Our impact: 2021

BMJ impact report 2021 | Better systems

The BMJ investigation into the formula industry has proved one of the most powerful levers for change I’ve ever been involved with. Chris van Tulleken , honorary senior lecturer, University College London, UK

The BMJ Asking questions. Questioning answers

authors to rapidly and openly respond to any issues that arrive post-publication. Moreover, The BMJ is a world renowned agent of change. Its investigative journalism has: • uncovered institutional research fraud and misconduct 21 • led to changes in national clinical practice guidelines 22, 23 • triggered parliamentary inquiries in Europe 24, 25 • moved a prominent professional society to divest from formula milk revenues 26, 27 We are now taking our investigative journalism to the next level with the launch of The BMJ Investigations Unit to tackle more instances of institutional, corporate, governmental, and regulatory

misconduct that harm patients and the public. Our work is intended to protect patients and the public’s welfare and improve health systems worldwide. A recent grant has boosted our investigative journalism capability, and allowed us to escalate our impact and influence on healthcare improvement. We plan to scale up and produce at least five investigative series over the next five years, as well as continue to seek external support for our independent journalism. The BMJ has been lauded for taking on medical, political, and corporate vested interests. We will continue to challenge the status quo where it goes against the public interest.

We’re also known for what we don’t do: no conflicts of interest are allowed in our educational articles and editorials—their power to shape clinical practice is just too great to allow for any risk of influence by vested interests. We also don’t over-focus on novel or positive results when selecting which research papers to publish—such content may be more newsworthy. Still, that sort of selection bias can tend to mislead. Other examples of editorial innovation include The BMJ’s ‘open data’ policy that demands greater transparency throughout the scientific publishing process. In addition, Rapid Recommendations was introduced to fast-track the process of turning original research evidence into clinically actionable insights. We always encourage readers to post Rapid Responses to articles, and ask

The BMJ is a known innovator in this area, often among the first to adopt a new standard. We then roll this out more widely across the BMJ journal portfolio, and are often emulated by other publishers. For instance, in the critical area of peer review, The BMJ , together with the Journal of the American Medical Association (JAMA), is a co-convenor of the prestigious biennial Peer Review Congress. 19 We have brought transparency to the peer review process through ‘open peer review’. And our use of patient reviewers also helps keep journals and authors focused on the impact a research paper might have on patient care. That focus on ‘Patient and Public Partnership’ 20 is demonstrated further by the way we challenge every submitting author to specify whether and how they have involved patients in their research.

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