An editor’s perspective of the importance ofcredible evidence being open and available

Improving credibility in journal publishing:

Anita Palepu, MD, MPHEditor and Founder of Open MedicineScientist, CHEOSProfessor of Medicine, UBC

• Editor, Open Medicine

• Associate Editor, General Medicine Annals of Internal Medicine

Disclosures

Cochrane Canada Symposium Plenary | 17 February 2011, Vancouver BC

• EQUATOR-Network– Importance of standardizing how we present

health research to ensure high quality reporting

• Open Access– Powerful societal movement to remove barriers

to scholarly information• Opportunities to innovate and partner

– Use of wiki to update systematic and scoping reviews

– Social media and broader dissemination

Roadmap

• To improve the quality of reporting of health research

• CONSORT Statement - for randomized controlled trials• PRISMA - for systematic reviews and meta-analysis• STROBE - for observational studies in epidemiology• STARD - for diagnostic accuracy studies• MOOSE - for meta-analysis of observational studies

Reporting Guidelines

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

• 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

Current model restricts access

The journal crisis

• High profile drug trial can earn up to $1m in reprint sales

• Market leader Elsevier earned adjusted operating profits of $693m/yr euros in 2009, margins of 35% on core journal business

• Medical publishing the fastest growing sub-sector of media industry for past 19 years

Restricted access drives big profits

• 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

Restricted access does harm

• 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

The web changed everything

•A business model

•Free access

•A replacement for peer review

•Low impact

What open access is not

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 is open access

Free, unrestrictedunrestricted 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

• Taxpayers (patients), policy makers, government

• Clinicians, researchers

• Teachers & students, libraries, librarians

• Learning organizations, universities

• Developing nations

Who benefits from OA?

• Updating systematic review – using wikis

• Leveraging social media to better disseminate

• Enhancing interactivity

• Disseminating Cochrane content through open access journals – Summaries

– Commentaries and Editorials

Opportunities to innovate and partner

Open Medicine wiki SR

Open Medicine wiki SR

Open Medicine wiki SR

• Integrity – Important clinical questions are answered using valid methods (Registration and Ethical conduct)

• Transparency – These results are reported using the best available reporting guidelines to ensure reproducibility

• Accountability – These findings are made open access to ensure widest dissemination to users and opportunities for data mining and derivative work

Credible Evidence Base