|Edited by||Richard Horton|
|ISSN|| 0140-6736 (print)|
The Lancet is a weekly peer-reviewed general medical journal. It is among the world's oldest, most prestigious, and best known general medical journals.
A general medical journal is an academic journal dedicated to medicine in general, rather than a specific field of medicine.
The journal was founded in 1823 by Thomas Wakley, an English surgeon who named it after the surgical instrument called a lancet, as well as after the architectural term "lancet arch",a window with a sharp pointed arch, to indicate the "light of wisdom" or "to let in light".
Thomas Wakley was an English surgeon. He gained fame as a social reformer who campaigned against incompetence, privilege and nepotism. He was the founding editor of The Lancet, a radical Member of Parliament (MP) and a celebrated coroner.
In modern medicine, a surgeon is a physician who performs surgical operations. There are also surgeons in podiatry, dentistry maxillofacial surgeon and the veterinary fields.
The journal publishes original research articles, review articles ("seminars" and "reviews"), editorials, book reviews, correspondence, as well as news features and case reports. The Lancet has been owned by Elsevier since 1991. Since 1995, the editor-in-chief is Richard Horton.The journal has editorial offices in London, New York, and Beijing.
Elsevier is a Dutch information and analytics company and one of the world's major providers of scientific, technical, and medical information. It was established in 1880 as a publishing company. It is a part of the RELX Group, known until 2015 as Reed Elsevier. Its products include journals such as The Lancet and Cell, the ScienceDirect collection of electronic journals, the Trends and Current Opinion series of journals, the online citation database Scopus, and the ClinicalKey solution for clinicians. Elsevier's products and services include the entire academic research lifecycle, including software and data-management, instruction and assessment tools.
An editor-in-chief, also known as lead editor or chief editor, is a publication's editorial leader who has final responsibility for its operations and policies. The highest ranking editor of a publication may also be titled editor, managing editor, or executive editor, but where these titles are held while someone else is editor-in-chief, the editor-in-chief outranks the others.
Richard Charles Horton, FRCP, FMedSci, is the present editor-in-chief of The Lancet, a United Kingdom-based medical journal.
According to the Journal Citation Reports , the journal has a 2017 impact factor of 53.254, ranking it 2nd after The New England Journal of Medicine in the category "Medicine, General".
Journal Citation Reports (JCR) is an annual publication by Clarivate Analytics. It has been integrated with the Web of Science and is accessed from the Web of Science-Core Collections. It provides information about academic journals in the natural sciences and social sciences, including impact factors. The JCR was originally published as a part of Science Citation Index. Currently, the JCR, as a distinct service, is based on citations compiled from the Science Citation Index Expanded and the Social Science Citation Index.
The impact factor (IF) or journal impact factor (JIF) of an academic journal is a measure reflecting the yearly average number of citations to recent articles published in that journal. It is frequently used as a proxy for the relative importance of a journal within its field; journals with higher impact factors are often deemed to be more important than those with lower ones. The impact factor was devised by Eugene Garfield, the founder of the Institute for Scientific Information (ISI). Impact factors are calculated yearly starting from 1975 for journals listed in the Journal Citation Reports (JCR).
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 as well as the oldest continuously published one.
The Lancet also publishes several specialty journals: The Lancet Neurology (neurology), The Lancet Oncology (oncology), The Lancet Infectious Diseases (infectious diseases), The Lancet Respiratory Medicine (respiratory medicine), The Lancet Psychiatry (psychiatry), The Lancet Diabetes and Endocrinology (endocrinology), and The Lancet Gastroenterology & Hepatology (Gastroenterology) all of which publish original research and reviews. In 2013, The Lancet Global Health (global health) became the group's first fully open access journal. In 2014, The Lancet Haematology (haematology) and The Lancet HIV (infectious diseases) were launched, both as online only research titles. In 2017, The Lancet Child & Adolescent Health (paediatrics) will launch. The three established specialty journals (The Lancet Neurology, The Lancet Oncology, and The Lancet Infectious Diseases) have built up strong reputations in their medical specialty. According to the Journal Citation Reports , the The Lancet Oncology has a 2017 impact factor of 36.421, The Lancet Neurology has 27.144, and The Lancet Infectious Diseases has 25.148.There is also an online website for students entitled The Lancet Student in blog format, launched in 2007.
A medical speciality is a branch of medical practice that is focused on a defined group of patients, diseases, skills, or philosophy. Examples include children (paediatrics), cancer (oncology), laboratory medicine (pathology), or primary care. After completing medical school, physicians or surgeons usually further their medical education in a specific specialty of medicine by completing a multiple-year residency to become a medical specialist.
