BMJ Group improves health outcomes worldwide with trusted evidence that professionals, patients, and the public can depend on
Impact report 2026 Improving health outcomes
Better evidence Better decisions
Better systems
Helping to create a healthier world since 1840
Welcome to our 2026 impact report The evidence environment is changing rapidly. Open access, the growth of global research, and artificial intelligence (AI) are reshaping how evidence is created, shared and used, making rigorous judgement, strong editorial standards and accountability more important than ever. Since joining BMJ Group in April 2026, I have seen how seriously colleagues take this responsibility. Research impact often takes time to emerge. This report therefore focuses on influence achieved during the past year, rather than when the underlying research was published, recognising the time needed for evidence to shape policy, clinical guidance and patient care. Following our impact framework shown to the right, the stories in this report show how that impact happens in practice, and the contribution we
Our purpose provides clarity to what we do and the impact we have
BMJ Group is a global healthcare knowledge provider with a vision for a healthier world. We share knowledge and expertise to improve health outcomes.
We do this by providing a continuum of services
Improved health outcomes
Policy and guidelines influence
Delivering quality research
Synthesised learning and best practice
Strengthened workforce
Clearer clinical decisions
Which leads to
Better evidence Patient engagement Improved research quality and integrity Faster and wider access to latest evidence
Better decisions Ability to apply best evidence Improved knowledge, skills, and career development Improved practice and patient care
Better systems High quality policy and guidelines Open research systems Improved healthcare provision
This ultimately results in
make at each stage. Niels Peter Thomas Chief executive officer, BMJ Publishing
Improved health outcomes
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BMJ Group is a top 10 policy influencer The research we publish is cited in clinical guidelines and health policy at a scale comparable to publishers many times our size.
Ranked 10th worldwide among academic publishers for total citations in clinical guidelines and health policy documents. 1
Nearly 100,000 submissions in the past year involving almost 483,000 authors and more than 37,500 peer reviewers. 2
500 staff across four global regions serving an international audience, with offices in the UK, North America, India and China.
The BMJ is one of the world’s top five general medical journals In the 2026 Journal Citation Reports, The BMJ ranked fifth overall in Medicine, General & Internal, with an impact factor of 55.1.
Cited nearly 5,000 times in 2025 in new and updated clinical guidelines and health policy documents. 1
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Impact in action
Better evidence
Over 70% of integrity concerns caught before publication BMJ Group’s content integrity team helped prevent research with potential integrity issues from entering the scientific record, protecting the reliability of the evidence base. | Page 7
Five systematic reviews underpin global hand hygiene guidance Published in BMJ Global Health, the reviews formed the evidence base for WHO and Unicef’s first global guidelines on hand hygiene in community settings. | Page 11
Four European jurisdictions act on slush ice safety
Research in Archives of Disease in Childhood identified acute glycerol intoxication in children, directly informing updates to food safety guidance in the UK, Ireland, Germany, and at EU level. | Page 13
Better decisions
One of 2 core resources selected by Google Research BMJ Best Practice was one of two clinical knowledge resources used to develop and evaluate 100 scenarios for Google’s 2026 AMIE research, grounding healthcare AI in continuously updated, evidence based guidance. | Page 23
277% of pre-integration page impression levels
35k course completions building research capability worldwide Research to Publication is helping clinicians strengthen research skills, publish their work and support healthcare improvement, with impact demonstrated across Qatar, India and Colombia. | Page 25
Clinicians reported faster access to information, greater confidence in decision making and more consistent practice after Medway NHS Foundation Trust integrated local guidelines with BMJ Best Practice into its electronic patient record. | Page 24
Better systems
25% reduction in postpartum haemorrhage The BMJ’s Racism in Medicine issue helped catalyse the creation of the NHS Race and Health Observatory, whose improvement programme supported a Lancashire maternity team to reduce postpartum haemorrhage rates from 12% to 9%. | Page 30
Four Australian states adopt family concern question A Healthcare Improvement Forum connection helped turn a Monash Health project into a national collaboration, with the approach now used routinely in four states and reflected in the UK through Martha’s Rule. | Page 32
First licensed NHS treatment for LHON
An independent evidence review by the BMJ Technology Assessment Group informed NICE’s recommendation of idebenone to treat visual impairment in people with Leber’s hereditary optic neuropathy. | Page 34
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Better evidence Research is the foundation of our business. We work with researchers, clinicians, patients, and partners to strengthen research integrity, improve how evidence is published and shared, and expand rapid access to trusted health information.
