British Medical Bulletin Journal Impact Factor & Information

Publisher: British Council. Medical Dept, Oxford University Press (OUP)

Journal description

This series of expert reviews on selected health topics in fields where significant new developments are occurring is aimed at non-specialists and postgraduate medics and serves as an invaluable reference source. It also allows those working in other specialities and younger clinicians and scientists to update their knowledge in important and well-defined subject areas. Each issue offers an authoritative and concise overview of the current state of knowledge in a specific area.

Current impact factor: 3.66

Impact Factor Rankings

2015 Impact Factor Available summer 2016
2014 Impact Factor 3.658
2013 Impact Factor 3.953
2012 Impact Factor 4.363
2011 Impact Factor 4.543
2010 Impact Factor 3.211
2009 Impact Factor 2.9
2008 Impact Factor 3.277
2007 Impact Factor 2.545
2006 Impact Factor 1.881
2005 Impact Factor 3.179
2004 Impact Factor 2.165
2003 Impact Factor 2.25
2002 Impact Factor 1.708
2001 Impact Factor 1.246
2000 Impact Factor 1.869
1999 Impact Factor 3.381
1998 Impact Factor 2
1997 Impact Factor 2.092
1996 Impact Factor 2
1995 Impact Factor 2.188
1994 Impact Factor 1.577
1993 Impact Factor 1.677
1992 Impact Factor 2.023

Impact factor over time

Impact factor

Additional details

5-year impact 4.42
Cited half-life >10.0
Immediacy index 0.19
Eigenfactor 0.00
Article influence 1.50
Website British Medical Bulletin website
ISSN 1471-8391
OCLC 165840904
Material type Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Oxford University Press (OUP)

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author cannot archive a post-print version
  • Restrictions
    • 12 months embargo
  • Conditions
    • Pre-print can only be posted prior to acceptance
    • Pre-print must be accompanied by set statement (see link)
    • Pre-print must not be replaced with post-print, instead a link to published version with amended set statement should be made
    • Pre-print on author's personal website, employer website, free public server or pre-prints in subject area
    • Post-print in Institutional repositories or Central repositories
    • Publisher's version/PDF cannot be used
    • Published source must be acknowledged
    • Must link to publisher version
    • Set phrase to accompany archived copy (see policy)
    • Eligible authors may deposit in OpenDepot
    • The publisher will deposit in PubMed Central on behalf of NIH authors
    • This policy is an exception to the default policies of 'Oxford University Press (OUP)'
  • Classification

