Public Access: The Pros and Cons of Open-Access Publishing

Open access (OA), in which a scientific article is made freely available, in full, to anyone who wants to download it, seems at first blush like a win-win for everyone in research: Science gets distributed without respect to the means to obtain it.

While proponents of the OA movement make a case that seems hard to argue with – making scientific papers available to the public and moving away from traditional for-profit, subscription-based publishing models will benefit science, advance medical and scientific discoveries, and thus benefit society in general – critics challenge whether OA is economically sustainable and whether OA without peer review or with limited peer review truly advances science over possible for-profit motives. Also, in cases in which journals don’t charge for access to their peer-reviewed articles, how are publishers covering the costs of peer review and production, and will that affect the quality of the research being published?

But how is it that this OA designation came about? The OA movement, along with its cousin, “preprint,” have quite the backstory. Even now, as OA has become ubiquitous in medical and scientific publishing, the debate continues as to whether this model is sustainable and, indeed, even desirable.

ASH Clinical News explores the history of OA and the pros and cons of this ever-evolving movement.

‘An Old Tradition and a New Technology’

The launch of the OA movement coincided with the internet boom of the 1990s; more people gained access to the World Wide Web, and online publishing became the rule rather than the exception.1

The term “open access” was first defined in 2002, when a group of major scientific publishers and open-science advocates convened in Budapest to develop a set of guiding principles for providing free access to research literature. Known as the Budapest Open Access Initiative, this document summarizes the OA movement’s lofty goal:

“An old tradition and a new technology have converged to make possible an unprecedented public good. The old tradition is the willingness of scientists and scholars to publish the fruits of their research in scholarly journals without payment, for the sake of inquiry and knowledge. The new technology is the internet. The public good they make possible is the world-wide electronic distribution of the peer-reviewed journal literature and completely free and unrestricted access to it by all scientists, scholars, teachers, students, and other curious minds.”2

Closer to home, in 2004 a consortium of 48 not-for-profit medical and scientific publishers – including the American Society of Hematology (ASH) – joined forces to issue the Washington DC Principles for Free Access to Science.3 Briefly, the DC Principles supports free access to scientific and medical journals to scientists/clinicians in low-income nations, free availability of full-text journals after a period of time, immediate access to selected articles on publication, search engine indexing, and reference linking among the signatories.

In a 2004 commentary, then Blood Editor-in-Chief Sanford J. Shattil, MD, offered the journal’s support of the DC Principles: “It is the goal of Blood to provide its content in the most unencumbered way and at the lowest possible cost to its readers and subscribers, without jeopardizing the journal’s mandate to provide rigorous editorial review and to publish the most significant advances in hematology.”4

An OA success story is the Public Library of Science (PLOS), a nonprofit scientific publishing project founded in 2001 that now publishes a suite of peer-reviewed journals across a number of areas of science and medicine. PLOS describes itself as being about more than just “free and unrestricted access to research, it’s also about open data, transparency in peer review, and an open approach to science assessment.”5

“PLOS launched the first journal in 2003, and the whole idea of OA was very foreign at that time,” explained Catriona MacCallum, PhD, senior advocacy manager at the San Francisco-based PLOS. “We weren’t the first OA publisher – BioMed Central launched their first journal before PLOS, as did another journal in the earth sciences called Copernicus.”

BioMed Central (BMC), part of Springer Science+Business Media, is another major OA player. In 2014, more than 100 BMC journals achieved impact factors, and the majority of those were ranked in the top half of their categories, based on an article in Journal Citation Report 2015.6

When PLOS launched their inaugural journals, they aimed high – PLOS Biology sought to compete with Science and Nature, while PLOS Medicine aspired to stand alongside the New England Journal of Medicine (NEJM).

“We wanted to show that OA was compatible with the highest level of science,” Dr. MacCallum said.