Evidence is at its most impactful when people can trust it, find it and use it. Our role is not simply to publish research, but to strengthen the evidence base, and help knowledge improve policy and practice for better health and wellbeing. Kamran Abbasi, Editor in chief, The BMJ
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Protecting the evidence that shapes research, policy and patient care Content integrity is embedded throughout our publishing lifecycle, and is central to our responsibility as a trusted global healthcare knowledge provider. Research published in our journals is cited in around 5,000 clinical guidelines and health policy documents each year, 3 influencing decisions that affect health and care. That influence makes rigorous scrutiny essential. By identifying concerns before publication, stopping or correcting problematic manuscripts, and using case analysis to strengthen policies and processes, we help protect the integrity of the scientific record. A dedicated team of clinicians and editors works with reviewers, statisticians and journal teams to identify concerns and investigate complex cases. This model gives journals direct access to specialist clinical, statistical and publication ethics expertise, while keeping editorial decisions independent of commercial publishing. 1,651 content integrity cases were handled in 2025. Of these, 1,192 (72%) arose before publication. 687 cases (42%) involved publication manipulation; 589 were identified through duplicate-submission screening. The screening programme led to 583 duplicate submissions being rejected. Post-publication investigations resulted in 12 retractions, nine expressions of concern and one correction. 4 Analysis of these cases led to new guidance on reviewer selection and the use of artificial intelligence, and revisions to consent, de-identification and editorial checks. Beyond individual cases, the content integrity team develops policy, evaluates new tools, and contributes to international standards, including reporting guidelines. It also contributes to research on publication practice, including peer review, reporting standards and AI governance. Findings from this work directly inform our editorial policies and publishing processes.
Safeguarding the evidence base Shaping publication ethics since 1997
Nearly 30 years ago, Richard Smith, then editor of The BMJ, helped found the Committee on Publication Ethics (COPE), establishing our longstanding role in strengthening publication integrity. 5 Active member of the International Committee of Medical Journal Editors (ICMJE) Contributing to the international recommendations that underpin ethical medical publishing. A specialist operating model A dedicated clinician and editorial-led content integrity team works alongside editors across every journal. Independent ethics committee Chaired by Dr Siobhán O'Sullivan, former chief bioethics officer, Department of Health, Ireland, the committee advises on the most complex editorial cases and helps shape policies and processes as new ethical challenges emerge.
We apply the same evidence based principles to publishing that we expect of healthcare: testing, evaluating and improving the systems that underpin trustworthy research.” Helen Macdonald, Publications ethics and content integrity editor, BMJ Group
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Transparent AI, trustworthy publishing
BMJ Group introduced guidance on the responsible use of generative AI in scholarly publishing in 2023. By October that year, only 24 of the world’s 100 largest academic publishers had issued guidance on its use. 6,7,8,9 Our AI use policy 10 requires authors to disclose whether and where AI was used and to remain accountable for all submitted work; editors may reject content where its use is judged inappropriate or has not been disclosed. Findings from BMJ Group’s subsequent disclosure study are now informing revisions to the policy, submission questions and guidance for editors. Evidence informing policy Mandatory AI disclosure questions introduced across 49 BMJ Group journals generated data from more than 25,000 research submissions. The resulting analysis, published in JAMA, 11 is now informing the next iteration of BMJ Group’s AI use policy and the submission process used to collect, assess, and report AI disclosures. The analysis showed that 5.7% of authors disclosed AI use, compared with survey estimates of 28% to 76%. Although not directly comparable, the findings suggest possible underreporting or uncertainty about disclosure requirements, highlighting the need for clearer guidance. 11
BMJ Group AI policy recognised as leading practice An independent analysis of guidance from the world’s 100 largest academic publishers identified BMJ as one of three examples of “well crafted guidelines”. The researchers highlighted the policy’s clear disclosure requirements and its insistence that authors remain accountable for work produced using generative AI.
Examples of journals with well crafted guidelines included BMJ, Physiological Reviews, and PLOS ONE.” 9
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Growing our portfolio to meet tomorrow’s health challenges BMJ Group publishes more than 80 medical and allied science journals, many of which are among the most influential in their fields. In 2026, we continued to expand our journal portfolio, launching new titles and strengthening priority specialties. This includes BMJ Connections, a series of journals focused on rapidly evolving areas of biomedical research. By creating dedicated homes for emerging fields, our new launches connect specialist communities, broaden the evidence base and help research respond to changing health needs.
For a complete list of our journals, visit journals.bmj.com
New and growing specialties 12
81% 52% 20%+ A strong and influential portfolio
Expanding our coverage across key areas of health and medicine
• Digital health & AI • Infectious diseases • Immunology • Rheumatology • Surgery • Stroke & neurointervention
• Women’s health • Endocrinology, metabolism & diabetes • Nutrition • Mental health • Humanitarian health • Disability & health
of indexed journals rank in the top half of their subject category
rank in the top quartile of their subject category
rank in the top 10 of their subject category
Portfolio citation rankings *
10,500 research and review articles published open access across our portfolio in 2025 13
10th in clinical medicine and science
9th in public health
8th in health services research
*Position based on total citations across all years, broad research areas. Dimensions, September 2026 Sources: BMJ Group internal data; Clarivate; Scopus; Dimensions, September 2026.
