![]() ![]() The NEJM implemented a policy Too close to call in 2001 to prevent “insider bias” among the editors (Curfman and Drazen 2001), when editors submitted work to their own journal. A finding of possible institutional inequality in the process of academic publishing. Recently, in the four top journals of humanities, an institutional bias towards publication of authors from Harvard and Yale was shown (Piper and Wellman 2017). The academic publication process in the NEJM should optimally ensure publication of only the most impactful papers, and the base for publication decision should rely primarily on scientific merit and novelty. Furthermore, 58% of the randomized controlled trials published in NEJM are entirely funded by a for-profit organization (Delgado and Delgado 2017). This increasing IF might reflect that only the scientifically most rigorous and influential medical papers are published in the NEJM. According to this, the New England Journal of Medicine (NEJM) is today the highest ranked general medical journal, with a steadily increasing impact factor (IF) over the last 20 years that has now reached 72 in IF (Garfield 1996 Reuters 2017). Scientific journals are ranked according to their impact factor (IF), where the IF is based upon the number of citations to that journals recent published articles divided by the number of published articles the two preceding years. Based on these results there appears to be low risk of institutional bias in the publishing process of original studies in the NEJM. In summary, citation rates were comparable between studies origination from the Harvard University compared to non-Harvard Institutions. The mean difference was not statistically different between affiliations, but fulfilled the requirements for noninferiority. ![]() The mean number of citations for Harvard affiliated studies was 625 (95% CI 358–952, median 354) and for non–Harvard affiliated studies 493 (95% CI 421–569, median 303). Twenty-two studies were affiliated to the Harvard University and 280 studies were not affiliated to the Harvard University. A two-sample noninferiority test based on the primary endpoint of citations was performed. We evaluated original research articles published in the NEJM in 2000 up until June 2001. We examined if studies originating from the Harvard University published in the NEJM were noninferior in terms of citation rates compared to articles with an origin outside Harvard University. It is unknown if there exists institutional bias favoring publication of articles originating from Harvard University, since the NEJM is produced by the Massachusetts Medical Society with close connections to the Harvard University. The New England Journal of Medicine (NEJM) is today the highest ranked general medical journal. Recently, in the four top journals of humanities, an institutional bias towards publication of authors from Harvard and Yale was shown. ![]()
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