Stevan Harnad, University of Southampton, May 8, 1999

[This is a revised draft of comments send to Harold earlier.]

The following are my comments on: http://www.nih.gov/welcome/director/ebiomed/ebiomed.htm

This extremely welcome and important initiative is deserving of the strongest support. The following recommendations are made in the interests of strengthening the proposal by clarifying some crucial central aspects and modifying or eliminating some minor, weaker aspects.

>E-BIOMED: A PROPOSAL FOR ELECTRONIC PUBLICATION IN THE BIOMEDICAL SCIENCES

> Prologue

> The full potential of electronic communication has yet to be realized. The scientific community has made only sparing use thus far of the Internet as a means to publish scientific work and to distribute it widely and without significant barriers to access.<

This generally accurate assessment of the current failure to exploit the full potential of the Internet for scientific publication has one prominent and extremely relevant and important exception. It would be much more accurate as well as helpful to note this explicitly from the outset, as this notable exception is very likely to be the model for all the rest of the disciplines:

Physics is the exception (and to some degree, mathematics). It is now both an empirical and a historical fact that well over half of the current physics (journal) literature is freely available online from the Los Alamos Archive and its 14 mirror archives worldwide, and is being used by perhaps 50,000 physicists a day.

http://xxx.lanl.gov/cgi-bin/show_monthly_submissions

It would be misleading in the extreme to describe this as "sparing use"! Instead, it should be acknowledged that this has been a revolutionary change in Physics, and if there were a way to extend it to the other sciences (and the other learned disciplines) then the full potential of electronic communication WOULD indeed be realized.

I stress this, because to pass over the revolution in Physics as if it had not happened is not only to fail to give historical facts their due, but it is to miss an important lesson for the rest of the scientific and scholarly world in general, and the Biomedical Sciences in particular.

Insofar as the other disciplines are concerned, the paragraph quoted above is a fair description of the status quo. The only bit of ambiguity is the word "publish" in: "sparing use thus far of the Internet as a means to publish scientific work and to distribute it widely and without significant barriers to access."

"Publish" has two meanings in this context. One is "to make publicly available in written form" (whether on paper, tape or screen), and the other is "to appear in a refereed journal." It is best to distinguish these two, as many people these days, usually well-meaning but extremely under-informed about the nature of peer-reviewed publication, have been suggesting that the latter (refereed publication) be watered down or abandoned entirely in favour of the former (making publicly available online).

I think that such proposals (to modify peer review or substitute for it the mere public online distribution of papers -- I am not speaking of the E-biomed Proposal here, but of the need to distance it from such proposals) are both (1) risky and (2) counterproductive

(1) Proposals to modify peer reviewed publication are based on armchair speculation about publication and quality control, rather than on any real experience with peer review or any tested alternatives to it (there are none at the moment). Hence armchair proposals put the quality and reliability of the research literature at risk without any proven alternative, should any substantial number of well-meaning people decide to go ahead and implement such proposals on any scale without first carefully testing them out empirically.

Peer review can certainly benefit from study and improvement, and it is indeed being studied empirically, but not by the armchair (or screenside) tacticians. This research takes time and careful experimental trials. And it is COMPLETELY INdependent of the medium -- paper or online -- in which the publication will take place. (The online implementation of refereeing can be much faster and more efficient, but this is just as true for paper publication, and indeed more and more of classical peer review is being implemented online already).

It is accordingly arbitrary and erroneous to couple changes in quality control mechanism with changes in medium a priori. Not only is it impossible to sort out the effect of two empirical variables if you change both of them at the same time, but if quality control is compromised by the implementation of untested alternatives, then the effect could be misattributed to the online medium with which is was coupled, thereby setting back the day when the learned community finally realises the full benefits of a free online corpus. This is why such proposals are not only risky (1), but counterproductive (2): They can set back the online agenda instead of advancing it.

Change one variable at a time. If one's mission is to reform quality control, then study and test new alternatives empirically. But if one's mission is to make the current quality-controlled literature, such as it is, freely available to everyone, everywhere online, rather than having access to it continue to be obstructed by toll-barriers (Subscription/Site-License/Pay-Per-View, S/L/P), then there is no need either to await the reform of peer review, or to test whether free access would be a good thing! The Los Alamos Archive has already proved that it is a good thing; the world Physics community has already voted with its eyes and fingers (and its papers, which are being self-archived in the LANL Archive at an astounding and accelerating daily rate).

So: About "publishing" vs. "distributing": the picture is clear now: Authors can now publicly self-archive their unrefereed preprints as well as their refereed reprints. There is no reason to redefine "publication." Let it continue to refer to acceptance by a refereed journal. And let authors continue to submit all their papers to the established refereed journals. But let them also self-archive them (both as unrefereed preprints, and, once accepted, as refereed reprints) in both their local institution's archive and in a global archive such as LANL, with which E-biomed should COLLABORATE, emulating its dramatically proven strengths, rather than trying to re-invent them or modify them a priori with untested incursions into either peer review or publication.

Preprint and reprint Archives are collective services to the world scientific community; their efforts and resources should be pooled to take advantage of economies of scale as well as to share the momentum of the faster moving disciplines.

See: http://www.library.yale.edu/~okerson/subversive.html

> Informative and even visionary essays have explored this topic (see, for example, articles by
Ginsparg http://xxx.lanl.gov/blurb/pg96unesco.html,
Walker http://www.amsci.org/amsci/articles/98articles/Walker.html, and
Harnad http://www.princeton.edu/~harnad/nature.html,
and references cited therein, as well as other recent proposals http://library.caltech.edu/publications/scholarsforum and
http://www.arl.org/newsltr/202/intro.html.<

I have done some critical commentary on both the Walker proposal and the CalTech proposal. It all appears in the American Scientist Archive:

http://amsci-forum.amsci.org/archives/september-forum.html

In a nutshell, Walker proposes financing free online eprints of published journal articles out of journal offprint page charges; but why should an author want to pay those charges if he can already self-archive, in his local institutional archive and the Global Archive (LANL/E-biomed), for free? There are some issues about how to pay for the quality control, and page charges are indeed the right way, but not author offprint charges levied by a journal that still blocks access via S/L/P!

The ARL initiative is largely backing new forms of licensing. Inasmuch as these retain the author's right to self-archive for free, they are commendable; inasmuch as they help to preserve S/L/P barriers -- in the form of L alone -- they are counterproductive.

The shared desideratum of all these initiatives is this:

"It is easy to say what would be the ideal online resource for scholars and scientists: all papers in all fields, systematically interconnected, effortlessly accessible and rationally navigable from any researcher's desk worldwide, for free."

The way to arrive at this optimal outcome is through online self-archiving by all authors (locally and globally). THAT is what needs to be encouraged and facilitated. The rest will then take care of itself (although we do need a rational transition strategy to cushion the conversion of publishers from hybrid paper/online publication with costs covered through S/L/P access barriers, to online-only publication with the scaled down cost covered by up-front page charges, and the literature then barrier-free for all).

