J Med Libr Assoc 94(4) October 2006449
Awareness and attitude
of Spanish medical authors
to open access publishing and the
‘‘author pays’’ model
By Angel A. Herna ´ndez-Borges, PhD, MD,
Rau ´l Cabrera-Rodrı ´guez, MD, email@example.com
Abia ´n Montesdeoca-Melia ´n, MD, firstname.lastname@example.org
Begon ˜a Martı ´nez-Pineda, MD, email@example.com
Pediatric and Intensive Care Unit—Department of
Neonatology, Hospital Universitario de Canarias Tenerife,
Maria Luisa Torres-A´lvarez de Arcaya, MD,
Primary Care Center La Orotava-Dehesa Servicio Canario
de la Salud, Tenerife, Spain
Alejandro Jime ´nez-Sosa, PhD, Psych, firstname.lastname@example.org
Research Unit, Hospital Universitario de Canarias
Open access publishing (OAP) aims to provide com-
plete and free electronic access to scientific research
articles . Such access may be achieved via (1) open
access journals (i.e., journals permitting free access to
online content), currently around 2% of the total cor-
pus of articles in science, technology, and medicine ;
or (2) self-archiving on institutional or personal Web-
sites, which provides free access to post- or preprint
manuscripts. In addition to universal access to scien-
tific knowledge, the OAP model may result in consid-
erable savings for libraries  and the potential benefit
for authors of greater exposure to their works. How-
ever, to date, citations to OA journals have only slightly
increased compared to subscription-based journals .
With respect to funding, nearly 20% of OAP articles
have been produced by charging authors (or indirectly,
their organizations) through so-called ‘‘publication
fees’’ or ‘‘author fees’’ . The success of such journals
greatly depends on authors’ willingness to submit
their research to such journals despite publication fees
ranging between $350 and $1,000 USD. It is unclear
whether authors, especially first-time and social sci-
ence authors, are reluctant to back OAP journals be-
cause the journals are not considered sufficiently pres-
tigious or because the authors consider the costs in-
volved too high [5, 6]. Moreover, the ‘‘author pays’’
Supplemental electronic content is included with this paper on
model also poses a significant financial obstacle for
researchers or their institutions in low-income coun-
tries . Certain OAP journals discretionally waive
charges to such researchers.
Little is known about how this model, first intro-
duced in English-speaking countries, will be adopted
in a country as culturally different as Spain. This re-
search sought to evaluate the extent of familiarity with
OAP of biomedical authors who publish in Spanish
and their attitudes toward the author-pays model.
The investigators selected the first authors of Spanish-
language articles (with the exception of letters) ap-
pearing in PubMed between June and December 2003.
To locate authors, the researchers used the following
search syntax: (‘‘com’’[ad] OR ‘‘es’’[ad] OR ‘‘org’’[ad])
NOT letter[pt] AND Spanish[Lang] AND (‘‘2003/06/
01’’[EDAT]: ‘‘2003/12/31’’[EDAT]), where ‘‘es’’ repre-
sents a specific email domain for Spain. Most Spanish
authors’ email addresses would be collected using
‘‘.com,’’ ‘‘.es,’’ and ‘‘.org.’’ The investigators excluded
those authors who did not provide an email address
and sifted the original list of 716 entries found in
PubMed, eliminating duplications and authors not re-
siding in Spain. This process resulted in a final list of
354 authors. Authors were classified according to (1)
type of institution (university, university hospital, non-
university hospital, or government institution), (2) res-
idential Spanish region, and (3) medical speciality.
This research employed an author-elaborated nine-
item questionnaire (supplemental appendix online).
Item relevance and face validity were established by
consensus among the researchers. Between February
and May 2004, the questionnaire was emailed thrice
by individual emailings to avoid spam-blocking sys-
tems. Despite this precaution, 14% of emails were au-
tomatically rejected. All responses received before
June 15, 2004, were analyzed.
