This is the Science-Based Medicine blog, but all too often we talk about things that are not science-based medicine. Examining what is not science-based medicine is a good way to better understand what science-based medicine is or should be. But let’s not forget to celebrate the successes of good science-based medicine.
The New England Journal of Medicine is one of the most prestigious medical journals with the most rigorous standards for publication. Jeffrey Drazen has been its editor-in-chief for 19 years, and as he prepares to retire, he has selected Drazen’s Dozen, twelve articles published during his tenure that stand out to him as the most important and useful articles that physicians could act on immediately to improve patient care.
- Exposure to peanuts is safer for infants than avoidance. (“Randomized Trial of Peanut Consumption in Infants at Risk for Peanut Allergy“.) Standard advice for infants at high risk of developing peanut allergies was to avoid peanuts in the early years of life. This study found that the standard practice increased the risk of peanut allergy, and that sustained peanut consumption in the first 11 months of life was associated with an 86% reduction in peanut allergy at 60 months of age.
- A better way to prevent strokes. (“Apixaban versus Warfarin in Patients with Atrial Fibrillation“.) Patients with atrial fibrillation were treated with warfarin to prevent strokes. Dosage was hard to adjust and required frequent blood tests; interactions with other drugs were common. Apixaban, a pill that doesn’t require blood tests, was shown to be superior to warfarin in preventing stroke or systemic embolism; it caused fewer bleeding complications and even reduced the risk of death from any cause by 11%.
- Lifestyle intervention, not drugs, is the best way to prevent Type 2 diabetes. (“Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin“.) Lifestyle changes (weight loss and exercise) were superior to the prescription drug Metformin: the number needed to treat to prevent one case of diabetes during a period of 3 years was 6.9 for lifestyle changes and 13.9 for Metformin.
- Colonoscopy screening saves lives. (“Colonoscopic Polypectomy and Long-Term Prevention of Colorectal-Cancer Deaths“.) Colonoscopy screening has long been recommended, but we had no direct evidence that it prevented deaths. Now we do. This study showed that after a mean period of nearly 16 years, mortality from colorectal cancer in study subjects was 53% lower among those who had undergone colonoscopy and had adenomas removed than in a reference group.
- A cure for chronic HCV infections. (“Sofosbuvir and Velpatasvir for HCV Genotype 1, 2, 4, 5, and 6 Infection“.) Chronic hepatitis C virus (HCV) infections cause liver cancers and deaths. 3 million Americans are infected, and as many as half of them don’t know it. Curing the infection reduces the risk of liver cancer by 76% and of death from any cause by 50%. Previous treatments caused side effects and were not very effective. A new treatment is much better. Clinical trials showed excellent safety and efficacy of once-daily use of a combination of two new drugs for 12 weeks.
- New hope for patients with chronic myelogenous leukemia (CML). (“Hematologic and Cytogenetic Responses to Imatinib Mesylate in Chronic Myelogenous Leukemia“.) CML is potentially curable with allogeneic stem-cell transplantation, but fewer than 30% of patients have suitably matched donors. The standard drug treatment, interferon alfa, is toxic and not very effective. In this study, patients who had failed interferon treatment were given imatinib mesylate (Gleevec). It was effective and well-tolerated. The progression-free survival rate was 89 percent.
- The cause of SARS was rapidly identified. (“A Novel Coronavirus Associated with Severe Acute Respiratory Syndrome“.) An outbreak of severe acute respiratory syndrome (SARS) started in China in 2002 and spread to other countries. A global collaborative effort led to the identification of its cause: a new coronavirus that may have originated in animals. The authors said, “The investigation of the SARS outbreak serves as a positive template for laboratory and epidemiologic response to possible future infectious-disease pandemics.”
- A new vaccine to prevent cancer. (“Quadrivalent Vaccine against Human Papillomavirus to Prevent High-Grade Cervical Lesions“.) Human papillomavirus (HPV) infections cause many types of cancer, especially cervical cancers in women. This new vaccine was the first explicitly designed to prevent cancer induced by a virus. In a randomized, double-blind placebo-controlled trial, the quadrivalent vaccine was 98% effective for the viral strains covered.
- Functional outcomes from strokes can be improved. (“A Randomized Trial of Intraarterial Treatment for Acute Ischemic Stroke“.) Initial treatment for a stroke is an intravenous drug to break up clots, but intraarterial treatments (retrievable stents, clot dissolution, clot retrieval) are often needed for revascularization. Intraarterial treatment in patients with acute ischemic stroke caused by a proximal intracranial occlusion of the anterior circulation was effective and safe when administered within 6 hours after stroke onset. There was a clinically significant increase in functional independence in daily life by 3 months, with no increase in mortality. Questions remain, but the accompanying editorial calls this study the first step in the right direction.
