Published 9/1/2018
Daniel R. Schlatterer, DO, MS

Read This Before Submitting an Open-access Manuscript

Are open-access journal platforms free of financial liability?

After completing a research study, an author must decide where to submit the manuscript for publication. Currently, there are two options: (1) traditional print journals, which can be read online or in mailed hardcopy; and (2) electronic journals that are accessible to anyone, anywhere, free of subscription costs but available only online (no hardcopy option). Before choosing an electronic journal, however, an author should ascertain the following:

  • article-processing fees
  • whether the journal is listed in a general (e.g., Scopus) or discipline-specific (e.g., PubMed) index
  • whether the electronic articles get assigned PubMed identification numbers (PMIDs), unique identifying numbers for easy online access to articles

Within orthopaedic surgery, there is a growing list of prestigious print journals with widespread readership. Web-based, electronic, open-access journals (OAJs) are not limited by the distribution of printed materials or subscriptions. Internet access is the only potential barrier to access. Many of the major print journals now routinely offer an open-access/paid option. Print journals cover their overhead expenses with subscription fees, advertising revenue, and single-article reprint fees. In contrast, OAJs charge authors hefty article-processing fees. Many of the major print journals now routinely offer an open-access/paid option, also for modest fees (Table 1).

Once fees are paid, OAJs tend to offer rapid peer review and faster, free online access to clinicians, surgeons, and researchers worldwide. If authors’ goals include wide and rapid dissemination of their data, an OAJ may seem to be the obvious choice. However, it’s important to consider the real versus perceived risks and benefits of both publication routes. Another subtler consideration is the peer-review process of all journals. Despite the arduous task of responding to reviewers’ comments, the review process benefits all stakeholders. For example, with careful peer review, theoretically, the end result is better science offering a clearer context for the data that, along with the prestige of the journal, makes the data more believable, actionable, and impactful. Currently, there is no metric to assess and report a journal’s peer-review process. If print journals were more stringent than OAJs, would authors prefer print journals?

Important considerations

The first consideration is the cost of publishing. Most but not all print journals have an article-processing charge, but the fees are substantially less than those associated with OAJs. The next consideration is acceptance rate. Information on rejection rates is not readily available on OAJ websites, except for claims of fast and rigorous peer-review processes. For example, the Open Orthopaedic Journal claims a submission to publication period of 18 days or less. The time to publication is an important factor if a researcher wants to be the first to report on an emerging topic. Otherwise, the time to publication may be irrelevant. Most print journals receive numerous submissions every year without adequate space to print all of the submissions; they likely have a single-digit acceptance rate. The influence OAJs have had on submission and acceptance rates for print journals is not known. In theory, manuscripts that are rejected by print journals find their way into OAJs, which indirectly raises questions about the content quality of OAJs versus print journals. The potential content discrepancy requires further study.

Authors also must consider the size and scope of print journals and OAJs. To date, there are 11,474 OAJs from 126 countries containing more than 3 million articles. By contrast, the number of print journals and scientific magazines that are peer reviewed and indexed by PubMed exceeded 28,000 as of 2014. Among print journals, Nature, which first published in 1869, has an impact factor (IF) of 38.138. The journal Science, which began publishing in 1880, has an IF of 33.61. The IF is a ratio that indicates how often the articles published in a particular journal are cited in other publications. The IF system was developed and is tracked by Thomas Reuters. The numerical IF value fluctuates annually and is a relative measure of the quality of research published in a journal. Here, too, a number of misleading IFs have been offered by unscrupulous publishers.

Given their specialized audience, most surgical journals (including orthopaedic print journals) report a single-digit IF, and OAJs are cited even less frequently, so their reported IFs hover around a single digit or less. Some OAJs report an IF, even though they are not tracked by Thomas Reuters. Those OAJs are part of larger online publishing groups that have been suggested to prey on young scholars. In 2008, librarian Jeffrey Beall from the University of Colorado took notice of that emerging trend and created and later removed a list of what he determined to be predatory journals based on a 52-point assessment. Mr. Beall noticed several trends: (1) the journal title was very similar to an established print journal except for one or two words; (2) the journal title often included the word international to give the impression that the journal was more legitimate; (3) often the publisher was based in a Western country such as the United States, Canada, or Great Britain. Interviews of Mr. Beall outlining his in-depth OAJ concerns can be found online. The most significant point of difference between print journals and OAJs is that many print journals are entities of nonprofit societies. In direct contrast, OAJs usually are part of much larger for-profit publishing companies. Recognizing the trend toward wider information dissemination and access through the internet, many of the reputable journals and subspecialties are developing their own OAJs, presumably with much higher standards than the for-profit journals.

