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Low-income Countries’ Orthopaedic Information Needs: Challenges and Opportunities

  • Symposium: ABJS Carl T. Brighton Workshop on Health Informatics
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

The Internet should, in theory, facilitate access to peer-reviewed scientific articles for orthopaedic surgeons in low-income countries (LIC). However, there are major barriers to access, and most full-text journal articles are available only on a subscription basis, which many in LIC cannot afford. Various models exist to remove such barriers. We set out to examine the potential, and reality, of journal article access for surgeons in LIC by studying readership patterns and journal access through a number of Internet-based initiatives, including an open access journal (“PLoS Medicine”), and programs from the University of Toronto (The Ptolemy Project) and World Health Organization (WHO) (Health InterNetwork Access to Research Initiative [HINARI]).

Questions/purposes

Do Internet-based initiatives that focus on peer-reviewed journal articles deliver clinically relevant information to those who need it? More specifically: (1) Can the WHO’s program meet the information needs of practicing surgeons in Africa? (2) Are healthcare workers across the globe aware of, and using, open access journals in a manner that reflects global burden of disease (GBD)?

Methods

We compared actual Ptolemy use to HINARI holdings. We also compared “PLoS Medicine” readership patterns among low-, middle-, and high-income regions.

Results

Many of the electronic resources used through Ptolemy are not available through HINARI. In contrast to higher-income regions, “PLoS Medicine” readership in Africa is proportional to both the density of healthcare workers and the GBD there.

Conclusions

Free or low-cost Internet-based initiatives can improve access to the medical literature in LIC. Open access journals are a key component to providing clinically relevant literature to the regions and healthcare workers who need it most.

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Acknowledgments

We thank “PLoS Medicine” for access to data.

Author information

Authors and Affiliations

  1. Paediatric Orthopaedic Surgery, Hospital for Sick Children, Room S-107, 555 University Avenue, Toronto, ON, M5G 1X8, Canada

    Kathryn Doughty MD, MPH, MS & Andrew Howard MD, MSc, FRCSC

  2. Department of Child Health Evaluative Sciences (CHES), Hospital for Sick Children, Toronto, ON, Canada

    Linda Rothman BscOT, MHSc

  3. University of Waterloo, Waterloo, ON, Canada

    Luke Johnston BSc Student

  4. University of Toronto, Toronto, ON, Canada

    Kim Le MPH

  5. Department of Health Sciences, McMaster University, Hamilton, ON, Canada

    Joanna Wu BSc

  6. Office of International Surgery, University of Toronto, Toronto, ON, Canada

    Andrew Howard MD, MSc, FRCSC

Authors
  1. Kathryn Doughty MD, MPH, MS
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  2. Linda Rothman BscOT, MHSc
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  3. Luke Johnston BSc Student
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  4. Kim Le MPH
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  5. Joanna Wu BSc
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  6. Andrew Howard MD, MSc, FRCSC
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Corresponding author

Correspondence to Andrew Howard MD, MSc, FRCSC.

Additional information

Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

The present study involved the analysis of anonymized Internet log files that cannot be tracked to individual human subjects. All participants in the Ptolemy project have provided written consent for such use. Ethics approval was obtained from the University of Toronto.

This work was performed at the Hospital for Sick Children, Toronto, Ontario, Canada.

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Doughty, K., Rothman, L., Johnston, L. et al. Low-income Countries’ Orthopaedic Information Needs: Challenges and Opportunities. Clin Orthop Relat Res 468, 2598–2603 (2010). https://doi.org/10.1007/s11999-010-1365-x

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  • DOI: https://doi.org/10.1007/s11999-010-1365-x

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