribution and re-use • Author retains ownership and rights to attribution• Manuscripts are deposited in a public online archive (usually full-text and xml [tagged html])Bethesda Principles, April 2003• A business model• Free accessWhat open access is not• A replacement for peer review• Low impact• Taxpayers, policy makers, government  • Clinicians, researchers, • Teachers & students, libraries, Who benefits from OA?librarians • Learning organizations, universities • Developing nationsFree, unrestricted access“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.”George Bernard ShawPLoS ImageRe-mix• Peer-reviewed, independent, open-access general medical journal• Indexed in MEDLINE, PubMed and we deposit our full-text at PubMed CentralWhat is Open Medicine?• Examines issues relevant to health and clinical medicine in Canada and internationally• A newer model of scholarly publishing• Unique venture, interdisciplinary group with qualified medical librarian• Openly-accessible, worldwide• Authors retain copyrights• Achieve publishing excellence• Maintain editorial autonomyOur core values @OM• Fiscal & political independence• Local community and international engagement • To know our community • Be technologically-innovative• Open source software is used• Willinsky’s Open Journal Systems (OJS) • Public Knowledge Project – SFU Library & UBC• Development of ideas and code• Use Drupal for OM blogOM journal production• XML conversion for later NLM indexing• Peer review, copy editing, layout• Weekly teleconference meetings• Internal editors’ wiki• 443 submissions since April 2007• 290 submissions peer-reviewed • Days to peer review ~26 d• Published 100 articles including editorialsOM submissions – 2010• Acceptance rate ~34%• Registered website users: 3833Media attention from National Post, Globe and Mail,, CCBC interviewed DAR on As it HappensAll had access to the full article as soon as it was publishedWe have no embargoOpen Medicine – the future• Develop stronger tiesto global research community, medical practitioners and libraries• Develop business & economic models/ deal with sustainability issues • Improve production efficiency• Fundraising & development process• Website redesign• Utilize more web 2.0 tools and multimedia; encourage social aspects, interactivity


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