She recalled that getting researchers on board with OA in the early days was not easy. Today, she estimates that only a quarter of the scientific community opts for the OA route, but that number will change as the OA landscape burgeons into a full-fledged “open-science movement.”

“It’s not just about articles – it’s about open data, access to other research objects, open collaboration, patient advocacy, and being more transparent with scientific, societal, and policy changes,” Dr. MacCallum said.

Gold, Green, and Everything in Between

Like every potentially disruptive movement, OA has its own lingo (see “Open-Access Glossary below). Two terms that are commonly used to describe OA journals are green (making a version of a manuscript freely available in a repository, often after an embargo period) and gold (making the final version of a manuscript freely available on publication, such as with PLOS and BMC journals). Blood offers an Author Choice option for any author who wishes to ensure his or her article is OA – an option that is particularly important for authors whose funding requires OA.7 The National Institutes of Health’s (NIH) Public Access Policy, for instance, mandates that NIH-funded researchers submit their final peer-reviewed journal manuscripts to PubMed Central (PMC), NIH’s digital archive of full-text biomedical journal papers available free online, within 12 months of publication. “[These manuscripts must be] accessible to the public on PMC to help advance science and improve human health,” according to the NIH’s policy.8

For Blood authors who select the option to publish their article as OA, upon payment of a $2,000 public access fee, in addition to the regular publication fees charged to authors, ASH will deposit the final, published version of the article into PMC and ensure free and immediate access to the article on the Blood website.7

However, NIH does draw a distinction between compliance with its Public Access Policy and OA – mainly concerning copyrights and licensing. “[Through PMC, NIH] provides access to the peer-reviewed and published results of all NIH-funded research at no cost, much like a library does, under the principles of Fair Use. … Generally, open access involves the use of a copyrighted document under a Creative Commons or similar license-type agreement that allows more liberal use (including redistribution) than the traditional principles of Fair Use.”8

Publishers are also experimenting with hybrid models, wherein the editors of traditional journals select certain papers for OA. Blood, for instance, designates “Free Research Articles” within each weekly issue – a service it has offered for at least a decade, according to Editor-in-Chief Bob Löwenberg, MD, PhD. The main criterion for the OA designation is that the research have a critical impact on patient care, Dr. Löwenberg, who also is professor of hematology at Erasmus University Medical Center in Rotterdam, the Netherlands, explained. The open designation is entirely up to the discretion of the Blood editors. “Basically, we make any clinical trial or any research that has clinical significance open access.”

Other publishing models grant OA status after a certain period of time. For instance, NEJM makes all research articles OA six months after publication, though not copyright release, while the Journal of the American Medical Association makes research articles freely available after six months for the main journal and after a year for its specialty journals.

Cheers for Peer Review?

Dr. Löwenberg pointed out that free access does not mean a “free-for-all” when it comes to cross-checking the research – all Blood articles undergo the same peer-review process

“We have a high-quality journal, so what we publish should be of broad interest, should have an impact on the field, and, perhaps most importantly, should be right. That requires a sophisticated peer-review system,” Dr. Löwenberg said.

Usually, three experts will review the manuscript and, if they green light it as particularly important, the paper goes back to the authors to address any reviewer queries with an eye toward making the paper even better, he explained. The average time to “First Decision” for all papers is around 19 days, according to the Blood website.

While Dr. Löwenberg said he appreciates that the OA movement is leveling the playing field when it comes to making information publicly available, he questioned whether those papers offer as much scientific value as those published traditionally – particularly if they don’t undergo peer review.

“I feel like every day, a new journal is founded, but I wonder, ‘Who is interested in the content of those journals?’” he said. “I worry that they contain a lot of junk science. I believe a reader wants to be assured that, when he or she opens a particular journal, it contains high-quality, peer-reviewed information. This information is considered ‘right,’ or, in other words, truthful and reproducible.”