- Prostate surgery reduces prostate cancer deaths but not overall mortality. (“A Randomized Trial Comparing Radical Prostatectomy with Watchful Waiting in Early Prostate Cancer“.) Prostate surgery carries a significant risk of impotence and incontinence. It reduces the rate of death from prostate cancer but does not increase overall survival compared to the option of watchful waiting. An accompanying editorial asks if all patients should get radical prostatectomy and if no one should be followed with watchful waiting; it answers both questions with a categorical “no”. This is a complicated subject with evolving criteria and ongoing trials, and it would be best to fully inform patients about their options and support their choices.
- Radical mastectomy is obsolete. (“Twenty-Year Follow-up of a Randomized Study Comparing Breast-Conserving Surgery with Radical Mastectomy for Early Breast Cancer“.) This long-term study demonstrated that the survival rate with breast-conserving surgery is as good as with radical mastectomy. Breast-conserving surgery is now the treatment of choice for relatively small breast cancers.
- Inducing labor can benefit mothers without harming babies. (“Labor induction versus Expectant Management in Low-Risk Nulliparous Women”.) A randomized trial found that inducing labor at 39 weeks in low-risk women decreased the C-section rate and did not increase adverse perinatal outcomes for babies compared to expectant management.
Conclusion: Science rules!
Note that these are all large, well-designed, rigorous, high quality studies that answer important questions for clinical practice. The authors’ conclusions don’t go beyond the data. They don’t indulge in fanciful speculations. They acknowledge remaining uncertainties and the need for more research.
Now look at some of the best studies you can find from the world of alternative medicine. There is no comparison. I once reviewed what a chiropractic website called the “top 10 chiropractic studies of 2013”. The quality of those studies was abysmal. You can read my analysis here.
You may not agree with Drazen’s selection of the top dozen, but I think you will agree that the NEJM is an excellent source of good scientific studies and has so far been resistant to quackademic medicine (as opposed to many other sources I could name). It is important to criticize poor science, pseudoscience, and CAM silliness, but it’s also important to celebrate the undeniable achievements of science-based medicine. As Bill Nye the Science Guy says, “Science Rules!”
Discipline | Medicine |
---|---|
Language | English |
Edited by | Eric Rubin |
Publication details | |
The New England Journal of Medicine and Surgery, The New England Medical Review and Journal, The Boston Medical and Surgical Journal | |
Publication history | 1812–present |
Publisher | |
Frequency | weekly |
Delayed (6 months) | |
79.258 | |
Standard abbreviations | |
New Eng. J. Med. | |
N. Engl. J. Med. | |
Indexing | |
CODEN | NEJMAG |
ISSN | 0028-4793 (print) 1533-4406 (web) |
LCCN | 20020456 |
OCLC no. | 231027780 |
Links |
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[1] as well as the oldest continuously published one.[1]
History[edit]
January 1814 edition of the Journal.
The New England Journal Of Medicine 2015
In September 1811, John Collins Warren, a Boston physician,[2] 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.[3] 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.[4] The journal was published quarterly.
1823 Boston Medical Intelligencer
On April 29, 1823, another publication, the Boston Medical Intelligencer, appeared under the stewardship of Jerome V. C. Smith.[5][6]
1828 Boston Medical and Surgical Journal
The Intelligencer ran into financial troubles in the spring of 1827, and the editors of the New England Journal of Medicine and Surgery and the Collateral Branches of Medical Science purchased it in February 1828 merging the two publications to form the Boston Medical and Surgical Journal,[5] published weekly.
The Massachusetts Medical Society purchased it in 1921 for $1[7] and renamed it in 1928 the New England Journal of Medicine.
Logo[edit]
The journal’s logo depicts the 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.
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February 23, 1928, cover of The New England Journal of Medicine. First use of present name.
Notable articles[edit]
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.[8] '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.[9]
- 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.[10]
- 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.[11] 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.'[12]
- 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).[13]
- A letter published in the NEJM in 1980 was later described by the journal as having been 'heavily and uncritically cited'[14] 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.[15]
- In December 1981, two landmark articles[16][17] 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.[18]
Website[edit]
On April 25, 1996, NEJM announced their new website, 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.[19]
The website 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. Two years later, online publication extended to include the full text of all articles.[20]{{Nonspecific|date=June 2014}
Since its launch, NEJM has added to its website:
- Videos in Clinical Medicine, peer-reviewed educational videos to teach procedures requiring skilled techniques and specialized physical examination.[21]
- 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.[22]
- NEJM Archive, the entire collection of the journal's published material.
