The New England Journal of Medicine
|Edited by||Eric Rubin|
Massachusetts Medical Society (United States)
|Delayed (6 months)|
|Bluebook||New Eng. J. Med.|
|ISO 4||N. Engl. J. Med.|
The New England Journal of Medicine (NEJM) is a weekly medical journal published by the Massachusetts Medical Society. It is among the most prestigious peer-reviewed medical journals as well as the oldest continuously published one.
In September 1811, John Collins Warren, a Boston physician, along with James Jackson, submitted a formal prospectus to establish the New England Journal of Medicine and Surgery and Collateral Branches of Science as a medical and philosophical journal. Subsequently, the first issue of the New England Journal of Medicine and Surgery and the Collateral Branches of Medical Science was published in January 1812. The journal was published quarterly.
The editors of the New England Journal of Medicine and Surgery and the Collateral Branches of Medical Science purchased the weekly Intelligencer for $600 in 1828, merging the two publications to form the Boston Medical and Surgical Journal, and shifting from quarterly to weekly publication.
The journal's logo depicts the snake-wrapped Rod of Asclepius crossed over a quill pen. The dates on the logo represent the founding of the components of The New England Journal of Medicine: 1812 for the New England Journal of Medicine and Surgery and Collateral Branches of Medical Science, 1823 for the Boston Medical Intelligencer, 1828 for the Boston Medical and Surgical Journal, and 1928 for the New England Journal of Medicine.
Notable articles from the course of The New England Journal of Medicine's history include:
- In November 1846, Henry Jacob Bigelow, a Boston surgeon, reported a breakthrough in the search for surgical anesthetics with the first uses of inhaled ether in 1846. This allowed patients to remain sedated during operations ranging from dental extraction to amputation. "A patient has been rendered completely insensible during an amputation of the thigh, regain consciousness after a short interval," Bigelow wrote. "Other severe operations have been performed without the knowledge of the patients."
- In June 1906, James Homer Wright published an article that described how he stained and studied bone marrow with descriptions of what are now known as megakaryocytes and platelets.
- In October 1872, a lecture by C. E. Brown-Séquard was published that proposed the then-revolutionary idea that one cerebral hemisphere can influence both sides of the body. The neurologist would go on to describe what is now known as the Brown-Séquard syndrome.
- In June 1948, Sidney Farber reported promising results in treatment of early childhood leukemia. Based on anecdotal evidence that children with acute leukemia worsened if they were given folic acid, he worked on blocking folic acid metabolism. His team gave 16 infants and children with acute lymphoblastic leukemia a folic acid inhibitor, aminopterin—10 showed improvement by clinical and hematologic parameters after three months. In his article, Farber advised receiving the results cautiously: "It is again emphasized that these remissions are temporary in character and that the substance is toxic and may be productive of even greater disturbances than have been encountered so far in our studies," he wrote. "No evidence has been mentioned in this report that would justify the suggestion of the term 'cure' of acute leukemia in children."
- In November 1952, cardiologist Paul Zoll published an early report on resuscitation of the heart. "The purpose of this report is to describe the successful use in 2 patients of a quick, simple, effective and safe method of arousing the heart from ventricular standstill by an artificial, external, electric pacemaker," he wrote. "For the first time it was possible to keep a patient alive during ventricular asystole lasting for hours to days. This procedure may prove valuable in many clinical situations."
- In February 1973, NEJM published the first report of polyp removal using a colonoscope and introduced a procedure during screening to reduce cancer risk. The authors reported on 218 patients, from whom they removed 303 polyps (at one or more procedures per patient).
- A letter published in the NEJM in 1980 was later described by the journal as having been "heavily and uncritically cited" to claim that addiction due to use of opioids was rare, and its publication in such an authoritative journal was used by pharmaceutical companies to push widespread use of opioid drugs, leading to an addiction crisis in the U.S. and other countries.
- In December 1981, two landmark articles described the clinical course of four patients—first reported in the CDC's June 1981 Morbidity and Mortality Weekly Report—with the disease that would come to be known as AIDS.
- In April 2001, Druker et al. reported a targeted therapy for chronic myelogenous leukemia. Based on the knowledge that BCR-ABL, a constitutively activated tyrosine kinase, causes CML, the authors tested with success an inhibitor of this tyrosine kinase in patients who had failed first-line therapy. The finding helped begin the era of designing cancer drugs to target specific molecular abnormalities.
