The Future of Scientific Publications: The Effects of Open Access, Social Media, and Altmetrics

Highlight From the 32nd Annual Meeting of the North American Spine Society

In an era where new digital technologies such as blogging and social media are changing how scientific knowledge is disseminated, a panel of editors from leading spine journals convened to discuss the movement toward open access articles, how journals are incorporating new digital technologies, and whether impact factor is an accurate measure of the impact of scientific journals. The panel discussion was moderated by Alok D. Sharan, MD, MHCDS, Deputy Editor of Clinical Spine Journal, at the North American Spine Society 32nd Annual Meeting, held October 25-28, 2017 in Orlando, Florida.

The excerpts from the discussion have been edited and condensed.
University library scene in black and whiteModern university libraries offer scientific publications in many forms that blend printed and online options. Photo Source:

Dr. Sharan: What is the role of open access in today’s academic journals?

Mark Schweitzer, MD, Editor-in-Chief, Journal of Magnetic Resonance Imaging
Our journal is a benefit of membership, and we want to encourage physicians to be members of our society. We offer limited open access after 5 years, and the author can pay a fee to make the article immediately freely available.

Gregory D. Schroeder, MD, Executive Editor, Clinical Spine Surgery
One of the difficult questions is how do you define open access? There is traditional open access where an author pays a fee, and an article is open forever. At Clinical Spine Surgery, important articles that we think should be open access are free on the web site for a certain amount of time. We also have videos on surgical techniques that are freely available. In addition, we work with the World Health Organization to allow open access to developing countries. Thus, while we are primarily subscription-based, we work hard to allow access to developing countries, as well as to certain portions of the journal in the United States.

Zoher Ghogawala, MD, FACS, Editorial Board of the Journal of Neurosurgery: Spine and Deputy Editor of The Spine Journal
The concept of true open access of scientific papers for physicians and patients should be a priority. The problem is how to make this concept operational, because it costs money to conduct peer reviews and edit articles. Currently, both the Journal of Neurosurgery: Spine and The Spine Journal have options where authors pay for their article to be available open access. Will everyone who publishes high-quality work be able to pay the fee associated with open access? Probably not. I don’t think that we have an answer on how to make articles available freely, but we recognize the importance of open access.

The Spine Journal, for example, is developing a second journal that will be open access. We also have to be careful about the perception that some open access journals don’t represent the same quality as subscription-based journals, with major exceptions such as Global Spine Journal and PLOS ONE). As we think through this process, we have to make sure that the peer review and editing process is intact, and that the system is not excessively costly.

The issues surrounding how to provide greater open access at lower cost is going to be a challenge for all journals. Today, we have a lot of confidence that if a paper comes out in Spine or Journal of Neurosurgery: Spine or The Spine Journal, it has been through a rigorous process, whether it is available open access or not. As we move toward greater open access and lower the barrier to publishing new information, we run the risk of not knowing what to believe. We need to preserve and protect the integrity of the process such that what we continue to produce is true.

James N. Weinstein, DO, Editor-in-Chief, Spine
First, I have the right to make any article open access that I think is of significant import. For example, when I see an article on major complications or something that will impact patients, I get it out immediately to open access. Second, any really good article has open access through the media. We have had several articles with incredible coverage in the media, and that creates open access in ways that you can’t do with a journal.

Third, what is the evidence that open access actually makes a difference? As a scientist, I would like to understand the impact of open access if anyone has studied this, because I think that really good information does get disseminated well. The public is served best as is the profession by making sure that things of significant import are available, and I think that we do a pretty good job of that.

Gregory D. Schroeder, MD, Executive Editor, Clinical Spine Surgery
One of the things that we are leading the charge on is making visual abstracts. Disseminating visual abstracts across the world through social media is really important and helpful. While not true open access, it gets the main points of the article out to as many people as possible. Even if an article is available open access, but if it doesn’t have social media promoting it, then people still aren’t going to find it.

Dr. Sharan: What is the best method to measure the impact of scientific journals?

