Jocalyn Clark's blog

Open access anxiety in the publish or perish world

Jocalyn Clark — Wed, 3 Sep 2008 11:31:39 -0700

I gave research rounds at a university hospital yesterday on a topic that seems to simultaneously inspire and provoke: open access publishing.

My sense—having socialized as a medical academic before defecting to the editorial world—is that one thing alone matters: Publish or Perish. (Or as my former colleague Joel Ray says, “PubMed-ish or perish.”). This will come as no surprise to anyone in the academic health sciences. Publishing is the chief currency in this universe, the main source of validation of one’s research, and often the key indicator of academic success. Promotion and tenure committees (and colleagues, chairs, deans) value peer-reviewed publications above all;...that is, regrettably, even above clinical performance or community service.

That “publish or perish” (PorP) generates perverse incentives and sometimes bad publication behaviour is a topic for another day.

But as the broader scientific landscape is shifting toward the importance of open access to the literature, the traditions of medical publishing—which prop up PorP—persist: the “top five” hierarchy, the importance of the impact factor, the codified order of authorship etcetera. To succeed in medical academia means to play by these rules, but these rules work to eclipse an interest in disseminating one’s work widely, the central benefit of open access (OA).

They do so partly because traditional medical publishers (except for the BMJ) do not as of yet provide OA. But these rules also create anxiety among medical academics because of some common misconceptions about open access publishing: OA publications don’t use peer review, OA journals are of lesser quality and reputation, authors “buy” their OA publications, and anyone can publish in an OA journal.

Debunking these misconceptions surely is one of the key challenges to the open access movement in medicine.

So after a lively discussion with colleagues during research rounds I was grateful this morning to receive this week’s edition of Peter Suber’s outstanding newsletter. In it he takes on this idea that OA cannot equate with prestige.

Peter’s treatise is long but well worth reading. I was particularly interested in the following arguments that have relevance to publishing in medicine:

On incentives:
- As OA proponents we have to “start working with the existing system of incentives”.... and that “researchers are not so preoccupied by their research that they can’t be induced to pay attention to relevant differences among journals, or at least the differences which universities make relevant. This gives hope to a strategy to get faculty to pay attention to access issues.” [my emphasis]

On prestige:
- “If most OA journals are lower in prestige than [traditional] journals, it’s not because they are OA. A large [part] of the explanation is that they are newer and younger” ... “There is already a growing number of high-prestige OA journals.”

(OA journals like PLoS Medicine, whose impact factors have consistently put it among the top 5 of general medical journals and whose influence means its articles are regularly cited in media and policy discussions).

On promotion and tenure reviews:
- “Universities tend to use journal prestige and impact as surrogates for quality. The excuses for doing so are getting thin” ... “If you've ever had to consider a candidate for hiring, promotion, or tenure, you know that it's much easier to tell whether she has published in high-impact or high-prestige journals than to tell whether her articles are actually good.” ... “When we want to assess the quality of articles or people, and not the citation impact of journals, then we need measurements that are more nuanced, more focused on the salient variables, more fair to the variety of scholarly resources, more comprehensive, more timely, and with luck more automated and fully OA.”

What I take from this is that we need in medical academia to care more about quality than prestige: the quality of our research, of our publication and dissemination goals, of the impact of our work, and of our hiring and promotion decisions. So instead of “Publish or Perish,” perhaps our mantra ought to be “Quality or Quit.”

Trackback URL for this post:

http://www.plos.org/cms/trackback/397

When do we stop stating the obvious?

Jocalyn Clark — Thu, 28 Aug 2008 13:23:53 -0700

Inequality is an area I’m very interested in but I’m always frustrated by headlines like this: “Social injustice is killing people on a grand scale”

To me this seems to state the obvious.

In this case, the headline belongs to a news article about a report released yesterday by the World Health Organization’s Commission on Social Determinants of Health called “Closing the gap in a generation: Health equity through action on the social determinants of health.”

According to the press release, the report “shows how the conditions in which people live and work directly affects the quality of their health.”

Sound familiar?

The report runs over 250 pages long and essentially reminds us that social determinants (housing, nutrition, physical activity, the environment) are more important to health than biomedical ones (medical care, drugs, hospitals, technological interventions). The Commission's three recommendations to reduce health equity are to 1) improve daily living conditions; 2) tackle the inequitable distribution of power, money and resources, especially between the genders; and 3) measure, understand, and evaluate the problem of health inequity.

I have no doubt a lot of time and effort was involved in the Commission’s work, and I do hope it succeeds in raising awareness about social injustice. But I feel like this message about the social determinants of health has been out there a long time with little action or progress.