- In October 2020, the journal published an editorial, signed by all 34 editors, in which they condemned the Trump administration's handling of the COVID-19 pandemic saying that "they are dangerously incompetent" and that "they have taken a crisis and turned it into a tragedy." This is the first time NEJM has ever supported or condemned a political candidate and only three other times in history has an editorial been signed by all the editors.
- In April 2021, Carhart-Harris et. al demonstrated that in the pharmacological treatment of major depressive disorder, there was no significant difference in antidepressant effects between the psychedelic drug psilocybin and the SSRI escitalopram after six weeks. Significant doses of psilocybin were only administered twice in the six-week period, while escitalopram was taken daily. This was the first time psychedelics and SSRIs were compared in the treatment of depression.
On April 25, 1996, the NEJM announced a new web site, which published each week the abstracts for research articles and the full text of editorials, cases, and letters to the editor. After print publishing for 184 years this was the NEJM's first use of the Internet for electronic publication.
The site was launched several months earlier in 1996, but the editors wanted proof that weekly electronic publication would work. Only then was an announcement approved for publication on the editorial page. In 1997, the website included prepublication releases of certain articles prior to their print publication. In 1998, online publication extended to include the full text of all its articles from 1993 forward.
Since its launch, NEJM has added to its site:
- Videos in Clinical Medicine, peer-reviewed educational videos to teach procedures requiring skilled techniques and specialized physical examination.
- Interactive Medical Cases, which mimic a clinical encounter by presenting the patient's history with results of the physical examination and laboratory and radiographic tests. Multiple-choice questions throughout test the taker's knowledge.
- NEJM Archive, the entire collection of the journal's published material.
The George Polk Awards site noted that its 1977 award to The New England Journal of Medicine: "...provided the first significant mainstream visibility for a publication that would achieve enormous attention and prestige in the ensuing decades."
The journal usually has the highest impact factor of the journals of internal medicine. According to the Journal Citation Reports, NEJM had a 2017 impact factor of 79.258, ranking it first of 153 journals in the category "General & Internal Medicine". It was the only journal in the category with an impact factor of more than 70. By comparison, the second and third ranked journals in the category (The Lancet and JAMA) had impact factors of 53.254 and 47.661 respectively.
Theodore Dalrymple feels that this influence is unwarranted. In False Positive: A Year of Error, Omission, and Political Correctness in the New England Journal of Medicine, he examines various articles on medical and social issues that the NEJM published over the course of a year. He found that many arrived at conclusions which were not supported by the evidence presented, or ignored easily available evidence that contradicted their conclusions.
The New England Journal of Medicine requires that articles it publishes have not been published or released elsewhere. Referred to as the Ingelfinger rule, the policy is intended to protect newsworthiness, and to subject research to peer review "before it is touted to the public or the profession". By 1991, four types of exceptions were recognized, including when "prepublication release of research conclusions is warranted because of immediate implications for the public health".
The rule was first described in a 1969 editorial, "Definition of Sole Contribution", by Franz Ingelfinger, the editor-in-chief at that time. A number of medical journals have similar rules in place.
Vioxx correction controversy
In the early 2000s, The New England Journal of Medicine was involved in a controversy around problems with research on the drug Vioxx. A study was published in the journal in November 2000 which noted an increase in myocardial infarction amongst those taking Vioxx. According to Richard Smith, the former editor of the British Medical Journal, concerns about the correctness of that study were raised with the journal's editor, Jeff Drazen, as early as August 2001. That year, both the US Food and Drug Administration and the Journal of the American Medical Association also cast doubt on the validity of the data interpretation that had been published in the NEJM. Merck withdrew the drug from market in September 2004. In December 2005, NEJM published an expression of concern about the original study following discovery that the authors knew more about certain adverse events than they disclosed at the time of publication. From the Expression of Concern: "Until the end of November 2005, we believed that these were late events that were not known to the authors in time to be included in the article published in the Journal on November 23, 2000. It now appears, however, from a memorandum dated July 5, 2000, that was obtained by subpoena in the Vioxx litigation and made available to the Journal, that at least two of the authors knew about the three additional myocardial infarctions at least two weeks before the authors submitted the first of two revisions and 4 1/2 months before publication of the article." During the five-year period between publication and Expression of Concern, it has been estimated that Merck paid NEJM as much as US$836,000 for article reprints that Merck used for promotional purposes. The journal was publicly rebuked for its response to the research issues in editorials appearing in publications including the British Medical Journal and the Journal of the Royal Society of Medicine.
