The future of biomedical publishing with a few extra thoughts Richard Smith Editor, BMJ
Transcript of The future of biomedical publishing with a few extra thoughts Richard Smith Editor, BMJ
The future of biomedical publishing with a few
extra thoughts
Richard SmithEditor, BMJ
www.bmj.com/misc/talks/
What I’m going to talk about• What’s wrong now with our attempts to provide doctors with the information
they need?• Why might journals die?• Drivers of change for the future of biomedical publishing• What might the future look like?• For research studies• For journals• For peer review• For meeting the information needs of doctors• For pharmaceutical advertising• For research misconduct• HINARI
Current problems• Our current information policy
resembles the worst aspects of our old agricultural policy, which left grain rotting in thousands of storage files while people were starving. We have warehouses of unused information rotting while critical questions are left unanswered and critical problems are left unresolved. Al Gore
Current problems• On my desk I have accumulated journals and books as
information sources, and I assume that I use them. But in some respects they are not as useful as they might be. Many of my textbooks are out of date; I would like to purchase new ones, but they are expensive. My journals are not organised so that I can quickly find answers to questions that arise, and so I don’t have print sources that will answer some questions. On the other hand, there is likely to be a human source who can answer nearly all of the questions that arise, albeit with another set of barriers. An ordinary doctor
Current problems
• Think of all the information that you might read to help you do your job better.
• How much of it do you read?
00.10.20.30.40.5
Lessthan 1%
1%-10%
11%-
50%
51%-
90%
More
than
90%Amount read
Per
cen
tag
eSeries2
Series1
Words used by 41 doctors to describe their information supply
• Impossible Impossible Impossible Impossible Impossible Impossible
• Overwhelming Overwhelming Overwhelming Overwhelming Overwhelming Overwhelming
• Difficult Difficult Difficult Difficult• Daunting Daunting Daunting• Pissed off• Choked• Depressed• Despairing• Worrisome
• Saturation• Vast• Help• Exhausted• Frustrated• Time consuming• Dreadful• Awesome• Struggle• Mindboggling• Unrealistic• Stress• Challenging Challenging
Challenging• Excited• Vital importance
Conclusions of studies of doctors’ information needs during consultations
• Information needs do arise regularly when doctors see patients (about two questions per consultation)
• Questions are most likely to be about treatment, particularly drugs
• Questions are often complex and multidimensional• The need for information is often much more than a
question about medical knowledge. Doctors are looking for guidance, psychological support, affirmation, commiseration, sympathy, judgement, and feedback.
Conclusions of studies of doctors’ information needs during
consultations
• Most of the questions generated in consultations go unanswered
• Doctors are most likely to seek answers to their questions from other doctors
• Most of the questions can be answered - but it is time consuming and expensive to do so
• Doctors seem to be overwhelmed by the information provided for them
The information paradox: Muir Gray
• Doctors are overwhelmed with information yet cannot find the information they need
Information paradox
• “Water, water, everywhere• Nor any drop to drink”• The Rime of the Ancient Mariner
What’s wrong with medical journals
• Don’t meet information needs• Too many of them• Too much rubbish• Too hard work• Not relevant• Too boring• Too expensive
What’s wrong with medical journals
• Don’t add value• Slow every thing down• Too biased• Anti-innovatory• Too awful to look at• Too pompous• Too establishment
What’s wrong with medical journals
• Don’t reach the developing world• Can’t cope with fraud• Nobody reads them• Too much duplication• Too concerned with authors rather
than readers
Predictions of Lord Kelvin, president of the Royal Society,
1890-95
• Radio has no future• X rays will prove to be a hoax• Heavier than air flying machines
are impossible
What are the drivers of a new form of publishing?
• Failures of the present system• A vision of something better• Money• Balkanisation of the literature• Slowness
A vision of something better
• "It's easy to say what would be the ideal online resource for scholars and scientists: all papers in all fields, systematically interconnected, effortlessly accessible and rationally navigable, from any researcher's desk, worldwide for free.” Stevan Harnad
A vision of something better
• If you have an apple and I have an apple and if we exchange these apple then you and I will still each have one apple. But if you have an idea and I have an idea and we exchange these ideas, then each of us will have two ideas.
George Bernard Shaw
MoneyWhat does the research community
do?• Do the research, often funded by public money, often costing
millions• Hand over the copyright to the journals• Do the editing, often unpaid• Do the peer review, almost always unpaid• Often do the technical editing, often unpaid• Buy the journals, often at inflated prices, some cost $10 000• Read the journals• Store the journals
MoneyWhat do the publishers do?
• May own the journals, although often they don’t• Manage the process• Lend the money to keep the process going• Design - usually minimal• Typeset, print, and distribute the journal• Market the journal - but often to libraries that have to have
them• Sell reprints - sometimes for $250 000 a time (nothing to
authors or funders of the research); can almost sell themselves• Sell advertising - often none