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I would like to point out that not only traditional publishers are challenged, but even the peer review process is under consideration, as there is no great evidence on its usefulness (BMJ 1999;318:44-45).However, it's still difficult to find something to substitute it...

Furthermore, Brown's attempts are not so new. PubMedCentral has been created for putting scientific papers (of traditional publishers) on the web for free, but it also includes a number of autonomous publications, which are free for readers; unfortunately, they are not free for authors, as administrative expenses (which exist for web-based journals too) are covered by a submission fee. Anyway, every research project includes publication costs, so this is a way for using them.

Enzo

Researchers have been clamoring for this since at least 1995.

It's about time. Entire libraries should be digitized and and available to all by now - the least we can do is make lifesaving biomedical technology available without a torturous middleman content industry.

This is a very unfortunate and common misconception; the first signs and symptoms of autism-spectrum disorders often appear around the time when the child begins to speak, and this coincides with the time when the MMR vaccine is given. The epidemiological evidence is strong against there being a causal link.

If you're seriously interested in reading about it rather than just deciding that the temporal correlation between the two is sufficient proof of causality, both BMJ and the Lancet have had a lot of original articles and correspondence on the topic in the past few years, for example the following study by Taylor et al.


Autism and measles, mumps, and rubella vaccine: no epidemiological evidence for a causal association


Taylor et al.

Summary

Background We undertook an epidemiological study to investigate whether measles, mumps, and rubella (MMR) vaccine may be causally associated with autism.

Methods Children with autism born since 1979 were identified from special needs/disability registers and special schools in eight North Thames health districts, UK. Information from clinical records was linked to immunisation data held on the child health computing system. We looked for evidence of a change in trend in incidence or age at diagnosis associated with the introduction of MMR vaccination to the UK in 1988. Clustering of onsets within defined postvaccination periods was investigated by the case-series method.

Findings We identified 498 cases of autism (261 of core autism, 166 of atypical autism, and 71 of Asperger's syndrome). In 293 cases the diagnosis could be confirmed by the criteria of the International Classification of Diseases, tenth revision (ICD10: 214 [82%] core autism, 52 [31%] atypical autism, 27 [38%] Asperger's syndrome). There was a steady increase in cases by year of birth with no sudden "step-up" or change in the trend line after the introduction of MMR vaccination. There was no difference in age at diagnosis between the cases vaccinated before or after 18 months of age and those never vaccinated. There was no temporal association between onset of autism within 1 or 2 years after vaccination with MMR (relative incidence compared with control period 094 [95% CI 060147] and 109 [079152]). Developmental regression was not clustered in the months after vaccination (relative incidence within 2 months and 4 months after MMR vaccination 092 [038221] and 100 [052195]). No significant temporal clustering for age at onset of parental concern was seen for cases of core autism or atypical autism with the exception of a single interval within 6 months of MMR vaccination. This appeared to be an artifact related to the difficulty of defining precisely the onset of symptoms in this disorder.

Interpretation Our analyses do not support a causal association between MMR vaccine and autism. If such an association occurs, it is so rare that it could not be identified in this large regional sample.

Lancet 1999; 353: 20262

In the medical field there is at least one great attempt of freeing the access to scientific literature: PubMedCentral, from the US government, aimed at hosting papers from traditional scientific journals. However, not so many publishers accepted such proposal. One important publisher offering free access to its journals is instead BMJ (as you can see from the above citation), available on the Web with a full range of services, including fast responses. The latter are a good way for transforming a paper on the web to a catalyst of discussion, as people may answer through the web avoiding the long times needed for a paper response.

"Informative", I hope...

I have no personal experience of the PathLAN software but the principles underlying the story are straightforward.

It is possible to screen to see whether the pregancy will result in a Down's syndrome child using a number of tests.

The most accurate test is amniocentesis, when a sample of the amniotic fluid in which the foetus floats is removed early in the pregnancy. The foetal cells in the fluid can then be analysed (karyotyped) and their chromosomal pattern determined. (Down's is usually caused by an extra chromosome 21).

