About
Peer Review & Publication Process
Publication Overview
NEJM Evidence seeks to advance clinical trial research and clinical practice by publishing high-quality clinical trials and observational studies from all facets of medicine, including internal medicine, pediatrics, obstetrics, surgery, mental health, and others. Our approach is to inform and challenge the broad medical community to take new approaches to clinical trial design and execution that yield more powerful clinical evidence to guide thinking about disease pathobiology, clinical diagnostics and therapeutics.
Founding NEJM Evidence editor-in-chief Dr. Jeffrey Drazen noted that when he was editor-in-chief of the New England Journal of Medicine (NEJM), a position he held for over 19 years, there was a lot of fascinating and important research that he simply couldn’t publish. Often, these manuscripts contained novel ideas that could change how we do research, used innovative methodologies, or tested interventions that could significantly impact patient care. But, space in NEJM was limited and these papers sometimes couldn’t make it over the bar.
NEJM Evidence provides an alternate forum for this important work. It is a journal for medical professionals who want to learn about the ideas and the data generated from trials that test novel ideas, that may lead to future accepted medical knowledge, or that reinforce or refute established medical practice.
In addition to “bottom line” results, NEJM Evidence explores these and many more related ideas in an open easily readable and digestible format. NEJM Evidence seeks to amplify the voices of established and emerging experts in a way that will drive our thinking forward; it is a glimpse into how medical knowledge is made, packaged, and meant to be used.
Peer Review
All original research and review articles undergo outside scientific peer review by at least two peer reviewers; original research articles and some review articles also undergo dedicated statistical review to insure that conclusions drawn are supported by the data provided. All articles that are “cascaded” from the New England Journal of Medicine will have received primary peer review. In such settings, there will have been at least two outside peer reviews with most cascaded articles having received 3 peer reviews from the New England Journal of Medicine prior to the "cascade" process. Additional outside scientific peer review may be sought if there is an area where the editors feel that the peer review at the time of cascade was inadequate. Authors are expected to respond to the issues raised in the peer review process.
All articles which contain statistical inference undergo statistical peer review. Because the specific aspects of statistical peer review are limited, NEJM Evidence has assembled a team of dedicated statistical peer reviewers. These reviewers make sure that the evidence presented supports the scientific claims made by the authors. NEJM Evidence follows the statistical reporting policies of NEJM Group that can be found at: https://www.nejm.org/doi/full/10.1056/nejme1906559. When indicated, a statistical reviewer may write a “Statistical Editorial” when there is a certain point of interest in the data or its analysis that provides a teaching opportunity. Moreover, Statistical Review articles, meaning solicited or submitted articles that review an area of interface between clinical medicine and statistical inference, undergo external peer review by both statistical experts and clinicians.
Specialty articles (i.e., Tomorrow’s Trial, Morning Report, and Curbside Consult) receive outside peer review as noted above, including statistical review if statistical inference is needed to support the conclusions drawn.
In all cases, authors are expected to respond in writing to all manuscript reviews as monitored by the article’s editor.
Peer Review is single masked (i.e., the reviewer knows the identity of the authors, but the authors do not know the identity of the reviewer) and is conducted under the guidance given by the International Committee of Medical Journal Editors (https://www.icmje.org/), the Committee on Publication Ethics (https://publicationethics.org/), and the Council of Science Editors (https://www.councilscienceeditors.org/); additional information can be found at their respective websites. Peer reviewers are reminded at the time they accept the article to review that the material they are being asked to review should be kept strictly confidential (i.e., not shared with anyone). NEJM Evidence will keep the identity of the peer reviewers confidential. Peer reviewers may, at their discretion, choose to reveal their identity to the author.
Reviewers who agree to review a manuscript are asked to immediately disclose any personal, professional, or financial conflicts with the authors and/or the topic in the manuscript. When a conflict arises, the editors seek out alternate reviewers.
