2. Perspectives Authors and editors perspective Is there much difference between perspectives of different stakeholders? –authors, readers, editors, clinicians, patients, society at large

3. Research is of many types Are the issues the same for all of types of article? Risk that opinions about publication are dominated by the headline studies in big general journals Large randomised controlled trials (RCTs) –Grab the headlines –Widely publicised even if not in open access journals Often have commercial sponsorship –Rare

4. Research is of many types Most trials are not large, and most (93%) are not published in general medical journals Most medical research is not RCTs (>90%?) Not all publications in medical journals are medical research –Methodological research? –Educational articles? –Commentaries, Letters Need to consider all types of article

5. Authors perspective I want others to have access to my work For most research, dissemination is passive –Depends on others having access –Open access More downloads more influence ( more citations) Authors also feel the pressure of prestige –The researcher's goal in publishing is to give away their research to the most prestigious journal that will publish it, because the more prestigious the journal that publishes the research, the better the researchers chances for future reward. [Chris Hurst. Who Will Publish Research? Open Access and the Future of the Scientific Paper http://www.ecclectica.ca/issues/2004/1/hurst.asp#TEXT5]

6. If I publish in a non-OA journal Fewer people will be aware of my work, especially those who only see open access journals … … or they will only see the published abstract –Abstracts often not well written –Minimal information –Abstracts of medical research may mislead Access is preferentially available to well funded countries/institutions I may not have free access to my own work –I object to a journal having copyright on my original work and charging me for access Profits go to publishers, but unpaid authors, peer reviewers and (often) editors do most of the work

7. Harm from limited access I recently met a physician from southern Africa, engaged in perinatal HIV prevention, whose primary access to information was abstracts posted on the Internet. Based on a single abstract, they had altered their perinatal HIV prevention program from an effective therapy to one with lesser efficacy. Had they read the full text article they would have undoubtedly realized that the study results were based on short-term follow-up, a small pivotal group, incomplete data, and unlikely to be applicable to their country situation. Their decision to alter treatment based solely on the abstract's conclusions may have resulted in increased perinatal HIV transmission. Arthur Amman, President of Global Strategies for HIV Prevention. PLoS Medicine Editors. The impact of open access upon public health. PLoS Med 2006;3(5):e252. How unusual is this?

8. Researchers perspective Researchers need to read many published papers relevant to their work –Those in poorly funded countries/institutions are at a big disadvantage Systematic reviewers need to consider hundreds or thousands of articles –Often cannot tell if a study is eligible for a review from abstract –May have to pay just to discover that it is not eligible

9. One disadvantage of open access There is considerable evidence that much published research is of poor quality I am a big supporter of open access publication But open access to bad research is not helpful Efforts to increase access to research must be accompanied by efforts to improve its quality –A key component of improving the quality of research is transparent reporting –Good scientific practice embraces all the procedures and practices that are necessary for planning, conducting and reporting research and scholarship within a framework of scientific integrity. [European Science Foundation Policy Briefing. Dec 2000]

10. Editors perspective Little direct experience Helped to start a new journal Trials in 2006 A key aim was to allow researchers to share their personal experiences of conducting randomised trials –To help others in similar situations in future Main target is less-experienced research groups –Open access is a necessary to reach the right audience

11. Trials … Trials offers a way to make data both freely available and highly visible to trialists worldwide; this will benefit the impact of your publication among peers and society. To date, journals have focused on reporting the results of trials, with very little coverage of why and how they are conducted … making it difficult to communicate the lessons learnt from conducting the trial, let alone include adequate details of how the trial was conducted. … trialists will be able to provide the detail required to be a true scientific record and do more to make the articles message comprehensible to a variety of reader groups. They will also be able to communicate not only all outcome measures, as well as varying analyses and interpretations, but also in-depth descriptions of what they did and what they learnt. This sharing of direct experience is fundamental to improving the quality and conduct of trials worldwide. www.trialsjournal.com