> Before describing our proposal, it is important to acknowledge the strengths of the current system for published scientific work, because it has served the scientific community well for over 300 years.<

I agree completely with the description that followed this passage, of the value of the classical system of peer reviewed publication. I would just add that even mentioning it risks introducing a red herring, because there is no need whatsoever to tamper with this proven system of quality control in order to achieve the optimal outcome above.

> No proposal to change the way scientists publish their results and ideas should ignore these and other virtues of the current system. But we believe that current practices also have many liabilities and that these can be addressed by an evolutionary approach that need not threaten most of the benefits attributable to the print-based publication system that is now in place. More importantly, electronic publication can offer several remarkable benefits that could never be achieved through the current system. Many of these benefits depend on low-cost, barrier-free access by scientists to all of the contributions of their fellow scientists in a conveniently displayed electronic format.<

I think that to formulate it as if realising the full potential of free networked online communication somehow depended on modifying classical quality control IN ANY WAY would be erroneous and would invite misunderstanding. Free, public, self-archiving is a SUPPLEMENT to classical peer review, not a SUBSTITUTE for it. We can have the optimal outcome while keeping classical peer review 100% intact.

Nor is there any reason to talk about changing the way scientists publish their results! The only thing wrong with the way they publish their results is that they are not available to everyone online for free. To achieve that, all they need to do is make them available to everyone online for free! All "current practises" continue: Papers continue to be submitted to the author's refereed journal of choice, as before, they continue to be refereed, as before, and if accepted, they continue to be published in the journal, as before. But IN ADDITION to this, the author self-archives the unrefereed preprint at the beginning of this quality-control process, and, still more important, also the refereed reprints at the end of this quality-control process.

Here is where E-biomed plays its crucial role: in providing a reliable, lasting archive for the author to self-archive in, one that authors can trust, one with the authority and prestige to draw the entire literature to it, and one that will support authors in exercising their right to self-archive.

Unfortunately, the E-biomed proposal is a little vague on some of the critical points, as I will try to show below. These critical points concern the status of the established journals and classical peer review. As for the rest of the above, it is all fine, feasible, and desirable, but merely a SUPPLEMENT to current practises. This should be made crystal clear, for attempting to change current practises, particular along the lines of an untested alternative, can only induce confusion and opposition.

> A proposal for E-biomed

In the plan presented here, the National Institutes of Health----through the National Center for Biotechnology Information, a component of the National Library of Medicine at the NIH---would facilitate a community-based effort to establish an electronic publishing site, called "E-biomed." It is important to emphasize at the outset that in no sense would the NIH operate as the owner or rule-maker for this enterprise. We are proposing this plan in an effort to accelerate much-needed public discussion of electronic publication in the United States and abroad and to provide the financial, technical, and administrative assistance to initiate such a program.<

Here is the question to ask at this point, before misunderstandings accumulate and wrong assumptions and inferences are made:

Track A: Is E-biomed going to be a GLOBAL EPRINT ARCHIVE (like LANL), where authors can self-archive their papers? If so, that is fine, highly desirable, and should receive the highest encouragement. (And it should pool resources, experience and expertise with LANL, which is already supported by NSF/DOE and colossally successful

http://xxx.lanl.gov/blurb/ups.html

as well as with other current archiving initiatives such as the Scholar's Forum

http://library.caltech.edu/publications/scholarsforum

and NCSTRL http://www.ncstrl.org/

Track J: Or is E-biomed instead (or also, which is almost as bad) meant as a rival to the established, peer-reviewed journals -- essentially a RIVAL JOURNAL OR JOURNALS, providing peer review and certification? For if so, you are again needlessly changing two empirical variables at once: (1) free online self-archiving (proven, good) and (2) new online journals, with new, untested forms of quality control (again, risky, and counterproductive, for we already have plenty of journals, and there is no need to cast the new MEDIUM's lot with that of a new journal or journals, competing with the established ones).

> In the plan we envision, E-biomed would transmit and maintain, in both permanent on-line and downloaded archives, reports in the many fields that constitute biomedical research, including clinical research, cell and molecular biology, medically-related behavioral research, bioengineering, and other disciplines allied with biology and medicine.<

So far this is compatible with public, self-archiving, LANL-style, Track J.

> The essential feature of the plan is simplified, instantaneous cost-free access by potential readers to E-biomed's entire content in a manner that permits each reader to pursue his or her own interests as productively as possible. We have attempted to endow the plan with the flexibility necessary for evolution as patterns of use become established and as new opportunities for enriching the system are proposed. And we suggest a mechanism for governance (the E-biomed Governing Board) that involves all of the parties concerned---the scientific community (readers and authors), editors, computer specialists, and funding agencies.<

It is unclear what entities this passage refers to. Deliver a universal Biology Archive of self-archived unrefereed preprints and refereed reprints, LANL style and LANL scale (Track A), and the online frills will take care of themselves. They are not the controversial part. Don't overstructure this, especially on the basis of untested, unproven structures: Deliver the free online literature and everything else will follow suit.

> Copyright to reports posted in E-biomed would be retained by the authors, with the provision that intact versions would be freely available for transmission, downloading, and publication. Portions of reports could be reproduced only with the permission of the authors.<

Of course authors should and will retain ownership of the intellectual property they self-archive in E-biomed, just as when they self-archive in LANL, or in CogPrints (the Archive I founded in order to extend the LANL revolution to the Cognitive Sciences -- Psychology, Neuroscience, Biology [!], Linguistics, Computer Science, Philosophy -- all destined for eventual subsumption by LANL, once they attain critical mass).

http://cogprints.soton.ac.uk/

But this all goes without saying. (This report is a combination of substantive and important steps toward achieving the optimal outcome described above, together with solemn statements of the obvious! It might fare better without the latter, I think.)

> Scientific reports in the E-biomed repository would be submitted > through either of two mechanisms, as described in more detail in the succeeding sections. (i) Many reports would be submitted to editorial boards. These boards could be identical to those that represent current print journals or they might be composed of members of scientific societies or other groups approved by the E-biomed Governing Board. (ii) Other reports would be posted immediately in the E-biomed repository, prior to any conventional peer review, after passing a simple screen for appropriateness.<

This is the core of the potential problem, and (i) is unfortunately profoundly ambiguous:

If the "boards" are indeed IDENTICAL to those of current print journals, then submitting to E-biomed would be tantamount to submitting to one of those journals, which is perfectly fine, but then this is merely the "overlay" system already being worked out at LANL: One can submit to the American Physical Society (APS) journals by depositing the preprint in the LANL Archive and specifying which journal it is submitted to. The journal then proceeds with the refereeing of the article, as usual (except online, which is faster and more efficient, and is the way all journals are moving anyway).

