“While I applaud exploring broader open access and the principles of early, immediate, and wide dissemination of medical information, the pace of conversion must be taken into account, as there could be some adverse consequences.
These include:
1.
This policy could be perceived as a restriction of academic freedom as stated in the recent International Committee of Medical Journal Editors recommendations (4). Are we ready for a policy that prevents investigators from publishing in journal x, because it was deemed not a qualified journal?
2.
Decrease in the quality of review and subsequent quality of scientific publications. In the process of peer review, significant augmentation of the quality of the paper occurs through a multi-review process. This involves not only recommending additional analyses, study augmentation, and adjustments to the analytical plan, but also identifying major and minor errors and correcting these reports before appearing in public. Peer review provides one guard against scientific misrepresentation.
3.
Increase in scientific misinformation, as it will be easier to promote reports in the open access forum without safeguards. Although some members of the scientific community believe that science is self-correcting, it can sometimes take years and can impose harm that could get into medical practice from erroneous conclusions that may affect patient care. Take the case of some recommendations against vaccines and statins.
4.
Important financial strain to small nonprofit subspecialty societies. The conduct of publishing journals through professional societies allows modest dollars to come into the smaller societies and support other important activities that may not have full support, such as education, conferences, research grants, patient awareness, and advocacy. These important initiatives would have to be re-evaluated in societies and may affect patient care by reducing other venues and methods of information dissemination and policy advocacy. As Dr. Mann has called out in his previous communication (5), it is important that we have a serious dialog about open access immediately and thoroughly, as this train has left the gate; it is up to the broader scientific community to delve into the details of how we transition from our current system that has served the community well in the past, but will not be the ecosystem of the future….”