Within 5 years, most medical journals will be open-access. That means every journal will do what Medscape has done since day 1 in May 1995: provide access to trusted articles and data at no cost.
Peer review as we know it will disappear. Rather than the secretive prepublication review process followed by most publishers today, including Medscape, most peer review will occur transparently, and after publication.
How will this look?
Three years ago I predicted medical articles in the future will look a lot like Wikipedia, an encyclopedia with millions of user-created articles in 253 languages. Today Wikipedia is the most referenced repository of information on the Web. Any user can start an article, link it to related sources, and publish revisions with a click of the mouse. Anyone who reads an article can edit it.
Wikipedia articles must be written with a neutral point of view -- NPOV: Anything not NPOV is quickly deleted. On Wikipedia, readers don't have to wade through thousands of articles written by a handful of authors. You read a single living article constantly updated, corrected, and improved by thousands.
Each Wikipedia community adopts its own quality controls. In German-language Wikipedia, anyone can edit an article, but it is only visible to the world at large after a trusted group of Wikipedians say the contributions are good. Trust is gained by the number of contributions made that are not corrected. Changes are measured by a mathematical formula created by computer scientists and semantic intelligence experts. It's more objective than traditional peer review, which is often clubby, biased, and incomplete.
Andrew Grove, the computer scientist who brought microprocessors to the masses at Intel Corporation, likens traditional peer-review systems to Middle Ages guilds. He calls for a "cultural revolution" in publishing to reinvent peer review.
That revolution will emerge as a variant of Wikipedia. Medical publishing, peer review, research, patient care, and commerce will be transformed. And for the better.
That's my opinion. I'm Peter Frishauf, founder of Medscape.
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Medscape J Med. 2008;10(11):267 © 2008
Cite this: The End of Peer Review and Traditional Publishing as We Know It - Medscape - Nov 24, 2008.