NEJM Evidence – A new journal in the NEJM group family
Over the past 20 years, the team at New England Journal of Medicine has reviewed many leading or clinically important research manuscripts that we have not published. Some of the groundbreaking work just wasn’t ready for prime time: studies that revealed new biological knowledge that could one day change practice, but lacked sufficient results to support immediate clinical utility. Many clinically important research trials have posed the reverse problem: Previous work had already established a new paradigm, so even rigorous trials that expand the range of utility of this paradigm have not been found to be new enough. to deserve a publication. This approach made sense and kept the amount of material published in the weekly Newspaper handy. It had one drawback: the Newspaper has not published any transformational work, such as the use of fetal DNA circulating in the blood of a pregnant person to diagnose fetal abnormalities or the use of gamma interferon release tests for the diagnosis of tuberculosis. It also meant that the Newspaper has not published the additional clinical trials that cemented the use of agents active on the PD-L1 pathway in certain cancers where its use has since become the standard of care.
This is about to change. In January 2022, the NEJM Group will start publishing a new journal, Proof of NEJM. This monthly, peer-reviewed, online-only general medical journal will publish original research that takes ideas and turns them into reality. This research includes work across the spectrum of clinical investigation, from the first human demonstrations of safety and potential efficacy that will pave the way for larger and longer clinical trials, at one extreme, to investigations. that strengthen the evidence and push one diagnosis or therapy into widespread use over another.
Corn Proof of NEJM will go even further. The editors of Proof of NEJM believe that understanding the nuances of study design and execution is essential to understanding how the results of a study can, or cannot, influence our clinical practice. Too often readers’ eyes turn glassy when they access the Methods section of a research article; Twenty years ago, when one of us took over as editor-in-chief of Newspaper, the Methods section was even printed in a smaller font than the rest of the article. Understanding the methods of a trial, grappling with the choices investigators were faced with when planning the trial, and assessing the potential impact of the inevitable trade-offs inherent in complex clinical research are essential to understanding how the data ‘a research report can inform your patient’s care in your community.
To meet this challenge head on, Proof of NEJM will provide new direction to make test methods and design attractive. We will post focused commentary on how a trial’s methodology may influence the significance of the observed results to clinical practice. We will present case studies written by investigators who share in depth the challenges they faced and the choices they made during a specific essay (see our first, titled ‘Behind the Scenes of TOPCAT – Taking a Look to inform “). We will develop short educational videos (which we call “Stats, STAT!”) Focusing on high performance statistical methodology relevant to clinicians and researchers. We will provide a platform for clinical trial participants to share their experience, as we work to intentionally raise new and diverse voices and perspectives too often excluded from conversations in academic publishing.
Much of our content will be aimed specifically at clinicians. In addition to the classic journal articles, we will be publishing a number of new types of articles. Our Morning Report series will feature short case reports similar to those experienced by trainees and will be written by members of clinical training programs around the world. The series is designed to bring an evidence-based approach to clinical reasoning. “The Trial of Tomorrow” will invite clinicians to share examples of common medical practice that are not supported by strong evidence and are ripe for a challenge in the form of a randomized trial. We hope this series will shed light on these open clinical questions, advance the discussion of barriers to a definitive answer, and ultimately spawn research to fill in the gaps. Our “Curbside Consult” series will address the clinical dilemmas that physicians face on their daily visits. These short review articles are intended to provide the best current answers to focused questions – short enough to be read quickly and reliable enough to leave the reader comfortable making clinical decisions based on the available evidence.
Proof of NEJM is committed to advancing equity and inclusion in medicine. Our editors, editorial board, statistical reviewers and editors (https://evidence.nejm.org/about/editors-and-publishers) are committed to the principle that patients are best served by work emanating from clinical trials that reflect the patients for whom the diagnoses and therapies under study are to be used. To this end, Proof of NEJM will follow the standard established by the Newspaper in that we will be asking the authors of all original research articles first published in January 2022 or later to provide information explicitly describing the diversity of patients recruited and how this compares to target populations affected by the disease in l ‘study. We are engaged in the active work required to dismantle the structures responsible for the pervasive inequalities that we all face.
In the months and years to come, we will try new approaches and adopt the most effective as we seek to publish the work and commentary that shapes clinical care today and influences research in the next generation. We invite you to join us on this journey by submitting your work to us (https://mc05.manuscriptcentral.com/evidence) as we strive to advance the NEJM Group’s mission: to serve healthcare professionals around the world, so that we can all do a better job of serving patients.