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Medical Scientific Publishing in the Twenty-first Century Synopsis of Symposium Presented at the Annual Meeting of the American Orthopaedic Association*
Michael W. Chapman, MD, Moderator; James D. Heckman, MD; David L. Hamblen, MD; Kathey Alexander
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*The Annual Meeting was held in Hot Springs, Virginia. The Symposium, presented on June 17, 2000, was moderated by Michael W. Chapman, MD (Sacramento, California), and the presenters included James D. Heckman, MD (Needham, Massachusetts), Michael W. Chapman, MD, David L. Hamblen, MD (Glasgow, Scotland), and Kathey Alexander (Philadelphia, Pennsylvania).
The full text of the Symposium is available on our web site (www.jbjs.org) and on our CD-ROM (call 781-449-9780, ext. 140, to order).

J Bone Joint Surg Am, 2001 May 01;83(5):e1-e1
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Computers and wide use of the Internet are rapidly changing the world of hard-copy publishing. The Internet has a number of potential advantages, including a more efficient peer-review process, timely publication, publication of video supplements, creation of interactive forums, opportunities to interact with authors and other experts, enhanced literature-search capability, and the ability to catalogue information of particular interest. However, the Internet provides unrestricted access to and permits the worldwide distribution of information that not only may be scientifically invalid but also may be fraudulent through either purposeful deception or ineptitude. Quality peer-reviewed scientific journals must play a major role in electronic publishing, as they will bring to the Internet the highest-quality peer-reviewed scientific information. The editorial processes of our best scientific journals can add substantial value to electronic publishing by sorting the valuable from the valueless, identifying important sources of information, and directing busy clinicians and scientists to the highest-quality information in an efficient and effective way. However, the transition to Internet publishing has been relatively slow. A major challenge facing publishers is how to derive sufficient income from electronic publishing. Internet advertising alone has not yet proven to be sufficient to support a major peer-reviewed scientific publication. The creation of revenue through advertising will be essential, and guidelines for advertising in Internet publications need to be carefully considered. Equally important is the issue of user confidentiality, since user information is readily available and is commercially valuable. Current methods of publishing are challenged by rising costs, creating a serials crisis in academic libraries. Alternative mechanisms of publication, in which authors post self-prepared manuscripts in electronic format on free or low-cost web sites, including the National Institutes of Health PubMed Central Repository, have become a threat to traditional journals. Web sites with free orthopaedic educational material have become particularly popular in international settings where the cost of many journals is prohibitive. The publisher faces all of these challenges, including the public perception that information should be free as well as the costs inherent in the building of the computer infrastructure and support necessary for Internet publishing. However, in spite of the challenges, the journal "brand" authenticates and provides quality assurance that is otherwise not available on the Internet. This added value creates optimism for the continuation of the peer-review process in the electronic medium.
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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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