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

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Choosing to be an open access journal Open Medicine Anita Palepu, MD, MPH Scientist, CHEOS Professor of Medicine, UBC Co-editor and Founder of Open Medicine • Editorial interference • Pharmaceutical advertising • Impact of internet on publishing • What Open Medicine has been able to Roadmap achieve • What you can do Recurring Theme Conflict between publisher and editor is a recurring theme Robert Fletcher : “The pharmaceutical 1992 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” • 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 1999 editors’ credibility to market content editors hadn’t reviewed 2006 • 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 B 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 • Effective governance depends on the integrity of both parties (publisher/editor) • An editor who doesn't share the values Editorial Independence of the association/publisher is vulnerable to loss of autonomy • A truly independent journal may not be able to exist within traditional publisher- editor relationship Current 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 publisher Current 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 ~$24,000   The 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 profits 2009 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 harm 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 • Driving a $9 billion/year drug industry • Accounted for US$448 million of medical journal revenue in 2003 Pharmaceutical 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 journals Ads 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 subscriptions In 1995, 12% of journal editors reported conflicts between advertisers’ Ads in Association Journals wishes 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 Advertisers Medical 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 2003 NEJM 2010 advertising rate card: FREE MARKET RESEARCH “NEJM conducts independent market research to track physicians’ reading Readers Surveys and prescribing habits and makes this information available to advertisers free of charge. NEJM also subscribes to Nielsen, FOCUS.” www.nejmadsales.org.   • The NEJM sold 929,400 reprints of the “Vioxx trial”- most to Merck • More than one for every physician Post-Publication Marketing and Reprint Sales in 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 reprints Current 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 practice Current 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, communicate The 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 amount Open 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 online Removes barriers to usage What 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 access What 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 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 • Peer-reviewed, independent, open-access general medical journal • Indexed in MEDLINE, PubMed and we deposit our full-text at PubMed Central What 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 autonomy Our 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 blog OM 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 editorials OM submissions – 2010 • 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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