The Lancet
The Lancet is a weekly peer-reviewed general medical journal, founded in England in 1823. It is one of the world's highest-impact academic journals and also one of the oldest medical journals still in publication.
The journal publishes original research articles, review articles, editorials, book reviews, correspondence, as well as news features and case reports. The Lancet has been owned by Elsevier since 1991, and its editor-in-chief since 1995 has been Richard Horton. The journal has editorial offices in London, New York City, and Beijing.
History
The Lancet was founded in 1823 by Thomas Wakley, an English surgeon who named it after the surgical instrument called a lancet. Wakley was motivated to create the journal due to alleged corruption of medical services he saw in London. On its founding, the journal had a "radical slant", challenging what its founder saw as the corruption, nepotism, and incompetence of the academic establishment of its day. Throughout its history, the journal has been considered one of the most prestigious in the world and has played an important role in reforming the healthcare system of United Kingdom.1823 issue of The 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 at United 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 for copyright infringement and defamation; every lawsuit was won by the journal, increasing its reputation among readers. Two years after the journal's foundation, over 4,000 people subscribed to The Lancet; its publications cost one sixpence. The Lancets readership grew, and many people started writing for the journal, including pamphleteer William Cobbett. Seven years after The Lancet
Members of the Wakley family retained editorship of the journal until 1908. In 1921, The Lancet was acquired by Hodder & Stoughton. Elsevier acquired The Lancet from Hodder & Stoughton in 1991. The Lancet is known for its positive views on social justice. The journal expressed its solidarity with the George 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, its editor-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 that The Lancet stands against racism and all other forms of discrimination.
Articles
During its early existence, the journal exposed unhygienic conditions at multiple hospitals, prompting the government to take action. The journal wrote an article about the first ever blood transfusion by physician James Blundell. In 1867, surgeon Joseph Lister, writing for the journal, explained how antiseptic can be used to treat abscesses. In 1915, physician Charles Samuel wrote the first ever article about shell shock in the journal. In 1918, psychiatrist William Rivers wrote another article about shell shock in The Lancet. Some articles published during the journal's early existence covered more than medicine. Until 1825, The Lancet published gossip about celebrities, political news and literary correspondence. In late 2020, German doctors who treated Alexei Navalny after he was poisoned by the FSB published an article in the journal about the incident; the article detailed their use of cholinesterase inhibitor to save him and his path to recovery. The Press Secretary of the President of Russia, Dmitry Peskov, commented on the Lancet article as follows: "We do not read medical publications".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 extensive peer 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 by International 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.
Ranking and impact
Journal ranking summary (2023)
The Lancet is consistently ranked among the top journals in general medicine based on major citation indexes:| Source | Category | Rank | Percentile | Quartile |
| Scopus | General Medicine in Medicine | 1 of 636 | 99.84 | Q1 |
| IF | Medicine, General & Internal | 1 of 325 | 99.80 | Q1 |
| JCI | Medicine, General & Internal | 2 of 329 | 99.39 | Q1 |
Impact Factor
According to Journal Citation Reports, the journal had a 2024 impact factor of 88.5, ranking it first above The New England Journal of Medicine in the category "Medicine, General & Internal". According to BMJ Open in 2017, The Lancet was more frequently cited in general newspapers around the world than The BMJ, NEJM and JAMA.Scientific controversies
Andrew Wakefield and the MMR vaccine (1998)
The Lancet was criticised after it published a paper in 1998 in which the authors suggested a link between the MMR vaccine and autism spectrum disorder. In February 2004, The Lancet published a statement by 10 of the paper's 13 coauthors repudiating the possibility that MMR could cause autism. 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 to The Lancet. The journal completely retracted the paper on 2 February 2010, after Wakefield was found to have acted unethically in conducting the research.The Lancets 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.
Iraq War death toll estimates (2004–2006)
The Lancet published an estimate of the Iraq 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. 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.PACE study (2011)
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 for myalgic encephalomyelitis/chronic fatigue syndrome. A follow-up study was published in Lancet Psychiatry in 2015. The studies attracted criticism from some patients and researchers, especially with regard to conclusions from data analysis that was different from that described in the original protocol. In a 2015 Slate article, biostatistician Bruce Levin of Columbia University was quoted saying "The Lancet needs to stop circling the wagons and be open", and that "one of the tenets of good science is transparency"; while Ronald Davis of Stanford University said: "the Lancet should step up to the plate and pull that paper". Horton defended The 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".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.
The results from the PACE trial have been used to promote graded exercise therapy; however, these recommendations are now viewed by most public health bodies as outdated and highly harmful to ME/CFS patients.
Surgisphere study on the use of hydroxychloroquine and chloroquine (2020)
In May 2020, The Lancet published an observational retrospective cohort study by Mandeep R. Mehra of the Harvard Medical School and Sapan S. Desai of Surgisphere Corporation, which concluded that the malaria drugs hydroxychloroquine and chloroquine did not improve the condition of COVID-19 patients, and may have harmed some of them.In response to concerns raised by members of the scientific community and the media about the veracity of the data and analyses, 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" The independent peer reviewers in charge of the investigation notified The Lancet that Surgisphere would not provide the requested data and documentation. The authors of the study then asked The Lancet to retract the article, which was done on 3 June 2020.
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.