Peer review is important, Dr. MacCallum agreed, but it’s not without its own problems, such as reviewer bias (based on gender, geography, practice-level, or other factors) or a failure to fully declare competing interests. “It is widely accepted that peer review is not perfect,” she said. “I was a professional editor for 18 years, and I handled thousands of manuscripts – I’ve seen the best and worst of peer review.”

As science grows more complex, Dr. MacCallum suggested that the model of one editor and a couple of reviewers looking at a manuscript may no longer be adequate. “Science is becoming increasingly global, collaborative, and multidisciplinary with huge datasets – how can one or two reviewers really assess every aspect of a paper?”

Even with those processes in place, those models are still based on an old algorithm; a more appropriate paradigm would be open peer review, Dr. MacCallum offered. In this model, reviewer information would be transparent and other interested parties who are not formal reviewers could still offer comments. The review process would continue after publication to ensure the ongoing accuracy of the data.

“OA is about the infrastructure to support digitally linking research objects in a networked, global, interactive environment,” Dr. MacCallum said. “The responsibility of OA publishers is to facilitate and enable that infrastructure through commonly agreed-upon standards to provide the tools and infrastructure to enable others to share research freely. It’s not just about slapping the article up on the web.”

The Preprint Pathway

In the fields of physical sciences and mathematics, “preprint”’ has been in play for some time. In this model, researchers upload their articles to a preprint server (the site where the content is hosted); that work can then be accessed – and commented upon – by end-users.

While the formal structure of preprint may be relatively new, the concept of sharing one’s work with colleagues is not, Jessica Polka, PhD, director of ASAPBio in Cambridge, Massachusetts, pointed out. “I think that scientists have been sharing their work before publication in various ways – face-to-face meetings, a poster presentation, a talk at a seminar. Preprint is bringing that kind of sharing on to the internet and democratizing the access to that content.”

ASAPBio is a researcher-driven initiative to promote preprints. However, unlike or – two major preprint servers in the physical sciences realm – ASAPBio does not have a preprint server. Rather, it’s an advocacy organization for the preprint movement, Dr. Polka explained.

What are the benefits of preprint and how does it differ from OA? First, preprint is an opportunity for researchers to get feedback on their work without going through the formal submission process to a journal – OA or otherwise.

“In one sense, preprint is OA, in that there are typically no restrictions on viewing or reading the content,” Dr. Polka noted. “But one advantage that preprint offers over OA is that the work gets out into the scientific community faster. Of course, that’s partly because there is no formal peer review built into preprint.”

Faster dissemination allows for more real-time feedback, she added, and preprint also may foster collaborations – for instance, a researcher may see a paper in preprint, realize that her group is working on something similar, and reach out to the authors of that preprint paper.

At, authors retain copyright, according to a blog post at ASAPBio from John R. Inglis, PhD, executive director of Cold Spring Harbor Laboratory (CSHL) in New York, which operates the preprint server. By posting on, authors explicitly consent to text mining of their work (e.g., by search engines or researchers). Once an article is published in a journal, will automatically update the preprint with a link to the published version.9

Preprint also “provides a way of transparently showing progress that could, in principle, be used to demonstrate productivity to anyone evaluating a researcher, whether that’s his or her funding source, his or her institution, or other stakeholders,” Dr. Polka said.

Ideally, a preprint article undergoes screening, and preprint research must meet at least two basic criteria, she explained. First, it cannot be copied or plagiarized work, and, second, it must be within the scope of the server’s designated scientific field.