If, however, the "boards" are not just the current journals (plus any new startups that might fledge), but RIVALs to them, then this proposal is conflating the establishment and encouragement of free public online archives with the establishment of new online journals -- a different proposition altogether, and definitely not one to which the fate of online self-archiving should be linked, for reasons I described in my critique of the CalTech proposal.

http://www.cogsci.soton.ac.uk/~harnad/Hypermail/Author.Eprint.Archives/

In contrast to (i), which concerns submitting to journals (old or new) through the Archive, (ii) simply refers to self-archiving in the archive. The latter is the generic category, however; the rest is just about TAGGING (is this self-archived paper "U," an Unrefereed Preprint, or is it "R," a Refereed Reprint? -- and if the latter, what Journal "X"?). The rest is just about sectoring the Archive: If Journal X has its own overlay, as the APS journals will have in LANL, then the author can submit to it via E-bionet, and if a final draft is accepted, it can receive an authentication tag not only from the author, but from the publisher, certifying that it is indeed the published, final draft. Search engines can then filter with that tag.

But underneath, generically, all we have is (i) self-archiving and tagging of preprints and reprints by the author, and (ii) authorised overlays by the journal publishers (whether the "new" rival journals, or the established ones, but if it is to include the latter, you must work to include them, as the APS was included in LANL: there will be resistance, though, as Floyd Bloom's Science Editorial indicates; NIH, however, can be a great asset in helping to persuade publishers to collaborate rather than compete with the optimal outcome for research and researchers).

http://www.cogsci.soton.ac.uk/~harnad/science.html

> (i) Submission to E-biomed through editorial boards

The first of the two mechanisms that authors would use to enter new scientific reports into the E-biomed database is closely aligned with current practice and retains scientific review as a prerequisite to publication. Authors would submit reports electronically to the central server, requesting review by the editorial board of an indicated journal in an appropriate field.<

If this refers to the current established peer reviewed journals, it is a splendid idea, exactly along the lines of the APS/LANL overlay. But if it refers only to "new" journals one hopes to spawn along with the Archive itself, it will only lead to trouble. Submitting for publication through the Archive is only attractive to authors if they can submit to the prestigious, high-impact journals of their choice -- not if it is to new, untested entities.

Work out agreements with a sufficient proportion of established journals, as in the case of APS/LANL, and this will be a highly attractive feature, and will hasten the success of the E-bionet Archive. But provide only the promise of some sort of peer-reviewed publication, and conflate it with the primary goal, which is self-archiving itself, and the only result can be confusion and resistance. This point MUST be clarified.

>If, after review, the report is accepted for publication in either its original or a revised form, the edited version would be posted immediately in E-biomed, and its title and list of authors would appear for a fixed period in the current table of contents for that journal. Later, it would continue to be accessible through the E-biomed search engine or through the journal's home page, annotated with the dates of submission, revision, and acceptance.<

This has the same ambiguity as the prior passage. If we are talking about new entities, prospects are bleak. If we are talking about the established journals, then don't you first need their collaboration in this? Will they agree to allowing their authors to self-archive their preprints in the first place? They ought to agree, but currently many explicitly do not (Science, and the New England Journal of Medicine are examples that immediately come to mind). Rather than announce it as a fait accompli, a priori, that established journals will allow their authors to self-archive online preprints and to submit to the journal via the Archive, I suggest you confirm this with a sufficient number of them so that you have a viable and attractive package to offer prospective self-archivers. (And if not, then drop the option for now.)

And it's not over with the unrefereed PREprint and the submission, for the journals will also have to agree to having the refereed REprint appear publicly for free in E-bionet. Again, they OUGHT to, and I don't doubt that they eventually will, in view of the optimality of the outcome for science and scientists, but we are not there yet, and there are quite a few critical transition points we still need to get through to get there.

The APS have officially granted all their authors the right to self-archive both their unrefereed preprints and their refereed reprints; this is partly because the APS is a very enlightened and progressive Learned Society, with an especially progressive and benign Editor in Chief, Marty Blume; but it is also true that Physics is the discipline which spawned LANL, and LANL is a fait accompli: Hence the whole field was, de facto, archiving all its preprints and reprints online already, well before any official overlay, collaboration, or PERMISSION from APS.

That is why the path of a prior agreement with journals in Biology is a much less sure one than one in which we set aside any promise of offering the capability of submitting to refereed journals through the E-bionet. Authors should simply be encouraged to self-archive all preprints and reprints, as they did in LANL. The rest will take care of itself. Waiting to build in, in advance, what LANL only gained by first SUCCEEDING as a self-archive risks preventing E-biomed from hastening us on the road to the optimal.

> If an editorial board judges the report unsuitable for inclusion among its own listings, the authors could resubmit the report for review by another board, defer further attempts to disseminate the findings, or publish in E-biomed through the alternative mechanism described in part (ii).<

This passage is beginning to compound the ambiguity I mentioned above, and to build it into a hypothetical structure with less and less basis in reality.

What is the "editorial board" above? One of the established journals? Then you are simply referring to conventional rejection and submission to another journal. If you mean "new" entities, it is not at all clear what all this is about. So I will assume you mean conventional journals. In that case, this passage is just stating the obvious: Of course, as always, if one journal rejects your paper without requesting revision and resubmission, and you still believe your paper worthy of publication, you submit to another journal. Why restate the obvious in this context? Stick to what is relevant and unique to free online self-archiving: An unrefereed preprint can always be archived, tagged and accessed as such: an unrefereed preprint, "U".

"Listings" somehow slipped in here too, and again it sounds like some sort of fantasy to the effect that there is more to all this than just self-archiving and journal submission: But journals publish, they do not "list." They publish what their referees and editors judge to be acceptable, and they tag it accordingly. The tag "JX" (eventually authenticated by an official journal overlay but good enough for now if the author so tags it) is all that's needed so that someone wanting to search through (or to point an automating alerting agent at) only the contents of Journal JX can do so, via the Archive.

("Content lists" and "issues" are outmoded papyrocentric concepts, not relevant to the online medium. To make this proposal credible, these should be eliminated, as they only encourage others to think in old and incompatible ways too!)

> Electronic publishing provides an opportunity to offer a third outcome to the review process, one that provides a novel solution to one of the most commonly encountered problems in current editorial practice. If a submitted report is deemed by an editorial board to be worthy of attention by some segment of the scientific community, but judged not to meet the criteria set for inclusion among a limited number of prime listings, the editorial board could still accommodate the report by choosing to maintain one or more additional listings. These additional listings might be grouped by specialty or simply designated as a larger, less exclusive version of the primary listing. Authors of reports that meet the criteria set for these listings---which, while less prestigious, still denote review and endorsement by the journal's editorial board --- could then elect immediate posting in E-biomed.<

This begins to become more and more hypothetical. Current established journals' only "listings" are the contents of the issues and volumes of papers they have accepted. They do not have different "levels" of acceptance. There do exist different levels of publication, however, and these correspond to the established hierarchy of journals: They differ in prestige, impact factor, rigour of peer review, and specialty/generality. If we are talking here about established journals, then these distinctions will continue to exist in the Archive, and will be marked by the journal tag, JX, JY, just as they are now, in paper. If a paper is not good enough for journal JX, it can be submitted to JY etc. If it is eventually accepted, that will be its tag, and that will be the journal that "lists" it.

