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Am Fam Physician. 2007;76(3):320

This year, the Council of Science Editors (CSE) celebrated its 50th anniversary by looking to the future. In May, at the CSE annual meeting in Austin, Texas, speakers addressed issues such as the future of print journals and the potential impact of new delivery methods. One subject in particular generated much debate: the controversial topic of open access.

What Is Open Access?

Open access is free and unrestricted online access to scholarly material. It primarily refers to peer-reviewed research articles in journals, but it also includes depositing research data into an open archive before or after publication. The various levels of open access are: (1) free access to the full text of a publication; (2) free reuse; and (3) free access to the underlying data. With full open access, users can read and download information; copy, distribute, and print articles (provided that the authors are properly acknowledged); and view and work with the original data.1

The Case in Favor: Unrestricted Information

Arguing in favor of open access in its broadest sense were speakers from the Public Library of Science (PLoS), Science Commons, and the Global Trial Bank.2 These speakers maintained that open access trial banks and creative reuse of data open up the possibilities for new research allowing a more useful form for the dissemination of knowledge. Chris Surridge from the online, interactive journal PLoS ONE reasoned that the author of a study is not the only person who can interpret the data. Documenting the talks and discussions that take place around articles (e.g., in Web communities) expands the original content, facilitating scientific collaboration and furthering research. In this sense, Surridge argued, the importance of open access is at the level of curing cancer or stopping world disease.

The Case Against: Unsustainable Idealism

Peter Banks of Banks Publishing questioned the value of open access, saying there is no evidence to prove that it increases the dissemination of information, speeds research, or improves patient care.3 Research, according to Banks, is dependent on funding, and although a majority of researchers claim that their access to information is too limited, only about one fourth will publish their work in open access journals.3 On the issue of patient care, Banks argued that open access is inefficient at disseminating information to the average patient, and in fact may do more harm than good by overwhelming the patient with too much information, most of which is probably irrelevant to his or her personal case.4 Banks feels there needs to be more research, evaluation, and public discussion to determine whether open access is really the best option.

Where Do We Come In?

Because AFP publishes review articles rather than original research, the questions around source data and creative reuse are not immediately relevant to this journal. However, AFP practices open access in its most narrow sense, i.e., freedom to read: our content published since 1998 currently is available online at no cost and is accessed and used by physicians throughout the world. The argument over open access may rage for some time, but AFP will continue to look to the future to best serve readers. Plans include enhanced Web features, such as links for referenced articles, and the introduction of a new and innovative department, “AFP Journal Club—The Story Behind the Study,” which will help readers critically evaluate journal articles. By providing new features such as these, AFP hopes to enhance the knowledge of our readers as well as encourage continued discussion and collaboration.

What Do You Think?

At stake in the debate around open access is what information is made available by whom and whom it reaches—issues that concern everyone involved in medical care. Let us know whether you feel open access is important to you and how it might affect your practice.

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Copyright © 2007 by the American Academy of Family Physicians.

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