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Introduction: Mitochondrial diseases are a group of heterogeneous disorders for which no curative therapy is currently available. Several drugs are currently being pursued as candidates to correct the underlying biochemistry that causes mitochondrial dysfunction. Sources of data: A systematic review of pharmacological therapeutics tested using in vitro, in vivo models and clinical trials. Results presented from database searches undertaken to ascertain compounds currently being pioneered to treat mitochondrial disease. Areas of agreement: Previous clinical research has been hindered by poorly designed trials that have shown some evidence in enhancing mitochondrial function but without significant results. Areas of controversy: Several compounds under investigation display poor pharmacokinetic profiles or numerous off target effects. Growing points: Drug development teams should continue to screen existing and novel compound libraries for therapeutics that can enhance mitochondrial function. Therapies for mitochondrial disorders could hold potential cures for a myriad of other ailments associated with mitochondrial dysfunction such as neurodegenerative diseases.
    British Medical Bulletin 11/2015; DOI:10.1093/bmb/ldv046
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    ABSTRACT: Background: Extracorporeal shock wave therapy (ESWT) is an effective and safe non-invasive treatment option for tendon and other pathologies of the musculoskeletal system. Sources of data: This systematic review used data derived from the Physiotherapy Evidence Database (PEDro;, 23 October 2015, date last accessed). Areas of agreement: ESWT is effective and safe. An optimum treatment protocol for ESWT appears to be three treatment sessions at 1-week intervals, with 2000 impulses per session and the highest energy flux density the patient can tolerate. Areas of controversy: The distinction between radial ESWT as 'low-energy ESWT' and focused ESWT as 'high-energy ESWT' is not correct and should be abandoned. Growing points: There is no scientific evidence in favour of either radial ESWT or focused ESWT with respect to treatment outcome. Areas timely for developing research: Future randomized controlled trials should primarily address systematic tests of the aforementioned optimum treatment protocol and direct comparisons between radial and focused ESWT.
    British Medical Bulletin 11/2015; DOI:10.1093/bmb/ldv047
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    ABSTRACT: Introduction: This review outlines the development of China's primary care system, with implications for improving equitable health care. Sources of data: Government documents, official statistics, and recent literature identified through systematic searches performed on NCBI PubMed. Areas of agreement: Community health centres (CHCs) are being developed as the major primary care provider in urban China, with laudable achievements. The road towards a strong primary care-led system is promising but challenging. Areas of controversy: The effectiveness in improving equitable care through the expansion of primary care workforce and redesign of the social medical insurance system warrants further exploration. Growing points: Healthcare disparities exist in the health system wherein universal health coverage and gatekeepers have not yet been established. Areas timely for developing research: Future prospective studies should aim to provide solutions for strengthening the leading role of CHCs in providing equitable care in response to population ageing and multimorbidity challenges.
    British Medical Bulletin 11/2015; DOI:10.1093/bmb/ldv043
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    ABSTRACT: Background: Human embryonic and induced pluripotent stem cells (hESC and hiPSC) have tremendous potential for clinical implementation. In spite of all hurdles and controversy, clinical trials in treatment of spinal cord injury, macular degeneration of retina, type 1 diabetes and heart failure are already ongoing. Sources of data: database, International Clinical Trials Registry Platform, PubMed and press releases and websites of companies and institutions working on hESC- and iPSC-based cellular therapy. Areas of agreement: The initial results from multiple clinical trials demonstrate that hESC-based therapies are safe and promising. Areas of controversy: Are iPSC cells safe in the clinical application? Is there a room for both hESC and iPSC in the future clinical applications? Growing points: Increasing number of new clinical trials. Areas timely for developing research: Development of hESC- and/or iPSC-based cellular therapy for other diseases.
    British Medical Bulletin 11/2015; DOI:10.1093/bmb/ldv045
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    ABSTRACT: Introduction or background: In 2013, responsibility for public health returned to local government from the National Health Service (NHS) in England. This article describes, as a case study, a new fresh approach to tackling health inequalities, which built on a desire by local councils in the north of England to rethink approaches and collaborate on new ideas to improving health and reducing health inequalities. Sources of data: The collaboration was supported by an independently commissioned inquiry that assessed the evidence and proposed new policy options. This article describes the context to the collaboration, called Health Equity North, findings from the independent inquiry and emerging impact. Four areas for action were recommended: linking poverty with economic prosperity, devolution and public sector reform, investment in early years