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BMJ Journals Leaders in their specialty
1st British Journal of Sports Medicine
2nd Journal of Medical Ethics #2 of 22 in medical ethics JIF 4.4 | CiteScore 6.9
3rd Journal of NeuroInterventional Surgery #3 of 18 in neuroimaging JIF 4.4 | CiteScore 9.0
3rd BMJ Quality & Safety #3 of 125 in health policy & services JIF 6.8 | CiteScore 10.8 5th BMJ Sexual & Reproductive Health #5 of 66 in family studies
#1 of 136 in sports sciences for the fifth consecutive year JIF 15.5 | CiteScore 22.1
4th Family Medicine and Community Health #4 of 29 in primary health care
5th The BMJ
5th Gut
#5 of 336 in general and internal medicine; ranked fourth when excluding review journals JIF 55.1 | CiteScore 8.9
#5 of 153 in gastroenterology & hepatology
JIF 4.5 | CiteScore 6.7
JIF 24.6 | CiteScore 48.1
JIF 3.2 | CiteScore 5.3
The Journal Impact Factor (JIF) is a widely used measure of average citations and is often seen as a marker of a journal’s influence. But no single metric can capture the whole picture. As a DORA signatory, BMJ Group offers a more balanced view of research impact. Alongside JIF, we share CiteScore, Altmetric mentions, time to first decision, and more, all available on our journal sites. These metrics help institutions assess quality, reach, and timeliness, and make informed decisions about where to subscribe and publish.
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Hand hygiene evidence shapes global guidance In October 2025, BMJ Global Health published an open access supplement bringing together five systematic reviews on community hand hygiene. 14 The reviews examined behavioural drivers, intervention design, and the infrastructure and materials needed to support effective hand hygiene. Handwashing with soap and water can reduce diarrhoeal disease by around 30% and acute respiratory infections by approximately 17%. 15
Building the evidence base for global hand hygiene policy Supporting government action The underpinning systematic reviews identified 75 government measures that affect hand hygiene. 16 A practical resource for governments The supplement offers a single open access source that governments can use when developing or adapting hygiene standards. 17 Supporting policy uptake WHO is integrating the guidance into existing commitments across water, health and education, including through the European Protocol on Water and Health. 18 Direct influence on global policy The BMJ Global Health supplement formed the formal evidence base for WHO and Unicef’s first global Guidelines on Hand Hygiene in Community Settings Reframing hand hygiene as a system responsibility The evidence synthesised in the supplement supported a shift in how hand hygiene is understood by policymakers Enabling real world policy uptake WHO is actively using the BMJ Global Health evidence package in government facing policy processes
Together, the five systematic reviews published in BMJ Global Health formed the evidence base for the World Health Organization (WHO) and Unicef’s first Guidelines on Hand Hygiene in Community Settings.
Launched on Global Handwashing Day in 2025, the guidelines translate the evidence published in BMJ Global Health into actions that governments can adapt and implement worldwide. The guidelines provide a framework for policy, financing, regulation, monitoring and implementation, helping countries strengthen infection prevention and improve public health. “If anyone ever asks me within WHO if I have any suggestions for how to do things, BMJ Global Health will be my first recommendation.” Joanna Esteves Mills, Global public health consultant, World Health Organization, Geneva, Switzerland
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FUTURE-AI framework informs international governance Published in The BMJ in 2025, FUTURE-AI: international consensus guideline for trustworthy and deployable AI in healthcare, 19 brought together 117 interdisciplinary experts from 50 countries to establish six guiding principles and 30 best practice recommendations for trustworthy AI across the healthcare lifecycle. Less than a year after publication, BMJ Impact Analytics identified citations to FUTURE-AI in guidance, policy reports and publicly funded initiatives across Ireland, Germany, Norway, Japan, and European Commission-funded programmes. In January 2026, the Health Information and Quality Authority (HIQA) used the FUTURE- AI guideline to inform an evidence review supporting the development of Ireland’s national guidance on the responsible and safe use of artificial intelligence in health and social care. The review synthesised 55 sources. FUTURE-AI was one of two included sources that used a multistakeholder consensus method, drawing on a modified Delphi process involving 117 participants. 20 HIQA’s national guidance takes a principle-based approach which incorporates evidence based concepts underpinning the responsible and safe use of AI in the health and social care system. These include concepts described in the FUTURE-AI Guideline and other international frameworks, including explainability, fairness, robustness, and traceability.” Deirdre Hyland, Health information programme manager, Health Information Standards, Health Information and Quality Authority, Dublin, Ireland
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The research rapidly influenced food safety policy, regulatory discussion, and clinical awareness across Europe, including the UK, Ireland and Germany The UK Food Standards Agency revised national guidance in 2025, 22 advising that children under seven should not consume glycerol-containing slush ice drinks, with Food Standards Scotland issuing updated supporting industry guidance. 23 The Food Safety Authority of Ireland contributed to European discussions and, following EFSA guidance, updated its advice in 2026 to recommend that children aged 10 and under should not consume glycerol- containing slush ice drinks. 24 Germany’s Federal Institute for Risk Assessment (BfR) concluded from the study that glycerol levels in slush ice drinks vary widely and may pose a health risk to children. 25 Its subsequent FAQ explicitly cited the study, and noted 21 reported UK and Irish cases between 2009 and 2024. 26 The European Food Safety Authority (EFSA) referenced the study in a scientific opinion recommending that the European Commission consider maximum glycerol levels in beverages. 27 The findings improved clinical awareness, with glycerol intoxication added to TOXBASE, and generated substantial public engagement, including more than 29,000 full-text downloads within six months. 28
Slush safety: exposing glycerol risks for children Research published in Archives of Disease in Childhood identified a serious and previously underrecognised risk linked to sugar-free slush ice drinks marketed to children. Following the introduction of sugar-sweetened beverage levies in the UK and Ireland, some manufacturers replaced sugar with glycerol (E422), which helps maintain the slush texture while reducing sugar content. The study 21 found that, in young children, rapid consumption of these drinks could cause acute glycerol intoxication, leading to severe illness.
