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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