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Letters Saturday 3 May 1997

Journals and the internet

Medical journals will continue to be important in prioritising important data

Editor,
Over the past three years I have tried to keep track of the developments on the internet that relate to medicine. Although a computer enthusiast, I still find that few examples of organiser software can match the convenience of a well structured Filofax. The perceived divide between the information superhighway and paper biomedical journals seems to be an artificial one-just as few couples decide on 'television or radio' or 'television or film' or 'film or book.' The media, which are seemingly in great competition when a new medium is launched, usually settle with time into a redesigned corner of the market and thereafter develop alongside each other.

The internet is a marvellous phenomenon. There is no other way of conducting a discussion forum among tens or hundreds or thousands across the globe. There is no other means of having such a vast amount of information at one's fingertips for retrieval. At the same time, data gluttony is not the answer. The information overload (and data in printed form are much more responsible for this than the internet is) can be handled only if the important few data are prioritised, sorted, and concentrated on. Medical journals do a great job with this, as Richard Smith says.(1) There is little doubt that they will continue to do so - far beyond the time when obituaries have been published about all of that pre-computer generation, for whom a chip was something you ate with fish.

M Palat Physician

Fachkrankenhaus Bernried,
Clinic for Internal and Psychosomatic Medicine,
82347 Bernried/Starnberger See,
Germany References

1 LaPorte R E, Hibbitts B, Smith R, Horton R, Lundberg G D, Davidoff F. Rights, wrongs, and journals in the age of cyberspace. BMJ 1996;313:1609-12. (21-28 December.)

Use of the internet for on line peer review must be explored further

(1) Articles would not be submitted to any particular journal but placed on the internet in a review forum web site.

(2) Rather than there being reviewers selected by editorial staff, any interested party could comment and suggest modifications. Relevant email comments would be posted alongside any response from the authors.

(3) Authors could modify their work in response to comment at any stage.

(4) Journal editors would be able to offer publication at any stage.

(5) Authors could either accept the first offer of publication or wait for subsequent offers from their preferred journals.

(6) A time limit would be set (for example, six weeks), at the end of which the authors would have to accept an offer to publish or withdraw the paper. Papers not attracting any offers of publication would sink at this stage - although useful data could be archived for future systematic reviews.

Anyone could have early access to new data in their field and the chance to offer constructive criticism. Comments could be either open or anonymous.(2) Papers might attract a mixture of both, the onus being on authors to confront or ignore criticism regardless of its provenance. The maximum duration of review would be six weeks, but well developed papers might be published much sooner, with journal editors essentially competing to publish high impact papers quickly.

For an open on line review forum to work, one or more of the leading hard copy journals would have to break ranks over the notion that placing a paper on the internet in this way constitutes prior publication,(3) rendering the paper ineligible for further consideration. Anxiety about this among journal editors may revolve around the possibility of a shift in the focus of their readership towards the review forum and away from the journal itself. In reality, a healthy symbiosis should develop, with readers using the review forum to sustain an up to the minute, interactive view of their narrow fields of interest but relying on definitive publication in hard copy or electronic journals for the broader context.

Bruce Allan Senior registrar
Nigel Morlet Research fellow
Richard Wormald Consultant ophthalmologist

Moorfields Eye Hospital,
London EC1V 2PD References

1 LaPorte R E, Hibbitts B, Smith R, Horton R, Lundberg G D, Davidoff F. Rights, wrongs, and journals in the age of cyberspace. BMJ 1996;313:1609-12. (21-28 December.)

2 Fabiato A. Anonymity of reviewers. Cardiovasc Res 1994;28:1134-9.

3 Kassirer J P, Angell M. The internet and the journal. N Engl J Med 1995;332:1709-10.

Copyright must be reconsidered

Many important medical libraries in sub-Saharan Africa have been unable to subscribe to any journals for over 10 years.(2) For these and many others in the developing world, licensing or subscription arrangements for electronic versions of journals offer no improvement on the present situation. For them the most cost effective way of obtaining their information requirements is on an article by article basis; this is improved by the speed with which electronic documents can be delivered.

Current trends in the handling of electronic copyright (especially in Britain) are not reassuring in this respect. In Belgium and Germany, documents requested by individual people for their personal study and research may be scanned by the holding library and sent over the network or internet to the requester. This is also possible in the United States, with some limitations. In Britain most electronic copying is prohibited; photocopied articles for developing countries have, therefore, to be sent by mail, which is often very slow - two to three weeks is not uncommon.

The increasing number of suppliers of electronic documents now entering the market automatically charge the copyright fee demanded by the publisher unless subscription or licensing arrangements are in place. Such practices bypass the 'fair dealing' exemption to copyright, which allows an individual person one copy of one article from any one issue of a journal for his or her personal study or research. Ignoring this exemption makes research and study more expensive-a very great disadvantage, if not an absolute deterrent, to those in developing countries.

It is difficult to escape the conclusion that some publishers charge a copyright fee on the basis of what the market in the developed world will stand rather than added value. Transfer of copyright to a publisher needs to be matched contractually by the publisher's responsibilities and obligation to the scientific community. Allowing large areas of the world's population to be unduly disadvantaged through the powers of copyright is one of the issues that need to be addressed.

Jean G Shaw Research officer,

SatelLife UK
The Old Rectory, Bath BA2 8NB References

1 LaPorte R E, Hibbitts B, Smith R, Horton R, Lundberg G D, Davidoff F. Rights, wrongs, and journals in the age of cyberspace. BMJ 1996;313:1609-12. (21-28 December.)

2 Levey L A. Wired for information: using technology to meet the needs of Rockefeller Foundation grantees. Washington, DC: American Association for the Advancement of Science, Sub-Saharan Africa Program, 1996.