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Choosing to be an Open Access Journal Palepu, Anita Oct 19, 2010

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Open Medicine Choosing to be an open access journal Anita Palepu, MD, MPH Scientist, CHEOS Professor of Medicine, UBC Co-editor and Founder of Open Medicine  Roadmap • • • •  Editorial interference Pharmaceutical advertising Impact of internet on publishing What Open Medicine has been able to achieve • What you can do  Recurring Theme  Conflict between publisher and editor is a recurring theme  1992  Robert Fletcher : “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”  1999 • Editor George Lundberg fired by the AMA for fast tracking a report describing what college students considered "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.”  1999 Editor Jerry Kassirer forced out because he objected to publisher’s use of editors’ credibility to market content editors hadn’t reviewed  2006  Plan B • 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 scientific research • Clear interference with editorial autonomy • Prioritized relationship with a collegial professional body over best interests of patients http://www.cmaj.ca/cgi/content/full/174/7/945  Editorial Independence • Effective governance depends on the integrity of both parties (publisher/editor) • An editor who doesn't share the values of the association/publisher is vulnerable to loss of autonomy • A truly independent journal may not be able to exist within traditional publishereditor relationship  Current Model of Publishing  Current model restricts access • 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 publisher • Billions of dollars of taxpayer research funding research seen by small fraction of the intended audience – Cost of annual subscription to Brain Research is ~$24,000  The journal crisis  Restricted access drives big profits • High profile drug trial can earn up to $1m in reprint sales • Market leader Elsevier earns adjusted operating profits of $693m/yr Euros in 2009 with margins of 35% on its core journal business • Medical publishing the fastest growing sub-sector of media industry for past 15 years  Restricted access does harm • Impedes global research • Contributes to knowledge gap in developing countries • Hampers capacity building and collaboration • Clinicians, patients and health policymakers can’t make decisions based on all the available information  Their goal is to fool most of the doctors most of the time – should we help them do it?  • PLoS Medicine June 2006  PLoS Med 3(6): e130. doi:10.1371/journal.pmed.0030130  Pharmaceutical Advertising • Driving a $9 billion/year drug industry • Accounted for US$448 million of medical journal revenue in 2003 • Medical journals are now dependent on revenue from pharmaceutical and medical device advertising  Ads in Association Journals • In 1996, 5 of 6 physician organizations raised 10% or more of their total annual revenue from pharmaceutical advertising in affiliated medical 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 subscriptions  Ads in Association Journals In 1995, 12% of journal editors reported conflicts between advertisers’ wishes and editorial decisions, and 21% reported that they had no control over advertisements  Courting Pharmaceutical Advertisers "The highly cited articles published in JCE&M discuss the application of your company's therapeutic products in the treatment of various endocrine disorders.”  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 • "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" • "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 2003  Readers Surveys NEJM 2010 advertising rate card: FREE MARKET RESEARCH “NEJM conducts independent market research to track physicians’ reading and prescribing habits and makes this information available to advertisers free of charge. NEJM also subscribes to Nielsen, FOCUS.” www.nejmadsales.org.  Post-Publication Marketing and Reprint Sales • The NEJM sold 929,400 reprints of the “Vioxx trial”- most to Merck • More than one for every physician in the USA • Revenues generated were ~$700,000 - conservatively for the NEJM  Current model driven by profit motive • Little space devoted to covering health issues of developing world given that editors must prioritize – What will sell ads and reprints – Audiences who can afford to buy: • Pharmaceutical and medical device advertisers • Physicians in wealthy nations  Current model creates conflict • Revenue from pharmaceutical “clients” vs. research-based best medical practice • Political and collegial relationships vs. best interests of patients and health policy • Profit from publications vs. best interests of progress in global health  The web changed everything • In 21st century, we are information-rich • Easier to access ‘medical evidence’ & exchange information, communicate • 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  Open access publishing • Subscription fees made sense before Internet • Printing, binding, and mailing each additional paper copy cost additional amount • Online publishers have one-time fixed cost – Cost of 2 readers = cost of 2000 readers – Why charge all 2000 readers?  What is open access Removes barriers to access: • Free, immediate access online Removes barriers to usage • 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  What open access is not  • A business model • Free access • A replacement for peer review • Low impact  Who benefits from OA? • Taxpayers, policy makers, government • Clinicians, researchers, • Teachers & students, libraries, librarians • Learning organizations, universities • Developing nations  Free, 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 Shaw  PLoS Image  Re-mix  What is Open Medicine? •  Peer-reviewed, independent, open-access general medical journal  •  Indexed in MEDLINE, PubMed and we deposit our full-text at PubMed Central  •  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  Our core values @OM • • • • • • • •  Openly-accessible, worldwide Authors retain copyrights Achieve publishing excellence Maintain editorial autonomy Fiscal & political independence Local community and international engagement To know our community Be technologically-innovative  OM journal production • 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 blog • XML conversion for later NLM indexing • Peer review, copy editing, layout • Weekly teleconference meetings • Internal editors’ wiki  OM submissions – 2010 • • • •  443 submissions since April 2007 290 submissions peer-reviewed Days to peer review ~26 d Published 100 articles including editorials • Acceptance rate ~34% • Registered website users: 3833  Media attention from National Post, Globe and Mail, Canada.com, C CBC interviewed DAR on As it Happens All had access to the full article as soon as it was published We have no embargo  Open Medicine – the future • • • • • •  Develop stronger ties to 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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