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
    ​ yellow

Publications in this journal

  • [Show abstract] [Hide abstract]
    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
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    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
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    ABSTRACT: Orthostatic hypotension (OH) is very common, particularly in older populations. Diagnostic criteria exist but appear to be arbitrary rather than evidence based. This review will visit the evidence for diagnostic strategies for OH. Medline (OvidSP), EMBASE (OvidSP), ISI Web of Science, the Health Technology Assessments Database and the Cochrane Library. A 5-min rest is required before measuring baseline. An active stand with continuous blood pressure (BP) monitoring is preferable to a tilt test to identify initial OH in particular. At least 2 min in the upright position is required. A systolic drop of 20 or a diastolic drop of 10 is supported by the evidence. Reproducibility when testing for OH is poor. Is the active stand preferable to the tilt test to diagnose classical OH? Although continuous BP monitoring increases diagnostic rates, does it improve clinical outcomes? Should symptoms be used to inform diagnosis? Establishing the long-term clinical outcomes for transient drops in BP detected on continuous, non-invasive monitoring. Evaluating the different patterns of BP drop to aid diagnosis and direct treatment. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail:
    British Medical Bulletin 05/2015; 115(1). DOI:10.1093/bmb/ldv025
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    ABSTRACT: Autoimmune hepatitis is a chronic immune-mediated liver injury, frequently associated with progression to end-stage liver disease if untreated. Patients commonly present with hepatitis, positive immune serology, elevated immunoglobulins and compatible liver histology, in the absence of an alternative aetiology. Data for this review were obtained using PubMed. Disease usually responds to steroids and azathioprine, and appears to be a manifestation of autoimmune predisposition triggered in genetically susceptible individuals exposed to likely environmental challenges. We provide an up-to-date approach to disease understanding and management along with the clinical approach to diagnosis and current treatment suggestions. Controversies such as second line therapies and novel markers of disease activity are introduced. Increased understanding of the immunoregulatory mechanisms behind autoimmune hepatitis has led to opportunities for new therapies. These are developed including a discussion of timely research studies relevant to future therapies for patients. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail:
    British Medical Bulletin 05/2015; 114(1). DOI:10.1093/bmb/ldv021
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    ABSTRACT: The V(D)J recombination is a DNA rearrangement process that generates the diversity of T and B lymphocyte immune repertoire. It proceeds through the generation of a DNA double-strand break (DNA-DSB) by the Rag1/2 lymphoid-specific factors, which is repaired by the non-homologous end joining (NHEJ) DNA repair pathway. V(D)J recombination also constitutes a checkpoint in the lymphoid development. V(D)J recombination defect results in severe combined immune deficiency (SCID) with a lack of T and B lymphocytes. The V(D)J recombination represents one of the few programmed molecular events leading to DNA-DSBs that strictly relies on NHEJ. Two NHEJ factors, Artemis and XLF/Cernunnos, were identified through the molecular studies of SCID patients. Mutations in PRKDC and DNA Ligase IV genes also result in SCID. Studies in mice have demonstrated that XLF/Cernunnos is dispensable for V(D)J recombination in lymphoid cells but not for the repair of genotoxic-induced DNA-DSBs, which raises the question of the implication of Rag1/2 factors in the DNA repair phase of V(D)J recombination. New factors of NHEJ, such as PAXX, are being identified. Patients with NHEJ deficiency (XRCC4) without immune deficiency were recently reported. We, therefore, may not have yet the complete picture of DNA-DSB repair in the context of V(D)J recombination. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail:
    British Medical Bulletin 05/2015; 114(1). DOI:10.1093/bmb/ldv020
  • [Show abstract] [Hide abstract]
    ABSTRACT: The current report reviews the data from the series Accidental Death and Suicide in India published by India's National Crime Records Bureau (NCRB) reporting official suicide rates based on police reports over the period of 10 years from 2004 to 2013. A reference to wider literature is made to present a comprehensive picture. Suicide in India is more prevalent in young, is likely to involve hanging and ingestion of pesticides and is related to social and economic causes. Reducing alcohol consumption, unemployment, poverty, social inequities, domestic violence and improving social justice are essential to reduce suicide in India. NCRB data might underreport suicide. Discrepancy in farmers' suicide rate between reports suggests that this might be overrepresented in NCRB data. An integrated suicide prevention programme with a multidimensional approach is needed. Mental health care bill and the recent launch of first national mental health policy are welcome measures. Decriminalization of suicide is likely to positively influence mental health practice and policy in India. Nationally representative studies investigating fatal and non-fatal suicidal behaviours, evaluation of models of service delivery for the vulnerable population, investigating suicide following different treatment services and effects of decriminalization of suicide on suicide rates should be the focus of future research. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail:
    British Medical Bulletin 05/2015; 114(1). DOI:10.1093/bmb/ldv018
  • [Show abstract] [Hide abstract]
    ABSTRACT: Desensitization, a term loosely referring to a collection of antibody reduction and B-cell depletional therapies aimed at improving rates of transplantation in highly HLA and ABO-incompatible transplant recipients, has seen significant growth in the last decade. Advancements relate to an increasing unmet medical need for FDA-approved therapies, advancements in antibody detection methodologies and improved renal pathological assessments of antibody-mediated rejection (ABMR). Data reviewed include collective summaries of experience with high-dose intravenous immunoglobulin (IVIG), B-cell depletion with rituximab and the use of plasma exchange with low-dose IVIG. Consensus suggests that these protocols are the most commonly used while experiences with other agents (i.e. bortezomib) are evolving. Controversy exists as to the extent of resources required, expense and outcomes of desensitization protocols. Here we review and synthesize data from evolving protocols and summarize developments of novel biologics aimed at modification of B-cells, antibodies and complement activation which will likely improve desensitization and treatment of ABMR. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail:
    British Medical Bulletin 05/2015; 114(1). DOI:10.1093/bmb/ldv013