But I am afraid that some "new" kinds of journals are being imagined here, untested ones, based on probably incoherent notions such as "listings" at different "levels" in the same "journal" by new kinds of "editorial boards."

To get into this is to get into open-ended experimentation with quality control and tagging -- a worthy long-term endeavour in itself, but not relevant to the much bigger and more immediate objective of freeing the literature for one and all online! There, it can only confuse and retard, with armchair notions, when the path to the optimal outcome (see your own first paragraph) is much clearer if unencumbered by these irrelevant side-issues.

> (ii) Submission to E-biomed through the general repository

Authors would also have the option of entering scientific reports directly into the E-biomed repository without soliciting endorsement by the one of its editorial boards.<

This is of course one of the primary functions of the archive: Apart from (a) submitting preprints for refereeing directly to journals via an Archive Overlay, and apart from (b) self-archiving already refereed reprints, one can also simply (c) self-archive unrefereed preprints.

That is exactly what it is; that is how it should be portrayed. The importance of these functions, by the way, is exactly the reverse: The most important is (c), for that is what a free, online, refereed literature consists of. The unrefereed preprints (b) are important too, and will speed communication and research in many cases. But the overlay agreements with the journals (a) must await developments, is not critical to the success or functions of the Archive, and certainly must not be waited for (or promised in advance).

> Before publication in the database, each report would need to be approved by two individuals with appropriate credentials. These credentials, to be established by the E-biomed Governing Board, should be broad enough to include several thousands of scientists, but stringent enough to provide protection of the database from extraneous or outrageous material. (Such credentials might be membership on any approved editorial board or receipt of a research grant from a reputable funding source. The Governing Board would establish mechanisms to ensure that authors need not personally know two validators in order to have their submissions considered for deposition in E-biomed.)<

This is potentially a bit confusing. Are there to be self-archived, unrefereed preprints, with no one's endorsement, plus self-archived, unrefereed preprints with some specialists' endorsement too? Fine, but why add these arbitrary extra features a priori? Perhaps people will want extra tags like this in calibrating their online browsing and reading: They might want a restriction that is somewhere between looking only at (1) papers that have been accepted by specific refereed journals, and (3) papers that have been accepted by no journal at all, in the form of (2) papers that have been vetted by an informal set of specialists. (But (2) is only possible on the untested assumption that peers are available to do more refereeing, and more levels of refereeing, than they already do now -- for peer review, at every level, is a scarce resource, and cannot be assumed to be compliant and available.)

But this all seems to be a pig-in-a-poke. We don't know whether peers will do (2); we don't know whether authors will want (2); we don't know whether readers will find (2) useful. Whatever is the case, (2) is a an uncertain extra feature, and certainly not a precondition for Archiving!

(And is all of Biomedical Science really just "several thousands of scientists"?)

> Criteria for approval of reports must be sufficiently firm to guard against gross abuse of the E-biomed repository, but sufficiently flexible to permit rapid posting of virtually any legitimate work.<

[Note added later: Paul Ginsparg has explained to me that this level of vetting was meant to be very rudimentary, simply to filter out crank and crackpot deposits. That is certainly a good idea and should be practised by every Global Archive, but especially a Biomedical one, where considerations of public health are involved.]

> At any time thereafter, the authors would be free to solicit review and endorsement from a specific editorial board as a means to provide greater prestige and visibility to a paper. Alternatively, interest in such reports could be enhanced by attaching to them informative commentaries written by other investigators.<

UNLESS the above is simply stating the obvious -- which is that papers self-archived in E-biomed as unrefereed preprints can also be submitted for peer review to journals, possibly through Journal overlays in E-biomed itself, and if accepted, can then appear in E-biomed also or instead as refereed reprints -- this again sounds like needless armchair fantasizing (neither necessary nor helpful to the Proposal, in my opinion). It just mixes up what is attainable and important with speculative scenarios that may or may not prove viable and useful some day, but on which nothing now is or ought to be dependent.

[There is an echo here of a naive proposal we here over and over again, that open commentary might somehow substitute for peer review: I would suggest emphasizing that the Archive will contain self-archived commentaries too, both unrefereed and refereed, and that these may be linked to the articles, but don't associate the Proposal any more closely with the quackish idea that spontaneous opinion polls could serve as a basis for calibrating one's reading.]

A word: If the entire preprint and reprint literature were freely available online, MUCH better ways of "publicising" one's work as well as of finding the work of others will evolve. Don't try to constrain it with the weak papyrocentric intuitions we have about this now, when the literature is mostly still on paper, and the little that is online is still behind financial firewalls.

> Initially, some authors might hesitate to try this route or might use it only to report information perceived to be difficult to publish in current journals. With experience, however, this mechanism is likely to become commonly employed because of its simplicity, flexibility, and speed; because electronic search engines are much more powerful than visual scanning of tables of contents to find relevant articles; and because other instruments (novel peer review mechanisms, appended commentaries, citation counts, and accession data) can be used to enhance the status and prominence of a report.<

And all these potential powers of the online medium are just as valid without these little speculative variants on peer review: They would be there if we just got the classical preprint and reprint literature online and freely available in E-biomed!

Commentaries are a whole new dimension:

Harnad, S. (1979) Creative disagreement. The Sciences 19: 18 - 20.

Harnad, S. (1984d) Commentaries, opinions and the growth of scientific knowledge. American Psychologist 39: 1497 - 1498.

Harnad, S. (1998) Learned Inquiry and the Net: The Role of Peer Review, Peer Commentary and Copyright. Learned Publishing 4(11): 283-292 http://citd.scar.utoronto.ca/EPub/talks/Harnad_Snider.html

> Open access to scientific reports and assembly of personalized journals

E-biomed would allow each user to invent his or her own "virtual" or personalized journal, by downloading the reports he or she would like to read that week.<

This too is an outmoded papyrocentic idea. Searching with the help of tags and links is the online way, along with automatic personalized alerting agents. Journals just become quality control tags; otherwise, they are an outmoded concept.

> Improved format for publication of modern biology

Obviously, especially with online searchability and availability of the entire corpus, including citation interlinking.