Publishing the research in Archives of Disease in Childhood helped the evidence reach clinicians, toxicologists, food safety authorities, and policymakers.” Ellen Crushell, Clinical professor, School of Medicine, University College Dublin; consultant paediatrician in inherited metabolic disorders at Children's Health Ireland (CHI); deputy chief medical officer, Department of Health, Ireland
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Safer schools through stronger allergy evidence
A cohort study 29 published in Archives of Disease in Childhood informed a national policy on allergy safety in schools and contributed to progress towards Benedict's Law, a package of protections designed to improve emergency care for children with severe allergies. Led by Paul Turner, professor of anaphylaxis, paediatric allergy and clinical immunology at the National Heart & Lung Institute, Imperial College London, a team of researchers examined how schools prepare for anaphylaxis. They found that the current system, based on individual prescriptions for adrenaline auto-injectors, is both inefficient and costly. During the 2023–24 academic year, almost two-thirds of pupils were prescribed more than two devices, contributing to an estimated national cost of more than £9 million. In the paper, Economic modelling of providing ‘spare’ adrenaline autoinjectors to all schools to improve the management of anaphylaxis, the researchers showed that a centrally funded, school-based supply of emergency adrenaline auto-injectors could provide universal access for around £4.5 million, saving at least £4.6 million annually while improving safety for children. The findings supported campaigning by the Benedict Blythe Foundation and were cited in the UK parliament during discussions of Benedict’s Law. 30 Turner said that the research and advocacy helped shift the debate by showing that allergy safety could be improved without increasing public spending. 31
1926-2026 Celebrating the centenary of ADC
Archives of Disease in Childhood, the official journal of the Royal College of Paediatrics and Child Health, is an international, peer reviewed journal published by BMJ Group. The journal has a 2025 Journal Impact Factor of 3.4 and is ranked in the first quartile (Q1) – the top 25% of paediatrics journals.
The research published in Archives of Disease in Childhood has provided additional gravitas to the evidence that improving safety from anaphylaxis in schoolchildren is achievable without necessarily increasing costs.” Paul Turner, Professor of anaphylaxis, paediatric allergy and clinical immunology, National Heart & Lung Institute, Imperial College London, UK
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Research informs inquiry into falling vaccination uptake As childhood vaccination uptake declines in England and vaccine confidence becomes an increasing public health concern, research published in The BMJ is informing parliamentary debate on how governments should respond. 32 The 2024 paper, titled Behavioural considerations for vaccine misinformation and hesitancy on social media, 33 reviewed the evidence on behavioural interventions to address vaccine hesitancy driven by misinformation on social media. It highlights the importance of building trust, engaging credible community voices and improving access to reliable information as promising approaches to addressing vaccine hesitancy. In April 2026, the paper was cited in written evidence submitted by Professor Sander van der Linden, Kai Ruggeri and colleagues to the UK House of Lords Childhood Vaccinations Committee inquiry, which is examining the causes of declining vaccination uptake and policy options to improve coverage. 34
BMJ Impact Analytics shows that the paper has also been cited in policy documents from Public Health Scotland, the Welsh Government and other UK public health organisations. 35 The paper reached a wide public audience, placing it in the top 5% of all research outputs tracked by Altmetric: 36 ● 170 news stories from 117 international news outlets ● 157 discussions on the social media platform X ● 112 scholarly citations 37 ● coverage in six blogs
The dream of good academic research is to drive real world decision making. I was excited, obviously, going into The BMJ. I assumed there was a pretty good
chance that policymakers would see it. That's a great thing about The BMJ.” Kai Ruggeri, Professor of health policy and management, Columbia University, US
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The diet that rewrote the rules on type 2 diabetes remission Clinicians have long treated type 2 diabetes as a progressive disease requiring increasing medication. But research from an NHS general practice in Southport challenged that assumption. An eight-year evaluation of a lower-carbohydrate diet with weight loss found that some patients could achieve drug-free remission. Its findings were published in the article, What predicts drug-free type 2 diabetes remission? Insights from an 8-year general practice service evaluation of a lower carbohydrate diet with weight loss, 38 which subsequently became the most discussed paper ever published in BMJ Nutrition, Prevention & Health. For eight years, GPs and nurses at Norwood Surgery offered routine advice on a low-carbohydrate diet and weight loss to patients with type 2 diabetes, and tracked outcomes for 186 people against the practice's wider list of 9,800 patients. Among those who took up the approach, 51% achieved drug-free remission, rising to 77% among people diagnosed within the previous year. Average weight loss reached 10 kg, glycated haemoglobin (HbA1c) fell from 63 to 46 mmol/mol, and the surgery spent £68,353 less per year on diabetes drugs than the local average.
