This week we are looking at perspectives from health professionals about the benefits of open access. We look forward to any personal, practical experience you have had with regards to open access (or restricted access). What difference has this made to your work and can you give a specific example?
A related question is 'How many specific examples can you give where access to the full text of a research paper saved a life?' I asked this question to ChatGPT and it gave 5 examples. I have previously commented on examples 1 and 2 here:
https://www.hifa.org/dgroups-rss/open-access-49-has-open-access-research...
and here
https://www.hifa.org/dgroups-rss/open-access-51-has-open-access-research...
Here is Example 3 with my comments below. I think it's an interesting example of a ChatGPT hallucination.
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3. Example: Open Access to Research on "Early Intervention for Preterm Birth"
Context: A study published in The Lancet (2017) reviewed clinical trials on interventions for preventing preterm birth and identified several effective treatments. The paper included evidence that administering magnesium sulfate to mothers at risk of preterm labor could significantly reduce the likelihood of severe complications in premature infants.
The Role of Open Access: The paper was open access, so it became available to hospitals in regions with high rates of preterm births, including low-resource areas. One hospital in a developing country used the information from the paper to improve its maternal care protocol.
Real-Life Impact: A pregnant woman at 27 weeks of gestation came into labor unexpectedly. The doctors, having read the open access research, immediately administered magnesium sulfate, which greatly reduced the likelihood of the newborn developing severe neurological issues associated with preterm birth. The infant survived, and the mother recovered without complications.
Why Open Access Was Crucial: Without the paper's specific guidance on magnesium sulfate use, the hospital staff might have missed the window to administer the life-saving drug. The open access research allowed them to intervene in a timely manner, saving both the mother and child.
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COMMENTS (NPW):
1. I was unable to find the 2017 study in The Lancet. It's notable that the purpose of the synthesis was to assess interventions for preventing preterm birth, but the authors appear to have made a conclusion about a different endpoint.
2. I found a paper in PLOS Medicine - Antenatal magnesium sulphate and adverse neonatal outcomes: A systematic review and meta-analysis - dated 2019. Curiously this paper did not mention the supposed 2017 Lancet paper.
3. I also located a 2018 paper in The Lancet - Interventions to reduce premature births: a review of the evidence - but this is not open access. The paper comprised only a conference abstract which included the sentence 'Identified interventions with strong evidence of benefit were smoking cessation, progesterone supplementation, cervical cerclage, preterm surveillance clinics and screening, diagnosis and preparation, corticosteroids, magnesium sulphate, and tocolysis'. It would not make sense for the doctors mentioned above to have provided magnesium sulphate on the basis of such an abstract.
4. For any information to be reliable and applicable, the ideal pathway is not by reading an abstract (or open-access full text) of a single research paper. ChatGPT reports that the 2017 paper was a synthesis and this gives stronger grounds for clinical decision-making. Systematic reviews may or may not include recommendations. Furthermore, there may be several extant systematic reviews that have relevance. The most robust way forward is to convene a clinical guideline group which uses a rigorous approach to assess all the available evidence and make international guidelines that can be adapted at country level.
5. Magnesium sulphate is currently recommended for neuroprotection of preterm infants for women at risk of preterm birth at less than 30 weeks’ gestation, based on high quality evidence of benefit
6. I located 'The Antenatal Magnesium Sulphate for Neuroprotection Guideline Development Panel: Antenatal magnesium sulphate prior to preterm birth for neuroprotection of the fetus, infant and child: National clinical practice guidelines'. This was published back in 2010. The WHO Essential Medicines List includes magnesium sulfate for pre-eclampsia and eclampsia but curiously the indications do not include neuroprotection in preterm birth.
I asked ChatGPT to give me the citation of the paper and it 'admitted': 'I could not locate a 2017 open-access paper in The Lancet exactly matching the description you provided (i.e., a 2017 Lancet review of magnesium sulphate for pre-term birth interventions that is open access).' Presumably this was a 'hallucination'. This puts into doubt the whole example.
Best wishes, Neil
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org