Plagiarism is a potential issue with preprint, although not necessarily a widespread one. According to an analysis of the preprint server, there were some signs of, at best, text overlap, and at worst, scientific plagiarism, according to an article in Science. The article goes on to state “it appears that copying text from other papers is more common in some nations than others, but the outcome is generally the same for authors who copy extensively: Their papers don’t get cited much.”10

And in a review article on preprint servers, Nicholas G. Tomaiuolo, instruction librarian, and Joan G. Packer, head of reference, at the Elihu Burritt Library at Central Connecticut State University in New Britain, Connecticut, acknowledged that plagiarism is a risk associated with all electronic publishing, but that the additional feedback from interested parties in the pre-print system was likely to compensate for this risk. Also, they suggested that “authors evidently see [plagiarism] as more of a potential problem than an actual one.”11

“The checks are designed to ensure that the work is ethically disclosed,” Dr. Polka added. “That work is usually done by a combination of computer algorithms, followed by a human screener who will review the paper to ensure it fits within the server’s scope. This screening is very light; there’s no intention of questioning the importance or the validity of the work.”
In that respect, preprint does not “challenge the critical role of the journals, which is to validate the work,” Dr. Polka stressed. In her estimation, preprint and all journals can work together and, indeed journals such as Nature and Science accept preprint because of the latter’s successful track record in the physical sciences world, she said.

“One of ASAPBio’s goals is to have conversations with journals about preprint,” Dr. Polka explained. “We view preprint as analogous to a conference presentation. It’s a different way to communicate within the scientific community.”

Curt Rice, PhD, rector (president) of Oslo and Akershus University College of Applied Sciences in Norway, agreed that while preprints may lead to a new type of peer review, the latter is still important to the scientific process. Dr. Rice founded the “Science in Balance” website (, which addresses OA issues.

“Publishing has two main legitimate goals: dissemination of scientific results to the scientific community and quality control,” Dr. Rice told ASH Clinical News. “The latter is embodied today in the peer-review part of the process. As you can imagine, there are many variants on peer review – including ‘crowd-sourcing’ review through preprints – but it cannot be abandoned.”

Regardless of how an article reaches the public eye, OA or preprint, “the substantial move toward digital publishing – independent of business model – opens the door to new approaches to quality control,” he added.

While other scientific fields may be optimistic about preprint, Dr. Löwenberg questioned whether it would be as popular in biomedicine. Blood, and most other major clinical journals, does not currently accept preprint papers, he noted, reiterating the importance of research being validated and reviewed prior to public release.

Notably, since preprint refers to published material, when a traditional journal selects to formally publish the article, the article essentially becomes “reprinted.” In this case, most journals require that copyright to the published material be transferred from the author to the journal. Springer Science+Business Media, for example, specifies in its policies that authors can keep prior versions of the accepted article on non-commercial preprint servers like, but the final published version of the article becomes the copyrighted material of the publisher. Copyright policies differ among publishers, though, and “many legal issues surrounding the internet and intellectual property are still murky and rapidly changing,” Mr. Tomaiuolo and Ms. Packer noted.

Mostly, the sources who spoke with ASH Clinical News advised authors to keep an open mind: OA is a rapidly evolving, thriving community with both good and bad aspects. If an OA journal looks too good to be true, then it probably is.

OA is certainly not a panacea; along with the promise, there are problems. The sustainability of the OA business model, and whether it can afford to support a strict peer review process, is still undetermined. The OA movement represents a cultural shift in scientific publishing. Without practices in place to ensure that that knowledge is as accurate and correct as possible, having people buy into that new model will be an uphill battle. —By Shalmali Pal 


  1. Cold Spring Harbor Laboratory Library. Guide to Open Access: History of the OA movement. Accessed August 4, 2016 from
  2. Budapest Open Access Initiative. About. Accessed July 22, 2016 from
  3. Washington DC Principles for Free Access to Science. Statement. Accessed September 25, 2016 from
  4. Shattil, S. Open access, yes! Open excess, no! Blood. 2004; 103:3257; doi:10.1182. Accessed September 25, 2016 from
  5. PLOS. Who We Are. Accessed September 4, 2016 from
  6. BioMed Central. BioMed Central journals see growth in impact. Accessed July 22, 2016 from
  7. Blood. Public Access. Accessed September 25, 2016 from
  8. National Institutes of Health. Frequently Asked Questions about the NIH Public Access Policy. Accessed September 26, 2016 from
  9. ASAPBio. bioRxiv: A Progress Report. Accessed September 25, 2016 from
  10. Bohannan J. Study of massive preprint archive hints at the geography of plagiarism, December 11, 2014. Accessed September 25, 2016 from
  11. Tomaiuolo NG, Packer JG. Preprint Servers: Pushing the Envelope of Electronic Scholarly Publishing. Accessed September 24, 2016 from