More rapid dissemination of scientific information

E-biomed would markedly speed up both the review and production processes currently used in scientific publishing.<

Yes, immediate electronic availability speeds up availability itself, and online peer review is faster than paper/mail. But referees' work stacks will not get smaller, and there are still only 24 hours in their days. As it stands, parts of this draft of the proposal would entail using up MORE of the finite pool of scarce referee-hours doing things that were not done in classical peer review. That could actually slow the whole system down, if it really caught on (but there is reason to doubt it would catch on, and no real reason to speculate about it one way or the other, for the core purposes of this proposal).

>Moreover, many fewer reports would be sequentially reviewed by more than one editorial board in order to find a publishing outlet;<

It is not at all clear why this proposal would lead to this, rather than the opposite! But I strongly suggest that E-biomed stay out of the peer review business (leave to the experts, who are doing well enough already) and our of peer review reform (leave that to quality control researchers, who can apply their tested findings to improving peer review, once they have some findings!).

>Reduced costs

Scientific journals are inherently costly. The price of publication and distribution is presently levied on users in a variety of ways: subscriptions to libraries and individual readers for print and electronic versions; page charges to authors; and the time and labor required to maintain and use libraries. (The expenses currently incurred by institutions have recently been the subject of a much publicized scholarly report---accessible at http://jan.mannlib.cornell.edu/jps/jps.htm---and have even been held responsible for the decline in publication of academic monographs [see "The New Age of the Book" by Robert Darnham in The New York Review of Books, pp.5-7, March 18, 1999 http://www.nybooks.com/nyrev/WWWarchdisplay.cgi?19990318005F].)

While our proposal cannot eliminate all of the costs associated with scientific publishing, movement to an electronic format is likely to reduce those costs dramatically (see an essay by Odlyzko for one account [http://www.research.att.com/~amo/doc/competition.cooperation.pdf. The most crucial effect of cost reduction would be the opportunity to remove price as a barrier to individuals seeking any of the vast information deposited in E-biomed. It would also offer savings to individuals, laboratories, institutions, funding agencies, and the editors and publishers who move to electronic formats.<

I think this proposal is extremely vague on the subject of cost and cost-recovery. One CAN be much more specific about this subject, but for E-biomed's immediate purposes there is no need at all to be more specific -- in which case one should not claim to have done so:

This proposal is mute on (1) how to make the transition from paper to online-only publication of journals, (2) how to recover the remaining costs of quality control. I have tried to sketch out a way http://www.cogsci.soton.ac.uk/~harnad/nature.html based on switching to cost-recovery from up-front page-charges, but the promotion of universal self-archiving by authors does not require a commitment to any specific transition scenario. It is best, though, not to claim to have helped solve cost-recovery problems that publishers are very likely to energetically dispute!

E-Biomed is offering authors an archive to self-archive their unrefereed and refereed papers. If they use it, this will, inter alia, provide the refereed journal literature for free. Only then will we have to worry about how to restructure journals to keep them afloat. But E-biomed certainly does not have any proposal for this, so it would be much better to drop any mention of a problem for which no solution has been provided.

> Other possibilities

E-biomed is designed to evolve in ways that might affect the way we practice science.

In an electronic publishing system, it is possible to engage electively in a more open reviewing process---one in which critiques of the scientific reports are accessible and possibly signed. This development, if widely accepted, could offer many benefits: more responsible reviews, an instructive and ongoing public conversation about published work, and career rewards for useful commentaries about work done by others. These reviews could be part of the vetting process that awards authors with a place on a table of contents of an E-biomed journal or they could be post-publication reviews appended to entries in the general E-biomed repository.<

See references on the differences between Peer Review and Peer Commentary, above. As in the other cases, the latter is a supplement to, not a substitute for, the former. And there is an empirical literature on the role of factors such as anonymity to supplement one's armchair intuitions on such questions. The Proposal does not gain strength and credibility but loses it when it is weighed down with unsupported armchair speculations.

The substantive core of the E-biomed Proposal -- an archive for author self-archiving -- is rock solid, feasible, and has strong empirical support. The speculative reforms are best left for another project, where there is no risk that they will drag down an already seaworthy and urgently needed vessel.

> Electronic publication could allow the amendment of reports, permitting authors to transmit additional information that might not warrant a separate report. Versions of reports containing supplementary information would be announced and clearly denoted as such, while the original versions are preserved as a 1.0 file for the historical record and downloaded for safekeeping<

Yes, self-archiving includes the possibility of self-archiving of updates and revised new editions of a paper, refereed and unrefereed, and linking to them, as well as to comments and responses (and to papers cited).

> The active E-biomed process might be accompanied by a much-needed effort to convert material already published on paper to digital text and image format, with hyper-linked citations. This additional initiative would ultimately allow all users of E-biomed to move seamlessly through the entire body of reported information in biomedical sciences. And it would also enhance scientific productivity and reduce burdens on library facilities.<

Very useful and desirable; copyright questions to resolve, however. And unless authors do their own scanning in and OCR for their own old texts, the cost of centralized scanning and digitization could be used as grounds for erecting permanent access-tolls to the retroactive literature, which would be a great pity for all. An outright subsidy would be preferable to reinstituting S/L/P for the pre-E-biomed retrospective corpus.

[Of course living authors can and should scan in and self-archive all their own retrospective work along with self-archiving their current work.]

>One further, less tangible benefit might also occur as a natural outcome of shared use of E-biomed: a heightened sense of community among biomedical scientists. This might be conducive to the adoption of uniform standards for sharing the data and providing access to the research tools described in E-biomed.<

Certainly sharing a uniform, universal resource, with shared metadata tags, will help to standardize and make the literature more interoperable.

>How do we guarantee equity in the new system?

Although the current system of scientific publishing can be criticized for lapses of fairness, it has, in general, served us well. Thus any new system must be developed with concern for the ambitions of trainees, little-known scientists, or scientists at less prestigious institutions or foreign sites. Clearly, electronic communication has enormous advantages for people in all of these categories, because it is a democratizing force that makes distance and wealth nearly irrelevant. However, it is important to ensure that opportunities to enter reports into E-biomed are just as rich as the opportunities to access the reports filed by others. The editorial boards and the Board of Governors will need to give careful attention to this issue; for instance, it will be imperative to provide a means for any author, however remotely located or poorly known, to have access to two "members" of the system to validate reports submitted to the general repository.<

This seems to be a pseudo-issue, unless the worry is about authors who have no access to the Web at all. If quack-vetting is feasible at all, there is no reason why any worthy paper should be at a disadvantage. Much more relevant and important is the democratization provided by the very existence of the online corpus, free for all. The access barriers were the greatest inequity of all. (Best to put this in context, rather than create needless pseudo-issues.)

>How should E-biomed get started?

Does the plan make sense? Is it likely to achieve the benefits we ascribe to it? Are there other (better) ways to achieve them?<

The self-archiving makes eminently good sense, and is a principle that has already been tried and has had resounding success in Physics. Plenty of empirical basis for extending it to Biology.

