--- name: the-lancet description: Use when targeting The Lancet or deciding whether a clinical medicine or global-health manuscript fits this venue. Encodes the journal's fit, framing, method-and-evidence bar, house style, official-submission re-check, and desk-reject heuristics. --- # The Lancet (the-lancet) ## Journal positioning The Lancet is one of the world's oldest and most influential general medical journals, published by Elsevier. It publishes practice-changing and policy-changing clinical and global-health evidence, with an explicit commitment to health equity, global burden of disease, and the social determinants of health. The readership spans clinicians, public-health practitioners, policymakers, and health systems researchers worldwide. Papers that merely confirm existing practice without shifting guidelines or informing policy do not belong here. This skill is a **fit / venue-selection / re-framing** tool. It does not replace the journal's current official submission guidelines. Before submitting, re-check the live author instructions on the publisher's own site or submission system. ## When to trigger - The author names The Lancet as the target venue for a clinical trial, systematic review, or global-health analysis. - A manuscript has potential practice- or policy-changing implications but needs framing around equity, global-health burden, or health-systems impact. - A clinical-medicine paper needs to distinguish The Lancet's editorial culture from NEJM or JAMA before deciding where to submit. - The author needs The Lancet's desk-reject risks and credible alternatives before submitting. ## Scope & topic fit - Large, well-powered randomised controlled trials with definitive superiority or non-inferiority results affecting clinical practice at scale. - Systematic reviews and meta-analyses (PRISMA-compliant) that resolve a contested clinical question or establish a new evidence base. - Global-health burden analyses, disease modelling, and epidemiological surveillance with policy implications for low- and middle-income countries. - Health equity research: interventions or analyses addressing disparities across geography, income, race, sex, or other social determinants. - Public-health emergencies, outbreak investigations, and pandemic-response science that reaches a global clinical and policy audience. - Landmark observational cohort studies with prospective design and precise, adequately adjusted effect estimates. ## Method & evidence bar - Randomised trials must be pre-registered (ClinicalTrials.gov or WHO ICTRP equivalent), follow CONSORT reporting in full, and have an independent data-safety monitoring board for longer-horizon studies. - Systematic reviews and meta-analyses require PRISMA adherence; protocol registration in PROSPERO or equivalent is expected; GRADE assessment of evidence quality is strongly encouraged. - Observational studies require STROBE reporting and explicit discussion of residual confounding; propensity-score or multivariable adjustment alone does not satisfy the standard. - The significance bar is definitiveness or paradigm-shift at population scale, not statistical significance in a convenience sample. - Ethics approval and participant informed-consent documentation are mandatory; ICMJE authorship criteria must be satisfied and author contributions declared. - Data sharing: a data-sharing statement is required; sharing individual participant data (IPD) for trials is strongly encouraged and increasingly expected. ## Structure & house style - The Lancet uses article types including Articles, Letters, Correspondence, Comment, and Review; choose the type that matches scope and length—re-check current word limits. - The abstract for an Article is structured (background, methods, findings, interpretation) and must close with a funding statement. - The opening paragraph of an Article must situate the work in current practice and articulate the evidence gap the study fills. - An "Added value of this study" summary panel (what is already known, what this study adds) is required for Articles and Reviews. - Statistical reporting must include absolute as well as relative effect measures; confidence intervals are mandatory; p-values alone are insufficient. - Figures should be colour-blind-friendly and publication-ready; maps showing global data are highly valued editorially. ## Official-submission checklist - Before giving submission-ready advice, read `../../resources/source-basis.md` and `../../resources/official-source-map.md`; start from the official source anchors for this journal family, then cite the current journal-specific page you checked. - Search the live site for "The Lancet information for authors" and follow the current Elsevier/Lancet version. - Re-check article type definitions and current word/figure limits; re-check abstract structure requirements and the "Added value" panel format. - Confirm trial or review registration number, ethics approval reference, and informed-consent statement are included. - Confirm the data-sharing statement specifies what data will be shared, when, how, and with whom. - Re-check competing-interests declaration (all authors), funding disclosure, ICMJE author-contribution statement, and AI-use disclosure policy. - Confirm CONSORT (trials) or PRISMA (reviews) or STROBE (observational) checklist is submitted as a supplementary file. - Re-check open-access/APC options, licensing terms, and preprint policy (The Lancet permits preprints; confirm current guidance). - If the live official instructions conflict with this skill, the official instructions win. ## Pre-submission self-check - [ ] One sentence stating why this finding changes clinical practice, public-health policy, or health-equity understanding at a population level. - [ ] The contribution is framed as definitive evidence, practice shift, or policy insight—not as a "first-ever" claim or a p-value. - [ ] The introduction positions the paper against the most relevant prior evidence, with an explicit statement of the remaining evidence gap. - [ ] Reporting guideline checklist (CONSORT/PRISMA/STROBE) is complete and attached; registration number is cited in the methods. - [ ] The "Added value" panel is drafted and accurately distinguishes this study's contribution from the existing literature. - [ ] Global-health or equity framing is authentic and data-supported, not appended as a rhetorical gesture. ## Common desk-reject triggers - Trials that are not pre-registered, lack a CONSORT flow diagram, or have a sample size powered only for a surrogate endpoint with no clinical-outcome data. - Systematic reviews without PROSPERO registration or PRISMA adherence, or meta-analyses dominated by high-risk-of-bias studies without sensitivity analysis. - Single-centre or small-sample studies that do not establish a definitively new finding at scale. - Observational studies framed as causal without credible identification strategy, or with STROBE-non-compliant reporting. - Absence of a data-sharing statement or an ethics-approval reference; missing ICMJE authorship contributions. - Global-health framing that is superficial—"this matters globally" asserted without burden-of-disease data or LMICcontext. ## Re-routing decision - Clinically definitive but more specialised in disease area → `the-lancet-oncology`, `the-lancet-infectious-diseases`, or `the-lancet-neurology` for condition-specific practice change. - US-centric clinical trial with a rigorous AMA-style structured abstract → `jama` or `nejm`. - Methodologically rigorous but emphasis on open data, EBM critique, or patient/public involvement → `the-bmj`. - Translational mechanism-to-trial story with biological depth → `nature-medicine`. - Open-access public-health focus with lower significance bar → `plos-medicine`. ## Output format ```text [Fit] High / Medium / Low (one-line reason) [Target] The Lancet [Topic tags] <2–3 closest topics> [Method/evidence] [Top risk] [Official items to re-check]
[Re-route suggestion] ```