Open Access News

Open Medicine launched today, but already the web site is overwhelmed with traffic.  Give it a few hours and try again.  While you're waiting, read some of the voluminous press coverage.

Update.  I finally got in.  Here's an excerpt from James Maskalyk's editorial in the inaugural issue:

...To attain their true worth, medical journals need to place the knowledge on their pages into as many capable hands as possible. In the past, this opportunity was limited mainly to those with a university library close by. Now, because of the Internet, one simply needs to be near a telephone line. The capacity of medical journals to disseminate knowledge has never been greater.

Unfortunately, physicians attempting to answer a clinical question are faced with two unappealing options: to navigate a sea of unedited pages of varying quality, or to pay for access to more carefully reviewed scholarly information. It seems an anathema to the spirit of medical research that, largely for economic reasons, the information it produces remains hidden from many potential users. Access is limited not only for health professionals in poorer countries, but also for health care providers in wealthy countries (most of whom do not have "free" access to information unless they work in universities), and for patients, who deserve the opportunity to become informed about research that affects their lives. The transformation of research findings and discussion of the results — the application of knowledge — is curtailed. Just as importantly, the debate over its merit is stifled before it can properly begin.

There is a necessary cost to medical publishing, the publisher's pursuit of profit notwithstanding. The reviewing and editing processes that help to ensure the reliability of information is intensive, requiring considerable resources. However, the costs of editing and peer review, where possible, should not be borne by the end user, but should be shared by a broader group in society who acknowledge that the utility of information lies in its application and that the health of individuals and populations is a common good. There is increasing recognition that the costs of publishing the results of medical research should be built into funding grants as an integral part of the cost of research: without dissemination, knowledge cannot truly be said to exist.

Traditional modes of medical journal publishing can also exact a price in other, less noticeable, ways. There is clear evidence of publication bias in medical journals predicated on financial conflicts, geography and poverty. There are also several important instances where information and debate have been stifled because of private and political concerns over making knowledge public. To an important degree, the impetus to launch Open Medicine arose from widespread dismay in the Canadian and international medical community over one such attempt to suppress open discussion and restrict the scope of health care discourse. Further, too much of the revenue that sustains medical journals comes from pharmaceutical advertising that attempts to influence physicians into making decisions based on brand recognition rather than on discerning scholarship.

Medical knowledge should be public and free from undeclared influence. When possible, it should be free for those who apply it. Since people's lives depend on it, that knowledge must be filtered several times before it is ready to use. Studies need to be peer reviewed, to have their statistics analyzed, their content edited, then copy edited, then published quickly for as wide an audience as possible. The prospect of having a high-quality source of information that held true to these principles but was also free and globally accessible was impossible to imagine 20 years ago....

[I]is our intention to make the journal not only open, but also collaborative. As an example, the editors considered the merits of publishing peer reviews along with accepted papers, and began reviewing the published evidence on the effectiveness of open peer review. Before reaching consensus, we realized that this is a discussion our readers and contributors should actively participate in. As we developed Open Medicine, we made extensive use of a wiki site and quickly realized how well it captured our combined efforts. We will continue to experiment with its use as an editing tool, and are discussing ways to add a wiki to our public site.

Information technology is evolving at a blistering pace. To try to keep step with its potential to influence medical science and practice, Open Medicine is hosting a blog on the topic. To manage it, we are using an open-source program (Drupal). So, too, for our manuscript management system (OJS)....Our intent is to harness as much power as possible from the collaborative potential of a connected world. With it, Open Medicine can publish articles as soon as they are peer reviewed and edited, host the discussion on their interpretation and perhaps even watch them change. Once they are published, they will be available to the widest possible audience and to the worldwide media who can cast them even further....

Ultimately, the success of Open Medicine will depend on how important our readers believe it is to have open access to high-quality medical information that is as free from commercial and political influence as possible. We believe there are few things more important....

Also see these two articles from the Analysis and Comment section:

• Gavin Yamey and four co-authors, The joys and challenges of being an open access medical journal
• Matthew E. Falagas, Peer review in open access scientific journals