From...

May 7, 1999
Web posted at: 11:02 a.m. EDT (1502 GMT)

by Todd Woody

(IDG) -- Breakthroughs in medical research are often announced in the pages of the New England Journal of Medicine, Nature and other scientific journals. For academic scientists, publication in such distinguished periodicals is de rigueur for tenure. Now a Web health-care company is putting the rigor of a peer-reviewed publication on Internet time by launching the first online-only general medical journal.

The debut of Medscape General Medicine on Medscape, a Web site for physicians, could mark another turning point in the medical community's use of the Internet. Doctors and medical scientists increasingly go online to conduct research and share ideas. But they still rely on print publications like the Journal of the American Medical Association to validate their work. The publication process, which involves submitting papers for review by selected experts, typically takes several months.

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Medscape aims to shake up the status quo by offering a continuous publication schedule that will expedite peer review. Medscape General Medicine, known as MedGenMed, will also be free to the 180,000 physicians and nearly 1 million consumers registered on the Medscape site. Annual subscriptions to the top-tier print medical journals run between $129 and $159. To compete with such stalwarts as the 187-year-old weekly New England Journal of Medicine, Medscape hired JAMA's longtime editor, Dr. George Lundberg, to run MedGenMed.

"We believe the time is right for this approach," says Lundberg, who was noted for turning JAMA into a prominent medical journal before he was fired in January over the publication of an article about attitudes toward oral sex. "We believe the reach we provide authors throughout the world, the fact that Medscape is free to all and the rapid turnaround time we provide authors will be attractive."

According to Lundberg, reviewers will be asked to critique articles in three days. The New England Journal of Medicine gives its reviewers at least two weeks. "We want the immediacy of the electronic transmission method to import a sense of urgency to people so they [will] give us a much faster turnaround than they normally would."

MedGenMed has yet to publish its first article, but the new journal's ambitions have already raised the hackles of competitors who argue that such a fast-track schedule could compromise scientific accuracy.

"I don't think it is a good idea," says Dr. Jerome Kassirer, editor in chief of the New England Journal of Medicine. "You might get quick and dirty reviews."

Lundberg emphasizes that MedGenMed authors and reviewers will adhere to the same rigorous guidelines for the publication of medical articles that other journals follow.

"We believe the main delay is not the amount of time it takes to do the review. It is the amount of time it sits on someone's desk," Lundberg says. "We certainly don't want to compromise quality."

MedGenMed's emergence could add to the pressure the Internet has put on print medical journals. As early as 1995, the New England Journal warned in an editorial that, "Direct electronic publishing of scientific studies threatens to undermine time-tested traditions that help to ensure the quality of the medical literature."

The Net's ability to widely disseminate ongoing research challenges the journals' rule against accepting papers that have been published elsewhere in other forms. In March, for instance, the New England Journal informed its readers that posting audio recordings and slides from a medical meeting on the Net would not violate the rule against prior publication.

The New England Journal itself has expedited peer review and published articles on its Web site weeks in advance of print publication when the subject involved an important public-health issue, according to Kassirer. Although the full text of the New England Journal is online, only about 15 percent of the publication's 230,000 subscribers have signed up for the Web version, Kassirer says.

"People want to get their papers published in certain journals because they're considered prestigious," he says. "When you start a new journal, whether on a Web site or on paper, that type of prestige takes a while to build up."

If MedGenMed generates such authority, then one day soon aspiring scientists may be only too happy to submit URLs to their tenure-review committees.