Healthy Skepticism Library item: 3906

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: news

Webster P.
Prescription for Canada: an unfettered medical journal
The Globe and Mail ( Canada) 2006 Mar 24
http://www.theglobeandmail.com/servlet/story/RTGAM.20060325.wxmedi25/BNStory/specialScienceandHealth/home

Keywords:
CMA CMAJ

Notes:

Ralph Faggotter’s Comments:

“ Since their departure, the CMAJ has imploded.”

A medical journal needs to be not just independent of external political pressures, it needs to be seen to be independent too.

Perhaps, in the long run, the fall-out from this shake up will achieve something positive — or will it just induce the CMA to tighten its grip on the CMAJ ?

Full text:

Prescription for Canada: an unfettered medical journal
PAUL WEBSTER

From Saturday’s Globe and Mail

It has been a month since the Canadian Medical Association, which represents 62,000 doctors, decided to freshen up its esteemed journal by firing the editor-in-chief, John Hoey, and his deputy, Anne Marie Todkill.

Dr. Hoey and Ms. Todkill spent a decade transforming the bimonthly Canadian Medical Association Journal into one of the world’s more respected scientific publications. On Thursday, a story they supervised was nominated for the coveted Michener Award for meritorious public service.

Since their departure, the CMAJ has imploded. Citing confusion within the doctors’ association over editorial independence — something Dr. Hoey and Ms. Todkill recently accused it of violating — eight senior and intermediate editors have resigned, along with 15 of the journal’s 19 editorial board members.

Many Canadian scientists who have published pioneering studies in the CMAJ on such issues as SARS and other infectious disease outbreaks are starting to wonder if it’s healthy for the country’s only major medical-science publication to belong to an association aimed at promoting special interests, however enlightened.

The time has come, many researchers say, to rethink how to disseminate Canadian medical research. Support is growing for a fully independent, not-for-profit journal, free from owners with vested interests, and not reliant on advertising income.

One of the ideas researchers are discussing is modelled on a series of journals published by Public Library of Science (PLoS), a San Francisco-based non-profit publisher launched in 2000 with support from almost 34,000 scientists and start-up financing from private foundations. PloS Biology, the most successful of the six Public Library of Science journals, already boasts having achieved more than twice as much measurable impact among scientists as the CMAJ does.

Born from concerns that the medical associations and private corporations that control most of the world’s traditional medical journals can skew scientific and journalistic principles to serve commercial and political aims, PLoS represents a radically different approach: The president of PLoS’s publishing operations is a scientist, PLoS journals don’t accept advertising from companies that make drugs or medical devices, and all the articles in PLoS journals are freely available on-line, and can be republished without restrictions.

Although CMAJ contents are free on-line, the journal is packed with pharmaceutical advertising, and is published by a holding company headed by a business executive. Many traditional journals now require that readers pay for on-line access, a development Dr. Hoey and Ms. Todkill pledged to resist before they were forced out.

PLoS Medicine senior editor Barbara Cohen says her journal soon aims to be financed entirely by researchers, who are expected to pay for publication with fees earmarked from their research budgets, although this is waived for poorer researchers.

“Scientists, unlike novelists, don’t expect royalties,” says Ms. Cohen, who notes that Alan Bernstein, a CMAJ board member who serves as president of the Canadian Institute for Health Research — Ottawa’s $800-million medical research agency — has consulted PLoS president Harold Varmus on ways to increase access to publicly supported Canadian research.

McGill University cancer researcher Eduardo Franco, one of PLoS Medicine’s three Canadian board members, calls the CMAJ flameout a major embarrassment for Canadian science. The editors should be reinstated immediately, he says.

But he also thinks the CMAJ crisis offers a strong opportunity for the launch of a Canadian medical journal free of corporate and political entanglement.

“Ownership by entities with strong commercial ties to big pharma, or, as in the case of the Canadian Medical Association, with strong ties to governments, often creates a situation where editors are not free,” says Dr. Franco, who was trained in Brazil, where free-access medical journals were pioneered.

He praises PLoS for making scientific publication more transparent. “I’d love to see the CMAJ go that route.”

Timothy Caulfield, a University of Alberta health-law researcher who also serves on PloS Medicine’s editorial board, says it makes good sense to divorce medical science from commercial publishing.

“There’s increasing evidence commercial issues impact on what’s published,” he says. “Numerous studies indicate, if you get commercial funding from any source, you’re more likely to publish results favourable to that source.”

John Willinsky, director of the Public Knowledge Project at the University of British Columbia, says he, too, feels that events at the CMAJ suggest an alternative scientific publication may be needed in Canada.

“The advantage of this model is that it can be started quickly and at low cost,” says Prof. Willinsky, who resigned from the CMAJ board last week. “We don’t want to rush into this, but we could definitely do it.”

Toronto writer Paul Webster also contributes to research publications, including Science and The Lancet.