and renewed impetus for the health sector. Areas of agreement: That health service action alone had been limited without addressing the wider determinants of health such as employment, education and housing. Areas of controversy: The so-called north-south divide appears to be widening, and renewed efforts are needed locally and nationally to tackle these wider determinants of health. Growing points: This collaborative approach spanning a large geography supported by local and national leaderships, enabled new work locally and influenced policy nationally, such as devolution of power and resources to local areas. Areas timely for developing research: Research is needed on the economic returns of investing in the social determinants of health. The examples of local action indicate the need for research on 'asset-based approaches' to improving community health, presented so to empower local lay decision makers such as councillor rather than for technical experts.
    British Medical Bulletin 11/2015; DOI:10.1093/bmb/ldv048
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    ABSTRACT: Background: Antibiotic resistance is a threat to the effective prevention and treatment of an ever-increasing range of infections caused by bacteria, parasites, viruses and fungi. Sources of data: Peer-reviewed journal articles, governmental and professional society publications. Areas of agreement and controversy: There is consensus about the development and spread of antibiotic resistance, the reasons for the development of antibiotic resistance and the clinical impact. There is more debate about the most appropriate way of tackling this increasing problem. Growing points: This review discusses a number of initiatives (local and global) that are being undertaken to protect the antibiotics we currently have available for use and to encourage the development of newer agents.
    British Medical Bulletin 10/2015; DOI:10.1093/bmb/ldv041
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    ABSTRACT: Introduction: The hepatitis B virus (HBV) causes chronic hepatitis B (CHB) in ∼350 million people worldwide who have an increased risk of end-stage liver disease and/or hepatocellular carcinoma. Sources of data: Several peer-reviewed papers featuring new approaches to anti-HBV management. Additionally, we also reviewed recent abstract presentations at international congresses. Areas of agreement: There has been great progress in CHB therapy with the development of standard and pegylated interferon (i.e. PEG-IFN) as well as nucleos/tide analogs (NAs). IFN has both antiviral and immunomodulatory effects and through immune-mediated destruction of infected hepatocytes offers the possibility of finite therapy. However, this 'killing for a cure' antiviral strategy may not be tolerated in many, especially in cirrhotic patients. NAs inhibit viral reverse transcriptase, have few side effects and prevent liver disease progression, but cannot offer a cure as they have little effect on the resilient HBV covalently closed circular DNA (cccDNA) intermediate. Moreover, NAs such as tenofovir and entecavir offer a high genetic barrier to resistance, but are expensive and not readily available in many global regions. Growing points: Despite significant treatment advances, there is increased recognition of the need for improved anti-HBV treatments, and new virologic tests for monitoring treatment response. Areas of controversy: The role of quantitative hepatitis B surface antigen, intrahepatic cccDNA levels and viral genotype in selecting treatment candidates and refining NA stopping rules. Areas timely for developing new research: Potential new therapies include viral entry inhibitors, RNA interference technologies (i.e. RNAi) and small molecules that modulate cccDNA transcription, as well as novel immunomodulatory therapies to boost HBV-specific T cell responses. The ultimate goal of new tests and anti-HBV therapies is to reduce the burden and expense of life-long CHB treatment, as 'only diamonds are forever'.
    British Medical Bulletin 09/2015; DOI:10.1093/bmb/ldv039
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    ABSTRACT: Hip fracture poses a significant global challenge both to healthcare systems and to patients themselves. We outline the management of this injury, highlight areas where the evidence is deficient and discuss research efforts towards improving the quality of the evidence base. We searched MEDLINE, PubMed and the Cochrane Library, using the core search terms 'hip fracture' and 'proximal femoral fracture'. In addition we reviewed national treatment guidelines for hip fracture care and references from relevant articles. Only articles published in English from inception to March 2015 were included. Modern hip fracture management should consist of a coordinated multidisciplinary approach with orthogeriatrician input, early surgery, adequate analgesia and liaison with related services to facilitate safe supported discharge. The optimum thromboprophylaxis to reduce venous thromboembolism remains a topic for debate. The use of bone cement has received much attention recently with concerns about its safety in the frailest of hip fracture patients. An increasing understanding of the severity and impact of sustaining a hip fracture upon quality of life. Strategies to improve postoperative mobility, postoperative nutrition and the role of home-based rehabilitation. There is a need to identify the optimum analgesic regimes and assessment tools for hip fracture patients with cognitive impairment. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail:
    British Medical Bulletin 08/2015; 115(1). DOI:10.1093/bmb/ldv036
