The past decades have opened the English language oral and maxillofacial surgery literature to the world. Through medical libraries, individual subscriptions, and Web-based portals such as Science Direct (an Elsevier project that brings more than 1,800 journals to medical libraries worldwide), the concept of regional journals, specialty journals, or association-based journals has become blurred. Both authors and readers are broadening their horizons and accessing knowledge and skills that were formerly hidden by distance, politics, and language barriers.
More than ever before, English has emerged as the language of clinical science and medical/surgical commerce. Surgeon investigators from across the globe are encouraged by their home academic center, often across deep political divides, to publish their work in the English language peer-reviewed journals. Concurrently, worldwide readership of clinical science has grown. The outcome is a common and more rapid growth of the evidence-based practice of oral and maxillofacial surgery. International authors and the academic clinical leadership of their institutions understand the most vital means of advancing medical science is through the English language peer-reviewed literature.
By accessing new clinical information and contributing to it, surgeons across the globe are able to advance the clinical care provided to their own patients. A recent example of this from the pages of JOMS includes the first understanding of bisphosphonate-associated osteonecrosis of the jaws. Just the past two years have brought this issue from unknown phenomenon to the level of general knowledge in every country thanks in part to the 23 contributions on the subject of bisphosphonates in JOMS. Clinicians across disciplines and in every nation are now aware of this unanticipated finding in patients who use bisphosphonates. Protocols for addressing this vexing problem are now being developed due to its global recognition.
An exciting outcome of clinical science globalization is that new lines of investigation are emerging that are truly making progress in a global fashion. Some of the best examples of this in JOMS are the many recent articles on topics such as growth factors, tissue engineering, and biological markers for cancer behavior. The investigations presented are not merely similar. They reflect the building blocks of emerging knowledge that require global talent and resources and a vehicle for immediate communication of findings through our English language journals. The next (and now emerging) step of this communication of ideas is direct, transglobal collaboration of investigators. Granting agencies such as the National Institutes of Health are acutely interested in the synergism that multicenter randomized clinical trials and other investigations can provide. In recognition of the advantages of such collaboration, the NIH has offered new funding mechanisms and incentives for such investigations.
Every major surgical journal now supports authors and readers from across the globe. A review of the articles published in JOMS in 2005 reveals that of 332 articles in JOMS, only 173 (52%) are from the United States. Similarly, cross-discipline publishing in our related surgical specialty journals of topics of interest to oral and maxillofacial surgeons is becoming more frequent. Our readers have a strong need to be able to access this critical clinical information in a coherent way. In order to promote essential communication that benefits clinicians and patients, it is paramount that our editorial leaders communicate.
Our editors understand that our journals are in the right place and the right time to further create an environment for positive change for the advancement of oral and maxillofacial surgery. With that goal in mind, the editors and staff of the Journal of Oral and Maxillofacial Surgery, the International Journal of Oral and Maxillofacial Surgery, the British Journal of Oral and Maxillofacial Surgery, and Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology met in Boston in September 2005 to review areas of common interest. We examined mutual problems in the peer review and editorial process and, most importantly, addressed the needs of our readers. It is our common belief that all practicing surgeons should have contemporaneous access to the complete oral and maxillofacial surgery peer-reviewed literature.
The editor group agreed that it would be beneficial to clinicians, investigators, and patients if every reader could have access to the complete English language oral and maxillofacial surgery literature, preferably in hard copy as well as electronic access. Putting the parochial interests of each journal aside, we all were certain that improved access to information would promote the advancement of science and the improvement of global health: the goal of every clinician, specialty organization, and government.
Issues that remained to be addressed in improving this access were noted as well:
1.A quickening of access to knowledge. Web-first or Web-only publishing is being examined as a means to support the rapid advancement of knowledge.
2.Systematic access to knowledge. While search engines can help, the systematic access to knowledge when it is needed remains an issue for patients as well as surgeons. Clinical alerts, while a systematic part of practice in specialties such as medical oncology and pediatrics, have not been used in oral and maxillofacial surgery. The editors group supported the idea of complete English journal access from a single website, a medical alert mechanism, as well as a simpler common search mechanism.
3.A means to assess the quality of knowledge. Objective criteria such as Consolidated Standards of Reporting Trials (CONSORT) have been developed to assess the qualities of clinical investigations. Some journals are investigating the means to inform readers on the quality of study design of each paper in an inserted section. Informatics and objective means of assessing clinical evidence are being developed. New journals devoted to assessing the quality of clinical knowledge are now available.
4.The cost of access. It is remarkable how inexpensive access to this vast continuous repository remains. Individual member journal subscriptions are less than $100 per year in most cases. However, access costs can be prohibitive to many individuals and in many settings.
Daily, new and vast clinical knowledge is here for the taking. Broadened access to knowledge should be the goal of every surgeon and the mission of every surgical organization, government, and journal. A worldwide contemporaneous repository of surgical knowledge has emerged. Can a world standard of care, educational criteria, and specialty identity be far behind?
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