The long road to democracy in medical publishing

The question of where a medical writer or clinician should submit their clinical research paper for publication is one of constant evolution and occasional revolution. Once upon a time, but in reality only twenty years ago, medical science journals were published exclusively in print by prestigious houses that acted as both curators and guardians of medical knowledge. If accessing their papers via databases in silent libraries was difficult enough, getting your study published in one was another matter entirely. To say the process was opaque is putting it kindly.

Then, as in so many other aspects of modern life, along came the internet. As publishers no longer had to compete for literal shelf space, they could produce a range of journals in every field of medicine, covering every sub-specialisation in great detail. This meant an explosion in the number of manuscripts published every year, and a huge increase in the likelihood of a research paper being published.

But it was also a revolution in the way clinicians accessed healthcare information. Medical knowledge was no longer controlled by a select few and slowly filtered down to doctors ‘on the ground’. Instead, the latest scientific data was available to every doctor, now and forever. Medical research was democratised, and individual doctors, and patients, were suddenly able to make much better informed decisions, for themselves.

Or that was the theory.

What actually happened is that publishing houses continued, and in some cases continue, to charge vast amounts of money for access to journals that were no longer the same product. After all, the majority of readers no longer wanted print versions of journals. Publishers, due to the sheer volume of manuscripts handled, no longer put the same editorial, design and publishing effort into each paper. Competition for publication decreased substantially with the increase in the number of journals. And the final straw was the internet becoming widely available across the world. Consequently, the best medical practice could be followed even in the poorest parts of the globe. Or at least it would be if the doctors there could afford to read the papers that would give them that potentially life-saving information.

So the open-access or open-source journal was invented. Scientific and medical research published in these journals is available free to the reader, whoever they are and whatever their background (although the researcher or their funding body does typically have to pay a publication fee). The idea was taken from open-source computer software, and its effects on where you can publish your medical research and how it is accessed are still being played out.

Nowadays, there are a number of exclusively open-access publishers, such as Hindawi, Biomed Central, and PLOS, all of which has been made possible by Creative Commons licensing. There is also a Open Access Scholarly Publishers Association to represent their interests. Even traditional publishers such as Elsevier are getting in on the open access act, with their own journals, articles and archives.

And the revolution hasn’t stopped there. The limitations of PubMed search results can be overcome with more intuitive search engines such as TRIP and Google Scholar, while websites such as Science 2.0 point to a whole new world of scientific collaboration.

But what does this all mean for the clinical researcher or medical writer trying to decide where to submit their manuscripts? With so many journals in every field, it is more confusing than ever to know which one to choose. The “impact factor” or the “Eigenfactor” can still help the medical writer or researcher examining which journals offer the greatest clinical influence (as pointed out here).  And, as we recently discussed in this blog post, rejection remains an important issue.

In addition to the opening up of published scientific information, there is a very strong movement in Europe demanding open-source access to withheld clinical trial results. The new European Union Regulation on Clinical Trials is currently being passed through parliament in Brussels. The Rapporteur’s draft report can be found here and the Commission’s proposal here.  One of the more controversial proposals relate to the obligation to publish full clinical study reports (instead of summaries of results) in an EU database. There are a number of  campaigns and petitions demanding a change in how clinical trial data is published and that all data is to be made available for independent researchers. One example is the AllTrials initiative (campaigning for the publication of the full clinical study reports from all clinical trials – past, present and future – on all treatments currently being used), another one is the Berlin Declaration 2012.

Furthermore, what if you have a partially completed study or ambiguous results that you know will never see the light of day in a recognised journal?

One answer to these all-too recognisable issues could be a fascinating and novel journal: UNAIS, or Unpublished Articles in Science. The aim? To publish rejected or theoretically unwanted research, along with peer review comments, in order to exchange and promote knowledge, and offer lessons and inspiration to other researchers.

In an exclusive interview with the founder of UNAIS, Dr Alessandro Diana, a paediatrician from Geneva, Switzerland, our next post will look at what drove him to start UNAIS, the reaction from the medical and wider science world and what hurdles remain for achieving his goals for the journal.

In the meantime, our medical writers can help you choose the most appropriate journal for your research, get your manuscript ready for publication and deal with any peer review comments.

About Frank Waaga

Frank has a passion for medical communications and over 12 years of experience providing professional and reliable support to product teams in the pharmaceutical, biotech and medical device industry.
0 replies

Leave a Reply

Want to join the discussion?
Feel free to contribute!

Leave a Reply

Your email address will not be published. Required fields are marked *