JAMA Surgery (jama-surgery)

Journal positioning

JAMA Surgery is a JAMA Network specialty journal for surgical clinical research across general, vascular, thoracic, transplant, trauma, and surgical-subspecialty practice. It favors rigorous, practice-relevant work — randomized and well-designed surgical trials, large surgical-outcomes and registry analyses, perioperative and quality-improvement research, and comparative-effectiveness studies — with JAMA's emphasis on patient- centered outcomes, adequate risk adjustment, and direct relevance to surgical care. Single-surgeon case series, descriptive technique reports without comparative outcomes, and underpowered studies are a weak fit. This skill is a fit / venue-selection / re-framing aid; it is not clinical or regulatory advice and does not replace the journal's current instructions for authors. Before submitting, re-check the live JAMA Surgery author instructions.

When to trigger

• The author names JAMA Surgery for a surgical trial, outcomes, or perioperative study and wants a fit/framing check.
• A surgical study must be re-framed around a comparative, patient-centered outcome with appropriate risk adjustment for a practicing-surgery audience.
• The author is choosing between JAMA Surgery, JAMA, and a surgical-subspecialty journal.
• The author needs the journal's surgical-trial reporting, registration, and desk-reject expectations.

Scope & topic fit

• Randomized and pragmatic surgical trials (operative vs. nonoperative, technique vs. technique, or perioperative interventions) with patient-centered outcomes.
• Large surgical-outcomes, registry, and claims analyses (e.g., NSQIP-style) with robust risk adjustment for case mix.
• Perioperative, enhanced-recovery, anesthesia-surgery interface, and surgical-safety research.
• Comparative-effectiveness and value-of-surgery studies, including de-implementation of low-value operations.
• Surgical quality, volume-outcome, disparities, and health-services research.
• Systematic reviews and meta-analyses answering a focused surgical question.

Method & evidence bar

• Studies must use patient-centered outcomes (mortality, complications graded by a standard scheme, function, quality of life) with adequate risk adjustment; technical success alone is insufficient.
• The applicable reporting guideline and checklist are required: CONSORT for trials, STROBE for observational studies, PRISMA for systematic reviews; surgical-innovation work should engage IDEAL-framework stages where relevant.
• Surgical-trial reporting challenges must be addressed explicitly: blinding is often impossible (state who was blinded — patients, assessors, analysts), the learning curve and surgeon/center experience must be reported, and the intervention must be standardized and described reproducibly.
• Trials require prospective registration; registration number, protocol, and statistical-analysis plan are expected.
• Observational/registry claims must address confounding by indication, selection bias, and clustering by surgeon/center; causal language must match the design.
• Volume-outcome and center-effect analyses need appropriate multilevel modeling.

Structure & house style

• JAMA Network format with a structured abstract and a Key Points box; re-check current article types (Original Investigation, Brief Report, Research Letter, etc.) and limits on the live guide.
• The introduction frames a focused, practice-relevant surgical question; the discussion states the clinical implication and net benefit/harm plainly.
• Tables/figures follow JAMA Network statistical-reporting standards; CONSORT/STROBE flow diagrams, complication tables, and risk-adjusted outcome figures are expected where applicable.
• Supplements carry the protocol, SAP, intervention standardization details, and additional analyses.

Official-submission checklist

• Before giving submission-ready advice, read ../../resources/source-basis.md and ../../resources/official-source-map.md; start from the ICMJE and JAMA Network anchors, then cite the current JAMA Surgery page you checked.
• Search the live site for "JAMA Surgery instructions for authors" and follow the current version.
• Re-check article types and word/reference/table limits, structured-abstract and Key Points format, and the JAMA Network statistical-reporting requirements.
• Confirm trial registration, the reporting checklist (CONSORT/STROBE/PRISMA), the data-sharing statement, and protocol/SAP submission.
• Re-check IRB/ethics and consent statements, ICMJE disclosures (including device/industry ties), funding, and AI-use disclosure.
• If the live official instructions conflict with this skill, the official instructions win.

Pre-submission self-check

• The study answers a practice-relevant surgical question with a comparative, patient-centered outcome and adequate risk adjustment.
• Blinding, the learning curve, and surgeon/center experience are reported; the intervention is standardized and reproducibly described.
• The correct reporting checklist (CONSORT/STROBE/PRISMA) is completed and attached; complications are graded by a standard scheme.
• Trials are prospectively registered with the number in the manuscript; protocol/SAP provided.
• Confounding by indication, selection bias, and surgeon/center clustering are addressed; causal language matches the design.
• IRB/consent, ICMJE disclosures (including device ties), and a data-sharing statement are prepared.

Common desk-reject triggers

• Single-surgeon or single-center case series and technique reports with no comparator or risk adjustment.
• Outcomes reported as technical success only, without complications, function, or patient-centered endpoints.
• Surgical trials that ignore blinding, the learning curve, or intervention standardization.
• Registry analyses with confounding by indication or unaddressed surgeon/center clustering and overstated causal claims.
• Missing trial registration, protocol, or the required reporting checklist.
• Narrow surgical-subspecialty interest better served by a subspecialty journal.

Re-routing decision

• Broadly practice-changing, top-tier surgical trial → general medicine (jama / NEJM / The Lancet in the natural-science bundle).
• Surgical-oncology with a cancer-endpoint center of gravity → jama-oncology / annals-of-oncology.
• Cardiac/cardiovascular surgical outcomes tied to cardiology endpoints → jama-cardiology.
• Neurosurgical/cerebrovascular focus → jama-neurology / stroke / brain.
• General internal-medicine or perioperative-medicine relevance over surgery → jama-internal-medicine.

Output format

[Fit] High / Medium / Low (one-line reason)
[Target] JAMA Surgery
[Specialty tags] <2–3 closest surgical topics>
[Study design / reporting guideline] <RCT-CONSORT / registry-STROBE / review-PRISMA / innovation-IDEAL>
[Method/evidence] <does outcome choice, risk adjustment, blinding/learning-curve, and registration clear the bar?>
[Top risk] <the single most likely reason for rejection>
[Official items to re-check] <article type / registration / checklist / standardization / ethics / disclosures>
[Re-route suggestion] <if not a fit, a better-matched venue>