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We plan to use clinical trial articles in one of the text annotation projects. This article mentions the license below.

This is an open-access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial, and no modifications or adaptations are made.

I am not sure if we can use this article for text annotation and distribute the annotated text.

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No, you are not allowed to distribute any derivatives (edits, transformations, derived works) of the article, and a text annotation would actually be considered a derivative, and therefore a breach of the license.

Section 2.a.1.B of the CC-BY-NC-ND license allows you to create derivative works (i.e. create the annotations), as long as you don't share it with 3rd parties.

If, however, there is an exception in a law which would allow it (such as 'fair use' in medical research), then you may be allowed to do what you plan. You should ask a lawyer about it.

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    Additionally, the OP could contact the authors of the article to ask for permission to perform the type of annotations they are intending to make. It could be that adding annotations is a kind of derived work that the authors did not intend to categorically forbid. Dec 7, 2022 at 9:45
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    @BartvanIngenSchenau I fully agree. Contacting the original author and asking for a special license or an exception is what anyone can always do with any licensed material regardless of the license terms. Dec 7, 2022 at 10:12

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