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The Growing International Audience for Medical Data: Meeting the Needs of the Many

Rohrich, Rod J. M.D.; Sullivan, Daniel M.Div.

Plastic and Reconstructive Surgery: February 2013 - Volume 131 - Issue 2 - p 423–425
doi: 10.1097/PRS.0b013e318278d876
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Dallas, Texas

From the Department of Plastic Surgery, University of Texas Southwestern Medical Center.

Received for publication September 28, 2012; accepted September 28, 2012.

Disclosure: The authors serve as Editor-in-Chief and Managing Editor of Plastic and Reconstructive Surgery. The authors have no financial interest to declare in relation to the content of this Editorial.

Last month's Editorial on open access journal publication1 provided the background trends for what is occurring in medical publication today. Academic science/technology/medicine publishers are rapidly adopting a new model for publishing articles: that of open access. Given the geometric growth in the number of open access journals, it is evident that open access publishing is widely accepted and is here to stay. Open access publishing of articles offers numerous attractive benefits, including the following:

  • Peer review of content ensures high quality of published data.
  • Streamlined, online-only publication of material dramatically reduces time from acceptance to publication.
  • There are far fewer restrictions on use and reuse of content; authors retain copyright of their published material.
  • Publicly funded research is disseminated freely to the public.

Although these and other various benefits make a strong argument in favor of open access publishing, a fundamental issue has to be kept at the forefront of any journal, publisher, and Web site administrator: Who benefits from our content that we publish? Who is our audience? How can we better serve a wider audience? What are the needs of that audience? This Editorial seeks to review the growing international audience for medical data as we strive to determine who benefits from open access publishing.

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It has often been said that we live in an age of information overload,2 a day in which our technological capabilities serve as primary driving forces in the quest for more knowledge and research. In essence, because our computers and communication structures can process faster, store more data, and transmit data faster, we are acquiring more information at a parallel rate. A negative aspect of this phenomenon for the plastic surgeon—or any physician—is the ever-increasing inability to keep current with all of the relevant medical literature. However, information overload is not the only by-product of improved technology; a positive by-product is that access to information is now increasing globally. Access to the Internet has grown dramatically since 2000. Table 1 shows 528.1 percent growth in the world Internet use from 2000 to December of 2011.3 Nearly 33 percent of the world's population has Internet access. Even though Africa, Asia, the Middle East, and Latin America/Caribbean islands have the least amount of Internet use among their respective populations, the growth in those regions has been the most rapid over the past decade. Figure 1 shows the Internet penetration rates in the world by geographic region.3 It is clear that the advent of the Internet has created new and large information markets, and Third World and developing countries are especially hungry for science/technology/medicine data.

Table 1

Table 1

Fig. 1

Fig. 1

In a draft article for the World Health Organization, Godlee et al. discussed how to improve access to health information in the developing world.4 They indicated that open access publishing of science/technology/medicine, and especially medical, research “more completely fulfils the goal of research publication in achieving unlimited dissemination of research results.” Similar comments were made in an article by Houghton and Sheehan published in Economic Analysis and Policy; they note that open access publishing is of particular benefit for developing countries, where access to the subscription-based literature has often been limited.5 One of the primary benefits of open access publishing is that it offers high-quality, peer-reviewed research data to the widest possible audience. Anyone who has access to the Internet has access to the data; according to the World Internet Usage statistics, that audience is approaching 2.3 billion people.3 For the author, that number of potential consumers of data is inconceivable.

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Of course, not all individuals with an Internet connection will access an article published by an open access journal. Who precisely is the audience? Who will access open access articles? Who benefits from open access publishing? Open access journals serve the needs of many groups, as follows.6

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Open access publishing provides authors with the broadest possible audience. No subscription-based journal can provide nearly as broad an audience. Authors who publish in an open access journal benefit because their published articles have greater visibility and potential impact than those in a subscription-based publication.

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By definition, open access journals are “open” to all people who have access to the Internet. There are no barriers to the articles posted by open access publishers. The cost of published research is effectively nil, and open access data that are indexed provide the additional benefit of offering free full-text searches, indexing, translation, and other data analysis benefits.

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Medical libraries have suffered under increasingly restricted budgets that limit their capability to hold physical resources and to purchase expensive hard-copy journals and books. Furthermore, the cost of scholarly journals continues to rise, creating budgetary crises for libraries. Open access journal content is free of charge, enabling librarians to provide almost unlimited data to their students and research faculties.

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Funding Agencies

More and more funding agencies, especially publicly funded agencies, mandate open access publication of results of the research they sponsor. The argument is simple: publicly funded research should be available to the public that funds it, and only open access publication can meet that challenge. In addition, open access funding of research guarantees a wider audience, makes the data more retrievable and more useful, and makes the funding agency more visible to the public. Open access publication is good for science and good for public relations for the funding agencies.

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Publishers and Journals

Because of the wider audience offered by open access publication, journals enjoy greater visibility of their content. Open access content is more discoverable, retrievable, and ultimately useful. Journals can use this visibility to attract submissions and advertising, and citations. Many open access journals enjoy significant impact factors. Gone is the day when open access journals could be disregarded wholesale as lower-tier publications. Now, many open access titles represent prestigious scientific publications (e.g., PLoS Medicine's most recent impact factor was 15.617, ranking it number five out of 153 titles in the medicine, general, and experimental category. PLoS Biology's most recent impact factor was 12.742, ranking it number one out of 86 journals in the biology category).

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The Individual

Until open access publication began, private citizens had very little if any access to science/technology/medicine articles. Most public libraries do have subscriptions to traditional science/technology/medicine journals. With open access publication, however, private citizens have full access to a wealth of information. Individuals can now make better, more informed decisions.

Open access publishing offers many benefits to a wide audience. In numerous instances, it provides a viable answer to providing the research needs of the many in an economical way. There remain many compelling arguments in favor of traditional, subscription-based journals; open access publication of science/technology/medicine data represents a complementary way of disseminating high-quality medical literature to the many.

Rod J. Rohrich, M.D.


Plastic and Reconstructive Surgery

5959 Harry Hines Boulevard, POB 1, Suite 300

Dallas, Texas 75390-8820

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The authors acknowledge and appreciate the assistance of Elizabeth Durzy in the research and editing of this Editorial.

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1. Rohrich RJ, Sullivan D. Trends in medical publishing: Where the publishing industry is going. Plast Reconstr Surg. 2013;131:179–181.
2. Rohrich RJ, Sullivan D. So you want to be a change artist? Plast Reconstr Surg. 2012;129:1435–1437.
3. Internet World Stats. Internet users in the world: Distribution by world regions, 2012 Q2. Available at: Accessed September 19, 2012.
4. Godlee F, Pakenham-Walsh N, Ncayiyana D, Cohen B, Packer A. Improving access to health information in the developing world. Draft paper, 22 March, 2004. Available at: Accessed September 19, 2012.
5. Houghton J, Sheehan P. Estimating the potential impacts of open access to research findings. Economic Analysis Policy 2009;39:127–142.
6. Suber P. Open access overview. Available at:∼peters/fos/overview.htm. Accessed September 19, 2012.
©2013American Society of Plastic Surgeons