Medicine 2.0: Online peer review? Facebook for physicians?

November 28, 2007

Medical Journals: relics of the past?

What lies ahead for patients and practitioners as the world of information technology converges ever deeply with the art and science of medicine and research?

That was among the questions informing a lively conversation last week between Dr. John Hoey, former editor-in-chief of the Canadian Medical Association Journal, and Dr. Richard Smith, former editor-in-chief of the British Medical Journal and author of The Trouble with Medical Journals (2006).

The discussion, held at U of T’s Trinity College, was the prelude to a fundraiser for Open Medicine, an open-access peer-reviewed journal that is itself part of a social movement to ensure access to scientific knowledge is free and content is widely disseminated (see MaRS blog last spring).

A long-time advocate of open-access medical publishing – the BMJ first posted its content free online for non-British users nearly a decade ago – Smith offered a range of sacred-cow tipping opinions, delivered with classic Brit candor and self-deprecating irreverence, on the evolution of medical publishing, the influence of Web 2.0 and the challenge of finding sustainable financial models for open-access journals.

Would the author-pays model of Public Library of Science (where he is an unpaid board member) hold if the venerable Nature and Science journals charged, say, $10,000+ a paper? (Smith thinks so, although in my non-academic view such steep fees would seem to set the bar precipitously high for a new investigator still building grant-writing prowess or an institution with lighter pocketbooks.)

If a journal’s research is freely available, should it charge instead for the premium analysis or opinion pieces it offers? What’s the role of social networking technologies like Facebook, as a tool for physicians to exchange information with each other? Are Google-informed patients starting to level the informational playing field and subsequent power balance by forcing doctors to more openly acknowledge the current limits of medical practice?

Smith also challenged the audience to consider the capricious “black box” that is the peer-review process itself in publishing. Why not open it up, he suggested: Post journal submissions online and invite the wider community, as well as the author, to debate the merits of research findings wiki-style.

Medicine 2.0 is no doubt good news for consumers in search of empowering information. But is the conventional, hierarchical research enterprise — whether sponsored by government, industry or private foundations — truly ready for the kind of open scrutiny and culture change associated with a wiki-like approach to creating and sharing knowledge?

Scientists, physicians, what say you?

Further reading on Medicine 2.0

  • http://www.jmir.org Gunther Eysenbach

    I am editor and publisher of the Journal of Medical Internet Research – JMIR (http://www.jmir.org), which is published at the Centre for Global eHealth Innovation at the University Health Network in Toronto – a couple of rooms away from where the Open Medicine board met.

    JMIR is now the number 2 ranked journal (by impact factor) in the ISI health informatics category, and #6 in the health services category. It was launched in 1998 with the first issue published in 1999 – well before BMC, PLoS, and Open Medicine started their businesses. We have been a pioneer in “grass-roots” OA publishing (with no large publisher involved), experimenting with and successfully implementing a hybrid business model (a combination of author-fees and a membership scheme which gives members value-added services such as PDF files). We have developed open source software to facilitate the publishing process (e.g. Word-to-XML conversion scripts – work that journals like Open Medicine now benefits from), and we are helping other journals to make transitions from a subscription-based to an open access model. We also developed tools like WebCite (http://www.webcitation.org) which is now used by hundreds of journals, including BioMed Central journals. JMIR has also run experiments with open peer-review (and is conducting another randomized trial at the moment). Finally, we have been doing seminal work on the impact of open access and hold a current CIHR grant to explore the relation between OA and knowledge translation.

    It is funny (and slightly bothering) to see an Open Medicine board meeting right next door revisiting and discussing these issues which we have been working on for many years. But I assume they are still at the stage where self-promotion and branding is a top priority over seeking collaborations with those who have been doing this for many years.

    Gunther Eysenbach
    Senior Scientist, e-publishing and open access group at the Centre for Global eHealth Innovation
    Publisher & Editor, JMIR

  • Pingback: What’s on the web? (1 December 2007) « ScienceRoll

  • http://www.mesquite-dentists.com/ Dental Mesquite

    I think that in online, it can be used a platform for anything. But for the professionals like doctors or members of the academe, there should be a suited version to exchange views. It is just up to them if they will open it for public or not.

Linda Quattrin @ MaRS

Linda Quattrin was a newspaper reporter and editor before applying her interest in science as communications director at Robarts Research Institute. A member of the Canadian Science Writers Association, she is responsible for media relations and corporate communications at MaRS.

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