Access to evidence-based care: a systematic review of trauma and surgical literature costs across resource settings

Abstract

BackgroundEvidence-based medicine has become the foundation for surgeons around the world to provide the most effective surgical care. However, the article processing charges (APCs) and subscription fees for surgical journals may be a barrier, particularly for those in low-income and middle-income countries (LMICs).ObjectivesThe objective of this study was to define the current options for producers and consumers of surgical literature, inclusive of trauma, across resource settings.Data sourcesThe Web of Science Core Collection database.Study appraisal and synthesis methodsA complete list of journals publishing surgical content between 2019 and 2020 was compiled. The most frequently indexed journals were reviewed using the individual journal websites to extract the type of access (ie, open, closed, hybrid), impact factors, publication languages, APCs, subscription pricing, and any discounts listed.ResultsThe literature search revealed 4759 unique journals. The 500 most frequently indexed were reviewed. The mean APC for a fully open access surgical journal was US$1574 and for a hybrid surgical journal was US$3338. The average costs for a 1-year subscription in a hybrid surgical journal were US$434 and US$1878 for an individual and institution, respectively. When considering purchasing power parity, APCs and subscription costs ranged from 2 to 15 times more expensive in LMICs when compared with those in the USA.LimitationsPrimary search term was in English only, and only peer-reviewed journal articles were reviewed.Conclusions or implications of key findingsAlthough initiatives exist to support peer-reviewed journals in LMICs, there is an exorbitant cost for authors in these countries, as well as those in high-income countries that are not affiliated with a large institution, to either publish in, or access, a majority of surgical journals. Efforts to lower the overall cost of publishing must be made to provide greater access to medical literature.PROSPERO registration numberCRD4202140227.Level of evidenceLevel IV.

Making publishing in trauma and acute care surgery possible for all resource settings: a moral and ethical imperative

“…The study published by LaGrone et al examines the financial barriers faced by low/middle-income countries (LMICs) in the form of article processing fees (APCs) to publish into, and pay walls to read and access, major surgical journals. 1 The study shines a light on two important issues dealing with equity as it applies to surgical science in terms of (1) access to existing knowledge to improve surgical care in LMICs, and (2) the ability to generate, publish and disseminate new knowledge that may be more relevant and applicable to the LMIC environment.…”