The paper's reach quickly outgrew the surgery. Written evidence submitted to the UK Parliament's Health and Social Care Committee inquiry into prevention cited it directly, quoting the study's remission rates, prescribing savings and average patient weight loss. It has since been included in a Royal Australian College of General Practitioners clinical handbook on managing type 2 diabetes, and fed into a 2025 update of an RCGP e-learning module on diabetes and glycaemic index, now free to all 50,000 UK GPs.
Audits like ours provide the external validity to answer questions a randomised controlled trial can't: how will this approach actually do in the NHS?” David Unwin, General practitioner and senior partner, Norwood Surgery, Southport, UK
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By this paper, potassium intake increase has been emphasised in addition to salt (sodium) reduction for the prevention of hypertension and cardiovascular diseases in Japan.” Professor Katsuyuki Miura, Co-principal investigator of the NIPPON DATA Research Group; director and professor, NCD Epidemiology Research Center (NERC), Shiga University of
Shaping national dietary guidance to prevent hypertension in Japan
Medical Science (SUMS), Seta-Tsukinowa-cho, Otsu, Shiga, Japan
In 2016, when researchers from leading Japanese institutions published their study in BMJ Open, they showed that dietary balance, not salt reduction alone, is a significant predictor of stroke, cardiovascular, and all-cause mortality in a national cohort followed over 24 years. A decade later, the paper, Dietary sodium-to-potassium ratio as a risk factor for stroke, cardiovascular disease and all-cause mortality in Japan: the NIPPON DATA80 cohort study, 39 remains highly relevant, contributing to the evidence base for the Japanese Society of Hypertension 2024 Consensus Statement on urinary sodium-to-potassium ratio 40 and the 2025 Japanese Society of Hypertension Guidelines for the management of elevated blood pressure and hypertension. 41
It was also cited alongside two papers in The BMJ 42 on sodium and blood pressure in the 2026 Japanese Society of Hypertension Guidelines for Blood Pressure Control Using Digital Technologies, 43 demonstrating the sustained contribution of BMJ Group evidence to national guidance on hypertension prevention and cardiovascular risk reduction. BMJ Impact Analytics shows that this influence extends across policy and clinical guidance. The paper is linked to 29 policy and guidance documents across two countries, including 28 from the Government of Japan. The research has informed prevention policy and has been cited in documents on potassium, hypertension, salt, diabetes, pregnancy, body weight, breastfeeding, and lifestyle disease.
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Defining remission: a global lupus standard Before the 2021 DORIS recommendations were published in Lupus Science & Medicine, 44 researchers used more than 20 different definitions of remission in systemic lupus erythematosus, making studies difficult to compare and treatment outcomes harder to assess. To solve this, an international task force established a unified, evidence based standard. Since its publication in 2021, the paper has been cited more than 350 times, with 70% of those citations occurring in the past two years, showing its growing influence on the field. 45 DORIS has been adopted by researchers globally, incorporated into clinical guidelines such as the 2024 Mexican Guidelines, 46 and its influence extends into drug development. Pharmaceutical companies increasingly include DORIS remission as a key secondary endpoint in lupus clinical trials, reflecting growing acceptance of remission as an important measure of treatment success. 47 Lead author, Professor van Vollenhoven indicates that DORIS remission is now used routinely as a secondary outcome in company-sponsored lupus trials. By replacing more than 20 competing definitions with a single internationally agreed standard, DORIS has given patients, clinicians, researchers, regulators, and industry a shared and measurable goal of remission, harmonising lupus research, improving comparison between studies, and shifting care towards achieving sustained disease control. “The response has been overwhelmingly positive. Many of those who have done studies of remission in lupus since publication have used the DORIS definition.” Ronald F van Vollenhoven, Professor of rheumatology, Amsterdam University Medical Centers; vice-chair and immediate past chair, EULAR research committee; editor in chief, Lupus Science & Medicine, The Netherlands
Lupus Science & Medicine is the official open access journal of the Lupus Foundation of America, owned by the Foundation and published by BMJ Group. The journal has a 2025 Journal Impact Factor of 4.2 and is ranked in the first quartile (Q1) of rheumatology journals. 48
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83%
Expanding access to trusted research
Making research openly accessible 83% of research articles published in 2025 were open access, enabling research to be read, used and applied without subscription barriers. 49
Open access is making trusted health research available to more people than ever before. By expanding access, supporting authors and partnering with institutions, we're making trusted health research available to more people in more places. Our Read and Publish agreements with institutions and consortia help researchers publish and read without barriers, even as the landscape changes. Through these agreements, article processing charge (APC) waivers, and partnerships with institutions around the world, we're supporting researchers to publish without financial barriers while supporting a sustainable future for open research.
231
Expanding access to open publishing BMJ Group’s Read and Publish agreements have grown by an average of 27% each year since 2021, now covering 231 institutions worldwide 50 and making it easier for more researchers to publish open access.
