 Cover of Volume 393, 2 March 2019 | |
| Discipline | Medicine |
|---|---|
| Language | English |
| Edited by | Richard Horton |
| Publication details | |
| History | 1823–present |
| Publisher | Elsevier (United Kingdom) |
| Frequency | Weekly |
| Delayed | |
| 88.5 (2024) | |
| Standard abbreviations ISO 4 (alt) · Bluebook (alt) NLM (alt) · MathSciNet (alt  ) | |
| ISO 4 | Lancet |
| Indexing CODEN (alt · alt2) · JSTOR (alt) · LCCN (alt) MIAR · NLM (alt) · Scopus · W&L | |
| CODEN | LANCAO |
| ISSN | 0140-6736 (print) 1474-547X (web) |
| LCCN | sf82002015 |
| OCLC no. | 01755507 |
| Links | |
The Lancet is a weeklypeer-reviewedgeneral medical journal, founded in England in 1823.[1] It is one of the world's highest-impact academic journals and also one of the oldest medical journals still in publication.[2][3][4][5]
The journal publishesoriginal research articles,review articles (divided intoseminars andreviews),editorials,book reviews, correspondence, as well as news features andcase reports.The Lancet has been owned byElsevier since 1991, and itseditor-in-chief since 1995 has beenRichard Horton.[6] The journal has editorial offices inLondon,New York City, andBeijing.[7]
The Lancet was founded in 1823 byThomas Wakley, an English surgeon who named it after the surgical instrument called alancet (scalpel).[1] Wakley was motivated to create the journal due to alleged corruption ofmedical services he saw inLondon.[8] According to BBC, the journal was initially considered to beradical following its founding.The Lancet said that unlike other medical journals, that it claimed were created and owned by elites, it was founded by a "marginal" medical professional with no reputation and his uniqueleft-leaning position in medicine.[9][10] Throughout its history, the journal has been considered one of the most prestigious in the world and has played an important role in reforming thehealthcare system of United Kingdom.[11]
1823 issue ofThe Lancet, written by Thomas Wakley, explained the journal's purpose. Wakley said its goal was to inform and teach the people about medicine. Wakley then began reprinting lectures from his professor atUnited Hospitals for free in the journal. This caused some controversy, as the lectures usually cost £15 to listen and were republished without permission.The Lancet was eventually sued by multiple people forcopyright infringement anddefamation; every lawsuit was won by the journal, increasing its reputation among readers. Two years after the journal's foundation, over 4,000 people subscribed toThe Lancet; its publications cost onesixpence.The Lancet's readership grew and many people started writing for the journal, like pamphleteerWilliam Cobbett.[12] Seven years afterThe Lancet's foundation, the journal's subscriptions grew to 8,000+. In 1840, the journal experienced growth and "dominated" medical news in the UK.[13]
Members of the Wakley family retained editorship of the journal until 1908.[14] In 1921,The Lancet was acquired byHodder & Stoughton.Elsevier acquiredThe Lancet from Hodder & Stoughton in 1991.[15]The Lancet is known for its positive views onsocial justice. The journal expressed its solidarity with theGeorge Floyd protests in 2020 and formed a "Group for Racial Equity"; it also published a special issue in December 2022 that discussed promoting racial and ethnic equity in science and other practices.Richard Horton, itseditor-in-chief since 1995, has stated that the journal practices "health equity" by dedicating more articles on problems related to low and middle-income countries, more than other medical journals. Senior editor of the journal, Maneet Virdi, has said thatThe Lancet stands against racism and all other forms of discrimination.[8]
During its early existence, the journal exposedunhygienic conditions at multiple hospitals, prompting the government to take action. The journal wrote an article about the first everblood transfusion by physicianJames Blundell. In 1867, surgeonJoseph Lister, writing for the journal, explained howantiseptic can be used to treatabcesses.[9] In 1915, physicianCharles Samuel wrote the first ever article aboutshell shock in the journal.[16] In 1918, psychiatristWilliam Rivers wrote another article about shell shock inThe Lancet.[9] Some articles published during the journal's early existence covered more than medicine. Until 1825,The Lancet publishedgossip about celebrities,political news and literary correspondence.[13] In late 2020, German doctors who treatedAlexei Navalny after he waspoisoned by theFSB published an article in the journal about the incident; the article detailed their use ofcholinesterase inhibitor to save him and his path to recovery. The Press Secretary of the President of Russia,Dmitry Peskov, commented on the article in Lancet as follows: "We do not read medical publications".[17]