Open access policy
NEJM provides delayed free online access to its research articles (it does so six months after publication, and maintains that access dating back to 1990). This delay does not apply to readers from the least developed countries, for whom the content is available at no charge for personal use.
NEJM also has two podcast features, one with interviews of doctors and researchers that are publishing in the journal, and another summarizing the content of each issue. Other offerings include Continuing Medical Education, Videos in Clinical Medicine (showing videos of medical procedures), and the weekly Image Challenge.
- Walter Prentice Bowers, 1921–1937
- Robert Nason Nye, 1937–1947
- Joseph Garland (cardiologist), 1947–1967
- Franz J. Ingelfinger, 1967–1977
- Arnold S. Relman, 1977–1991
- Jerome P. Kassirer, 1991–1999
- Marcia Angell, 1999–2000
- Jeffrey M. Drazen, 2000–2019
- Eric Rubin, 2019–present
- Zuger, Abigail (March 19, 2012). "A journal stands out in prestige and longevity". The New York Times. Retrieved June 24, 2014.
- "Scholar Metrics: Top Publications". Google Scholar.
- Cary, John (1961). Joseph Warren: Physician, Politician, Patriot. Urbana: University of Illinois Press. OCLC 14595803.
- Boston Patriot. September 28, 1811
- "January 1, 1812, table of contents for the New England Journal of Medicine and Surgery and the Collateral Branches of Medical Science". Retrieved 2011-12-22.
- "About NEJM: Past and Present". nejm.org. New England Journal of Medicine. Retrieved 2021-08-31.
...publishing the first quarterly edition of the New England Journal of Medicine and Surgery and the Collateral Branches of Medical Science (Boston) in January of 1812.
- Fitz-Gilbert Waters, Henry (1894). The New England Historical and Genealogical Register. 48. New England Historic Genealogical Society. pp. 148–149.
- Garland, Joseph (1952). "The New England Journal of Medicineand the Massachusetts Medical Society". New England Journal of Medicine. 246 (21): 801–806. doi:10.1056/NEJM195205222462101. PMID 14929322.
- Campion, Edward W.; Miller, Pamela W.; Costello, Jean; Duff, Ellen; Drazen, Jeffrey M. (2010). "The Journalfrom 1812 to 1989 at NEJM.org". New England Journal of Medicine. 363 (12): 1175–1176. doi:10.1056/NEJMe1009367. PMID 20843253.
- "About NEJM: Past and Present". nejm.org. New England Journal of Medicine. Retrieved 2021-08-31.
In 1921, the journal merged with the Boston Medical Intelligencer to become the Boston Medical and Surgical Journal; it also began weekly publication that year and was purchased by the Massachusetts Medical Society for $1.
- "About NEJM: Past and Present". nejm.org. New England Journal of Medicine. Retrieved 2021-08-31.
Renamed to the New England Journal of Medicine in 1928, the journal is known for many firsts in medicine, ....
- Kassirer, Jerome P. (1996). "The Journal's New Look". New England Journal of Medicine. 335: 50–51. doi:10.1056/NEJM199607043350110.
- Bigelow, Henry Jacob (1846). "Insensibility during surgical operations produced by inhalation". The Boston Medical and Surgical Journal. 35 (16): 309–17. doi:10.1056/NEJM184611180351601. S2CID 46290593.
- Wright, James Homer (1906). "The origin and nature of the blood plates". The Boston Medical and Surgical Journal. 154 (23): 643–45. doi:10.1056/NEJM190606071542301.
- Brown-Sequard, C.E.; Webber, S.G. (1872). "The origin and signification of the symptoms of brain disease". The Boston Medical and Surgical Journal. 87 (16): 261–3. doi:10.1056/NEJM187210170871601.
- Farber, Sidney; Diamond, Louis K.; Mercer, Robert D.; Sylvester, Robert F.; et al. (1948). "Temporary remissions in acute leukemia in children produced by folic acid antagonist, 4-Aminopteroyl-Glutamic Acid (Aminopterin)". New England Journal of Medicine. 238 (23): 787–93. doi:10.1056/NEJM194806032382301. PMID 18860765.
