BACKGROUND: Open-access (OA) publishing is increasingly prevalent in dermatology, and many journals now offer hybrid options, including conventional (subscription-based access [SA]) publishing or OA (with an author publishing charge) in a subscription journal. OA publishing has been noted in many disciplines, but this has been rarely studied in dermatology.
METHODS: Using the Clarivate Journal Citation Report, we compiled a list of English-language dermatology hybrid OA journals containing more than 5% OA articles. We sampled any OA review or original research article in 4 issues from 2018 to 2019 and matched an equal number of SA articles. Citation count, citation count excluding self-citations and view counts found using Scopus and Altmetrics score were recorded for each article. Statistical analyses were performed using logistic and negative binomial models using R software.
RESULTS: Twenty-seven hybrid dermatology journals were found, and 538 articles were sampled (269 OA, 269 SA). For both original research and review articles, OA articles had significantly higher mean citation counts (mean 13.2, standard deviation [SD] 17.0) compared to SA articles (mean 7.9, SD 8.8) (odds ratio [OR] 1.04; 95% CI 1.02-1.05; P < .001) including when adjusted for time from publication. Original research OA articles had significantly higher citation counts than original research SA articles (excluding self-citations; OR, 1.03; 95% CI, 1.01-1.05; P = .003), and review articles also had OA citation advantage than review SA articles (OR, 1.06; 95% CI, 1.02-1.11; P = .008). There was, however, no significant difference in citation counts between review articles and original research articles (OR, 1.00; 95% CI, 0.19-5.31; P = 1.000). There was no significant difference seen in view counts (OA: mean±SD 17.7±10.8; SA: mean±SD 17.1±12.4) and Altmetric score (OA: mean±SD 13.2±47.8; SA: mean±SD 6.3±25.0) between OA and SA articles. Potential confounders included the fact that more OA articles were published in Europe than in Asia, and pharmaceutical-funded articles were more likely to be published OA.
CONCLUSIONS: We noted a higher citation count for OA articles than SA articles in dermatology hybrid journals. However, dermatology researchers should take into account confounding factors when deciding whether to increase the impact of their work by selecting OA over SA publishing.
OA articles had significantly higher mean citation counts (mean 13.2, SD 17.0) compared to SA articles (mean 7.9, SD 8.8) (OR 1.04; 95% CI 1.02-1.05; P < .001).
observational comparison with unresolved confounding and an unreconciled OR-versus-IRR primary estimate
Original research OA articles had significantly higher citation counts than original research SA articles (excluding self-citations; OR, 1.03; 95% CI, 1.01-1.05; P = .003).
direction persists after excluding self-citations, though OA self-selection remains incompletely controlled
Review articles also had OA citation advantage than review SA articles (OR, 1.06; 95% CI, 1.02-1.11; P = .008).
reported subgroup association from a smaller review-article sample with residual confounding
There was no significant difference seen in view counts and Altmetric score between OA and SA articles.
reported null comparisons use directly collected bibliometric measures, though practical measurement limits remain
Derived from the full evaluation — not a separate score.
Strengths
OA and SA articles were compared within the same hybrid journals and were matched by article category and proximity, reducing differences that arise from comparing separate OA and subscription journals.
↳ Materials and Methods, article-sampling paragraph; Introduction, paragraph 2
The Discussion addresses systematic-review findings, small or absent effects in other fields, and randomized trials that found more downloads but no citation advantage at later follow-up.
↳ Discussion, paragraphs 2–3
The study examines article-level OACA in dermatology, a specialty the Introduction identifies as previously unstudied, using 538 articles from 27 hybrid journals.
↳ Introduction, paragraph 2; Results, paragraph 1
Limitations
The Abstract reports OR 1.04 for the headline citation comparison, whereas Results reports IRR 1.44 from a negative-binomial model. These estimates imply materially different effect magnitudes and require correction or explanation.
↳ Abstract, Results; Materials and Methods, statistical-analysis paragraph; Results, paragraph 1 and Table 3
Article topic, author prestige, geography, and industry funding can influence both OA selection and citations. The paper acknowledges these factors, including a 43% versus 15% industry-funding imbalance, but cannot isolate an access effect.
↳ Results, Figure 2D and Table 4; Discussion, confounding and limitations paragraphs
The sample covers selected 2018–2019 issues from English-language dermatology hybrid journals with more than 5% OA content, excluding issues without OA articles. The findings therefore may not transfer to pure OA journals, other specialties, or newer publishing conditions.
↳ Materials and Methods, eligibility and sampling paragraphs; Discussion, limitations paragraph
The within-hybrid-journal comparison and negative-binomial approach are appropriate for estimating citation-count associations, and the sensitivity analysis shows that the direction persists after excluding several freely accessible SA categories. The principal methodological constraint is that choosing OA is associated with funding, geography, article topic, and author prestige, so the analysis cannot identify a causal access effect. The Discussion handles this limitation responsibly by engaging conflicting randomized evidence and qualifying the conclusion. The Abstract's OR 1.04 and Results' IRR 1.44 nevertheless require reconciliation because they give materially different numerical interpretations of the headline finding.
Nabu’s assessment, alongside the field’s view.
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Sound3.0
Confidence highThe study adds a dermatology-specific, article-level estimate to an established and mixed OACA literature. Its advance is genuine but incremental because it does not identify the mechanism or causal effect of selecting OA.
“To our knowledge, OACA has not been studied in the field of dermatology.”
The matched hybrid-journal design, power calculation, count-data model, and access-status sensitivity analysis provide a credible association study. Unmeasured article quality, topic, and author prestige, together with the OA-selection mechanism and adjacent-SA sampling, materially limit identification.
“limitations and biases that exist in our study include unavoidable confounders, such as article topic and author prestige.”
The paper follows a coherent question-to-methods-to-conclusion structure and explicitly qualifies interpretation. However, OR 1.04 in the Abstract and IRR 1.44 in Results give materially different accounts of the headline effect magnitude.
“Results of the negative binomial regression were expressed as incidence rate ratio (IRR) and 95% CI.”
The Discussion presents supportive studies alongside randomized trials and systematic-review evidence showing small or absent citation advantages. It also carries residual-confounding concerns into a qualified conclusion, although it does not quantify their likely bias.
“results should be interpreted bearing in mind confounders”
Lower confidence on Methodological Rigour, Reporting — domain match limited.
Concerns4 of 4 checks
The primary OA citation effect is directionally consistent but numerically and terminologically unreconciled across the Abstract, Methods, and Results. The discrepancy affects which model estimate and effect magnitude should be treated as primary.
The study states that institutional ethics approval was not required because it analyzed publicly available bibliometric data. No text-grounded research-conduct concern was identified.
Flags: 1 declared / 5 total
23 of 23 checkable references verified
36 references in manuscript 13 are books, websites or datasets — counted, but not index-checkable
References not verified automatically are resolved manually within 24 hours.
No retraction or expression of concern found in Crossref (includes Retraction Watch).
Sources: Crossref (incl. Retraction Watch) ✓
Where this paper’s evidence sits on the path from initial observation to real-world use.
The study provides an observational bibliometric association rather than evidence that paying for or selecting OA causes additional citations. Residual self-selection and the inconsistent primary estimate leave it short of decision-ready guidance.
“These are undoubtedly confounders that may affect interpretation of our results”
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