Unfortunately, amniocentesis, though a definitive test, is not itself without risk. There is a slight chance--somewhere around 1 in 200--that the test itself will lead to abortion (loss of the pregnancy).

So a lot of energy over the years has gone into selecting pregnancies at higher risk of Down's Syndrome. The best strategy is still up for debate, but basically, tests on maternal blood and also foetal ultrasound have been shown in large trials to differentiate successfully between high and low risk pregnancies. And of course, the age of the woman is a significant risk factor (the risk of Down's Syndrome rises sharply over the age of 35).

Presumably the PathLAN software was programmed to produce an overall risk score using data on maternal age, and from maternal blood and ultrasound tests. The age of the women was incorrectly calculated by the software, altering the overall risk score, and the women were subsequently incorrectly advised on the need for amniocentesis.

I don't know whether PathLAN was a proprietary or an open source system, but it is precisely because of occurrences like this that we must have open source software development methods if we are going to get serious about using computers to support clinical practice in medicine. We need to open the code, as well as the medical knowledge it implements, to proper peer review. And once we have done that, we have an ethical duty to share that peer-reviewed code so that no other patient suffers needlessly from a similar error again.

Support the Open Source Healthcare Alliance: http://www.oshca.org/

This was one of their first articles introducting their online edition ( "BMJ on the internet"). It also has links to many more articles.

BMJ seems to have been able to maintain their prestige, yet successfully move to the internet. As a non-doctor, I often read the articles on their site with great interest -- but would never be able to afford to purchase a subscription to keep up with research purely for interests sake.

People have praised the move for more worthy reasons too -- MD's in developing countries now have immediate and free access to valuable advances in medical knowlege. The traditional approach locks information into the developed world thus deepening the divide

This is one of their latest thoughts on the subject " What is Publication?"

This was one of their first articles introducting their online edition ( "BMJ on the internet"). It also has links to many more articles.

BMJ seems to have been able to maintain their prestige, yet successfully move to the internet. As a non-doctor, I often read the articles on their site with great interest -- but would never be able to afford to purchase a subscription to keep up with research purely for interests sake.

People have praised the move for more worthy reasons too -- MD's in developing countries now have immediate and free access to valuable advances in medical knowlege. The traditional approach locks information into the developed world thus deepening the divide

This is one of their latest thoughts on the subject " What is Publication?"

This was one of their first articles introducting their online edition ( "BMJ on the internet"). It also has links to many more articles.

BMJ seems to have been able to maintain their prestige, yet successfully move to the internet. As a non-doctor, I often read the articles on their site with great interest -- but would never be able to afford to purchase a subscription to keep up with research purely for interests sake.

People have praised the move for more worthy reasons too -- MD's in developing countries now have immediate and free access to valuable advances in medical knowlege. The traditional approach locks information into the developed world thus deepening the divide

This is one of their latest thoughts on the subject " What is Publication?"

The reason for not vaccinating is because then you can't tell if the animal has the disease (and is contagious) or merely has anti-bodies from the vaccine (and is not contagious)

Incidently, hoof/foot and mouth is often not fatal by itself, but causes animals to lose weight and generally become unsalable/unproductive. Also, in animals that have recovered, you have the same antibodies/contagion problem you have with vaccines. The virus is very very contagious -- a human can pass it on simply by walking through a field where an infected animal has been, and then walking through another field where a non-infected animal will be soon.

Some useful links:

The Gaurdian's Information on Foot and Mouth Disease

An Editorial, with information about when humans catch foot and mouth Foot and mouth disease: the human consequences (yes, it can happen, it's very rare and not really dangerous)

BTW, Foot and mouth is not yet found in the U.S.

Yet may be the key word here, however. If it gets here, it could not only affect domestic animals, but also deer and other hooved wild life.

Some of the same issues raised here are discussed there, but by physicians and other people in medicine (what about support, whom do you blame when it fails, and so on). The author of the article also posts some clarifications by RMS.

Even Science Friday doesn't do this...