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lancet-fit
GitHub用于在撰写前评估研究是否符合《柳叶刀》标准，判断其临床或公共卫生重要性、全球相关性、对实践/政策的影响及公平性视角。帮助决定投稿至《柳叶刀》、家族期刊或其他医学期刊，避免无效投入。
触发场景
起草前评估是否适合投《柳叶刀》
需对同事的投稿意向进行冷静复核时
在《柳叶刀》、其他顶级综合期刊和专科期刊间选择目标时
安装
npx skills add brycewang-stanford/Awesome-Journal-Skills --skill lancet-fit -g -y
SKILL.md
Frontmatter
{
"name": "lancet-fit",
"description": "Use when scoping a project and before any writing, to stress-test whether a study clears The Lancet's bar — clinically or public-health important, globally relevant, and likely to change practice or policy, often with an equity lens. Decides The Lancet vs a Lancet family title vs another general medical journal."
}
Scope & Significance Fit (lancet-fit)
Why this is skill #1
The Lancet triages most submissions to rejection without external review. The gate is not "is the trial sound" — it is "is this clinically or public-health important, globally relevant, and likely to change practice or policy." A rigorous single-centre confirmatory study is rejected if it does not move practice for a broadly relevant problem. Run this before investing in prose.
When to trigger
- Before drafting, to decide if The Lancet is even the right venue.
- When a co-investigator says "this is a Lancet paper" and you need a sober second opinion.
- When choosing among The Lancet, the Lancet family, NEJM/JAMA/BMJ, and a specialty journal.
The Lancet bar (four lenses)
A strong Lancet paper usually scores on most of these:
- Clinical / public-health importance — affects a common or high-burden condition, or a decision clinicians/policymakers actually face.
- Global relevance — matters beyond a single high-income setting; ideally international or low/middle-income-country (LMIC) data, or a lesson that generalises globally.
- Practice- or policy-changing — the result should alter a guideline, a treatment choice, or a public-health program — not merely add to the literature.
- Equity / advocacy angle — The Lancet actively favours work on health inequity, marginalised populations, and the social/structural determinants of health.
Significance ladder (weak → strong)
- Confirms an established treatment effect in one centre. (Weak — specialty/family title.)
- Extends a known effect to a new population or setting. (Borderline.)
- Resolves a clinically important uncertainty a guideline panel is debating. (Strong.)
- Establishes a new standard of care, or a public-health intervention that works at scale. (Strong.)
- Changes global policy or overturns a widely used practice with decisive trial/observational evidence. (Strongest.)
If you cannot place the work at rung 3+, The Lancet is a long shot — name the realistic target.
Fatal triage triggers
- Narrow / local: single-centre, small, high-income-only, no global lesson.
- Incremental: extends the authors' own prior trial without changing the decision.
- Surrogate-only: a surrogate endpoint with no clinical or policy consequence demonstrated.
- Over-claiming: causal or practice-changing language that outruns the design (a top rejection reason).
- Underpowered for the clinically meaningful effect, or analysis not pre-specified.
Venue routing (within and beyond the Lancet family)
| Situation | Recommend |
|---|---|
| Rung 4–5, globally relevant, practice/policy-changing | The Lancet (Article) |
| Global-health / LMIC focus, strong but not top-tier general | Lancet Global Health |
| Population/public-health intervention or surveillance | Lancet Public Health |
| Specialty-defining clinical result | Lancet specialty title (e.g. Oncology, Respiratory, Neurology) |
| Solid, rigorous, but not practice-changing for a broad audience | EClinicalMedicine (open access) |
| Definitive RCT, possibly US-centric, no global/equity emphasis | NEJM / JAMA |
| Generalist EBM / strong patient-partnership angle | BMJ |
Worked micro-example (illustrative numbers — not real data)
Two hypothetical studies arriving at the same desk, to show how the fit gate sorts them.
Study A (illustrative): single-centre RCT, high-income city, n=180, surrogate endpoint
improved (biomarker -0.4 SD, 95% CI -0.7 to -0.1). No global lesson, no policy hook.
-> Lens scores: importance weak, global weak, policy weak, equity weak
-> Significance rung 1 (confirms in one centre) -> NOT The Lancet; route to a specialty/family title.
Study B (illustrative): pragmatic cluster RCT across 3 LMICs, n=12 400 in 60 clusters,
hard clinical outcome: mortality 4.1% vs 5.6% (absolute risk reduction 1.5 pp,
95% CI 0.7-2.3; NNT ~67, illustrative), scalable low-cost intervention.
-> Lens scores: importance strong, global strong, policy strong, equity strong
-> Significance rung 4 (establishes a scalable public-health intervention) -> The Lancet (Article).
The numbers are not the deciding factor — Study A has a tidy effect but no practice-changing, globally relevant claim, while Study B changes a public-health decision at scale with an equity lens. That contrast is the fit gate.
Reviewer / editor-pushback patterns and the venue-specific fix
- "Global-health relevance / equity not addressed." → State who the result serves beyond a high-income setting; add the PROGRESS-Plus/LMIC generalisability angle or reroute to a family title.
- "This is incremental over the authors' prior work." → Name the specific decision it now changes; if it changes none, the venue is wrong.
- "The endpoint is a surrogate with no demonstrated clinical or policy consequence." → Show the downstream clinical/policy impact, or move to a specialty title.
- "The claim outruns the design." → Narrow to what the design supports; over-claiming is a top rejection reason — confirm scope expectations against the journal's current author guidelines.
Output format
【Lancet lens scores】 importance / global relevance / practice-or-policy change / equity (each: strong / weak)
【Significance rung】 1–5 + one-line justification
【Fatal triggers present】 [...]
【Recommended venue】 The Lancet / Lancet Global Health / Lancet Public Health / specialty title / EClinicalMedicine / NEJM-JAMA-BMJ
【If staying with The Lancet, the one sentence of clinical/global importance】 "..."
【Next】 lancet-study-design (if pass) | reconsider venue (if fail)
Anti-patterns
- Do not dress a local, confirmatory result as "globally relevant" with adjectives — editors discount adjectives.
- Do not confuse statistical significance or trial size with clinical importance.
- Do not let sunk cost (the trial is finished) drive the venue decision.
- Do not ignore the equity/global angle — it is often what distinguishes a Lancet paper from an NEJM one.
版本历史
- 1839142 当前 2026-07-05 14:01
