THE JOURNAL's Policy Regarding Release of Information to the Public

The public is interested in health information, and the public news media try to provide it as quickly as possible. Peer-reviewed, primary-source medical journals, however, consider original articles only if they have not been published previously. Thus, a conflict sometimes exists between the representatives of the news media and editors of medical journals who prefer to disseminate complete reports of medical information after validation through peer review.^{2 - 4} All concerned want medical information to be as accurate as possible. Medical editors rely on rigorous peer review to evaluate such accuracy prior to accepting papers for publication, and clinicians rely on journal publication to provide complete reports of validated information they can assess and explain to patients. Editors of JAMA consider scientific and clinical reports (ie, submitted manuscripts) individually, first, to evaluate the quality of these reports and to decide whether to accept them for publication and, second, to appraise the need for and the timing of the dissemination of medical information contained in these reports through the appropriate media at the earliest possible time. With few exceptions as described below, this dissemination should coincide with publication in THE JOURNAL.

Thus, editors of JAMA will consider a scientific manuscript for publication only if it (or substantial portions of it) has not been published previously and it is not under consideration for publication by another journal or publication. Papers that have been posted or distributed on the Internet generally are considered to be previously published. This policy, based on the Ingelfinger rule,^{5 - 7} also extends to significant news media coverage in which the major study results are reported in detail and widely distributed.

Manuscripts submitted for evaluation for possible publication are considered confidential and privileged communications among authors, editors, and peer reviewers. No information about submitted papers will be released by THE JOURNAL staff to anyone outside the editorial review process, without the permission of the author. Conversely, authors should refrain from informing other third parties (such as colleagues, professional organizations, and the news media) that their manuscript is under consideration or has been accepted by JAMA.

There are 4 general exceptions to THE JOURNAL's policy precluding prepublication release of information. The most common exception is the dissemination of such information during open scientific or clinical meetings. Less frequent exceptions include the prior release of information during testimony before government agencies, consideration of clinically useful information that is part of the public domain, and prior release of information that is determined to be of urgent public health need.

Presentation of research findings during, or publication of an abstract for, an open scientific or clinical meeting does not preclude consideration of the study for publication in JAMA. News media reports based on coverage that occurs during the usual course of presentation of a scientific or clinical paper does not preempt a manuscript from consideration for publication. However, authors presenting papers at such meetings are advised to refrain from providing additional information beyond that covered during the course of their presentation and exchange with meeting attendees. Authors who present information contained in a manuscript that is under consideration by THE JOURNAL (or before it is formally submitted) during open scientific or clinical meetings should not distribute complete reports (ie, copies of manuscripts) or data presented as tables and figures to conference attendees or journalists. Publication of abstracts in print and online conference proceedings is acceptable, but publication of full reports in such proceedings, or in the news media, could jeopardize chances for subsequent publication in a journal.

Authors of submitted manuscripts under consideration or accepted but not yet published, as well as authors' institutions and sponsors, must not participate in press conferences or issue press releases before publication. Authors also must refrain from granting interviews with the news media about the information under consideration, or accepted but not yet published, unless the journalist agrees to abide by THE JOURNAL's embargo policy.

Testimony before a government agency or institution (such as the Food and Drug Administration or Congress) that includes information not yet published will not preclude consideration for publication by THE JOURNAL.

Reports of clinical information from government health agencies (such as the Centers for Disease Control and Prevention) or other public domain reports that have been previously published in print or online will be considered for publication on a case-by-case basis if the editors determine the information will be useful to readers.

There should be no delay in the release of medical information to the public in circumstances in which there is an urgent public health need, even if this release precedes publication in THE JOURNAL. However, very little medical research has such urgency that the findings must be released prior to peer review and acceptance for publication.⁸ In these circumstances, the appropriate authorities and agencies, such as the National Institutes for Health (NIH), responsible for public health should be involved in decisions about prepublication release and should be responsible for immediate dissemination of the information to clinicians and the news media (such as with a NIH clinical alert).^{8 - 9} In such situations, THE JOURNAL will work with authors and the appropriate authorities to expedite review and publication decisions and coordinate the release of information.

For other major studies that have important public health or treatment implications, THE JOURNAL will expedite the peer-review and publication process, such as with JAMA-EXPRESS evaluation.¹⁰ After peer review, appropriate revision, and acceptance, reports of studies that have immediate implications for public health or clinical practice will be posted on THE JOURNAL's Web site prior to print publication.

Information contained in articles accepted for publication in THE JOURNAL is embargoed until the date of publication. This embargo is an agreement between journal editors and the news media that the information contained in a manuscript that has been accepted but not yet published in THE JOURNAL will not be released by the news media in any format, including print, television, radio, or via the Internet, until a specified date and time.⁴ Such medical news embargoes extend back to and might have begun with Morris Fishbein, MD, editor of JAMA from 1924 to 1949.¹¹ The embargo typically holds until 3 PM Central time the day before the cover date of THE JOURNAL. Copies of JAMA are mailed to physicians and reporters prior to the embargo release during the week before the cover date. The embargo policy is intended to enable physicians to have access to the published articles several days before news coverage occurs so they will be prepared if patients ask them about news reports based on a published article. In addition to the distribution of advance copies of THE JOURNAL, press releases and a video news release are prepared by science writers for selected journal articles and approved by JAMA editors for release to the news media the week before the embargo is released. This advance information and the news embargo are intended to provide journalists from various competitive news media equal access to news sources and an equal amount of time to prepare their news stories.⁴ Authors may cooperate with reporters for interviews or to discuss other information related to the study during the week before publication but only on the condition that the information will be released in accordance with THE JOURNAL's embargo policy. Authors should resist pressure from their institutions, sponsors, the news media, or others to release information before the embargo.

Authors, their institutional representatives, sponsors, and the news media who have questions about THE JOURNAL's policies regarding release of information should contact the editorial office.