I dusted off my copy of the Lalonde Report, a Canadian governmental report that is considered by many to be the first acknowledgment by a major industrialised nation that health is determined by more than just biological factors. It was produced in 1974.

The Lalonde report was seminal, and led to other important international documents like the WHO’s Declaration of Alma-Ata. This for the first time internationally asserted the importance of primary health care, but is also credited with advancing the notion of health as a human right.

Alma-Ata also declared the inequity between the developed and the developing world to be unacceptable, stated that economic and social development was necessary for health, and that in turn health contributes to economic and social development and world peace. Alma-Ata was released in 1978.

Given the conclusions of yesterday’s report, it’s fascinating to look back over these declarations and see how prescient they were. The Lalonde report, for example, begins with these words: “Good health is the bedrock on which social progress is built. A nation of healthy people can do those things that make life worthwhile, and as the level of health increases so does the potential for happiness.”

It goes on to state “The health care system, however, is only one of many ways of maintaining and improving health....For these environmental and behavioural threats to health [environmental pollution, city living, habits of indolence, the abuse of alcohol, tobacco and drugs, and eating patterns which put the pleasing of the senses above the needs of the human body], the organized health care system can do little more than serve as a catchment net for the victims.”

Thirty four years later we have a new report, with seemingly no new messages. Regrettably I think we can assume no new progress on social justice.

Trackback URL for this post:

http://www.plos.org/cms/trackback/395

Is the NIH open access policy regressive?

Jocalyn Clark — Fri, 25 Jul 2008 13:31:04 -0700

I was thrilled that several PLoS colleagues attended the ISMB conference this past week in Toronto, where I live. The massive event is the official conference of the International Society for Computational Biology, and PLoS Computational Biology is the official journal of the Society.

My friends asked me: “What is computational biology?”

I said: “Good question!”

Wikipedia tells me it’s an intoxicating mix of computer science, applied mathematics, and statistics applied to biology. (ok, I added the intoxicating bit).

My PLoS Biology colleague Robert Shields tells me it’s “the biology that counts.” (ba dum dum).

Definitions aside, I took two things away from the conference that matter to PLoS Medicine.

First, Mark Gerstein from Yale University gave an outstanding talk in a session called The Future of Scientific Publication, remarking that it was unusual (but inspiring) for a computational biology conference to include a session on publishing.

He emphasised the use of text mining to study the “structure of science.” He says this is Science 2.0 (or, the science of science), which uses network theory and technologies to discover new scientific relationships. Whereas conventional challenges have us struggling to keep up with the volume and growth of scientific papers (this reminds me of Muir Gray’s information paradox in medicine - overwhelmed with information but unable to find the knowledge when we need it), new technologies to structure and text mine scientific publications can help scientists share information and foster collaboration. (Including using publications as the annotation for the genome).

Gerstein and colleagues' fascinating maps of publication patterns, gene names, topic clusters within whole research areas, and the emergence of new scientific fields are reminiscent of the recent PLoS Medicine editorial in which we argue that everything in medicine is connected through networks. (When I chatted with Gerstein after his session he agreed that network guru Albert-Lásló Barabási is a genius.)

But none of this is possible without open access, countered Matt Cockerill from BioMed Central. He said that we absolutely need the raw material (whether it be biological data or bibliometric information) freely and openly available to apply the network algorithms so we can visualise the structure of science. Currently, much information is behind access controls thus disrupting the whole vision of an interconnected and collaborative scientific world.

The second issue of note was raised during the session’s Publishers’ Panel, populated by Catherine Nancarrow (PLoS), Claire Bird (Oxford University Press), and Matt Cockerill (BioMed Central). Panellists noted that the recent NIH public access policy emphasises free not open access. That is, the policy may lead to freely accessible publications (for which publishers or organisations may reap profits from charging authors a fee to deposit their manuscripts), but these will remain under restrictive licenses (thus limiting text-mining).

This, Cockerill argued, makes the NIH policy regressive.

Trackback URL for this post:

http://www.plos.org/cms/trackback/385

In(s) and Out(s) of Academia

from A Blog Around The Clock on Fri, 2008-07-25 18:52

Bjoern Brembs is on a roll! Check all of these out: Incentivizing open scientific discussion: Apart from the question of whether the perfect scientist is the one who only spends his time writing papers and doing experiments, what incentives can...

What is good evidence for safe injection?

Jocalyn Clark — Thu, 17 Jul 2008 03:08:30 -0700

The US presidential campaign, while fascinating, tends to overshadow policy debates in other countries.

This week the debate about safe-injection sites in Canada again reared its ugly head. Safe-injection sites, which exist in only a few cities in the world, are health facilities that allow injection drug users to legally use under supervision, with the aim of reducing harm to users’ health and to the public.

