It's a wiki wiki world

EDITOR—Abbasi et al are to be congratulated on their crystal ball gazing.1 Communication in the modern world is clearly changing, and even in the world of medical publishing the old ways are giving way to the new. Although Homer may make some minor changes, his children will never follow in his footsteps.

The future belongs to Lisa. Smart and articulate, she will thrive in a milieu that she manipulates so that useful information will flow towards her. By participating in her online communities and achieving status in these groups, she will be the one who knows (or at least who knows who knows) the required information.

Lisa will have accepted the basic precepts of the cluetrain manifesto (http://www.cluetrain.com/), its essence being that communication in the modern world is based on continuous online conversations by email between service providers and clients, their immediacy and formality being somewhere between a letter and a telephone call. Lisa will participate continuously in her global conversations, irrespective of her physical location. The lines between her work and leisure will blur.

Abbasi et al seem unsure as to how many journals there will be in Lisa world. They list the range as 0 to 1 million. Conversation is great, but we still need to separate the wheat from the chaff and the signal from the noise. Fortunately the internet has given us the answer—one—the Wikipedia concept, which has developed as a result of the open source software model using free (wiki) software (www.wikipedia.org/wiki/Medicine). The essential features are a revision control system, unrestricted editing of articles on the wiki by any registered member, unrestricted membership of the wiki, and the ability to fork articles (or see current versions at the same time). In addition, no copies are deleted and the newer versions of an article comprise the original article with all additions made cumulatively.

There needs to be a fifth world

EDITOR—For scientists and medical professionals the Lisa world scenario poses the biggest challenge, at least for the near future.1 Today, the internet is crowded with spurious, if not false, information. Until some way is found to help users in identifying what is chaff and what is substance, it will be dangerous for authors to bypass publishers who spend a lot of time, energy, and money in peer reviewing submitted articles and posting their papers on the internet. The peer review system may not be faultless, but at least it serves the scientific and medical community well in deterring some quack would-be authors.

Furthermore, online information is increasingly free to users in places such as west Africa, but access is still very expensive for most potential users because the personal computer, the phone line, and the power and subscription to internet providers are still scarce and costly. Paper is still cheaper, unlike in some other parts of the world (this might be changing but only slowly).

The Lisa world of publishing will exacerbate plagiarism unless website providers will guarantee to archive publications for long periods of time so that references can be checked for authenticity long after they are used in bibliographies. Perhaps there should be a fifth world, where publishers give authors greater rewards for their work so as to retain their confidence. This fifth world will ultimately benefit everyone, the scientist, the medical professional, and the patient, wherever they may be located on the globe.