If a young physician’s goal is academic notoriety and advancement, then publications with PMIDs may be more important and valuable. Articles published in indexed journals have PMIDs, whereas articles in many OAJs do not, although some OAJs are getting indexed, as publication quality improves. Annual reporting of publications has moved beyond simply listing authors, article title, journal title, volume, issue, and page numbers. Now, accreditation agencies, such as the American College of Surgeons for trauma center designations and site visits, request PMIDs for scholarly work reported by Level I trauma centers. Publications without PMIDs cannot be listed as evidence of academic endeavors.

The primary advantage of OAJs is that they provide readers access to their publications without charge. Restricted access without a subscription likely has impeded more than one author’s work from reaching readers. The annual subscription costs for print journals generally range from less than $500 to nearly $1,000 (Spine). Without a subscription, readers typically pay $35 to $40 to access a single article. With OAJs, authors typically pay about $100 to publish an article. Publication memberships are available and provide unlimited publications at an annual fee of $2,000, with a lifetime option of $5,000. One more route to access the literature is through publisher-specific subscriptions, or Ovid, which is often subscribed to only by large institutions with budgets to cover the expense of what amounts to individual print journal subscriptions. This is more feasible for institutions and not individuals.

In 2013, The Journal of Bone & Joint Surgery (JBJS) added a $250 article-processing fee, and the number of submissions declined thereafter. Many indexed and print journals offer to put an accepted manuscript in print and on an open-access platform for hundreds of dollars or more. JBJS lists its open-access fee at $2,000. An author must determine which OAJ has the widest orthopaedic readership; a free journal does not necessarily have wide readership.

Currently, there is no metric reported for readership or views. Authors can search a particular journal on the Web of Science and find its IF online or simply review the articles in previous issues for relevance to their research. Recent disruptive newcomers to the OAJ arena are PLOS and PLOS One—a conglomerate of electronic journals and books across many fields of medicine and surgery. The difference is not a lack of an article-processing charge, rather that they offer compensation for reviewers and royalties to authors. At the other end of the open-access spectrum are the Liebert OAJs. Liebert works directly with abstracting and indexing services to ensure that its articles are discoverable in bibliographic databases, contained in library catalog systems, and available for citation tracking. These are very favorable benefits to reach a wide audience, but it still falls short of PMID recognition.

Readership concerns may be enough for authors to submit manuscripts only to the more popular orthopaedic journals, despite high rejection rates and article-processing fees. On occasion, discounted open-access fees are granted upon request, and this should be clarified prior to agreement on publishing a manuscript. All authors collaborating on a project should come to an agreement before committing to an OAJ.

It will probably be some time before electronic journals achieve the prestige of print journals, which likely will continue to carry the impact and notoriety a researcher may feel is important.

In summary, the pressure to publish may make OAJs attractive to young practitioners. Authors should be wary of the financial liability and the other concerns presented in this editorial when responding to an unsolicited email invitation to submit an article to an OAJ. The publication may not be everything desired in a print journal, and there are financial strings attached. Electronic journals do not guarantee publication but may provide faster and more widespread dissemination of new data. Furthermore, recent literature has shown that IFs can be skewed. For example, a few highly cited articles can falsely inflate an IF. A journal’s IF will not predict citation rates for all subsequent articles. In fact, most published work is not cited in the first two years following publication. Assessment of an article’s quality, therefore, is remote from the journal’s IF, and each reader should determine the merit, methodology, and conclusions of a study in the reader’s own parameters of relevance and clinical impact. Choosing a journal for manuscript submission is a multifactorial process. Hopefully this article brought to light some of the lesser-known details of both print and electronic journals.

Daniel R. Schlatterer, DO, MS, is an orthopaedic trauma surgeon at WellStar Medical Group at Atlanta Medical Center and a member of the AAOS Medical Liability Committee. He can be reached at danschlatterer67@gmail.com.


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  2. Nwachukwu BU, Schairer WW, So C, et al: The early impact of an administrative processing fee on manuscript submissions at The Journal of Bone and Joint Surgery. J Bone Joint Surg Am. 2016;98:e82.