1. Knowledge access and sharing An overview of access models Fiona Godlee Head of BMJ Knowledge www.clinicalevidence.com

2. Access to scientific information How much information (raw data?) When (before or after peer review?) To whom (free/paid for?)

3. Controlling access - I Industry (and researchers) Sharing raw data

4. Data sharing: pros Efficient use of resources - reuse of datasets to replicate findings or address new questions Can help to formulate research questions/refine measurement instruments/calculate sample sizes Facilitates meta-analysis Allows others to check whether conclusions were justified Makes fraud more difficult –Davey-Smith G. Increasing accessibility of data. BMJ 1994: 308; 1519-20

5. Data sharing: cons Practicalities Misuse of data Commercial considerations

6. Data sharing: making it possible Funders - make grants conditional Clearing houses Searchable registers of ongoing and completed projects Freedom of information act Journals - make it a requirement (and make it feasible) Make it a routine part of informed consent for participants –Delamothe T. Whose data are they anyway? BMJ 1996; 312:1241- 42

7. Controlling access - II Journal editors Before or after peer review

8. Controlling access - III Publishers Free or paid for

9. Access to peer reviewed research An emerging spectrum: The subscription model Variants on the subscription model Models aimed at ameliorating the impact of the subscription model Open access

10. Why open access? Reduces costs of dissemination (more money for science and health care) Amenable to market forces Encourages author power Globally inclusive Facilitates scientific exchange/discovery Removes reasons for not building on the entirety of the scientific record Restores a public good

11. Journal ChoiceMonopoly Journal Article Libraries

12. Spiralling prices Between 1986 and 1999 –207% price increase –Brain Research –1991: £3,713 –2001: £9,148 –Average number of journal subscriptions across US research libraries dropped by 6% –(Association of Research Libarians)

13. Spiralling prices 1999 - 2002 –Global medical publishing sector grew by estimated 20% –revenues $2.69 billion

14. Spiralling prices ‘I think scientists all over would be shocked to realise what a phenomenally lucrative business scientific publishing can be.’ Nicholas Cozzarelli- editor in chief of the PNAS

15. Why not open access? Unproven Unsustainable Author power means readers will not be served Publishers add value Quality will suffer There will be fewer good journals Need additional filters Societies will no longer be able to support their other valuable activities

16. The subscription model

17. Variants on the subscription model Authors can pay for their article to be open access Original research open, “value added” content closed Selected articles free Archive open/free after a period of time

18. Models that attempt to ameliorate the impact of the subscription model

23. Open access

28. Author charges Reverse the business model, from output-paid, to input-paid Paid on acceptance/publication Reflect prestige of journals and service to authors May be a range of charges for different levels of service Ideally, not paid by individual authors but by their institution or funding agency Waived for authors who are unable to pay

30. Open access : finance Costs cut Paper, printing Distribution, warehousing Maintaining subscriptions –Marketing, Sales, Admin Protecting content, copyright Costs left Ensuring and organising rapid peer review Electronic (XML) mark-up Quality Control Web site Customer services

31. Does open access mean no peer review?

37. What does open access mean?

39. An open access publication is one that meets the following two conditions: The author(s) and copyright holder(s) grant(s) to all users a free, irrevocable, worldwide, perpetual (for the lifetime of the applicable copyright) right of access to, and a licence to copy, use, distribute, perform and display the work publicly and to make and distribute derivative works in any digital medium for any reasonable purpose, subject to proper attribution of authorship[2], as well as the right to make small numbers of printed copies for their personal use. A complete version of the work and all supplemental materials, including a copy of the permission as stated above, in a suitable standard electronic format is deposited immediately upon initial publication in at least one online repository that is supported by an academic institution, scholarly society, government agency, or other well-established organization that seeks to enable open access, unrestricted distribution, interoperability, and long-term archiving (for the biomedical sciences, PubMed Central is such a repository).

40. Bethesda statement: notes An open access publication is a property of individual works, not necessarily of journals or of publishers. Community standards, rather than copyright law, will continue to provide the mechanism for enforcement of proper attribution and responsible use of the published work, as they do now.

41. Support for open access

45. Wellcome Trust report “Journal subscriptions are a significant financial burden on institutional libraries and individual researchers, and present a major obstacle to the timely and comprehensive sharing and use of scientific information.” –Economic analysis of scientific research publishing. The Wellcome Trust, 2003

46. Specifically, the Trust welcomes the establishment of free-access, high-quality scientific journals available via the Internet; will encourage and support the formation of such journals and/or free- access repositories for research papers; will meet the cost of publication charges including those for online- only journals for Trust-funded research by permitting Trust researchers to use contingency funds for this purpose; encourages researchers to maximize the opportunities to make their results available for free and, where possible, retain their copyright, as recommended by the Scholarly Publishing and Academic Resources Coalition (SPARC), and as practiced by BioMed Central, the Public Library of Science, and similar organizations; affirms the principle that it is the intrinsic merit of the work, and not the title of the journal in which a researcher's work is published, that should be considered in funding decisions and awarding grants.

48. What’s the BMJ doing? bmj.com has been completely free access since its launch in 1995 From 2005, user charges will be in place All content will be free for all for a week After which “value added” content will be available to subscribers only Original research may be charged for...

49. “one last big kick…” But who from, and where?

50. Who are the stakeholders in clinical research?

51. Future patients Present patients Clinicians Research participants Purchasers of health care Sponsors of research Health research institutions Individual researchers –Evans and Evans, 1996

52. Who are the stakeholders in clinical research? No mention of… Publishers Journal editors Industry

53. “one last big kick…” Here’s a job for the Funders’ Forum

54. Thank you fiona@bmjgroup.com