- Zoll, PM (November 1952). "Resuscitation of the heart in ventricular standstill by external electric stimulation". New England Journal of Medicine. 247 (20): 768–71. doi:10.1056/NEJM195211132472005. PMID 13002611.
- Wolff, William I.; Shinya, Hiromi (1973). "Polypectomy via the fiberoptic colonoscope". New England Journal of Medicine. 288 (7): 329–32. doi:10.1056/NEJM197302152880701. PMID 4682941.
- Porter, J.; Jick, H. (1980). "Addiction Rate in Patients Treated with Narcotics". New England Journal of Medicine. 302 (2): 123. doi:10.1056/NEJM198001103020221. PMID 7350425.
- "Opioid crisis: The letter that started it all". BBC News. June 3, 2017. Retrieved June 3, 2017.
- Gottlieb, Michael S.; Schroff, Robert; Schanker, Howard M.; Weisman, Joel D.; et al. (1981). "Pneumocystis carinii pneumonia and mucosal candidiasis in previously healthy homosexual men". New England Journal of Medicine. 305 (24): 1425–31. doi:10.1056/NEJM198112103052401. PMID 6272109.
- Masur, Henry; Michelis, Mary Ann; Greene, Jeffrey B.; Onorato, Ida; et al. (1981). "An outbreak of community-acquired Pneumocystis carinii pneumonia". New England Journal of Medicine. 305 (24): 1431–38. doi:10.1056/NEJM198112103052402. PMID 6975437.
- Druker, Brian J.; Talpaz, Moshe; Resta, Debra J.; Peng, Bin; et al. (2001). "Efficacy and safety of a specific inhibitor of the BCR-ABL tyrosine kinase in chronic myeloid leukemia". New England Journal of Medicine. 344 (14): 1031–7. doi:10.1056/NEJM200104053441401. PMID 11287972. S2CID 8399298.
- Kolata, Gina. "In a First, New England Journal of Medicine Joins Never-Trumpers". The New York Times. Retrieved October 8, 2020.
- Carhart-Harris, Robin; Giribaldi, Bruna; Watts, Rosalind; Baker-Jones, Michelle; Murphy-Beiner, Ashleigh; Murphy, Roberta; Martell, Jonny; Blemings, Allan; Erritzoe, David; Nutt, David J. (2021-04-14). "Trial of Psilocybin versus Escitalopram for Depression". New England Journal of Medicine. doi:10.1056/NEJMoa2032994. ISSN 0028-4793.
- Sloat, Sarah. "Scientist compared psilocybin against antidepressants for the first time". Inverse. Retrieved 2021-05-24.
- "Psychedelic drug worked for depression as well as common antidepressant, small trial finds". NBC News. Retrieved 2021-05-24.
- Siebert, Amanda. "Could Psilocybin Treat Depression? New Head-To-Head Trial Shows It's At Least As Effective As Leading SSRI". Forbes. Retrieved 2021-05-24.
- Campion, Edward W. (1996). "The Journal's new presence on the internet". New England Journal of Medicine. 334 (17): 1129. doi:10.1056/NEJM199604253341712.
- Kassirer, Jerome P.; Angell, Marcia (1997). "Prepublication Release of Journal Articles". New England Journal of Medicine. 337 (24): 1762–1763. doi:10.1056/NEJM199712113372409. PMID 9392703.
- Campion, Edward W. (1998). "Improvements to the Journal's Site on the World Wide Web". New England Journal of Medicine. 339 (9): 629. doi:10.1056/NEJM199808273390912. PMID 9718386.
- "The New England Journal of Medicine Celebrates 200th Anniversary in 2012" (Press release). Business Wire. January 12, 2012. Archived from the original on 2021-09-27. Retrieved 2021-09-27.
- McMahon, Graham T.; Ingelfinger, Julie R.; Campion, Edward W. (2006). "Videos in clinical medicine—A new Journal feature". New England Journal of Medicine. 354 (15): 1635. doi:10.1056/NEJMe068044.
- McMahon, Graham T.; Solomon, Caren G.; Ross, John J.; Loscalzo, Joseph; et al. (2009). "Interactive medical cases—A new Journal feature". New England Journal of Medicine. 361 (11): 1113. doi:10.1056/NEJMe0809756.
