Why Open Access in Radiology

Susanna I. Lee, MD, PhD, is chief of women’s imaging and officer of mentored research in the Department of Radiology at Massachusetts General Hospital (MGH) and associate professor of radiology at Harvard Medical School in Boston. Dr. Lee has served as a principal investigator in several trials funded by the National Cancer Institute. She previously served as deputy editor of Radiology. Dr. Lee is the inaugural editor of Radiology Advances.

Every year, during the last full week of October, the Scholarly Publishing and Academic Resources Coalition (SPARC), a global partnership of libraries and academic institutions, organizes International Open Access Week. It is dedicated to campaigns that promote open scholarship. In its 19^th year, RSNA participates in this international celebration and as the Editor of Radiology Advances, the Society’s fully open access journal, I wholeheartedly welcome their advocacy.

The appeal of open science in health care is readily apparent. Research findings, and their attendant data and methods, are made freely available to scientists, health care providers, patients and the public at large. Open science facilitates more rapid dissemination of new knowledge, promotes transparency and encourages collaboration. It has enabled the Human Genome Project, our swift responses to the Zika and COVID-19, and the development of large language models, such as ChatGPT.

So how is open access relevant to radiologists? The majority of our new discoveries are now reported there. In 2017, the number of radiology articles published open access surpassed that in subscription journals. Our major public funding agencies (e.g. National Institutes of Health in the United States, European Union and the World Health Organization) require that the research they support be published open access. Also, in the private sector, open access publishing is gaining popularity because of its ability to garner more attention (i.e. citations, article views and downloads and social media posts) than articles behind paywalls.

Publishing, nevertheless, is a commercial venture. The process of vetting, editing, layout, copyrighting, and distribution of a “version of record” comes with costs. With open access, this fiscal burden, born by readers and libraries in the past, has been transferred to researchers and their sponsors, primarily in the form of article processing charges. These fees are paid by the author at the time of publication or, for those affiliated with an academic institution with a read and publish agreement with the journal’s publisher, it is paid by the author’s organization. In 2023, these fees averaged approximately $3000 per article in a fully open access journal.

With this change in the economic model for scholarly publishing has arisen ethical concerns. These include financial barriers for researchers from low-income institutions, potential conflicts of interests on the part of publishers, and threats to scientific integrity posed by predatory journals. In response, respected journals, including those published by RSNA, have adopted rigorous quality standards as defined by the Committee on Publication Ethics (COPE) and the International Committee of Medical Journal Editors (ICMJE). These organizations advocate on behalf of the researchers pursuing reputable venues for their manuscripts and the readers seeking trustworthy peer reviewed information.

In principle, open science is the ideal. In practice, the logistics of how to achieve it and protect scientific integrity is a work in progress. RSNA, with Radiology Advances, has stepped into this evolving landscape and, in the domain of medical imaging, the Society’s members will be the ones guiding it.