Neurology is a branch of medicine dealing with disorders of the nervous system. Neurology deals with the diagnosis and treatment of all categories of conditions and disease involving the central and peripheral nervous systems, including their coverings, blood vessels, and all effector tissue, such as muscle. Neurological practice relies heavily on the field of neuroscience, the scientific study of the nervous system.
Oncology is a branch of medicine that deals with the prevention, diagnosis, and treatment of cancer. A medical professional who practices oncology is an oncologist. The name's etymological origin is the Greek word ὄγκος (ónkos), meaning "tumor", "volume" or "mass" and the word λόγος (logos), meaning "study".
Prior to 1990, The Lancet had volume numbering that reset every year. Issues in January to June were in volume i, with the rest in volume ii. In 1990, the journal moved to a sequential volume numbering scheme, with two volumes per year. Volumes were retro-actively assigned to the years prior to 1990, with the first issue of 1990 being assigned volume 335, and the last issue of 1989 assigned volume 334. The table of contents listing on ScienceDirect uses this new numbering scheme.
ScienceDirect is a website which provides subscription-based access to a large database of scientific and medical research. It hosts over 12 million pieces of content from 3,500 academic journals and 34,000 e-books. The journals are grouped into four main sections: Physical Sciences and Engineering, Life Sciences, Health Sciences, and Social Sciences and Humanities. Article abstracts are freely available, but access to their full texts generally requires a subscription or pay-per-view purchase.
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The Lancet has taken a political stand on several important medical and non-medical issues. Recent examples include criticism of the World Health Organization (WHO), rejection of the WHO's claims of the efficacy of homoeopathy as a therapeutic option,disapproval during the time Reed Exhibitions (a division of Reed Elsevier) hosted arms industry fairs, a call in 2003 for tobacco to be made illegal, and a call for an independent investigation into the American bombing of a hospital in Afghanistan in 2015.
The Lancet was criticized after it published a paper in 1998 in which the authors suggested a link between the MMR vaccine and autism.In February 2004, The Lancet published a statement by 10 of the paper's 13 coauthors repudiating the possibility that MMR could cause autism. The editor-in-chief, Richard Horton, went on the record to say the paper had "fatal conflicts of interest" because the study's lead author, Andrew Wakefield, had a serious conflict of interest that he 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 Lancet's six editors, including the editor-in-chief, were also criticized in 2011 because they had "covered up" the "Wakefield concocted fear of MMR" with an "avalanche of denials" in 2004.
A December 2003 editorial by the journal, titled "How do you sleep at night, Mr Blair?", called for tobacco use to be completely banned in the UK. The Royal 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 he concluded that a "ban on tobacco would be a nightmare." Amanda Sandford, spokesperson for the anti-tobacco group Action on Smoking and Health, stated that criminalizing a behaviour 26% of the population commit "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 of The Lancet responded to the criticism by arguing that no other measures besides a total ban would likely be able to reduce tobacco use.
The smokers rights group FOREST 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 unhealthy junk foods, alcohol consumption, and participation in extreme sports. Health Secretary John Reid reiterated that his government is 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."
The Lancet also published a controversial 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 (see Lancet 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.
The estimates provided in the second article are much higher than those published in other surveys from the same time. Most notably, the "Iraq Family Health Survey" published in the New England Journal of Medicine surveyed 9,345 households across Iraq and estimated 151,000 deaths due to violence (95% uncertainty range, 104,000 to 223,000) over the same period covered in the second Lancet survey by Burnham et al. The NEJM article stated that the second Lancet survey "considerably overestimated the number of violent deaths" and said the Lancet results were "highly improbable, given the internal and external consistency of the data and the much larger sample size and quality-control measures taken in the implementation of the IFHS."
In January 2006, it was revealed that data had been fabricated in an articleby the Norwegian cancer researcher Jon Sudbø and 13 co-authors published in The Lancet in October 2005. Several articles in other scientific journals were withdrawn following the withdrawal in The Lancet. Within a week, the New England Journal of Medicine published an expression of editorial concern regarding its published research papers by the same author, and in November 2006 the journal withdrew two oral cancer studies led by the Norwegian researcher.
In August 2010, The Lancet Infectious Diseases published an article about an enzyme conferring multi-drug-resistance properties in bacteria,which had previously been named New Delhi metallo-beta-lactamase or NDM-1 based on the assumed origin of the mechanism. The article reported 44 clinical isolates of bacteria positive for NDM-1 from Chennai, 26 from Haryana, 37 (from 29 patients) from the UK, and 73 from other sites in India, Pakistan, and Bangladesh. Of the 29 UK patients, 17 had a history of travel to India or Pakistan within 1 year, and 14 had been admitted to hospital in these countries. The authors of the article cited medical tourism to India for the spread of bacteria carrying NDM-1, which the Indian government denied.
