Together with UC Davis Ophthalmology faculty member, Ala Moshiri, M.D., Ph.D., I published a commentary in the American Journal of Ophthalmology regarding the challenges to making off-label use of products a standard of care in retina therapies in ophthalmology. This continues a theme from a previous paper regarding this issue with antibiotics in cataract surgery. While off-label use and compounding medications on a patient by patient basis is supported by U.S. code, a more general policy for standard of care creates a narrow ledge for patients and physicians.
The American Academy of Ophthalmology recently updated its Glaucoma Practice Pattern. In this document, also published in the AAO’s Journal Ophthalmology, the Committee, headed by Steven J. Gedde, M.D., glaucoma is defined as a chronic, progressive optic neuropathy. The document then further describes the best practices for diagnosis, follow-up and therapy. Dr. Novack’s work on the issues of treatment adherence (patients taking their medication as prescribed) and performance (challenges to patients to properly use eyedrops). His work on novel therapeutics drugs and devices is also cited.
My article with Michele Lim MD is listed first in the American Journal of Ophthalmology, December 2019 issue. This was my personal patient’s view of retinal detachment, including my atypical presentation of symptoms. Colleague Dr. Lim added a perspective on Electronic Health Records – and why the federal mandate for EHR still does not mean interoperability – and thus why I had to give my patient information so many times in one day.
Academic journals have long worked on the “subscription model”, where print subscribers pay to read articles that, for the most part, authors submit for free. With the advent of digital content, the same model has been used – subscribers pay and author provide content for free. There is a shift to “open access”, which typically means that the authors pay upon submission, and readers view for free. Among the first quality journals adopting this model is PLOS One. Other quality journals are moving in this direction, and we are currently in a mixed model paradigm shift, where authors can pay for non-subscribing readers to have free access (“Open Access”). This is not to be confused with “predatory journals” – technically open access journals – but ones that are of low quality.
Universities, through a special application of the subscriber model, pay a subscription fee to allow their faculty and staff to have access to many journals, including those from Elsevier, Wiley, etc. Academic researchers find this tool of high value. For decades, there has been a symbiotic relationship. UC’s researchers contribute quality research for free to quality journals, which in turn publish the “peer-reviewed” paper, key to academic prestige. UC has paid for subscriptions. However, in the paradigm shift, academic authors are starting to have to pay fees – and thus universities are caught in a financial bind. There’s no increase in income for the Universities – yet universities are paying for both subscriptions and author fees for open access. In particular, this has been an issue for the University of California and one of the largest publishers of medical literature, Elsevier. In short, Elsevier’s view of the fees to be paid by the University of California in this transition phase were greater than what UC thought they should pay. This came to a head in January 2019, when it became public that the two were not able to come to a resolution (as discussed in a piece by University of California, Davis, University Librarian, MacKenzie Smith.
Throughout this period, University of California researchers still had access to Elsevier publications. That changed in early July, with Elsevier announcing that they are now stopping that access.
The impact of this decision has yet to be felt or fully comprehended.
(Disclosure – I am an alumnus and professor of the University of California, serve on the UC Davis Library Leadership Board, and an author, reviewer and on the editorial board for Elsevier journals).
In the 10 May 2019 issue of Science magazine, Assistant Professor of the University of Florida, Alan H Chambers, writes about his experience with a predatory journal. In a moment of weakness after rejection of a manuscript, he submitted it to a newly launched journal. It turns out it was a “predatory journal” in all aspects of the phrase. He realized his mistake and requested it be withdrawn. With a quality journal, this would be honored immediately. This journal demanded payment. Only with repeated demands from the University was the paper “let go”. The author also suggests ways to test a journal (e.g., look at the editorial board, contact them separately to confirm, etc.). Moral of the story – the pressure to publish are real – but don’t succumb to submitting to these journals.
In a recent editorial in EyeNet on the importance of collaboration in successful research, past-president of the American Academy of Ophthalmology, Ruth Williams, M.D. cites Dr. Novack. Dr. Novack stated “…You cannot be successful unless you realize that you do NOT know everything”. Further she states that “…major breakthroughs usually require a multi-disciplinary approach, ophthalmic researcher must recognize and woo individuals who may not currently be working on vision research”. A prime example of this is the Glaucoma Research Foundation’s “Catalyst for a Cure”.