The speculations about peer review the vague promises about collaboration with journals, old and new, are on much weaker ground, completely unnecessary, and in my opinion considerably weaken the proposal. The archiving has face validity; the refinements on peer review and the relations with journals are just notional. Best to completely uncouple the former from the latter, rather than dooming them to a shared fate.

> How should E-biomed be financed and managed? The NIH is prepared to provide funds and expertise to initiate the project. Should other funding agencies, in the U.S. and abroad, also support it? Or should funds be developed through other mechanisms, such as "submission charges" paid by authors?<

Only the archiving facility needs support (not the refereeing system innovations or the journal structures). This could be partnered with NSF/DOE's LANL Archive, the Scholar's Forum initiative, and the ACM's interoperable Gateway, NCSTRL, which will unify it with local institutional Archiving Initiatives. One foreign partner could be the UK's JISC eLib Electronic Libraries Programme, which is already partnering with NSF and LANL. INSERM in France is contemplating taking such steps too. The objective should be a worldwide, free archive for the current research literature in all disciplines. The first form this should take is an Archive for self-archiving by authors. CogPrints (funded by JISC eLib) has adapted the LANL interface to generalize it to other disciplines. This will be further adapted in conjunction with a new JISC/NSF project to citation-interlink the entire contents of the LANL Archive. NIH would be a welcome partner in all this, and all resources could be shared.

>What should be the composition of the E-biomed Governing Board? And how much authority should the Governing Board have over the functions of editorial boards that participate in E-biomed? What responsibilities should the Board have beyond developing rules of operation, producing an annual budget projection, negotiating with groups asking to establish editorial boards, and resolving disputes?<

In my opinion, this is all irrelevant. E-biomed should not get into the editorial-board and peer-review business. It needn't, and that has nothing to do with the goal, which is to make the entire reprint and preprint literature available online for free for all. I strongly counsel you to drop all this refereeing-reform and journal-overseeing if you really want to speed things on the road to the optimal. Otherwise you will instead become involved interminably in Quixotic reform proposals that have little to do with the goal that motivated the whole undertaking, as described in your own Prologue!

> Once these and other questions have been considered, the NIH will publicize an appropriately modified proposal, assemble the Governing Board, and establish the E-biomed site with the Board's guidance.<

I have been at so many meetings, in so many countries, in so many disciplines in the past few years: Almost all of them want to make a "policy statement" about what to do in the "electronic communication revolution"; they want to make recommendations to governments; they want to publicize in the general press. But none of them has a coherent picture or plan. I just dissuaded the Commission of the German Learned Societies from drafting a letter to the Science Minister triumphantly announcing that the way of the future was "National Site Licensing (NSL)," along the lines of BIDS in Britain. (Utter nonsense: NSL is a Trojan Horse, one of the three horseman of the Trade Troika, S/L/P, which are actually responsible for keeping this entire literature -- (the refereed journal literature), unique for being freely donated by its authors -- separated from its readers by a spurious financial firewall.)

Please don't now tell the NIH's governing Board that the way to free the literature is to set up all kinds of new pig-in-poke reviewing and editorial structures, in the hope that editors/referees will collaborate and that authors will prefer them! The real message is simple: Provide the resources and incentive for universal self-archiving of preprints and reprints, as NSF/LANL does with such colossal success and utility, and the rest will take care of itself!

If you want a model, and proof of principle and practise, just copy (or better, collaborate with) LANL!

> Summary

The advent of the electronic age and the rise of the Internet offer an unprecedented opportunity to change scientific publishing in ways that could improve on virtually all aspects of the current system. The NIH has addressed this opportunity by proposing a new system, E-biomed, that has many advantages over the existing means of disseminating research findings: open access, greater speed, reduced cost, and enhanced depth of presentation. We now welcome constructive comments from the scientific community, with the intention of putting a suitably revised plan into operation in the near future.<

All these virtues are already there, demonstrated and realised, in LANL. Don't take something known that works astoundingly well, and turn it into something unknown that may not work at all, by getting it mixed up with notional peer review reform, with which it has no intrinsic connection.

Stevan Harnad
Professor of Cognitive Science
Department of Electronics and Computer Science
University of Southampton
Highfield, Southampton

I don't get involved in these things very often, but just let me say that the publication of an electronic journal, supported by the NIH, as described in the Varmus proposal, is among the very WORST ideas I have ever heard. I certainly don't mind it if someone wants to start a new journal, although I cannot imagine a need for one. However, if any part of this is not to be very carefully peer-reviewed, it will inevitably become a massive repository of taxpayer-supported junk that very few will read. Even worse, since it will be supported or sponsored in some way by the NIH, it will be perceived as being legitimate, and masses of unsubstantiated reports deposited there will be used to prop up bad legislation and bad policies in Washington. This proposal is not just bad, it is dangerous and has the potential to undermine the science that NIH is trying to support.

The reasons put forward to support this proposal do not have much substance, and it sounds a lot like a method to get around the peer-review system. We all take our lumps in this system, but to weaken it would hurt all of us much more.

Please don't do this!

Mike Cox

Neil H. Mendelson, Professor, University of Arizona, May 6, 1999

Dear Dr. Varmus,

I am anxiously awaiting the implementation of E-biomed for the following reasons:
i. It is going to save us an awful lot of wasted time now spent pursuing the conventional publication process.
ii. It has the potential to bring inter- or multi-disciplinary work, work on unusual systems, and other non-conventional findings to the attention of a broad audience.
iii. It will provide an excellent opportunity for distributing images and film sequences that are difficult to include in conventional publication although some effort is now being made by journals to accommodate data of this sort.
iv. Electronic publishing could in fact be a way to archive full data sets, research film collections, image collections and the like, in contrast to the tip of the iceberg that now appear in conventional papers.
v. New discovery and new ideas are becoming more and more difficult to publish in most specialized journals. The tendency is to favor conventional experimental approaches and results that are in the mainstream. Submission of E-biomed postings through the general repository would provide an excellent way for something different to get a hearing. I suspect many future directions that go beyond current trends will make there appearance in these postings.
vi. Have you considered having all submissions posted to the general repository and passing the job on to the journals to bid for the papers they want instead of having authors do so initially?
vii. My colleagues in physics and math frequently post their papers in an electronic data base at Los Alamos either prior to sending them to print journals or as the sole means of distribution. Putting a paper on the net in E-biomed before submiiting it to a print journal in biology would probably violate the "has not been published elsewhere" constraint. This might be a talking point with the journals however, particularly if they see that something like E-biomed is likely to obsolete them and their profits.

I have said too much already. The main point is that after 35 years of conventional publishing, and 20 years of working across disciplines to learn something about bacterial cells, E-biomed would be a welcome and significant advance. I suspect there are others with the same opinion.