To determine whether responding authors were rep-
resentative of the global sample initially selected, the
team compared the following demographic and pub-
lication variables: province of residence, institution
type, biomedical speciality, existence of an online edi-
tion of the journal in which articles were published,
and publication of other articles during the same pe-
The investigators then studied the association be-
tween author responses and medical speciality, type of
institution, and region of residence. All comparisons
were performed using Pearson’s chi-square test. All
statistical calculations were performed using SPSS
J Med Libr Assoc 94(4) October 2006 455
The funding organization (National Library of Medi-
cine, USA.) had no role in the design and conduct of
the study; in the collection, analysis, and interpretation
of data; or in the preparation, review, and approval of
the manuscript. The Hedges Team includes Angela
Eady, Brian Haynes, Susan Marks, Ann McKibbon,
Doug Morgan, Cindy Walker-Dilks, Stephen Walter,
Stephen Werre, Nancy Wilczynski, and Sharon Wong,
all in the Health Information Research Unit, Depart-
ment of Clinical Epidemiology and Biostatistics at Mc-
Master University, Hamilton, Ontario, Canada.
1. WESTBROOK JI, GOSLING AS, COIERA E. Do clinicians use
online evidence to support patient care? a study of 55,000
clinicians. J Am Med Inform Assoc 2004 Mar–Apr;11:113–20.
Epub 2003 Dec 07.
2. MCDONALD S, TAYLOR L, ADAMS C. Searching the right
database. a comparison of four databases for psychiatry jour-
nals. Health Libr Rev 1999 Sep;16(3):151–6.
3. ROYLE P, BAIN L, WAUGH N. Systematic reviews of epi-
demiology in diabetes: finding the evidence. BMC Med Res
Methodol 2005 Jan 8;5(1):2.
4. JADAD AR, MCQUAY HJ. A high-yield strategy to identify
randomized controlled trials for systematic reviews. Online
J Curr Clin Trials 1993 Feb 27#c no. 33.
5. MARSON AG, CHADWICK DW. How easy are randomized
controlled trials in epilepsy to find on Medline? the sensitiv-
ity and precision of two Medline searches. Epilepsia 1996
6. ADAMS CE, POWER A, FREDERICK K, LEFEBVRE C. An in-
vestigation of the adequacy of MEDLINE searches for ran-
domized controlled trials (RCTs) of the effects of mental
health care. Psychol Med 1994 Aug;24(3):741–8.
7. DUMBRIGUE HB, ESQUIVEL JF, JONES JS. Assessment of
MEDLINE search strategies for randomized controlled trials
in prosthodontics. J Prosthodont 2000 Mar;9(1):8–13.
8. NWOSU CR, KHAN KS, CHIEN PF. A two-term MEDLINE
search strategy for identifying randomized trials in obstet-
rics and gynecology. Obstet Gynecol 1998 Apr;91(4):618–22.
9. ROBINSON KA, DICKERSIN K. Development of a highly
sensitive search strategy for the retrieval of reports of con-
trolled trials using PubMed. Int J Epidemiol 2002 Feb;31(1):
10. WILCZYNSKI NL, WALKER CJ, MCKIBBON KA, HAYNES
RB. Assessment of methodologic search filters in MEDLINE.
Proc Annu Symp Comput Appl Med Care 1993:601–5.
11. HAYNES RB, WILCZYNSKI N, MCKIBBON KA, WALKER CJ,
SINCLAIR JC. Developing optimal search strategies for de-
tecting clinically sound studies in MEDLINE. J Am Med In-
form Assoc 1994 Nov–Dec;1(6):447–58.
12. WILCZYNSKI NL, HAYNES RB, FOR THE HEDGES TEAM.
Developing optimal search strategies for detecting clinically
sound causation studies in MEDLINE. AMIA Annu Symp
13. WONG SSL, WILCZYNSKI NL, HAYNES RB, RAMKISSOON-
SINGH R, FOR THE HEDGES TEAM. Developing optimal search
strategies for detecting sound clinical prediction studies in
MEDLINE. AMIA Annu Symp Proc 2003:728–32.
