Publishing at any cost: a cross-sectional study of the amount that medical researchers spend on open-access publishing each year

Objective: To estimate the financial costs paid by individual medical researchers from meeting the article processing charges (APCs) levied by open access journals in 2019. To investigate the emotional burden to researchers using a novel metric (the APC Twitter Whinge Score). Design: Cross-sectional analysis. Data sources: Scopus was used to generate two random samples of researchers, the first with a senior author article indexed in the 9Medicine9 subject area (i.e., general researchers) and the second with an article published in the ten highest impact factor general clinical medicine journals (i.e., high-impact researchers) in 2019. For each researcher, Scopus was used to identify all first and senior author original research and review articles published in 2019. Researcher and journal information was obtained from Scopus, institutional profiles, Journal Citation Reports, publisher databases on APCs, the Directory of Open Access Journals, and individual journal websites. Twitter searches were conducted to identify and classify APC-related tweets using a novel APC Twitter Whinge Score. Main outcome measures: Median APCs paid by general and high-impact researchers for all first and senior author research and review articles published in 2019; additionally, we examined median APCs paid by researcher gender, affiliation, training, and geographic region. APC Twitter Whinge Score. Results: There were 241 general and 246 high-impact researchers identified as eligible for our study. In 2019, the general and high-impact researchers published a total of 914 (median 2, interquartile range 1-5) and 1471 (4, 2-8) first or senior author research or review articles, respectively. 42% (384/914) of the articles from the general researchers and 29% (428/1471) of the articles from the high-impact medical researchers were published in fully open access journals. The median total APCs paid by general researchers in 2019 was $191 (interquartile range $0-$2500) and the median total paid by high-impact researchers was $2900 (interquartile range $0-$5465); the maximum paid by a single researcher in total APCs was $30115 and $34676, respectively. There were no differences in total APCs paid by gender, affiliation, or training. However, high-impact researchers from the Region of the Americas had a lower median total APCs paid than those from other regions ($1695, interquartile range $0-$3935) vs. $4800, $1888-$8290); P<0.001). Among a sample of 195 APC-related tweets in 2019, 121 (62.1%) were publicly resentful (with or without sweary language) of APCs, scoring in the highest two categories of the APC-related Twitter Whinge Score. Conclusions: Medical researchers in 2019 were found to have paid between $0 and $34676 in total APCs. As journals with APCs become more common, it is important to understand the cost to researchers, especially those who may not have the funding or institutional resources to cover these costs, or we risk creating a pay-to-publish system that favors well-resourced authors from well-resources institutions and areas of the world. We also present evidence that these APCs may cause emotional damage to researchers, causing them to divert effort to moaning on Twitter. We postulate that behind this behavior may lie hidden harmful cycles of personal penury, domestic argument, insomnia, poor work relationships, inadequately prepared coffee, and even the possible use of alcohol before tweeting.