A December 2010 article determined that alcohol had the worst medical and social effects compared to other recreational substances such as heroin and crack cocaine. The drugs marijuana, ecstasy, and LSD scored far lower in terms of related harms. The authors did not advocate alcohol prohibition, but they suggested that the government raise the price of alcohol until it was no longer widely available.Gavin Partington, spokesman of the Wine and Spirit Trade Association, responded to the report by saying that alcohol abuse affects "a minority" needing "education, treatment and enforcement". He also remarked that millions of British citizens enjoy alcohol as "a regular and enjoyable social drink".
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 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 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 that "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 condition.
In August 2014, The Lancet published an "Open letter for the people of Gaza" in their correspondence section.As reported in The Daily Telegraph , the letter "condemned Israel in the strongest possible terms, but strikingly made no mention of Hamas' atrocities." The authors of the letter include doctors who "are apparently sympathetic to the views of David Duke, a white supremacist and former Ku Klux Klan Grand Wizard." One of the doctors responded by saying: "I legitimately use my right of freedom of opinion and do not agree or value the politics of the government of Israel, nor of many others, including Jews in and out of Israel." A second one responded with: "I didn't know who David Duke was, or that he was connected to the Ku Klux Klan. I am concerned that if there is any truth in the video, that Jews control the media, politics and banking, what on earth is going on? I was worried."
The editor of The 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."However, Horton subsequently came to Israel's Rambam Hospital for a visit and said that he "deeply, deeply regrets" publishing the letter.
Mark Pepys wrote: “The failure of the Menduca et al. authors to disclose their extraordinary conflicts of interest... are the most serious, unprofessional and unethical errors. The transparent effort to conceal this vicious and substantially mendacious partisan political diatribe as an innocent humanitarian appeal has no place in any serious publication, let alone a professional medical journal, and would disgrace even the lowest of the gutter press." In addition, Pepys accuses Horton personally, saying that "Horton's behavior in this case is consistent with his longstanding and wholly inappropriate use of The Lancet as a vehicle for his own extreme political views. It has greatly detracted from the former high standing of the journal." In response, Horton said: "How can you separate politics and health? The two go hand-in-hand."
The following persons have been editors-in-chief of the journal:
The MMR vaccine is a vaccine against measles, mumps, and rubella. The first dose is generally given to children around 9 to 15 months of age, with a second dose at 15 months to 6 years of age, with at least 4 weeks between the doses. After two doses, 97% of people are protected against measles, 88% against mumps, and at least 97% against rubella. The vaccine is also recommended in those who do not have evidence of immunity, those with well controlled HIV/AIDS, and within 72 hours of exposure to measles among those who are incompletely immunized. It is given by injection.
Fatigue is a subjective feeling of tiredness that has a gradual onset. Unlike weakness, fatigue can be alleviated by periods of rest. Fatigue can have physical or mental causes. Physical fatigue is the transient inability of a muscle to maintain optimal physical performance, and is made more severe by intense physical exercise. Mental fatigue is a transient decrease in maximal cognitive performance resulting from prolonged periods of cognitive activity. It can manifest as somnolence, lethargy, or directed attention fatigue.
Autistic enterocolitis is the name of a nonexistent medical condition proposed by discredited British gastroenterologist Andrew Wakefield when he suggested a link between a number of common clinical symptoms and signs which he contended were distinctive to autism. The existence of such an enterocolitis has been dismissed by experts as having "not been established". Wakefield's now-retracted and fraudulent report used inadequate controls and suppressed negative findings, and multiple attempts to replicate his results have been unsuccessful.
A non-communicable disease (NCD) is a disease that is not transmissible directly from one person to another. NCDs include Parkinson's disease, autoimmune diseases, strokes, most heart diseases, most cancers, diabetes, chronic kidney disease, osteoarthritis, osteoporosis, Alzheimer's disease, cataracts, and others. NCDs may be chronic or acute. Most are non-infectious, although there are some non-communicable infectious diseases, such as parasitic diseases in which the parasite's life cycle does not include direct host-to-host transmission.
Claims of a link between the MMR vaccine and autism have been extensively investigated and found to be false. The link was first suggested in the early 1990s and came to public notice largely as a result of the 1998 Lancet MMR autism fraud, characterised as "perhaps the most damaging medical hoax of the last 100 years". The fraudulent research paper authored by Andrew Wakefield and published in The Lancet claimed to link the vaccine to colitis and autism spectrum disorders. The paper was retracted in 2010 but is still cited by anti-vaccinationists.
The history of chronic fatigue syndrome is thought to date back to the 19th century and before.
Treatment of chronic fatigue syndrome (CFS) is variable and uncertain, and the condition is primarily managed rather than cured.