100+
Supporting researchers worldwide Authors in more than 100 countries benefited from APC waivers, helping to reduce financial barriers to publication. 51
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Research from East Africa helps shape the future of global HIV care A review of health policies across six East African countries has been cited by UNAIDS as it reshapes the global HIV response, contributing to the evidence on how HIV services can be integrated sustainably with wider health systems. For decades, human immunodeficiency virus (HIV) programmes in many low and middle income countries have operated separately from wider health services. But as people living with HIV live longer and increasingly develop non- communicable diseases, integrating their care has become an important global health priority. In 2021, BMJ Global Health published the paper, Integration of non- communicable disease and HIV/AIDS management: a review of healthcare policies and plans in East Africa. 52 Looking at policies and plans across six East African countries, the authors found that HIV and non-communicable disease services were still not well integrated. They called for more joined-up care, with better monitoring and evaluation of how integration is working. It can take years for research to influence policy. In 2025, UNAIDS cited the review in its flagship Global AIDS Update, 53 as part of the evidence supporting more joined-up HIV and other health services. This has become more important as countries face cuts to international HIV funding and look for more sustainable ways to provide care.
Nearly 95% of LMIC-originated research was published open access in early 2025, up from 56% in 2022.
Greater integration of HIV services with primary health care, wider health systems and other sectors is now embedded in the Global AIDS Strategy 2026–2031, 54 which sets out 16 global targets for 2030. In June 2026, UN Member States adopted a new Political Declaration on HIV/AIDS that includes all 16 targets. This brings the Strategy’s targets into a formal UN declaration agreed by Member States. 55
BMJ Global Health is accessible with a reputation for high quality research. It’s a place that our colleagues go to. For research like this, you want it to also be accessible to the people who can actually use it. Being open access means policymakers and
researchers in the countries we were studying can read and share the work without a subscription.” Anupam (Anu) Garrib, Principal research associate, RESPOND-Africa Partnership, UK
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Mapping research influence from publication to policy BMJ Impact Analytics is a comprehensive tool that enables research organisations and funders to track and share the real world influence of their medical and health research by identifying where it is cited in global health policy, clinical guidelines, and regulatory documents. An essential tool for research organisations, BMJ Impact Analytics shows not only what they have published, but how their research has influenced wider decision making. The George Institute for Global Health integrated BMJ Impact Analytics into its institutional impact measurement framework to strengthen how it evidences research impact for funders, partners and policymakers. BMJ Impact Analytics revealed a substantially broader picture of policy and clinical guideline influence than the Institute's previous tracking approach. These insights subsequently played a key role in the production of The George Institute's Impact Report 56 by providing the policy and guideline citation data to create interactive maps and infographics. The George Institute's approach to capturing impact was presented at the 2026 Bibliometrics and Research Impact Community conference 57 in Canada as an example of connecting research metrics with meaningful evidence of societal impact. “The data from BMJ Impact Analytics helps us to quantify the take- up of our publications in policy and clinical guidelines, and can also provide insights into the policy landscape around a research topic.” Deeksha Bhardwaj, Manager – impact and engagement, The George Institute for Global Health, New Delhi, India
BMJ Impact Analytics insights: Revealed citations of the Institute’s research in nearly 7,200 health policies and clinical guidelines (January 2019–March 2026) Identified research influence across nearly 100 countries and over 1,000 organisations Enabled richer impact reporting through interactive maps and infographics
Demonstrated substantially greater policy and guideline reach than previous tracking methods
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Better decisions
Research alone is not enough. We help healthcare professionals build their knowledge, apply the latest evidence, and make better clinical decisions through trusted guidance, education, tools, and services. As patient needs become more complex, health professionals need evidence based support at the point of care. BMJ Best Practice equips clinicians with the tools to make informed, personalised decisions so they can improve outcomes across every level of care. Integrated into BMJ Best Practice, the Comorbidities Manager is the only tool that offers tailored plans for patients with multiple conditions.
A R O U N D 1 in 5 90% 50k+
NHS trusts integrate BMJ Best Practice into electronic health records 58
guideline combinations available through the integrated Comorbidities Manager
of Australia’s public health professionals have access via state health department agreements
Accredited by over 65 organisations, including the Royal College of Physicians, Royal Australasian College of Physicians, and the Cleveland Clinic National access across five countries: England, Scotland, Wales, the Republic of Ireland, and New Zealand (as of July 2026)
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Trusted tools for responsible clinical AI
In 2026, Google published its latest evaluation of the Articulate Medical Intelligence Explorer (AMIE), 59 examining whether AI could safely support longitudinal disease management across multiple patient consultations. Unlike earlier studies focused on diagnosis, this research evaluated AI's ability to reason about investigations, treatment selection, medication prescribing, disease progression and follow-up care over time. 60 To develop and evaluate the study, Google selected just two core clinical knowledge resources for evidence based clinical practice guidance: BMJ Best Practice and National Institute for Health and Care Excellence (NICE) guidance. Together, they informed the development of 100 multivisit clinical scenarios used to assess AI performance against evidence based standards of care. 61 Explaining the decision to include evidence from BMJ Best Practice in the AMIE evaluation, the Google team said they selected "authoritative clinical knowledge sources that are widely accepted and used in clinical practice", citing the tool's "international coverage and strong evidence appraisal" as key factors in its inclusion. Google also noted that the evidence based content provided in "both human-readable PDF format and machine-parsable structured formats" was helpful for evaluating how AMIE and clinicians used the content. 62
At Google, we believe that working closely with partners that curate trusted clinical content is paramount in our journey of studying AI for clinical tasks in a responsible manner. The international coverage and strong evidence
appraisal of guideline content were additional reasons for us to partner with BMJ Best Practice.” Mike Schaekermann, Staff research scientist and research lead, Google, Toronto, Canada
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Making clinical guidance easier to use at the point of care Medway NHS Foundation Trust integrated local guidelines with BMJ Best Practice into its electronic patient record (EPR) after research with 18 frontline clinicians found that staff wanted faster access to evidence and local protocols during patient care, with mobile access, staff training and digital champions supporting implementation. This created a centrally governed resource that brought local protocols and national evidence together and could be updated consistently across clinical teams. Clinicians reported faster access to information, greater confidence in decision making and more consistent practice across teams. Richard Pemberton, knowledge and library service strategic manager at Medway NHS Foundation Trust, said that rapid access to local guidance was particularly valuable during the meningitis outbreak in Kent.
