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Open Medicine: because health care information belongs to everybody

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Open Medicine got its start when the Canadian Medical Association interfered with the editorial independence of the Canadian Medical Association Journal (CMAJ) in 2006. The Journal was about to publish a news article regarding pharmacists who were asking women buying an over-the-counter emergency contraceptive pill for personal information such as the woman's name, address, date of last menstrual period, when she had unprotected sex, customary method of birth control, and reason for dispensing the medication. At the instigation of the Canadian Pharmacists Association, the CMA ordered the Journal’s editor to significantly alter the  story's content, which was subsequently published. The editor-in-chief and senior deputy editor were later fired and Palepu, then an associate editor, as well as other associate editors and many editorial board members resigned.

The incident led Palepu and her colleagues to examine their values and how they felt about the dissemination of medical research. "Rather than just be angry, we decided to do something positive." And so Open Medicine was born online in 2007.

Palepu is proud of how far it’s got in the past four years, and proud that it’s retained its independence at a time when other open journals are being bought up by the large commercial publishers.

Several other open access medical journals exist, but Open Medicine is the only general medical journal based in Canada. Most contributors are Canadian, says Palepu, with others coming from the United States and even further afield, such as India and Zimbabwe. 

Since its inception, Open Medicine has published many case reports, opinion pieces (on whether doctors should tell patients their test results, for example) and articles. There have been stories about humanitarian impulses in Haiti, emergency room visits during the Olympics, homeless access to primary health care, breast screening and medical tourism. All articles are available without cost and without having to fill in registration information, though registration is required if you want to comment on an article.

Open Medicine, she notes, makes its articles available for anyone to read and distribute under a Creative Commons Attribution Non-Commercial Share Alike License. “This means that anyone can freely copy, download, reprint, reuse, distribute, display or perform the work we publish.”

Open Medicine is completely virtual. It has no office space. It does not produce a print version, and while it "publishes" quarterly, articles appear online as soon as they are ready (after peer review and editing).

Because of the CMAJ experience, Palepu and her colleagues take advertising conflicts and other potential conflicts of interest very seriously. Advertising is not accepted from for-profit pharmaceutical companies or medical device companies. Potential authors must disclose any financial or personal relationships that might bias their work and state any such conflicts either in or in addition to the article. Peer reviewers must also disclose potential conflicts.

Palepu says Open Medicine has just launched a fundraising campaign, to get the publication on a more secure footing and to improve it. Plans include a wiki approach so that systematic review articles become living documents that readers can add to and revise; plain language summaries of published research and reviews; and a more interactive, social media-friendly website. Information on contributing to Open Medicine is available at openmedicine.ca/pages/view/Donate.

She sums up Open Medicine’s uniqueness like this: “If you’re sick, try finding information that’s high quality. A traditional media story about a medical study will tell you what the journalist and the researcher thinks. With an Open Medicine article or any open-access journal article, you can go back to the original study and take a look. It’s empowering, it’s giving the information back to the people who largely paid for it. That’s very powerful.”

"It’s empowering, it’s giving the information back to the people who largely paid for it. That’s very powerful."

Open Medicine is accessible online at www.openmedicine.ca. For more information about open journals in general or to find open journals in a particular field, go to http://www.doaj.org, which links to almost 7,000 journals.

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