Chronic fatigue syndrome (CFS) is an illness with a long history of controversy. For years, many professionals within the medical community did not recognize CFS as a true condition, nor was there agreement on its prevalence. There has been much disagreement over the pathophysiology of chronic fatigue syndrome, how it should be diagnosed, and how to treat it.
The clinical descriptions of chronic fatigue syndrome (CFS) vary. Different agencies and scientific bodies have produced different guidelines to define the condition, with some overlap of symptoms between descriptions. Aspects of the condition are controversial, with disagreements over etiology, pathophysiology, treatment and naming between medical practitioners, researchers, patients and advocacy groups. Subgroup analysis suggests that, depending on the applied definition, the CFS population may represent a variety of conditions rather than a single disease entity.
Andrew Jeremy Wakefield is a discredited former British doctor who became an anti-vaccine activist. He was a gastroenterologist until he was struck off the UK medical register for unethical behaviour, misconduct and dishonesty for authoring a fraudulent research paper that claimed a link between the measles, mumps and rubella (MMR) vaccine and autism and bowel disease.
Daniel Peterson is an American physician in private practice in the state of Nevada, and has been described as a "pioneer" in the treatment of chronic fatigue syndrome (CFS). He graduated from the University of Rochester School of Medicine, Rochester, New York, in 1976 and was an intern and resident at the University of Utah Medical Center from 1976 to 1979. In 1979, he became a diplomate of the American Board of Internal Medicine. He is president of Sierra Internal Medicine of Incline Village, established in 1981.
Sir Simon Charles Wessely is a British psychiatrist. He is professor of psychological medicine at the Institute of Psychiatry, King's College London and head of its department of psychological medicine, vice dean for academic psychiatry, teaching and training at the Institute of Psychiatry, as well as Director of the King's Centre for Military Health Research. He is also honorary consultant psychiatrist at King's College Hospital and the Maudsley Hospital, as well as civilian consultant advisor in psychiatry to the British Army. He was knighted in the 2013 New Year Honours for services to military healthcare and to psychological medicine. From 2014 to 2017, he was the elected president of the Royal College of Psychiatrists.
The Whittemore Peterson Institute for Neuro-Immune Disease (WPI) is a research institute and charitable foundation known for its claims that the retrovirus xenotropic murine leukemia virus-related virus (XMRV) is associated with and may cause chronic fatigue syndrome (CFS) and a variety of additional diseases. A report by WPI scientists of an association between CFS and XMRV was forcibly retracted by the journal Science when the results could not be replicated, and it was discovered that XMRV was a laboratory-created recombinant of two mouse viruses. Amid allegations of sloppiness and scientific misconduct, WPI personnel criticised the methods and motives of other scientists, implying that the negative results were part of a "cover-up" or a "bias against this disease (CFS)".
New Delhi metallo-beta-lactamase 1 (NDM-1) is an enzyme that makes bacteria resistant to a broad range of beta-lactam antibiotics. These include the antibiotics of the carbapenem family, which are a mainstay for the treatment of antibiotic-resistant bacterial infections. The gene for NDM-1 is one member of a large gene family that encodes beta-lactamase enzymes called carbapenemases. Bacteria that produce carbapenemases are often referred to in the news media as "superbugs" because infections caused by them are difficult to treat. Such bacteria are usually susceptible only to polymyxins and tigecycline.
Chronic fatigue syndrome (CFS), also referred to as myalgic encephalomyelitis (ME), is a medical condition characterized by long-term fatigue and other persistent symptoms that limit a person's ability to carry out ordinary daily activities.
Herman Hugh Fudenberg was a retired clinical immunologist who ran the Neuro Immuno Therapeutics Research Foundation (NITRF) in Spartanburg, South Carolina. Fudenberg published over 600 papers, including case reports and case series in the New England Journal of Medicine.
Chronic Lyme disease is a generally rejected diagnosis that encompasses "a broad array of illnesses or symptom complexes for which there is no reproducible or convincing scientific evidence of any relationship to Borrelia burgdorferi infection." Despite numerous studies, there is no clinical evidence that "chronic" Lyme disease is caused by a persistent infection. It is distinct from post-treatment Lyme disease syndrome, a set of lingering symptoms which may persist after successful treatment of infection with Lyme spirochetes. The symptoms of "chronic Lyme" are generic and non-specific "symptoms of life".
The Lancet MMR autism fraud centred on the publication in 1998 of a research paper titled Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children in The Lancet. The paper, authored by Andrew Wakefield, claimed to link the MMR vaccine to colitis and autism spectrum disorders. Events surrounding the research study and the publication of its findings led to Wakefield being struck off the medical register. The paper was retracted in 2010.