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The Price of Publishing: An Investigation of the Open Access Landscape in Hand Surgery
The Price of Publishing: An Investigation of the Open Access Landscape in Hand Surgery Pooja S. Yesantharao, MS1; Chao Long, MD1; Meewon O. Park, BA2; Paige M. Fox MD, PhD2; James Chang, MD2; Gordon K. Lee, MD2; Rahim S. Nazerali, MD2 1. Department of Plastic & Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, Maryland, USA 2. Division of Plastic Surgery, Stanford University School of Medicine, Stanford, California, USA

Background: Open access publishing in hand surgery has rapidly gained traction. In fact, many subscription-based journals in the field have now adopted "hybrid" formats, to facilitate open access publishing. Prior literature has demonstrated that open access articles are more likely to reach a larger audience. However, there are also certain challenges with open access publishing: there are concerns that open access platforms do not uphold traditional standards for published research, and some open access journals are associated with "predatory publishing" tactics. This study investigated the digital landscape of open access publishing in hand surgery, to gain a better understanding of this publishing model in the field.

Methods: This was a cross-sectional bibliometric investigation of hand surgery journals. Three major publication models were investigated: (1) traditional, subscription-based journals (Hand Clinics), (2) hybrid journals (JHS - publish both open access and paywalled articles), and (3) open access journals (JHS GO). Three investigations were undertaken. First, longitudinal trends in hand surgery publishing were analyzed between January 2010-November 2020. Second, all hand surgery journals that met inclusion criteria were characterized with regards to features such as publication speed and impact factor. Third, all original hand surgery research articles from the first quarter of 2019 were extracted and analyzed for article quality/reach (i.e. Altmetric score).

Results: The study cohort consisted of 15 hand surgery journals. In 2010, only one English language hand surgery journal was open access, while the remainder were subscription-based. Conversely, in 2020, open access journals comprised 40% of all English language hand surgery journals online, while hybrid journals comprised another 40% and subscription journals comprised only 20%. Of the open access publications, one was identified to be predatory. Hybrid/subscription journals were significantly more likely to have affiliations with surgical societies (chi-square: p<0.001), have blinded peer review (chi-square: p=0.01), and be PubMed indexed (chi-square: p<0.001). Hybrid journals had the greatest social media presence (chi-square: p=0.007) and the highest median impact factor (Kruskal-Wallis: p<0.001). In fact, multivariable linear regression demonstrated that after adjusting for journal content, society affiliation, social media presence, and PubMed indexing, only hybrid journals were significantly positively associated with impact factor (beta coefficient: 1.2; F(5, 14)=980; p=0.03; R2: 0.84). However, hybrid journals had significantly greater median article processing charges than open access journals for open access publishing (Kruskal-Wallis: p<0.001). Consequently, for open access publishing, we found that impact factor and article processing costs were significantly positively correlated (Pearson's correlation coefficient: r(25)=0.39, p=0.04). Lastly, level of evidence offered by articles from open access journals versus hybrid/subscription journals differed.

Conclusion: Overall, this study demonstrated that there are many options for affordable, trustworthy open access publishing in hand surgery. Overall, open access articles had greater visibility than paywalled articles, and had more rapid publication speeds. However, open access journals can be limited in content originality/quality, and hybrid/subscription journals offered higher impact factors. Study findings were used to generate recommendations for navigating open access publishing in plastic surgery (Figure).

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