The case for open access.

Open access in medical publication refers to unrestricted online access to peer reviewed scholarly research. A common form is publication in open access journals such as Arthroplasty Today, which provide immediate access to all of their articles on the publisher's website. Conventional journals cover publishing costs through access tolls such as subscriptions, site licenses or pay-per-view. Open access journals cover publishing costs through article processing charges (APCs), typically after independent peer review and decision to accept the manuscript. Active debate over the economics and reliability of various ways of providing open access continues among researchers, academics, librarians, university administrators, funding agencies, government officials, and commercial publishers.

The open access movement is growing and parallels the proliferation of information available on the web. Open access scientific publication benefits a world audience that may not be able to afford tolls, or have library access. This may be even more important in surgical publications than in scientific publications, because of the immediate impact on patients. If quality standards are high, this information, disseminated in a timely and ubiquitous manner, can directly influence surgical practice.

As the open access movement progresses and publications proliferate [1], some of the strongest concerns are over stringent peer review, expense of publication, and reaching the right audience. A recent Harvard University study showed that a phony study written by a random text generator was accepted for publication by 17 medical journals [2]. As open access grows, so too, do predatory publications. Mark Shrime, author of the counterfeit manuscript, points out that fake journals seem to target doctors and researchers in developing countries. Even journals without nefarious goals can have publication fees, and often do not reach their intended audience. General “for profit” journals often act as a repository for publications, but are rarely read by medical professionals. According to one study, half of academic papers are read only by their authors and journal editors [3].

The American Association of Hip and Knee Surgeons (AAHKS) is in a unique position to both embrace the open access movement and address the concerns related to open access publishing. AAHKS has always had a strong academic and volunteer focus, and our call for interested and capable peer reviewers has been answered with enthusiasm. A majority of our reviewers are experienced; previously reviewing for high impact factor journals such as The Journal of Arthroplasty and The Journal of Bone and Joint Surgery. Our capable editorial staff completes the peer review process with the goal of producing an excellent and professionally published journal. Cost concerns are addressed through discounts using member dues, and APCs for Arthroplasty Today are among the lowest in the industry. In addition, scholarships are available for trainees, submissions from countries listed as low-income by the World Bank, and those lacking research funding. We are confident that our new journal will reach the right audience. AAHKS membership is at an all-time high, as is our international membership. Dedicated and earnest members have demonstrated a thirst for specialty knowledge, and our popular annual meeting, accessible website, and engaged leadership offer an unparalleled platform to disseminate arthroplasty knowledge.

For these reasons, I submit that open access publishing is the way of the future for us, our international colleagues, and our patients. AAHKS is poised to embrace this publishing practice and once again lead the way in our field by introducing the first full open access arthroplasty journal.