Regards,
Neil H. Mendelson
Professor, University of Arizona

Albert Henderson, Editor, Publishing Research Quarterly, May 6, 1999

We share a vision of effective science using the rapid communication features of information technology. We differ when it comes to the means of reaching this goal.

My comments focus on

(A) problems inherent in the present rather radical proposal and (B) solutions that I believe you have not considered

The complaint of NIH director Harold E. Varmus that, "researchers spend hundreds of dollars of their NIH awards on subscriptions to scientific journals," (1) reveals serious defects in policy choices made over the last 30 years or so. Using grant money for subscriptions has always been an option. My recollection is that universities, not research grants, once paid for most subscriptions found in offices and laboratories. Universities canceled most such "duplicates" in the 1970s. In recent decades, over the protests of faculty and faculty senates, universities continued to cut library spending. They have been canceling the last remaining copies of many journals. (2) Studies indicate nevertheless that researchers use libraries more than ever, with library borrowing rates sharply increased. (3) It also appears that better financed researchers now order their own copies of journals no longer found in the library. Although they purchase these publications with public money, they neither share them generally nor maintain formal collections. In other words, local colleagues may still have to order interlibrary photocopies of articles that they identify via information services and citations rather than browsing.

Vannevar Bush charged universities with the responsibility to conserve knowledge as part of the government-academic research partnership. (4) It was a Faustian bargain. Instead of maintaining information produced and used by government research programs, universities cut library spending (and Federal agencies permitted it!). Universities seek further relief from library costs, even in the robust economy of the 1990s, while confessing that the imbalance between library and research growth is a source of serious problems. (5) The millions of dollars of subscriptions now paid by research grants, described by Dr. Varmus to Congress, represents the unloading of universities' traditional responsibility onto researchers who have grants. The cancelations also drove publishers' prices upward, providing a foundation for denunciation and calls for new solutions. Taking the prospect of "no library" another step, provosts at CalTech and elsewhere propose that researchers divert even more grant money to self-publishing their work. (6) The present proposal falls directly into this trap. It would make it easy for universities to justify the further elimination of their subscriptions to advanced research journals and information services by shifting the full responsibility for conserving knowledge to the government.

The present proposal serves such financial goals without realistically solving problems in dissemination and the quality of research. I note generous use of the appeal of "free" information. What is the cost to the taxpayer? How much equipment, labor, time, and other resources will be needed? How many articles a year will be served electronically? What about standards and obsolescence? Who will pay for equipment required for access? What will be the impact on scientists and institutions who are not fully wired? What will be the impact on the use of publications produced only in paper, including the corpus of previously published literature? Will NIH take responsibility for digitizing that? What about copyrights? There are also major questions of permanance being asked about the use of fragile storage for journals often called "archival." How will the E-Biomed proposal deal with the growth of science -- now generating millions of articles a year and growing exponentially? Is NIH prepared to face Congressional challenges to technology that is far from perfect? I am certain there are other good reasons that faculty who quickly embraced email, bibliographic databases, mainframe computing, and laptops are reluctant to join administrators' undaunted support of support electronic journals.

I believe Federal agencies were in error when they ended studies of science communication in the mid-1970s. The present proposal has no recent science or scientists to provide a context for evaluation. It has only lobbies with financial, rather than scientific, priorities and enthusiasts who more often than not have no experience as publishers. Many recommendations of pre-1977 studies meant to improve dissemination. They were ignored, even after such goals were explicitly adopted by the National Science and Technology Policy, Organization, and Priorities Act of 1976. (Public Law 94-282; 42 USC 6601+) (7) The incorporation of library fair use into the 1976 copyright law apparently misled policy makers to the presumption that photocopies would solve all dissemination problems. Researchers obviously did not agree. They simply circumvented the bureaucracy, its decimated library collections, and the red tape of interlibrary photocopying. They ordered their own subscriptions. As a promise of better dissemination, photocopying backfired by justifying substandard library collections. Twenty years later, it still takes an average of two weeks to obtain an interlibrary loan. (Many referees are asked to respond in that time.) The present proposal echoes the unfulfilled promise of the plain paper copier.

If NIH truly wishes to improve dissemination, it must have the courage to ask how the unarticulated policy that bars its evaluation of its researchers' information resources -- mainly academic libraries -- interferes with its mission and its performance. The systemic impoverishment of academic libraries created a bottleneck in communications and a hostile environment for investment of resources. (8) One of the worst effects has been publishers' curtailment of editorial coverage of indexes. (9) It is questionable whether one can prepare a comprehensive review relying on Biosis, Index Medicus, Agricola, and other bibliographic databases. (10) It was the forbidding commercial nature of the library market that led the American Physical Society and many others to avoid aggressive investments in electronic publishing. (11) This opened the door for Paul Ginsparg's experiment in welfare for rather rich scientists and universities. It also provides the foundation for lobbying that spurred the E-Biomed idea.

NIH's earlier adventure with preprints, in the 1960s, ended in disaster. (12) Plunging into commercial conflict now with thousands of privately-owned science journals and indexes will end similarly. It can only aggravate the present defect in policy.

A proposal with striking similarities to E-Biomed was made to the Senate committee on government operations shortly after Sputnik. Modeled on the Soviets' unified information system, it was quickly rejected. (sorry I don't have a reference handy) Policy focused then on improving libraries and encouraging the development of electronic bibliographic databases by organizations with appropriate experience. The 1960s became a period remembered for its outstanding accomplishments in research and development as well as for the development of electronic bibliographic services, translation journals, author prepared cold-type publication, and the science citation index -- all developed in the private sector, many by entrepreneurs.

First, recalling this highly successful solution to the Sputnik situation, I suggest another path you must consider. The tenets of Federal policy promise a fair share of the indirect costs of research. (13) Government science accounts for sixty per cent of academic research spending. Yet grant overhead allowances support only about ten per cent of library spending at research universities -- none of it tied to purchase of journals. If libraries matched the growth of research, neither NIH nor its scientists would complain about dissemination. Backlogs of accepted articles would be lower and information technology would be more fully exploited. NIH would do well to investigate how better-financed and systematically evaluated academic libraries would further its interest in rapid dissemination. A more hospitable economic environment -- supporting robust academic libraries, open to the public -- would encourage private investments in technology, synthesis, indexing, and competition.

Second, as a government agency, NIH also has a perfect right and a moral responsibility to qualify research contractors' equipment and resources. The present blind spot has done more to promote mediocrity at research universities than any other policy. I question whether researchers at an institution with spotty local resources can prepare effective proposals and provide reliable peer review.

Finally, there are good reasons that there are thousands of journals rather than a single unified "government" system envisioned under E-Biomed. Solutions to dissemination should evolve as they have since Henry Oldenberg launched the Philosophical Transactions, aiming for a commercial profit of 40 pounds a year. That would leave the economic risks and opportunities in the private sector, where they belong.