Do Your Homework

Two issues are clear: Open access (OA) will continue to mature, and so will the animated discussion around it. That may leave researchers and clinicians wondering if the OA landscape is worth venturing into. The people who spoke with ASH Clinical News agreed it has some value, but offered several points authors and publishers should bear in mind:

Do your due diligence. Before submitting to any OA journal, visit websites such as the Open Access Scholarly Publishers Association ( or the Directory of Open Access Journals ( to find reputable publishers (see “OA Resources”).

Make inquiries. Scan the editorial boards of journals for colleagues, or at least familiar names. Predatory journals have been known to pilfer editorial board lists from legitimate publications, so consider contacting an editorial board member to confirm the relationship with that journal.

Approach solicitations carefully. An invitation to publish shouldn’t be taken at face value, especially those that arrive by email. Confirm all purported journal impact factors, and determine if the journal has a history.

Make contact. Check to see that the publisher has real contact information, such as a physical address and phone number, on their website. Put in a call or request a call back. If the entity is unresponsive, move on.

Review content. Borrow a page from the preprint playbook and be your own screener by looking at other studies that the journal has published. Do any of the data seem too familiar? Is the research within the scope of the journal’s stated field? Does it seem valid, reproducible, or even just generally sound?

Self-assign as OA. When submitting to a hybrid-model journal, it may be possible to put in a request for OA designation. Be wary of “double dipping” with journals that have subscriptions plus an APC; those APCs can sometimes be higher than what a strictly OA publication will charge.

Confirm Creative Commons licensing. The OA movement has always been clear that articles can be freely re-used as long as the author is given appropriate attribution. Be wary of publishers that claim OA, but then issue “bespoke licensing,” which may still restrict commercial or derivative use, such as text- or data-mining.

Open-Access Glossary

Open Access (OA): Making peer-reviewed scholarly manuscripts freely available online, permitting any user to read, download, copy, distribute, print, search, or link to the full text of these articles, crawl them for indexing, pass them as data to software, or use them for any lawful purpose, without financial, legal, or technical barriers other than those inseparable from gaining access to the internet itself.

Open Educational Resources (OER): Openly licensed, online educational materials for sharing, use, and reuse.

Copyleft: A form of licensing that makes a creative work freely available to be modified and requires all modified and extended versions of the creative work to be free, as well. (OA does not require works to be copyleft, nor does it necessarily exclude copyleft works from being OA.)

Creative Commons (CC): A suite of licenses that set out the rights of authors and users as alternative to the standard copyright.

CC Attribution (CC-BY): A license clause that allows the reuse, sharing, and remixing of materials providing the original author is appropriately attributed.

CC Non Commercial (CC-NC): A license clause allowing the reuse, sharing, and remixing of materials providing that it is for non-commercial purposes.

CC No Derivatives (CC-ND): A license clause requiring that derivatives are not made of the original works.

CC Share Alike (CC-SA): A license clause requiring that derivative works have the same license as the original.

CC-O: A waiver of copyright with no rights reserved.

Paywall: A restriction via a financial barrier to research.

Login wall: A requirement to log in to a system in order to access content.

Open-washing: The appearance of OA for marketing purposes, while continuing proprietary practices.

Green OA: Making a version of a manuscript freely available in a repository.

Gold OA: Making the final version of a manuscript freely available on publication.

Diamond OA: A form of gold OA where there is no APC.

Gratis OA: A work is available to read free of charge, though reuse is restricted.

Libre OA: A work available under an open license.

Version of Record (VOR): The final version of a manuscript after peer review and publisher processing.