Journal of the Royal Society of Medicine

To examine whether the increased risk of cardiovascular events with rofecoxib represents a class effect of cyclooxygenase-2 (COX-2) specific inhibitors.

Systematic review and meta-analysis of randomized double-blind clinical trials of celecoxib of at least 6 weeks’ duration and presented data on serious cardiovascular thromboembolic events. Data sources included six bibliographic databases, the relevant files of the United States Food and Drug Administration, and pharmaceutical company websites.

Pooled fixed effects estimates of the odds ratios for risk of cardiovascular events with celecoxib compared with comparator treatment were calculated using the inverse variance weight method. The main outcome measure was myocardial infarction.

Four placebo-controlled trials with 4422 patients were included in the primary meta-analysis comparing celecoxib with placebo. The odds ratio of myocardial infarction with celecoxib compared to placebo was 2.26 (95% confidence interval 1.0 to 5.1). For composite cardiovascular events [odd ratio 1.38 (95% CI 0.91 to 2.10)], cardiovascular deaths [OR 1.06 (95% CI 0.38 to 2.95)] and stroke [OR 1.0 (95% CI 0.51 to 1.84)] there was no significant increase in risk with celecoxib. The secondary meta-analysis which included a total of six studies (with placebo, diclofenac, ibuprofen, and paracetamol as comparators) of 12 780 patients, showed similar findings with a significant increased risk with celecoxib for myocardial infarction [OR 1.88 (95% CI 1.15 to 3.08)] but not other outcome measures.

The available data indicate an increased risk of myocardial infarction with celecoxib therapy, consistent with a class effect for COX-2 specific inhibitors.

We aimed to assess journal authors’ current knowledge and perceptions of open access and author-pays publishing.

An electronic survey.

Authors of research papers submitted to BMJ, Archives of Disease in Childhood, and Journal of Medical Genetics in 2004.

Familiarity with and perceptions of open access and author-pays publishing. Results: 468/1113 (42%) responded. Prior to definitions being provided, 47% (222/468) and 38% (176/468) reported they were familiar with the terms ‘open access’ and ‘authorpays’ publishing, respectively. Some who did not at first recognize the terms, did claim to recognize them when they were defined. Only 10% (49/468) had submitted to an author-pays journal. Compared with non-open access subscription-based journals, 35% agreed that open access author-pays journals have a greater capacity to publish more content making it easier to get published, 27% thought they had lower impact factors, 31% thought they had faster and more timely publicaitons, and 46% agreed that people will think anyone can pay to get published. 55% (256/468) thought they would not continue to submit to their respective journal if it became open access and charged, largely because of the reputaiton of the journals. Half (54%, 255/468) said open access has ‘no impact’ or was ‘low priority’ in their submission decisions. Two-thirds (66%, 308/468) said they would prefer to submit to a non-open access subscription-based journal than an open access author-pays journal. Over half thought they would have to make a contribution or pay the full cost of an author charge (56%, 262/468).

The survey yielded useful information about respondents’ knowledge and perceptions of these publishing models. Authors have limited familiarity with the concept of open-access publishing and surrounding issues. Currently, open access policies have little impact on authors’ decision of where to submit papers.