Highlight HEALTH

Jonathan Eisen, an evolutionary biologist at U.C. Davis Genome Center, has been named the first Academic Editor-in-Chief at the Public Library of Science (PLoS) journal PLoS Biology. He wrote an editorial published Tuesday on the PLoS Biology website that discusses his conversion and commitment to open-access publishing. His personal experience exemplifies what to me is the principle reason for open access [1]:

So there I was — a scientist and a taxpayer — desperate to read the results of work that I helped pay for and work that might give me more knowledge than possessed by our doctors. And yet either I could not get the papers or I had to pay to read them without knowing if they would be helpful.

Decisions in health and medicine frequently aren’t black and white. In the Internet age, more and more people are using the web to guide healthcare decision making. Allowing healthcare consumers and e-patients access to evidence from biomedical research studies will enable them to make more informed decisions about their healthcare. Open access is pivotal to that empowerment.

Why is Open Access Important?

The foundation for future progress in health and medicine is biomedical research. Open access is advantageous for the way scholarly research is executed and how results and conclusions are used.

Open access publishing provides exposure to the widest audience. Anyone interested in the research can read it, which translates into increased usage and greater impact. Open Access also means greater visibility, accessibility and impact of scientific research. A recent study of open access to research literature provided evidence that open-access articles are more immediately recognized and cited than non-open-access articles [2], suggesting that open access is likely to benefit science by accelerating dissemination of research findings. And clearly, faster diffusion of research impacts future investigation. Indeed, everyone has an interest in “the efficient and effective progress of scholarly endeavor” [3].

The NIH Public Access Policy

On April 7, 2008, the National Institutes of Health (NIH) public access policy goes into effect. The policy makes mandatory a previously voluntary NIH initiative to submit electronic versions of final, peer-reviewed manuscripts upon acceptance for publication to the National Library of Medicine’s PubMed Central. Submitted articles will be made publicly available no later than 12 months after the official date of publication. The policy applies to any journal article supported in whole or part by funding from the NIH.

However, some object to the policy, including The Association of American Publishers, who is questioning the policy’s legality, claiming that it undermines publisher copyright and is inconsistent with U.S. intellectual property laws. The AAP wants the NIH to get public input in a formal rulemaking [4].

What can you as a healthcare consumer do? Tell your Senators and Representatives that you expect your government to support science and the public interest over the private interests of publishers. Insist that taxpayer-funded research be made available free of charge to the public.

More information for faculty, administrators, librarians, students, foundations, societies and governments on how to support open access can be found in Peter Suber’s article What you can do to promote open access.

References

1. Eisen JA. PLoS Biology 2.0. PLoS Biol. 2008 6(2): e48 doi:10.1371/journal.pbio.0060048.
2. Eysenbach G. Citation advantage of open access articles. PLoS Biol. 2006 May;4(5):e157. Epub 2006 May 16.
   View abstract
3. Swan A. Open Acess: Why should we have it? Cahiers de la Documentation: Bladen voor Documentatie. 2006.
4. Sciencescope. Science. 2008 Jan 11;319(5860):145.

Elsevier, a leading publisher of over 400 medical and scientific journals serving more than 30 million scientists, students and health and information professionals worldwide, has initiated a beta test program called Patient Research. The program gives patients, family members and caregivers access to medical articles to help them understand their health issues.

Typically, access to literature costs $30.00 per article. With the Patient Research program, a charge of $4.95 is assessed per article for a 24 hour period of access. Within those 24 hours, users may access and print purchased content. Elsevier allows users to share and discuss the content with family members and medical professionals involved in their medical care or the care of a family member. Users are also allowed to make copies of purchased content for family members and medical professionals.

According to the Elsevier website, 30 journals are participating in the program, including:

• American Journal of Medicine
• Journal of Pediatrics
• Journal of Adolescent Health
• Journal of Pain and Symptom Management
• Alzheimer’s and Dementia
• American Journal of Cardiology
• Surgery of Obesity and Related Disorders
• Complementary Therapies in Medicine
• Surgery
• Seminars in Oncology
• Cancer Treatment Review
• Current Problems in Cancer
• American Journal of OB/GYN
• Urology

PubMed abstracts of Elsevier-published journals include a link to the Elsevier Article Locator page with an image labeled “ELSEVIER FULL-TEXT ARTICLE” on the right side of the page (see photo above, top). On the Elsevier Article Locator page, articles that are accessible through the Patient Research program will be indicated (see photo above, bottom). Patient Research is a search engine for patients with medical need only and, per the Terms and Conditions, may not be used by any medical facilities or professionals.

