Comments on E-Biomed -- 07/19

Editorials too will continue to be written, presumably, by whoever wrote them in the past, and will continue to be available to clinicians requiring them in order to interpret refereed clinical studies. There is no contingency here. (Perhaps refereed clinical articles too require a warning label: "Do not use without consulting editorial"...)

> and by timing public disclosure to coincide with the date of journal
> publication.

This, unfortunately, has to be called the nonsense that it is! If it is not merely a reflexive bid to safeguard journal primacy and revenue (which would be deplorable, and one hopes that that is not what motivates it), then it is merely an expression of a superstitious adherence to completely irrelevant and obsolete features of the print-on-paper era for journal publication.

There is no need whatsoever for an author to hold back his REFEREED report once the final draft is done and accepted. The rest is just the unfortunate retardation of a bygone papyrocentric era.

> Mistakes, inaccuracies, and misinterpretations in clinical research
> pose a far greater risk to health and the public welfare than do errors
> in basic-science research. A system that allowed immediate electronic
> publication of new clinical studies without the usual careful process
> of peer review and revision would be risky at best and might well fill
> the clinical data bases with misleading and inadequately evaluated
> information.

This is a false opposition (conflating the two objections into one): We are talking about the REFEREED literature here.

> Even if E-biomed were to eliminate the second pathway and accept only
> work that had passed full peer review and revision by journal editorial
> boards, immediate posting on the Web site before publication would
> still be problematic, because the information would be made public
> without the benefit of simultaneous expert commentary and
> interpretation.

Repetition unfortunately does not strengthen this argument. Besides, for those papers that would benefit from simultaneous editorial commentary, there is no reason that synchronization cannot be arranged in the Archive too. (In other words, this entire issue is trivial, and a red herring.)

> The few weeks saved between acceptance and print publication would not
> justify the confusion and misunderstanding that would often attend the
> immediate electronic posting and subsequent publicizing of clinical
> studies.

Again conflates the two objections, and sounds rather hyperbolic and alarmist as well.

(What proportion of the refereed clinical literature is accompanied by a concurrent editorial? Why can't similar arrangements be made for this subset in the new medium too? There could even be two different formal acceptance criteria for referees if need be: R = "accept unconditionally." RE = "accept only on condition of being accompanied by editorial." Is this a failure of imagination or animus against the new medium for some unstated reason?)

> And in any case, policies adopted by the Journal, and many other
> leading clinical journals, already allow any studies with urgent major
> implications for public health and safety to be released immediately
> after final editorial review and acceptance.

And so...?

> most clinical journals already have their own Web sites, which do much
> of what is proposed by E-biomed.

No doubt. But here I think we come to the heart of the matter (and perhaps to those "unstated reasons"), for those Web sites happen to be accessible only via Subscription/Site-License/Pay-Per-View (S/P/L), the very access barriers from which self-archiving is meant to free the literature.

In fact, the one thing "proposed by E-biomed" that no proprietary journal Web site can or will do is to free the literature for one and all, everywhere, forever.

> In addition, on-line data bases such as Medline are regularly used to
> search the published clinical literature. Electronic data bases should,
> and will, continue to grow in clinical medicine

Except that alas many of these secondary providers do this for a fee, and none retrieve the full texts for free (because most are not yet self-archived, hence not yet available free).

But it is a foregone conclusion that once the entire biomedical corpus is self-archived in E-biomed for free, there will be (free) search and navigational capabilities that will threaten the niche of commercial secondary providers even more profoundly than they do the niche of primary journal publishers.

(The latter will be able to downsize and restructure so as to continue to provide the service of quality control -- peer review, editing, certification -- paid for by the author-institution out of a small part of the institutional S/L/P cancellation savings, but it is not at all clear what the secondaries and tertiaries will be providing in this new PostGutenberg world.)

http://www.cogsci.soton.ac.uk/~harnad/citation.html

> but they cannot replace the essential functions of peer-reviewed
> clinical journals.

E-biomed cannot and will not replace the journals' essential function of peer review. But that is the ONLY function that journals will continue to provide.

http://www.cogsci.soton.ac.uk/~harnad/nature.html

> I imagine that the proponents of E-biomed would reply that there is no
> intention to replace peer-reviewed journals. As long as accepted
> manuscripts were posted promptly on the E-biomed Web site, the NIH plan
> would not prevent the peer-reviewed clinical journals from continuing
> to review and publish original research articles as usual, together
> with whatever additional editorial and educational material they chose.
> Journals could also continue to maintain their own Web sites if they
> wished.

That would indeed be the quite obvious and correct response (indeed, it has essentially been made above). Journals are free to continue to sell an S/L/P version -- as long as dubious objections like the above ones are not used as an excuse for delaying the optimal and inevitable solution of self-archiving the free online versions of their (refereed) papers by their authors -- the same authors who have given those same papers to the journals for free.

Only the improvement and certification added by peer review needs to be paid for, and once S/L/P is no longer viable, institutional S/L/P savings can amply cover those quality-control/certification (QC/C) costs up-front on the author-institution end, instead of at the access-blocking reader-institution end. But meanwhile E-biomed will also allow authors to give away their refereed eprints to one and all for free.