Average monthly page impressions reached 277% of pre-integration levels following BMJ Best Practice integration into the Trust’s EPR
277% of pre-integration level
Average monthly page impressions in the seven months following integration compared with the preceding three months.
100 (baseline)
Before integration (Sep-Nov)
Following integration (Dec-Jun)
Medway NHS Foundation Trust internal usage data, September 2025–June 2026
“Libraries are here to take the heavy lifting out of accessing information. BMJ Best Practice is an excellent tool for doing that.” Richard Pemberton, Knowledge and library service strategic manager, Medway NHS Foundation Trust, UK
The initiative, Right Guidance, Right People, Right Time, was shortlisted for Digital Clinical Safety Initiative of the Year at the 2026 HSJ Patient Safety Awards. The nomination recognised Medway’s development of a single source of clinical guidance that staff could access within the EPR. 63
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Building research capability across three health systems Research to Publication is an online programme that develops research methodology, scientific writing and publishing skills among doctors and healthcare researchers. Around the world, clinicians and researchers are using Research to Publication to strengthen research skills, improve publication quality, and support healthcare improvement.
→ Qatar: Hamad Medical Corporation’s ambulance service needed to reduce repeat emergency calls from people with diabetes who declined transport to hospital. After completing Research to Publication, Hassan Farhat, operations manager for quality, patient safety and risk management, published a quality improvement study in BMJ Open Quality. Across four improvement cycles between 2017 and 2021, the team tested interventions to help paramedics provide more consistent diabetes education to patients who declined hospital transport. Callback rates fell during the initial interventions, although the improvement was not sustained. Findings from the project contributed to changes in the ambulance service’s diabetes clinical practice guidance and subsequent training for 477 staff. 65
The programme improved my methodological approach and how I present it. Understanding the expectations of peer review helped me design studies more rigorously and report findings more clearly.” Hassan Farhat, Operations manager for quality, patient safety and risk management, Hamad Medical Corporation, Qatar
227 35k 226
individual course completions in 2025
→ India: At the SDM College of Medical Sciences and Hospital, associate professor of paediatrics Ashwini Sankannavar wanted to strengthen her scientific writing and publish her clinical research in an international journal. After completing Research to Publication, she published her first BMJ Group article in BMJ Case Reports, describing Kawasaki disease following adenovirus infection. 66 The publication led to wider academic engagement through discussions with infectious disease researchers about potential collaboration and invitations to review manuscripts.
→ Colombia: Fundación Valle del Lili hospital produces more than 300 scientific papers each year and wanted to help its researchers communicate clinical evidence more clearly to international audiences. Chief research and innovation officer Sergio Prada used Research to Publication to strengthen the structure and clarity of English-language manuscripts. Since completing the programme, Dr Prada has published in several BMJ journals, including BMJ Global Health, 67 BMJ Innovations, 68 BMJ Open, 69 BMJ Open Respiratory Research, 70 and BMJ Paediatrics Open. 71
articles published in BMJ journals after programme completion
users or authors involved in those publications 64
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Using BMJ Learning to lead quality improvement Foundation year 2 (FY2) doctor Aia Youssef began her NHS career in Northern Ireland, where she used BMJ Learning quality improvement modules 72 to develop the skills and confidence to undertake her first quality improvement project. Working alongside consultant physician Darshan Kumar in the Direct Assessment Unit at Antrim Area Hospital, Northern Ireland, Youssef undertook a project examining venous thromboembolism (VTE) risk assessments and anticoagulation prescribing. Her work involved reviewing acute admissions against hospital policy and national standards. After completing and presenting a VTE audit to senior colleagues, Youssef used insights gained from BMJ Learning to look beyond data collection and analysis and consider how the findings could support ongoing improvement and shared learning. She subsequently proposed developing the work into a quality improvement project focused on education, measurement and continuous improvement. Accessing BMJ Learning through her BMA membership, Youssef completed a package of courses covering project selection, improvement methods and implementation. The training helped her develop the confidence to present her findings and identify opportunities for further improvement.
