You Could be Reading this Full Article: Ransomized Clinical Trials

Today I purchased four songs on iTunes and no surgical literature. Next week I’ll do the same even though my digital life is filled with links to excellent research. Sort of. Surgery Unnecessary in All Cancers: A Double-Blinded Prospective Randomized Controlled Multi-National Trial of 3.7 Million Patients, says a link. I’m intrigued. I click. Up pops a news article referencing the trial. I skim, finding a link to the study in a prestigious journal. I know the routine, but I click anyway. You could be reading this full article… says a ransom note on the landing page. My options: $35 to view a single article, an invitation to subscribe to the journal, a reminder that I may have access through my institution... I immediately reach for my wallet. Just kidding... Strange place, the peer-reviewed journals find themselves now: long the collectors, editors, and distributors of studies that transformed medicine, the major science publishers now refine quality research and prevent its otherwise viral spread... I understand the business model of the publishers, but patients shouldn’t have to wait for the trickle-down of evidence-based care... Formerly, much of the publisher’s value was in distribution. Now, distribution is dirt cheap on the internet. Also, today’s budding researcher is pretty self-sufficient. A generation who grew up on Microsoft Office has poster-ready graphs before the last patient is even enrolled in the trial. Peer-review? At the least, peers should be pre-viewing important research – offering critique before an expensive trial is conducted – not waiting around to poke holes in monthly submissions. Don’t researchers yet co-plan related studies, share data, and continuously collaborate on a dynamic body of science? I only just learned of research tools such as Mendeley and ResearchGate, but I’m surprised the internet hasn’t already obviated the need for our historic scientific publishing model in the same way print journalism and music production have been transformed... The whole idea of periodic literature is so last millenium. It’s not how we roll now. We roll continually in our hyper-connected world. Continually communicating, educating, entertaining, working, shopping, and building networks relevant to our lives...