Reportedly,The Lancet accepts only 5% of articles submitted, with each article being reviewed by the journal's staff within 72 hours. If an article is accepted, it is published within four weeks and undergoes an extensivepeer review process. The publishing guidelines state that the journal considers every article that "advances or illuminates medical science or practice, or that educates or entertains the journal's readers". All potential authors for the journal must follow authorship rules created byInternational Committee of Medical Journal Editors. While article submission to the journal is free, authors are offered the option to have their accepted articles sponsored for a $5,000 fee.The Lancet has published over 10,000 articles in total and has 1.8 million active users.[18][17]
The Lancet is consistently ranked among the top journals in general medicine based on major citation indexes:[19]
| Source | Category | Rank | Percentile | Quartile |
|---|---|---|---|---|
| Scopus | General Medicine in Medicine | 1 of 636 | 99.84 | Q1 |
| IF (Web of Science) | Medicine, General & Internal | 1 of 325 | 99.80 | Q1 |
| JCI (Web of Science) | Medicine, General & Internal | 2 of 329 | 99.39 | Q1 |
According toJournal Citation Reports, the journal had a 2024impact factor of 88.5, ranking it first aboveThe New England Journal of Medicine in the category "Medicine, General & Internal".[20] According toBMJ Open in 2017,The Lancet was more frequently cited in general newspapers around the world thanThe BMJ,NEJM andJAMA.[21]
The Lancet was criticised after it published a paper in 1998 in which the authors suggested alink between theMMR vaccine andautism spectrum disorder.[22] In February 2004,The Lancet published a statement by 10 of the paper's 13 coauthors repudiating the possibility that MMR could cause autism.[23] Editor-in-chief,Richard Horton went on the record to say the paper had "fatal conflicts of interest" that the study's lead author,Andrew Wakefield, had not declared toThe Lancet.[24] The journal completely retracted the paper on 2 February 2010, after Wakefield was found to have acted unethically in conducting the research.[25]
The Lancet's six editors, including the editor-in-chief, were also criticised in 2011 because they had "covered up" the "Wakefield concocted fear of MMR" with an "avalanche of denials" in 2004.[26]
The Lancet published an estimate of theIraq War's Iraqi death toll—around 100,000—in 2004. In 2006, a follow-up study by the same team suggested that the violent death rate in Iraq was not only consistent with the earlier estimate, but had increased considerably in the intervening period (seeLancet surveys of casualties of the Iraq War). The second survey estimated that there had been 654,965 excess Iraqi deaths as a consequence of the war. The 95%confidence interval was 392,979 to 942,636. 1,849 households that contained 12,801 people were surveyed.[27]
In 2011,The Lancet published a study by the UK-based "PACE trial management group", which reported success with graded exercise therapy and cognitive behavioural therapy formyalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).[28] A follow-up study was published inLancet Psychiatry in 2015.[29] The studies attracted criticism from some patients and researchers, especially with regard to conclusions from data analysis that wasdifferent from that described in the original protocol.[30] In a 2015Slate article, biostatistician Bruce Levin ofColumbia University was quoted saying "The Lancet needs to stopcircling the wagons and be open", and that "one of the tenets of good science is transparency"; whileRonald Davis ofStanford University said: "the Lancet should step up to the plate and pull that paper".[30] Horton defendedThe Lancet's publication of the trial and called the critics: "a fairly small, but highly organized, very vocal and very damaging group of individuals who have, I would say, actually hijacked this agenda and distorted the debate so that it actually harms the overwhelming majority of patients".[30]
Starting in 2011, critics of the studies filed Freedom of Information Act requests to get access to the authors' primary data, in order to learn what the trial's results would have been under the original protocol. In 2016, some of the data was released, which allowed calculation of results based on the original protocol and found that additional treatment led to no significant improvement in recovery rates over the control group.[31][32]
The results from the PACE trial have been used to promotegraded exercise therapy; however, these recommendations are now viewed by most public health bodies as outdated and highly harmful to ME/CFS patients.[33][34][35]
In May 2020,The Lancet published an observationalretrospective cohort study byMandeep R. Mehra of theHarvard Medical School and Sapan S. Desai of Surgisphere Corporation, which concluded that the malaria drugshydroxychloroquine andchloroquine did not improve the condition ofCOVID-19 patients, and may have harmed some of them.[36]