Sincerely,
Albert Henderson, Editor
Publishing Research Quarterly

References:

1. Paulette Walker Campbell. 1999. NIH may use the internet to distribute findings of research financed by its grants. Chronicle of Higher Education. 45,35:A33. (May 7)

2. Albert Henderson. 1999. Information science and information policy. The use of constant dollars and other indicators to manage research investments. JASIS: Journal of the American Society for Information Science. 50,4:366-379.

3. Carol Tenopir and Donald W. King. 1997. Trends in scientific scholarly journal publishing in the United States. Journal of Scholarly Publishing. 28,3 (April):135-170.

4. Vannevar Bush. 1945. Science -- The Endless Frontier. A Report to the President on a Program for Postwar Scientific Research. Washington DC:National Science Foundation. Reprint 1990. NSF 90-8.

5. Anonymous. 1998. To Publish and Perish. Policy Perspectives. 7,4. (March) Co-sponsored by the Association of Research Libraries, The Association of American Universities and the Pew Higher Education Roundtable. Published by Institute for Research on Higher Ecucation. http://www.irhe.upenn.edu/pp/pp-main.html

6. Lisa Guernsey. 1998. A provost challenges his faculty to keep copyright on journal articles. Chronicle of Higher Education. 45,4. (Sept. 18).

7. Charles R. McClure and Peter Hernon. 1989. U.S. Scientific and Technical Information (STI) Policies: Views and Perspectives. Norwood NJ: Ablex.

8. Albert Henderson. 1994-95. The bottleneck in research communications, in Publishing Research Quarterly. 10,4:5-21.

9. Richard T. Kaser. 1995. Secondary information services. Mirrors of scholarly communication. Publishing Research Quarterly. 11,3:10-24.

10. L. L. Deitz and L. M. Osegueda. 1989. Effectiveness of bibliographic databases for retrieving entomological literature: a lesson based on the Membracoidea (Homoptera). Bulletin of the Entomological Society of America. 35:33-39.

11. American Physical Society. 1991. Report of the APS task force on electronic information systems, in Bulletin of the American Physical Society. 36,4:1119-1151.

12. Eugene A. Confrey. 1966. (Letter) The information exchange groups experiment. Science. 154:843. (18 Nov.)

13. Vannevar Bush. Op cit.; J. Merton England. 1982. A Patron for Pure Science. The National Science Foundations Formative Years, 1945-57. Washington DC: National Science Foundation.

PS. Princeton professor Robert Darnton [not Darnham] is the author of the article in New York Review of Books.

Kenneth McHenry, M.D., J.D. former Anatomy Fellow at Univ. of Mo. Med School, May 5, 1999

Dear Dr. Varmus,

Your proposal for e-biomed is terrific and brilliant. May I give you an example, I am a physician and former researcher, with a disease known as Central Pain. It is just basically nerve injury pain from injury to the central nervous system. For some reason, doctors did not realize I had Central Pain, including the surgeons. They had not heard the term. Central Pain does not respond to opioids. Needless to say, there was tremendous confusion, fear, and suffering early on.

Through a peculiar set of circumstances I was led to John Bonica, who diagnosed the Central Pain, and then to Patrick Wall, editor of the Textbook of Pain.Dr. Wall asked me to begin a database of Central Pain symptoms. Since the symptoms are not experienced by anyone without the disease, there is really no vocabulary, no vernacular. Borrowing terms from nociceptive pain just confuses researchers. Dr. Wall hoped with my background I could classify the verbal descriptions so that clinicians would recognize Central Pain. We now have a database of over 100 people. These include those who got Central Pain after stroke, cord injury, MS, syphilis, AIDS, toxic exposures, and syringomyelia.

I have discovered patients who have the neuropathic pain in each pain system. For example, most have skin "burning", some have muscle spindle pain, and some have visceral pain. Ron Tasker, who discovered the function of the spinothalamic tract has said that Central Pain can be the worst pain known to man. Tasker trained Lenz at Hopkins and most of the thalamic pain experts in the U.S. I suspect almost no doctors are aware that Central Pain can present in these many different fashions. Tasker shocked the pain world by pointing out that a lesion anywhere in the CNS can give identical Central Pain. This is true, but our research indicates there can be discrete injury to various pain systems without involving others. PET scans on CP patients show perfusion changes in various areas. We are trying to correlate PET changes with "indescribable" clinical symptoms.

A volunteer operated a website for years to gather our data. (painonline.com) No one else has this kind of data.The problem is that most doctors do not realize which symptoms are neuropathic(part of the CP) and which are nociceptive. Many do not realize that pain from the sensory wing of the gamma motor system(sensory supply to themuscle spindle) can be part of Central Pain. In multiple sclerosis, "gamma pain" is known as "MS Hug", a feeling of tightness around the chest. Most MS docs do not know this is Central pain.

We would like to publish our results, but because I am now disabled and hold no particular credentials, I am not going to get through a peer reviewed article in a major journal. If e-biomed existed, where only a couple of referees would have to scrutinize our data, this would put important material in the literature online. A search engine for a doc who sees neuropathic pain could pull it up, however, and the patient would not be doubted who had some of these symptoms.

Dr. William Willis, the leading benchtop researcher on neuropathic pain has expressed reluctance to continue inducing Central Pain in rats (and squid), because of ethical constraints(the animals try to chew off affected limbs) re: inducing agony in animals. Paradoxically, at the same time, most neurologists reject claims of great severity in humans, yet CP is virtually the sole elective indication for brain ablation surgery! Until PET scans showed brain changes it was a hard sell to convince clinicians that something major was going on in CP. Humans with CP represent living, articulate laboratories and could contribute much to the understanding of neuropathic disease. A journal like e-biomed would bring much of this material to the literature much sooner.

The location and function of spinal tracts was discovered through humble research by autopsying those with spinal tuberculomas and then retrospectively looking at their history of neurologic loss. Nothing better has been published since. In fact, most spinal work has never been performed in humans. Axinos points out that there is no evidence proving that the posterior columns carry proprioception in primates. The large spinocervical tract in rats (pain from hair follicles) has never been described in humans and is not acknowledged to exist. However, we have CP patients who report not only pain but spatial windup from stroking hairs. This provides evidence for such a spinocervical tract in humans. Ironically, it is solely clinical evidence and so is not going to make the bigtime research literature.

The search for the neurotransmitter of pain is done mainly at NIDH. We feel e-biomed would allow us to come in at a slightly lower level peer review and make known material which is signficant. We hope you will continue with your plans for e-biomed as described and planned. We congratulate you on such a proposal. It democratizes the literature, allows for an alternative viewpoint, and gives smaller research efforts a chance to come forward.

Sincerely yours,
Kenneth McHenry, M.D., J.D.
former Anatomy Fellow at Univ. of Mo. Med School