Influence[edit]
The website for the George Polk Awards 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.'[23]
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,[24] ranking it first of 153 journals in the category 'General & Internal Medicine'.[25] 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.[26]
Ingelfinger rule[edit]
The New England Journal of Medicine requires that articles it publishes have not been published or released elsewhere. Referred to as the Ingelfinger rule, this policy protects the originality of content.
The rule was first described in a 1969 editorial by Franz Ingelfinger, the editor-in-chief at that time. A number of medical journals have similar rules in place.
Vioxx correction controversy[edit]
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.[27] 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.[28]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.'[29] 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.[30] The journal was publicly rebuked for its response to the research issues in editorials appearing in publications including the British Medical Journal[28] and the Journal of the Royal Society of Medicine.[31]
![The new england journal of medicine nejm The new england journal of medicine nejm](https://infertilityschool.ru/wp-content/uploads/2016/09/the-new-england-journal-of-medicine.jpg)
Open access policy[edit]
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).[32] This delay does not apply to readers from the least developed countries, for whom the content is available at no charge for personal use.[33]
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.
Editors[edit]
- Walter Prentice Bowers, 1921–1937
- Robert Nason Nye, 1937–1947
- Joseph Garland, 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
See also[edit]
References[edit]
- ^ abZuger, Abigail (March 19, 2012). 'A journal stands out in prestige and longevity'. The New York Times. Retrieved June 24, 2014.
- ^Cary, John (1961). Joseph Warren: Physician, Politician, Patriot. Urbana: University of Illinois Press. OCLC14595803.
- ^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 December 22, 2011.
- ^ ab'The Boston Medical Library: A reconstruction of the collection of 1805 and its history'. Retrieved December 22, 2011.
- ^Fitz-Gilbert Waters, Henry (1961). The New England Historical and Genealogical Register. 48. New England Historic Genealogical Society.
- ^'About NEJM: Past and Present'. nejm.org. Retrieved December 22, 2011.
- ^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.
- ^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. PMID18860765.
- ^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. PMID13002611.
- ^Wolff, William I.; Shinya, Hiromi (1973). 'Polypectomy via the fiberoptic colonoscope'. New England Journal of Medicine. 288 (7): 329–32. doi:10.1056/NEJM197302152880701. PMID4682941.
- ^'Addiction Rate in Patients Treated with Narcotics'. New England Journal of Medicine. 302 (2): 123. 1980. doi:10.1056/NEJM198001103020221.
- ^'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. PMID6272109.
- ^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. PMID6975437.
- ^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. PMID11287972.
- ^Campion, Edward W. (1996). 'The Journal's new presence on the internet'. New England Journal of Medicine. 334 (17): 1129. doi:10.1056/NEJM199604253341712.
- ^'First NEJM website'. Retrieved May 7, 2012.
- ^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.
- ^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. PMID11087881.
- ^ abDobson, 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. PMC1502213. PMID16840463.
- ^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. PMID16339408.
- ^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. ISBN9780433452218.
- ^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. PMC1533509. PMID16893926. 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.
Further reading[edit]
- Conaboy, Chelsea (June 17, 2012). 'You've come a long way, doc'. The 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. PMID22216863.
External links[edit]
Retrieved from 'https://en.wikipedia.org/w/index.php?title=The_New_England_Journal_of_Medicine&oldid=903424073'
The New England Journal of Medicine (NEJM) is an English-language peer-reviewed medical journal published by the Massachusetts Medical Society. It describes itself as the oldest continuously published medical journal in the world. The journal publishes editorials, papers on original research, review articles, correspondence, and case reports, and has a special section called 'Images in Clinical Medicine'. 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. On April 29, 1823, another publication, the Boston Medical Intelligencer, appeared under the stewardship of Jerome V.C. Smith. The Intelligencer ran into financial troubles in the spring of 1827, and the editors of the New England Journal of Medicine and Surgery and the Collateral Branches of Medical Science purchased it in February 1828
- Publisher
- Massachusetts Medical Society
- Country
- United States
- History
- The New England Journal of Medicine and Surgery (1812–1826);
The New England Medical Review and Journal (1827);
The Boston Medical and Surgical Journal (1828–1927);
The New England Journal of Medicine (1928–present) - Impact factor
- 53.484 (2010)
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