The BMJ Learning quality improvement modules made me ask different
questions. They helped me think about what else I could do and what other insights I could gain.” Aia Youssef, Foundation year 2 doctor, UK
557,367 courses completed among 37,083 assessed BMJ Learning learners *
33% average knowledge improvement *
4.9/5 average learner rating across all BMJ Learning content *
* Between January 2025-June 2026
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The CHANCE programme gave clinicians stronger evidence on when to use short-term dual antiplatelet therapy after minor stroke or TIA, and how genetic testing could support more personalised treatment. BMJ Impact Analytics enabled the researchers to demonstrate how these findings had informed clinical guidance and policy across 62 countries, providing a broader picture than academic citation counts alone. The CHANCE programme of clinical trials, 75 led by Professor Yongjun Wang, president of Beijing Tiantan Hospital and the Chinese Stroke Association, generated important evidence on how that risk could be reduced. The studies showed that short term dual antiplatelet therapy reduced recurrent stroke risk and later demonstrated how genetic testing could guide more personalised treatment. Stroke studies from China shape global guidance A landmark programme of stroke research published in The BMJ, Stroke and Vascular Neurology, and The New England Journal of Medicine helped establish new approaches to preventing recurrent stroke after minor stroke and transient ischaemic attack (TIA). Analysis from BMJ Impact Analytics demonstrated the extent to which the wider CHANCE * research programme had informed clinical guidance and health policy worldwide. Stroke affects around 15 million people worldwide each year and remains one of the leading causes of death and long term disability. 73 Effective prevention strategies are a global clinical priority. 74 People who experience a minor stroke or TIA face a heightened risk of a subsequent stroke, making timely and effective secondary prevention critical.
BMJ Impact Analytics reveals the programme's global influence: 76 57 citations in clinical guidelines and health policy documents from CHANCE-related papers collectively 14 years of CHANCE research (2009–2023) 5,000+ patients enrolled at 114 centres in China in the original CHANCE trial 77 62 countries citing Chinese stroke research in policy and guidance documents Research was cited by NICE, the WHO, the American Academy of Neurology, and the European Stroke Organisation The CHANCE programme has made an important contribution to our understanding of how best to prevent recurrent stroke after minor stroke or TIA. Its influence on clinical guidance internationally demonstrates the value of rigorous clinical research, especially large randomised
controlled trials, in informing and improving patient care around the world.” Philip Bath, Professor of stroke medicine and CHANCE-2 investigator, University of Nottingham, UK
*Clopidogrel in high-risk patients with acute non-disabling cerebrovascular events (CHANCE)
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Better systems
Better decisions depend on stronger health systems. We use evidence, policy influence, investigations, and advocacy to help shape guidelines, improve transparency, and strengthen health systems and public health.
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Tackling racial inequality in healthcare
DPYD testing and dosing A systematic review commissioned by the Observatory identified limitations in routine DPYD testing and an additional variant, c.557A>G, associated with African ancestry. 85 The North West Genomic Laboratory Hub subsequently introduced the variant into routine testing based on the research findings, enabling clinicians to adjust chemotherapy starting doses for patients at increased risk of severe adverse reactions. 88,89 Pulse oximetry The Observatory’s work on racial bias in pulse oximetry also contributed to updated national guidance, an independent government review and further research into equitable medical devices. 90,91,92 Maternal health Over the past five years, MBRRACE-UK has reported a reduction in the disparity in maternal mortality, with the relative risk for Black women compared with White women falling from around fivefold to around threefold. 93,94 While many organisations contributed to this improvement, Professor Habib Naqvi, chief executive of the NHS Race and Health Observatory, says it demonstrates that evidence based action can begin to reverse longstanding inequalities.
In February 2020, The BMJ published a special issue dedicated to racism in medicine, examining racial discrimination and health inequalities experienced by patients and doctors. 78
The special issue helped bring about the establishment of the NHS Race and Health Observatory, which, six years later, continues to provide national leadership and develop global partnerships to reduce ethnic health inequalities through evidence, policy and implementation. 79
Partnerships and progress 2021–24: Observatory research on racial bias in pulse oximetry leads to updated NHS guidance and contributes to an independent government review of bias in medical devices. 80,81 A 2024 systematic review also identifies gaps in routine DPYD testing for patients of non-European ancestry. 82 2025: The Observatory partners with NICE to address ethnic bias in clinical guidance. In September, an additional DPYD variant associated with African ancestry is introduced into routine testing by the North West Genomic Laboratory Hub following the Observatory’s research. 83,84,85 2026: NHS England commissions the Observatory to help deliver a national programme tackling racism and discrimination in maternity and neonatal care. 86 Chief executive Habib Naqvi also chairs the health equity group of the government’s National Maternity and Neonatal Taskforce. 87
I keep The BMJ Racism in Medicine edition on my desk. It still reminds me how powerful evidence can be in
driving change. We are beginning to see credible outcomes because organisations are adopting evidence based interventions that shift the inequity dial.”
Professor Habib Naqvi, Chief executive, NHS Race and Health Observatory, UK
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