Dear HIFA colleagues,
I sent a comment on ChatGPT's example #2 earlier today (with thanks to David Cawthorpe). I concluded 'This is a good example in that it demonstrates how pre-prints can accelerate research communication. But it also seems to me to underline the importance of journals and their role in editing and peer-review.' But it's arguable whether it serves as an example of 'how access to the full text of a research paper saved a life, or even contributed directly to clinical decision-making'. On reflection, I don't think it demonstrates such an example. For example, we don't know of a specific health professional that sought the preprint and made a clinical decision on that basis, as compared with a specifc health professional that made such a decision based on the NEJM paper and/or commentary. Indeed, while the NEJM paper was free to read at the time of the publication, it was not open-access. (If we had a situation where clinicians were unable to access the NEJM paper because if was behind a paywall, and that quality of care was reduced as a result, this would have been a good example.)
It is also notable that, by the time of publication (July 2020), leading publishers had committed (in March 2020) 'to making all of their COVID-19 and coronavirus-related publications, and the available data supporting them, immediately accessible in PubMed Central (PMC) and other public repositories. This will help to support the ongoing public health emergency response efforts'. The fact they did so suggests, in itself, that the needs of public health (particularly in emergency situations) are better served by open (or at least free) access.
If we turn our attention to #3 of ChatGPT examples, this also relates to COVID-19:
#3: COVID guideline pipelines that were fully OA (for example, rapid recommendations in The BMJ; national guidance updates) show measurable prescribing shifts once OA recommendations cited the RECOVERY preprint/journal article—again underscoring that open, immediately accessible evidence changed treatment at scale. The Japanese study noted dexamethasone prescriptions rose from ~2.5 % to ~35.2 % after week 29 (July 2020) when it was formally included in guidance.
Reference: Higuchi T, et al. The Japanese Guide affected the prescription of steroids for COVID-19 inpatients in Japan.
COMMENT (NPW): This paper (June 2023) simply showed that national guidance in Japan led to increased use of dexamethasone in that country, which is unremarkable. This paper could hardly be an example of a paper that a health professional might seek to help in clincial decision-making for an individual patient. The 'Japanese Guide' itself was published back in March 2020. Clearly, the guide would have been used by health professionals, but this is outside the remit ouf our question, which is looking at the impact on healthcare of open-access, full text research papers.
Best wishes, Neil
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org