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    ABSTRACT: Radionuclide imaging for the diagnosis and monitoring of cardiac involvement in sarcoidosis has advanced significantly in recent years. This article is based on published clinical guidelines, literature review and our collective clinical experience. Gallium-67 scintigraphy is among the diagnostic criteria for cardiac involvement in systemic sarcoidosis, and it is strongly associated with response to treatment. However, fluorine-18, 2-fluoro-deoxyglucose (FDG) positron emission tomography (PET) is now preferred both for diagnosis and for assessing prognosis. Most data are from small observational studies that are potentially biased. Quantitative imaging to assess changes in disease activity in response to treatment may lead to FDG-PET having an important routine role in managing cardiac sarcoidosis. Larger prospective studies are required, particularly to assess the effectiveness of radionuclide imaging in improving clinical management and outcome. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail:
    British Medical Bulletin 08/2015; 115(1). DOI:10.1093/bmb/ldv033
  • [Show abstract] [Hide abstract]
    ABSTRACT: This paper reviews evidence on equity as a policy goal of resource allocation in the English NHS, focussing on the role of clinical commissioning groups (CCGs) as purchasers of health services since 2013 and their capacity to achieve equity through the process of commissioning. A systematic search of literature published since 1990 and review of grey literature, including policy documents published by CCGs and other organizations in the healthcare system. Despite a stated policy commitment to equity of access in the NHS, the 2012 reforms have created a structure that allows and encourages great variation between devolved purchasers of care. Evidence suggests that CCGs, which are structurally separated from public health, have limited capacity and incentives to commission for equity. Concepts of equity of access and health inequalities lack consistent definitions and may not be implemented. However, it remains unclear whether variation between CCGs implies inequity. The 2012 reforms have sought to contain costs and improve quality, thus achieving efficiency gains, while equity has remained an afterthought. The NHS should be expected to work towards equity of access to healthcare and can contribute to reducing health inequalities; however to achieve a more equitable distribution of health, wider social policies are also needed. Additional assessments of structural capacity should be complemented by further development of indicators of equity of access and studies that quantify inequities. Research should also explore how an equity principle can be embedded in commissioning, which currently revolves around cost containment and efficiency. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail:
    British Medical Bulletin 07/2015; 115(1). DOI:10.1093/bmb/ldv031
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    ABSTRACT: Streptococci are a genus of Gram-positive bacteria which cause diverse human diseases. Many of these species have the potential to cause invasive infection resulting from the presence of bacteria in a normally sterile site. Original articles, reviews and guidelines. Invasive infection by a streptococcus species usually causes life-threatening illness. When measured in terms of deaths, disability and cost, these infections remain an important threat to health in the UK. Overall they are becoming more frequent among the elderly and those with underlying chronic illness. New observational evidence has become available to support the use of clindamycin and intravenous immunoglobulin in invasive Group A streptococcal disease. Few interventions for the treatment and prevention of these infections have undergone rigorous evaluation in clinical trials. For example, the role of preventative strategies such as screening of pregnant women to prevent neonatal invasive Group B streptococcal disease needs to be clarified. Studies of invasive streptococcal disease are challenging to undertake, not least because individual hospitals treat relatively few confirmed cases. Instead clinicians and scientists must work together to build national and international networks with the aim of developing a more complete evidence base for the treatment and prevention of these devastating infections. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail:
    British Medical Bulletin 07/2015; 115(1). DOI:10.1093/bmb/ldv027
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    ABSTRACT: Obesity is associated with an increased risk of developing osteoarthritis (OA), even in non-weight bearing joints. High levels of adipose tissue-associated inflammation may explain this association. Published evidence looking at the associations between components of Metabolic Syndrome (MetS) and knee, hip or hand OA and the higher mortality described with knee OA. Development of MetS and OA shares a relationship with adipose tissue-associated inflammation. This review supports this inflammatory pathway being part of the shared mechanism behind obesity as a risk factor for OA and the recently described OA-associated increased mortality. In an era of an obesity epidemic, this review identifies a need for well-designed cohort studies assessing early metabolic changes in populations at high risk of OA and MetS, and to identify risk factors for increased mortality in patients with OA. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail:
    British Medical Bulletin 07/2015; 115(1). DOI:10.1093/bmb/ldv028

  • British Medical Bulletin 06/2015; 114(1):1-4. DOI:10.1093/bmb/ldv023