We ask for reviews to be returned within two weeks of the reviewer agreeing to undertake the project. Reviewed materials are considered privileged information and cannot be copied or shared.
Reviewers must maintain the confidentiality of the manuscript as outlined above, which may prohibit the uploading of the manuscript to software or other AI technologies where confidentiality cannot be assured. Reviewers should disclose to journals if and how AI technology is being used to facilitate their review. Reviewers should be aware that AI can generate authoritative-sounding output that can be incorrect, incomplete, or biased.
The Path of a Cascaded Manuscript
Many of the manuscripts published in NEJM Evidence are cascaded from the New England Journal of Medicine (NEJM). These manuscripts have undergone both internal and external peer review and, for a variety of reasons, the NEJM editors decided not to offer publication in NEJM.
However, many such manuscripts contain important ideas that have the potential to change medical thinking or shape medical practice. The NEJM Evidence editors work with the NEJM editors to identify these important manuscripts. When this occurs and when NEJM Evidence editors and submitting authors agree, the manuscript is transferred to NEJM Evidence for final revision and publication.
Peer and Statistical Review
All manuscripts submitted to NEJM Evidence are subject to a highly rigorous peer-review process, as would be expected from a publication of NEJM Group.
For manuscripts submitted to NEJM Evidence de novo: NEJM Evidence editors will review the paper and if they feel that peer review is warranted, they will assign expert reviewers in the field covered by the work to examine the submission and to make recommendations. The editors will take these recommendations under consideration when they determine if the manuscript is to move forward towards publication or be declined.
For manuscripts transferred to NEJM Evidence by cascade: NEJM Evidence editors will work out the offer, terms of transfer, and manuscript handling with the authors. At the point when manuscripts are transferred to NEJM Evidence, most have usually undergone external peer review, and even potentially statistical review. Manuscripts without a formal statistical review are subject to a preliminary rapid statistical review prior to receiving an offer of transfer to NEJM Evidence. If the transfer is offered and the authors agree, the manuscript then undergoes a formal statistical review.
For manuscripts submitted by NEJM Evidence editors or members of the Editorial Board: All original and review articles submitted to the journal by NEJM Evidence editors or members of the Editorial Board are handled by a separate peer-review pathway that is overseen by Joseph Loscalzo, MD, PhD, NEJM Evidence editor-at-large. Professor Loscalzo, who served as editor-in-chief of Circulation for over a decade and was Chief of the Medical Service at Brigham and Women’s Hospital for over 15 years, will assign peer reviewers and make an initial decision to move a manuscript forward or decline it. He will apply the same rigorous peer review standards employed for manuscripts submitted by people who are not members of the NEJM Evidence core editorial group. Our policy is that a decision by Dr. Loscalzo to decline a manuscript cannot be overturned, but the editors of NEJM Evidence may decide to decline a manuscript he brings forward if they feel that the work is not consistent with the remit of NEJM Evidence.
Revision, Final Review & Acceptance for Publication
Once a manuscript has been peer-reviewed, the NEJM Evidence editor makes the decision to either reject the submission or move the manuscript forward towards publication. A decision letter is sent to the authors detailing questions raised during the peer-review process and, where applicable, recommends revisions to meet NEJM Evidence publication standards. The authors in turn respond with a revised manuscript accompanied by a letter detailing all changes.
When authors resubmit their revised manuscript, it is again reviewed internally by the editor and a decision is made whether further peer or statistical review is needed. If additional outside review is not needed, the manuscript will be sent for additional editing and revisions in collaboration with the editor and its authors.
The NEJM Evidence editor-in-chief reviews all final (revised) submissions and may raise further questions. The editor-in-chief is the only person who can officially accept a manuscript for publication. Following Dr. Sacks’ formal acceptance of an article for publication, the manuscript will then move through rigorous processes for manuscript editing, production, and publication.
For more information, visit NEJM Evidence Editorial Policies.