- Hershey, Edward. "A history of journalistic integrity, superb reporting and protecting the public: The George Polk Awards in Journalism". LIU Brooklyn. Archived from the original on March 28, 2010.
- "Media Center: Fact Sheet". nejm.org. Massachusetts Medical Society. Retrieved August 20, 2014.
- "Rank in Category: New England Journal of Medicine". 2017 Journal Citation Reports. Web of Science (Science ed.). Thomson Reuters. 2015.
- "Journals Ranked by Impact: Medicine, General & Internal". 2014 Journal Citation Reports. Web of Science (Science ed.). Thomson Reuters. 2015.
- Dalrymple, Theodore (2019). False Positive: A Year of Error, Omission, and Political Correctness in the New England Journal of Medicine. Encounter. p. 272. ISBN 978-1641770460.
- Relman, Arnold S. (1981). "The Ingelfinger Rule". New England Journal of Medicine. 305 (14): 824–826. doi:10.1056/NEJM198110013051408. PMID 7266634.
- Angell, Marcia; Kassirer, Jerome P. (1991). "The Ingelfinger Rule Revisited". New England Journal of Medicine. 325 (19): 1371–1373. doi:10.1056/NEJM199111073251910. PMID 1669838.
- "Definition of Sole Contribution". New England Journal of Medicine. 281 (12): 676–677. 1969. doi:10.1056/NEJM196909182811208. PMID 5807917.
- Altman, L.K. (1996). "The Ingelfinger rule, embargoes, and journal peer review-part 1". The Lancet. 347 (9012): 1382–1386. doi:10.1016/s0140-6736(96)91016-8. PMID 8637347. S2CID 44524038.
- Kardas-Nelson, Mara (2020). "Covid-19's impact on US medical research—shifting money, easing rules". BMJ. 369: m1744. doi:10.1136/bmj.m1744. PMID 32357953. S2CID 218479874.
- VIGOR Study Group; Bombardier, C.; Laine, L.; Reicin, A.; et al. (2000). "Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis". New England Journal of Medicine. 343 (21): 1520–28. doi:10.1056/NEJM200011233432103. PMID 11087881.
- Dobson, Roger (July 15, 2006). "NEJM "failed its readers" by delay in publishing its concerns about VIGOR trial". BMJ. 333 (7559): 116. doi:10.1136/bmj.333.7559.116-f. PMC 1502213. PMID 16840463.
- Curfman, Gregory D.; Morrissey, Stephen; Drazen, Jeffrey M. (2005). "Expression of Concern: Bombardier et al., "Comparison of Upper Gastrointestinal Toxicity of Rofecoxib and Naproxen in Patients with Rheumatoid Arthritis," N Engl J Med 2000;343:1520-8". New England Journal of Medicine. 353 (26): 2813–4. doi:10.1056/NEJMe058314. PMID 16339408. S2CID 10745161.
- Lemmens, Trudo; Bouchard, Ron A. (2007). "Regulation of Pharmaceuticals in Canada"". In Downie, Jocelyn; Caulfield, Timothy A.; Flood, Colleen M. (eds.). Canadian Health Law and Policy (3rd ed.). Toronto: LexisNexis Canada. p. 336. ISBN 9780433452218.
- Smith, Richard (August 2006). "Lapses at The New England Journal of Medicine" (PDF). Journal of the Royal Society of Medicine (editorial). 99 (8): 380–2. doi:10.1258/jrsm.99.8.380. PMC 1533509. PMID 16893926. Retrieved May 22, 2010.
- "About NEJM: Online access levels" (PDF). nejm.org. Massachusetts Medical Society. Retrieved October 26, 2011.
- "About NEJM: Access from outside the U.S". nejm.org. Massachusetts Medical Society. Retrieved October 26, 2011.
- Conaboy, Chelsea (June 17, 2012). "You've come a long way, doc". The Boston Globe Magazine (milestones of the NEJM).
- Müller, Daniel C.; Duff, Ellen M.C.; Stern, Kathy L. (2012). "Timeline: 200 years of the New England Journal of Medicine". The New England Journal of Medicine. 366 (1): e3. doi:10.1056/NEJMp1114819. PMID 22216863.