As advocates began a cross Canada tour this week to highlight the merits of harm reduction, the country’s leading national newspaper (The Globe and Mail) began a four part series on drug policy. The second part calls into question the evidence on safe-injection sites by stating we do not have “scientific proof” for harm reduction’s success.

But what is “good” evidence for safe injection?

InSite is North America’s only safe-infection site. Established in 2003 in response to high rates of injection drug use and HIV in what is perhaps Canada’s most desperate and vulnerable neighbourhood (the Downtown Eastside of Vancouver), InSite provides a place where drug users can inject under medical supervision and receive clean needles, condoms, counselling, and referral to other medical and social services. InSite operates because it has been given exemption from the federal drug laws. Harm reduction is an established part of drug policy and health promotion in many countries, but unsurprisingly is not without controversy. (When it opened, a White House drug control director called InSite “state-sponsored suicide”).

Since a recent change in national government in Canada, the extension of InSite’s exemption has been cast into doubt. Months of political dodge-ball, passionate debate, and now legal wrangling have ensued. And it all seems to be revolving around evidence.

The federal government claims their heel dragging is because they are still waiting for research that supports the safe injection site. Advocates say there are lots of data, from Vancouver and from Europe and Australia, which show that safe injection sites help people and reduce the spread of disease. Liz Evans, a founder of InSite, has been quoted as saying it “has not increased or prompted drug use, there is less needle sharing, less HIV and there has been no crime increase. People who visit the facility are 33% more likely to receive detox treatment, ... and there have been 1 million injections at InSite without a single death.”

And now The Globe and Mail’s columnist has weighed in; charging the research is tainted because it is produced by people who have an interest in InSite continuing. She quotes an “addictions doctor” who says “You can churn out all the research you like if you've got a vested interest.”

Tell that to the BMJ, Lancet, New England Journal of Medicine, and Canadian Medical Association Journal, all of whom have peer-reviewed and published research on InSite's impact. Among the authors are HIV scientists and physicians and the current president of the International AIDS Society—all of whom surely are interested in promoting the health and health care of injection drug users.

Indeed, as Hathaway and Tousaw have argued, scientific arguments alone will not change peoples’ minds about drugs and health promotion. And appreciating the human rights approach that underlies safe-infection sites does not require “evidence.”

In other words, if you have an interest in safe-injection sites not continuing, no evidence will likely ever be good enough.

Trackback URL for this post:

http://www.plos.org/cms/trackback/380

Happy International Clinical Trials Day!

Jocalyn Clark — Tue, 20 May 2008 02:34:51 -0700

Since today (20 May) is the third annual international clinical trials day it seemed the perfect occasion to share some trials news with PLoS Medicine readers.

Many of you will know that new FDA legislation in the United States will require, from September 2008, public reporting of basic trial results within one year of study completion. Many organisations and institutions will now be thinking about how to comply with the new requirements. Some groups are coming together to discuss how to standardise and implement results disclosure — as they did for trial registration with the Ottawa Statements and the WHO International Standards of Trial Registration.

We recently participated in an initiative called PROCTOR (Public Reporting Of Clinical Trial Outcome and Results), organised by the Canadian Institutes of Health Research (CIHR) and bringing together stakeholders from the worlds of research, journals, industry, consumer groups, and policy. The idea was that while many parties are calling for the public reporting and accessibility of clinical trial results, there’s as yet no consensus about how this might be achieved.

Over two days in late March in beautiful Ottawa (as the Canada based editor at PLoS, I live down the road in Toronto), the discussions centred on the importance and opportunities to improve the transparency, completeness, and usability of trial results—partly by using new technologies, and also by developing universal standards. The group also identified many challenges to implementing a fair and trusted global system, and agreed that the meeting was only the beginning of an international dialogue with many other stakeholders and organisations.

Of real interest to us journals and one of the concerns from researchers and the industry was the impact that results disclosure might have on subsequent publication. At PLoS we support the public disclosure and open access publication of all clinical trial results and feel that more disclosure can only be good; hence our policy, revised recently in the light of these initiatives, is that “prior disclosure of results on a public website such as clinicaltrials.gov will not affect the decision to peer review or acceptance of papers in PLoS journals.”

This is in keeping with our general policy that “Authors are of course at liberty to present and discuss their findings ahead of publication: at medical or scientific conferences, on preprint servers, in public databases, and in blogs, wiki and other informal communication channels.”

The PROCTOR group has recently proposed to the WHO that a broader international dialogue be initiated. And indeed the WHO has recently announced its consultations on clinical trials results reporting, which we’re all invited to contribute to starting today and running until 27 June 2008.

Trackback URL for this post:

http://www.plos.org/cms/trackback/354