> That response, while technically true, ignores the probably
> disastrous effects of E-biomed on journals. A flourishing E-biomed
> system that included clinical studies would very likely reduce the
> submissions, paid circulation, and income of most clinical journals
> enough to threaten their survival. Were this the price to be paid for a
> much better and less expensive clinical publishing system that would
> serve physicians and the public at least as well as the present
> arrangement and that would clearly facilitate the work of the clinical
> research community, I would take a more favorable view of the proposal.
> But I do not believe that most of the important functions of
> peer-reviewed clinical journals can be adequately replaced by E-biomed.
> And cost savings, noted by Varmus as one reason to adopt E-biomed, are
> not an issue with the leading clinical journals. In general, they are
> far less expensive than most basic-science journals.

Now it is becoming clear that concern about S/L/P revenue may indeed be what is behind these objections.

As noted, of Dr. Relman's two sole substantive objections here, the first only concerns unrefereed clinical preprints, and is a valid objection, but it is also readily accommodated by E-biomed. The second objection is invalid.

Is the revenue objection a third one? And is the fact that clinical journals are "less expensive" a justification for continuing to hold this literature hostage to S/L/P access tolls? Perhaps the simplest answer comes from putting the question in principle to the authors of all those clinical papers:

"Now that it is possible to make your refereed paper available online to everyone and everyone everywhere for free by self-archiving it in NIH's E-biomed, do you nevertheless prefer to continue instead to restrict access to it to those individual and institutional subscribers who can afford it -- even though you don't get a penny of the revenue and have always given away the reprints to all requesters for free, just as you gave the paper itself for free to the journal (to sell), presumably because your sole objective was to report your findings to one and all, once they had been approved and accepted by peer review?"

No, I don't think that the goal of sustaining journals' current revenue streams and modera operandi can or should persuade authors to keep their research findings behind a financial firewall that is no longer necessary -- particularly as there are obvious alternative ways for journals to recover the surviving costs of their sole remaining essential service -- QC/C -- out of S/L/P savings, once they have downsized and restructured to provide that one essential service alone.

This "disastrous effect" sounds like a highly beneficial one for the research community (both basic and clinical), and it sounds like something the journals could successfully adapt to if they try, in the interests of the research community they serve.

> A final worrisome aspect of E-biomed is that its proposed organization
> and management are so complicated as to raise doubts about its ability
> to function. It would be a huge conglomerate of different scientific
> fields, journals, editorial boards, and other "interested parties,"
> overseen by a necessarily very large and disparate governing board.

This was indeed a weakness of the original E-biomed, but it is all quite easily and trivially remediable once it is recognized that E-biomed, like Los Alamos, is merely a reliable, permanent infrastructure for the SELF-ARCHIVING of all refereed and unrefereed papers by their authors in the first instance, and eventually a facility for official journal overlays, authenticated by the journals themselves.

http://www.nih.gov/welcome/director/ebiomed/com0509.htm#harn45

No new "complications" over and above the tried, tested and spectacularly successful features of the 8-year-old Los Alamos Archive are involved -- other than the special measures for the unrefereed clinical sector called for by (among other things) Dr. Relman's own sole valid objection!

> It takes a lot of work by editors to supervise a high-quality
> peer-review system.

Correct; and this is precisely the work that the QC/C charges will cover out of the S/L/P savings.

> Even the simplified, two-reader system of approval envisioned
> as the alternative to editorial review by a journal would prove to be
> much more complicated than expected. How would differences between
> reviewers or between reviewers and authors be adjudicated? Suppose a
> reviewer's approval was conditional on suitable revision or correction
> of the manuscript. Who would oversee such negotiations? And who would
> be responsible for vetting the contentious issues that might arise
> later concerning corrections and commentary? All such functions are now
> carried out by the editors of peer-reviewed journals. I do not see how
> any system concerned about the quality of clinical data and their
> impact on the public health and medical practice could afford to ignore
> these questions.

This is conflating peer review (which will proceed exactly as before) with the vetting of the unrefereed clinical preprint sector, a special case that will be handled as the peers at NIH see fit, but should not be confused with peer review, which will proceed apace.

> In clinical research, the best way to handle new data is to require
> rigorous peer review before their dissemination and, with few
> exceptions, to post the results in electronic data bases only after
> they have been published in carefully edited, peer-reviewed journals.
> That is because prepublication evaluation of the reliability of
> clinical studies and impartial assessment of their implications for
> health care are usually more important than the speed with which the
> data are made available.

I hope this has all been put in context and answered by now. Let me close by saying that "speed" is only one of the virtues of E-biomed, and by no means the foremost, which is the freeing of the literature for one and all, everywhere, forever, to the eternal benefit of research and researchers the world over, especially those whose access to the research corpus was blocked or limited by its current system of financial firewalls.

I hope these remarks will be accepted in the spirit of cautionary editorial quote/commentary that sometimes needs to accompany even the nonclinical papers that appear in refereed journals...