Elsevier also recently launched OncologySTAT, which offers users advertising-supported free access to medical journals in exchange for registration. Although the portal was designed for U.S. oncologists, hematologists, oncology nurses and all other healthcare professionals involved in the treatment, care and diagnosis of patients with cancer, it appears that the site permits registration by consumers (e.g. cancer caregiver, patient, relative, survivor, etc). The site offers access to over 100 Elsevier cancer-related journals, including The Lancet Oncology, The Breast, Lung Cancer, The American Journal of Medicine and Cancer Letters. Additionally, users have access to:

• Select sections of textbook content from Abeloff’s Clinical Oncology (3rd edition, 2004)
• Chemotherapy regimens from The Elsevier Guide to Oncology Drugs & Regimens (2006)
• Professional drug monograph and interactions database powered by Gold Standard
• News feeds and regulatory updates from FDC Reports’ “The Pink Sheet Daily” and Elsevier Global Medical News
• Spotlight collections with information on 27 cancer types featuring news, journals, article scans, clinical text summaries, patient handouts and webinars
• Integrated MEDLINE search
• Blog and multimedia content

Registered users will also have limited access to other journals, with free summaries of cancer-related articles from 25 other leading journals, including the Journal of the American Medical Association, Journal of the National Cancer Institute and the New England Journal of Medicine. Full text of these articles will still have to be purchased until they become publicly available (normally 6-12 months following publication). Note that the content is limited to current articles (within 1 year). Additionally, journal access is limited to search results — a table of contents is not available.

Reed Elsevier hopes that OncologySTAT users will be an attractive target for advertisers [1]. The website could be a model for a number of portals focusing on specialties such as infectious diseases, neurology, cardiology and psychiatry.

In addition to the resources described above, there are a number of open access biomedical literature resources available at no cost to patients, family members and caregivers:

• PubMed Central
• Public Library of Science (PLoS)
• BioMed Central
• Directory of Open Access Journals
• Free articles via PubMed

Hint: To limit PubMed searches to return biomedical citations that are public access, simply add “AND free full text [sb]” to end end of your query. However, doing this will likely not return abstracts of articles that are participating in the Elsevier Patient Research program.

References

1. A Medical Publisher’s Unusual Prescription: Online Ads. The New York Times. 2007 Sep 10.

The National Institutes of Health (NIH) is the world’s largest source of funding for biomedical research. Taxpayers provide more than $28 billion annually for the NIH [1], yet only about a third of the research studies are made publicly available in various repositories after a 12-month delay [2]. Lawmakers are trying to change this and the U.S. Senate is currently deliberating a bill that would require all research funded by the NIH to be freely available to the public within 12 months of publication.

The requirement builds upon an earlier voluntary NIH initiative to establish a web-based repository for barrier-free access to primary reports in the life sciences [3]. Unfortunately, since it’s implementation, the voluntary initiative has failed to attain a deposit rate greater than 5% by individual researchers [4]. Thus, advocates of open access to scientific research have been lobbying to make it a mandatory requirement.

The U.S. House of Representatives passed the provision earlier this year as part of the FY2008 Labor, HHS, and Education Appropriations Bill [5]. The Senate Appropriations Committee followed and it is slated for full Senate consideration by the end of the month. The bill, S.1710, includes language requiring:

… that all investigators funded by the NIH submit or have submitted for them to the National Library of Medicine’s PubMed Central an electronic version of their final, peer-reviewed manuscripts upon acceptance for publication to be made publicly available no later than 12 months after the official date of publication: Provided, That the NIH shall implement the public access policy in a manner consistent with copyright law.

More information can be found at GovTrack.us. The Senate bill requires public access, not open access, meaning that while the research articles will be free of charge, they will still be under copyright.

Public access to research will help to accelerate scientific advancement and improve public health. As someone who advocates the public taking a greater interest in the evidence from scientific research studies to guide health and healthcare decisions, I strongly encourage you to contact your Senator and ask them to support the NIH Public Access Policy. You can use the cut-and-paste version of the American Library Association/Alliance for Taxpayer Access (ALA/ATA) text provided by DigitalKoans to send a message to your Senator right now. It only takes a minute.

According to Coturnix, the Online Community Manager at the Public Library of Science (PLoS), your message needs to be sent no later than Friday, September 28, 2007 as that’s when the bill is slated to appear before the Senate.

Open access biomedical literature resources:

• PubMed Central
• Public Library of Science (PLoS)
• BioMed Central
• Directory of Open Access Journals
• Free articles via PubMed

Hint: To limit PubMed searches to return biomedical citations that are public access, simply add “AND free full text [sb]” to end end of your query.

UPDATE: The public access mandate was signed into law by President Bush on December 26, 2007.

References

1. Budget of the United States Government, Fiscal Year 2007. U.S. Office of Management and Budget. 2007.
2. Steinbrook R. Public access to NIH-funded research. N Engl J Med. 2005 Apr 28;352(17):1739-41.
   View abstract
3. PubMed Central: An NIH-Operated Site for Electronic Distribution of Life Sciences Research Reports. National Institutes of Health. 1999 Aug 30.
4. Call to Action: Influence House and Senate Vote on NIH Public Access Policy. Barbara Cohen, Senior Editor, PLoS Medicine, Public Library of Science. 2007 July 13.
5. House Backs Taxpayer-Funded Research Access . The Alliance for Taxpayer Access. 2007 Jul 20.