Gregory D. Schroeder, MD, Executive Editor, Clinical Spine Surgery
I think that the impact factor is outdated and is just one of many tools. Altmetrics is a whole field that looks at how much an article is clicked on, liked on Facebook, twittered, or picked up by The New York Times. All of these things should be as important as the impact factor. Unfortunately, academia is a slow-moving field.

Zoher Ghogawala, MD, FACS, Editorial Board of the Journal of Neurosurgery: Spine and Deputy Editor of The Spine Journal
Most people feel that the impact factor is flawed in many ways and can be manipulated by journals. There are journals that consistently produce high-quality articles that attract people who are generating new findings, and that is hard to measure. For example, New England Journal of Medicine is highly sought after and has an impact factor that dwarfs that of any spine journal. It is widely read and picked up by the press often. However, there are other journals in various disciplines that attract thought leaders and the most impactful work in that field, and that does not necessarily align with the impact factor. Nevertheless, there is no question that journals and boards pay attention to impact factor, academic promotion is dependent upon it, and we don’t really have a better system right now.

Mark Schweitzer, MD, Editor-in-Chief, Journal of Magnetic Resonance Imaging
Within a subspecialty, the impact factor and citation index vary quite a bit from one group of subspecialty journals to another group. One way of tweaking an impact factor is using an average impact factor, where the impact factor for a given specialty is adjusted compared to other specialties. Traditionally, for example, journals on cardiac diseases have higher citation indexes than journals on musculoskeletal diseases.

The second way to tweak an impact factor is the quality of the papers that are citing your paper, a double impact factor if you will. How often a paper that cited your paper was cited itself is another way of tweaking the impact factor.

A third way is to understand that there are differences between clinical scientists and non-clinical scientists. For non-clinical scientists, things like altmetrics and how many times a paper is downloaded are probably less important because they live and breathe by getting grants, and by the rules that getting grants and getting promoted were based on.

In the world of clinicians, there will be far better ways to measure the impact of an article in the future than using an impact factor. That impact may be how often people in the lay media look at an article, how often clinicians download it or read it, or how many times people look at the abstract as opposed to the paper as a whole. I think we will be stuck with impact factor and citation index for another 10 years, and the quality of the papers that a journal gets will be based on those 2 metrics predominantly.

James N. Weinstein, DO, Editor-in-Chief, Spine
I wouldn’t hang my hat on impact factor. If one article in a journal is a “home run” in the sense of news media, quotations, etc, it impacts that journal for a number of years. There are other tools out there. For example, Oxford University is looking at newer ways to examine the impact of journals.

In the future, as people have access to information through cloud-based libraries, it will be easier to access the exact information a physician is interested in. Impact factor will become irrelevant. We are in an age in which we use smartphones to get information that is important to us.

In addition, I believe quantum computing will have a huge impact on imaging and information access. Quantum computing will allow us to pull information together almost immediately on what is important or relevant. The journals will be part of that database, and using specific keywords will bring you the best information.

Dr. Ghogawala disclosed that he is Board of Directors: American Association of Neurological Surgeons - NeuroPoint Alliance, Congress of Neurological Surgeons (Vice President), NASS (Research Council Director), Cervical Spine Research Society; Research Support - Staff and/or Materials: Stuart Foundation (paid directly to institution/employer); Grants: NIH, PCORi (paid directly to institution/employer)

Dr. Schroeder disclosed trips/travel: Medtronic; grants: Medtronic (paid directly to institution/employer)

Dr. Sharan disclosed the following: stock ownership: Medtel (<1%), ReVivo (<1%); consulting: Cartiva, McKinsey; speaking and/or teaching arrangements: Globus; trips/travel: Globus; Board of Directors: Indo-American Spine Alliance; Scientific Advisory Board: ReVivo; other: Jaypee Brothers

Dr. Schweitzer’s disclosures were not available at the time of the meeting.

Dr. Weinstein disclosed relationships outside the one-year requirement: NIAMS-NIH (Grant, Dissolved 1999-2014).

Updated on: 09/12/19
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