In response to concerns raised by members of the scientific community and the media about the veracity of the data and analyses,[37][38][39]The Lancet decided to launch an independent third party investigation of Surgisphere and the metastudy. Specifically,The Lancet editors wanted to "evaluate the origination of the database elements, to confirm the completeness of the database, and to replicate the analyses presented in the paper"[40] The independent peer reviewers in charge of the investigation notifiedThe Lancet that Surgisphere would not provide the requested data and documentation. The authors of the study then askedThe Lancet to retract the article, which was done on 3 June 2020.[36][41][42]
To improve quality control, the editors of The Lancet Group announced changes to the editorial policy in a comment titled "Learning from a retraction" which was published on 22 September 2020.[43][44]
In September 2022,The Lancet published the report of their "COVID-19 Commission" headed byJeffrey Sachs, an economist with no medical background, who has pushed the conspiracy theory that Covid came from a US "biotechnology" lab.[45][46]Before the report's release, Sachs appeared on the podcast ofRobert F. Kennedy Jr., who has previously spread vaccine conspiracy theories. On the podcast episode, Sachs claimed that "Government officials such asAnthony Fauci "are not being honest" about the virus's origins".[47] The published report included claims that "'independent researchers have not yet investigated' US labs, and said the National Institutes of Health has 'resisted disclosing details' of its work."
VirologistAngela Rasmussen commented that this may have been "one of The Lancet's most shameful moments".[48]David Robertson from the University of Glasgow'sCentre for Virus Research said that "It's really disappointing to see such a potentially influential report contributing to further misinformation on such an important topic" and "It's true we've details to understand on the side of natural origins, for example the exact intermediate species involved, but that doesn't mean there's... any basis to the wild speculation that US labs were involved".[46]
In October 2023,The Lancet retracted two papers from 2008 and 2014 by surgeonPaolo Macchiarini. These papers, which discussed the first tissue-engineeredtrachea transplant, were found to contain fabricated information following an investigation by the Swedish National Board for Assessment of Research Misconduct.[49]
Before the 2023 retractions, in September 2015,The Lancet published aneditorial titled, "Paolo Macchiarini is not guilty of scientific misconduct".[50]
A December 2003 editorial by the journal, titled "How do you sleep at night,Mr Blair?", called fortobacco use to becompletely banned in the United Kingdom.[51]
TheRoyal College of Physicians rejected their argument. John Britton, chairman of the college's tobacco advisory group, praised the journal for discussing the health problem, but concluded that a "ban on tobacco would be a nightmare." Amanda Sandford, spokesperson for the anti-tobacco groupAction on Smoking and Health, stated that criminalising a behaviour 26% of the population practise "is ludicrous." She also said: "We can't turn the clock back. If tobacco were banned we would have 13 million people desperately craving a drug that they would not be able to get." The deputy editor ofThe Lancet responded to the criticism by arguing that no other measures besides a total ban would likely be able to reduce tobacco use.[52]
The smokers' rights groupFOREST stated that the editorial gave them "amusement and disbelief". Director Simon Clark called the journal "fascist", and argued that it is hypocritical to ban tobacco while allowing unhealthyjunk foods,alcohol consumption, and participation inextreme sports. Health SecretaryJohn Reid reiterated that his government was committed to helping people give up smoking. He added: "Despite the fact that this is a serious problem, it is a little bit extreme for us in Britain to start locking people up because they have an ounce of tobacco somewhere".[53]
In August 2014 and during the2014 Israel–Gaza conflict,The Lancet published an "Open letter for the people ofGaza" in their correspondence section.[54] As reported inThe Daily Telegraph, the letter "condemnedIsrael in the strongest possible terms, but strikingly made no mention ofHamas' atrocities."[55] According toHaaretz, the authors of the letter include doctors who "are apparently sympathetic to the views ofDavid Duke, a white supremacist and formerKu Klux KlanGrand Wizard."[56] One of the doctors responded by saying that the letter was a legitimate exercise in freedom of expression, while a second one stated that he had no knowledge about David Duke or the Ku Klux Klan.[55]
The editor ofThe Lancet,Richard Horton, said: "I have no plans to retract the letter, and I would not retract the letter even if it was found to be substantiated".[56] However, Horton subsequently came to Israel'sRambam Hospital for a visit and said that he "deeply, deeply regret[ted] the completely unnecessary polarization that publication of the letter by Dr Paola Manduca caused."[57][58][59][60]
