Publishers Are Making All COVID-19 Research Freely Available

Among the many challenges brought on by the rapid and ongoing spread of COVID-19 is the need to learn as quickly as possible the many unknowns of the disease: why some people develop more severe disease, whether contracting the virus confers immunity, and, if so, for how long, and what therapeutics will be effective. Medical journals around the world are opening access to COVID-19-related research for public viewing to ensure timely access to information and to share research that may slow and eventually end this pandemic.

Open access journals aren’t new. Beginning in the early 2000s with the growing expansion and use of the internet, a number of initiatives emerged advocating open access. The Budapest Open Access Initiative, the Berlin Declaration on Open Access to Knowledge in the Sciences and Humanities, and the Bethesda Statement on Open Access Publishing defined open access as basically providing publishing content at no cost with unrestricted allowance to reuse content with the appropriate attribution (BMJ Open. 2019;9:e028655. doi: 10.1136/bmjopen-2018-028655). The copyright for the article remains with the author rather than the journal.

A fundamental difference from traditional journal publishing is the financial model used to support and sustain open access journals. Instead of the subscription or licensing fees covering the cost of publication, publication costs are borne by the author and are often subsidized by their affiliated organization or grant monies from publicly sponsored research.

Over the past couple of decades, a number of journals have switched to open access for all or some content, or with initial embargo periods. These include high-impact journals such as the New England Journal of Medicine, Journal of the American Medical Association, and The Lancet, all of which have opened access to COVID-19-related research during this pandemic period. Other journals were created as solely open access journals, often accompanying more traditional journals associated with a particular medical association. Among these journals are Laryngoscope Investigative Otolaryngology, OTO Open, and Ear, Nose & Throat Journal.

Arguments for transitioning to full open access of medical research include acknowledgement that taxpayer-supported research should be made easily available to everyone. A provision in a law passed by the U.S. Congress in 2008 (the Consolidated Appropriations Act of 2008; H.R. 2764) supports this but with a caveat: All research funded by the National Institutes of Health (NIH) is required to be accessible via PubMed Central within 12 months of publication. Other countries have similar open access repositories. European countries have taken a strong lead in expanding open access with a goal (called Plan S) to mandate that publicly funded research be published open access by 2020.

In the United States, large university systems are calling for open access publication of their research. On June 16, the University of California (UC) joined with Springer Nature in what has been touted as the largest open access agreement in North America to date. The UC is one of many university systems endorsing a 2019 framework by the Massachusetts Institute of Technology (MIT) on negotiating publisher contracts for open access. Days before the UC-Springer announcement, MIT reported a similar attempt to negotiate an agreement with publisher Elsevier, which has failed to date.

On June 29, MIT launched a new open access journal called Rapid Reviews: Covid-19 designed to accelerate peer review of COVID-19-related research, rapidly review preprints of research posted without peer review on servers such as bioRxiv and medRxiv to prevent dissemination of false or misleading research, and offer a publishing outlet for authors of positively reviewed papers.

Restriction Equals Prestige?

The prestige accompanying publishing in high-impact journals that restrict access to license holders or subscribers remains a strong incentive to send research to such journals. As Charlotte J. Haug, MD, PhD, states in an article published in the New England Journal of Medicine (2019;380:1181-1185. DOI: 10.1056/NEJMms1900864), “Many scientists want their work to be vetted and endorsed by third parties with a reputation for quality and independence; such an endorsement comes from many sources, including long-established journals.”

[Open access journals are] a nice option for more rapid publication, for publishing more experimental or non-mainstream papers, or for those without the same rigor of main journal studies. —John. H. Krouse, MD, PhD, MBA

Otolaryngologists, like other medical specialists, need access to good research and information to provide the best care possible to their patients. As researchers, they also need to establish their credentials and build their scientific reputation by publishing in high quality and respected journals. To help weigh the value of open access journals to accomplish both these goals, we asked the following editors-in-chief of the three open access otolaryngology journals for their thoughts on open access.

Rakesh K. Chandra, MD, editor-in-chief, Ear, Nose & Throat Journal

Dr. Chandra underscored the idea that the quality of open access journals has come a long way since they first emerged. Historically, publishing in these journals was often considered less prestigious, he said, because of the fewer legitimate open access journals available and their known lower peer review standards.

Dr. Chandra noted that many of the early open access journals were predatory journals, charging people large publishing fees for thinly peer-reviewed articles, or no peer review or editing at all. “People were essentially paying money to have articles published,” he said. “Some of those open access journals were outright spam, fishing-type expeditions.”

Many open access journals now, however, mandate a more rigorous peer review process. Prestige in publishing, Dr. Chandra said, now depends on the journal. Dr. Chandra explained that all articles he accepts are vetted through a thorough peer review process and are fully indexed in Medline.

D. Bradley Welling, MD, PhD, editor-in-chief, Laryngoscope Investigative Otolaryngology

Dr. Welling suggested another aspect of the evolution and quality of open access journals: Open access journals need to establish themselves in the shadow of the larger presence of traditional journals. One advantage of Laryngoscope Investigative Otolaryngology is the feasibility of publishing articles in color and in longer formats at no extra cost. “We have really nice papers published, and award-winning Triological Society theses, along with nicely designed and executed high quality studies,” he said, adding that negative studies are also published, which helps to reduce others from repeating unnecessary research.

John. H. Krouse, MD, PhD, MBA, editor-in-chief, Otolaryngology–Head and Neck Surgery and
OTO Open

Dr. Krouse doesn’t think publishing in open access journals is necessarily less prestigious than traditional journals. “There are some very highly rated, high-impact, open access journals, particularly in Europe,” he said. Dr. Krouse also noted the push in Europe to change the metrics from traditional impact factors to other ways to evaluate the utility and rigor of a study.

We have really nice papers published, and award-winning Triological Society theses, along with nicely designed and executed high quality studies. —D. Bradley Welling, MD, PhD

Dr. Krouse thinks of open access and traditional journals as complementary. “It’s nice to have both options,” he said. While Otolaryngology–Head and Neck Surgery journal remains the flagship journal for the academy, he likes having OTO Open as an alternative. “It’s a nice option for more rapid publication, for publishing more experimental or non-mainstream papers, or for those without the same rigor of main journal studies,” he said.

Ongoing Challenge: Separate the Good from the Bad

All three journal editors agreed that a major challenge for both authors and readers of open access journals is the ability to separate legitimate open access journals from predatory journals. “Predatory publishing is a problem that we do all we can to educate our authors and users about,” said Dr. Krouse.

With many journals now adopting open access for COVID-19-related research, issues still unresolved or ambiguous about the merits and challenges of the publishing model may become clearer. Ensuring that high quality and scientifically sound research remains the standard, whether in open access or traditional publishing, requires strong editorial policies and oversight focused on only disseminating research that meets the highest scientific standards. Open access journals can also help meet this moment. 

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Mary Beth Nierengarten is a freelance medical writer based in Minnesota.