14. HAYNES RB, WILCZYNSKI NL, FOR THE HEDGES TEAM.
Optimal search strategies for retrieving scientifically strong
studies of diagnosis from MEDLINE. BMJ 2004 May 1;
328(7447):1040. Epub 2004 Apr 08.
15. WILCZYNSKI NL, HAYNES RB, FOR THE HEDGES TEAM.
Developing optimal search strategies for detecting clinically
sound prognostic studies in MEDLINE: an analytic survey.
BMC Med 2004 Jun 9;2(1):23.
16. WONG SS, WILCZYNSKI NL, HAYNES RB. Developing op-
timal search strategies for detecting clinically relevant qual-
itative studies in MEDLINE. Medinfo 2004; 2004:311–6.
17. MONTORI VM, WILCZYNSKI NL, MORGAN D, HAYNES RB,
FOR THE HEDGES TEAM. Optimal search strategies for retriev-
ing systematic reviews from MEDLINE: analytical survey.
BMJ 2005 Jan 8;330(7482):68–73.
18. HAYNES RB, MCKIBBON KA, WILCZYNSKI NL, WALTER
SD, WERRE SR. Optimal search strategies for retrieving sci-
entifically strong studies of treatment from Medline: analyt-
ical survey. BMJ 2005 May 21;330(7501):1179. Epub 2005 May
19. HOLLAND JL, WILCZYNSKI NL, HAYNES RB, HEDGES
TEAM. Optimal search strategies for identifying sound clin-
ical prediction guides in EMBASE. BMC Med Inform Decis
Mak 2005 Apr 29;5(1):11.
20. WILCZYNSKI NL, HAYNES RB. Optimal search strategies
for detecting clinically sound prognostic studies in EMBASE:
an analytic survey. J Am Med Inform Assoc 2005 Jul–Aug;
21. WILCZYNSKI NL, HAYNES RB, HEDGES TEAM. EMBASE
search strategies for identifying methodologically sound di-
agnostic studies for use by clinicians and researchers. BMC
Med 2005 Mar 29;3(1):7.
22. HAYNES RB, KASTNER M, WILCZYNSKI NL, HEDGES
TEAM. Developing optimal search strategies for detecting
clinically sound and relevant causation studies in EMBASE.
BMC Med Inform Decis Mak 2005 Mar 22;5(1):8.
23. HEALTH INFORMATION RESEARCH UNIT, MCMASTER UNI-
VERSITY.Full title of journals indexed in MEDLINE. [Web
document]. [cited 9 Jun 2006]. ?http://hiru.mcmaster.ca/
24. HEALTH INFORMATION RESEARCH UNIT, MCMASTER UNI-
VERSITY.List of EMBASE journals. [Web document]. [cite 9
Jun 2006]. ?http://hiru.mcmaster.ca/hedges/List%20of%
25. WILCZYNSKI NL, MCKIBBON KA, HAYNES RB. Enhancing
retrieval of best evidence for health care from bibliographic
databases: calibration of the hand search of the literature.
Medinfo 2001; 10(pt. 1):390–3.
26. WONG SSL, WILCZYNSKI NL, HAYNES RB, FOR THE
HEDGES TEAM. Developing optimal search strategies for de-
tecting clinically sound treatment studies in EMBASE. J Med
Libr Assoc:[accepted for publication].
27. WILCZYNSKI NL, HAYNES RB, FOR THE HEDGES TEAM.
EMBASE search strategies achieved high sensitivity and
specificity for retrieving methodologically sound systematic
reviews. J Clin Epidemiol:[accepted for publication].
28. BACHMANN LM, ESTERMANN P, KRONENBERG C, TER RIET
G. Identifying diagnostic accuracy studies in EMBASE. J Med
Libr Assoc 2003 Jul;91(3):341–6.
29. LOWE HJ, BARNETT GO. Understanding and using the
Medical Subject Headings (MeSH) vocabulary to perform lit-
erature searches. JAMA 1994 Apr 13;271(14):1103–8.
Received September 2005; accepted June 2006