Mark Pepys, a member of the Jewish Medical Association, criticised the letter as being a "partisan political diatribe" inappropriate for a serious publication. Pepys criticisedRichard Horton personally for allowing the publication of such political views.[55]
On 19 February 2020,The Lancet published a letter signed by 27 scientists that stated: "We stand together to strongly condemn conspiracy theories suggesting that COVID-19 does not have a natural origin ... [Scientists] overwhelmingly conclude that this coronavirus originated in wildlife," adding: "Conspiracy theories do nothing but create fear, rumours, and prejudice that jeopardise our global collaboration in the fight against this virus." The letter has been criticised for having a chilling effect on scientific research and the scientific community, by implying that scientists who "bring up the lab-leak theory... are doing the work of conspiracy theorists";[61][62][63] the statement was deemed to have "effectively ended the debate over COVID-19's origins before it began".[62] Further criticism of the letter was focused on the fact that, according to emails obtained through theFreedom of Information Act, members involved in producing the letter concealed their involvement "to creat[e] the impression of scientific unanimity" and failed to disclose conflicts of interest.[62]
After having published letters supporting only thenatural origins theory,The Lancet published a letter in September 2021 from a group of 16 virologists, biologists, and biosecurity specialists saying that "Research-related hypotheses are not misinformation or conjecture" and that "Scientific journals should open their columns to in-depth analyses of all hypotheses."[64]The Times of India describedThe Lancet's decision to publish the letter as a "u-turn".[65]
In June 2024,The Lancet wrote an op-ed stating that "SARS-CoV-2 is a natural virus that found its way into humans through mundane contact with infected wildlife" and that "doubling down on flawed assumptions in the face of growing evidence calls motivations into question".[66]
The 25 September 2021 edition ofThe Lancet included a review of an exhibition about the history ofmenstruation at theVagina Museum. The journal's cover displayed a quotation from the review that referred to women as "bodies withvaginas". The quotation drew strong criticism onTwitter accusingThe Lancet ofsexism, arguing that this language was "dehumanising" and an "unhelpful" attempt at inclusivity.[67][68] Horton later issued an apology on the journal's website.[69][70]
On 5 July 2024,The Lancet published in its correspondence section a letter with an estimate of the number of direct and indirect deaths that may be caused in the coming months and years by theGaza war. Using other conflicts, where the number of indirect deaths was 3 to 15 times higher than the number of direct deaths, the authors estimated the total number of conflict-related deaths by multiplying the reported deaths by five, and argued that in the coming months and years "it is not implausible to estimate that up to 186,000 or even more deaths could be attributable to the current conflict in Gaza".[71]
The estimate quickly gained traction in both international and regional media,[72][73][74] with some of the outlets misrepresenting the 186,000 figure as the actual number of deaths, rather than long-term cumulative estimate.[75][76] As a result, three days after the publication, one of the letter's authors,Martin McKee, wrote that the letter "has been greatly misquoted and misinterpreted" and clarified that the 186,000 figure was "purely illustrative".[77][78]
The letter has been criticised by the Chair of "Every Casualty Counts" networkMichael Spagat, who wrote that the estimate "lacks a solid foundation and is implausible".[79]Peter A. Singer, former Special Adviser to the Director-General of WHO, characterised the letter's methods as "take one unreliable number and multiply by another unreliable number to get a bigger unreliable number".[80]
Consequently,American Jewish Committee called uponThe Lancet to "remove the letter from its website and, moving forward, exercise greater caution in selecting the claims it amplifies".[81]
The following persons have beeneditors-in-chief of the journal:
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Were it not for the GMC case, which cost a rumored £6m (€7m; $9m), the fraud by which Wakefield concocted fear of MMR would forever have been denied and covered up.
{{cite journal}}:Cite journal requires|journal= (help){{cite journal}}:|last1= has generic name (help)A Tweet sharing the front page has provoked a maelstrom of criticism, with academics cancelling their subscriptions and resigning as reviewers, doctors blasting the phrase as "dehumanising" and activists suggesting the term is "unhelpful" for broader debates about inclusivity.
Last year, the editor of The Lancet, a British medical journal, apologized for a cover that referred to "bodies with vaginas" rather than women.
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