British Medical Bulletin (Br Med Bull)

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

2016 Impact Factor Available summer 2017
2014 / 2015 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

  • Robert A Lever · Christopher J M Whitty
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    ABSTRACT: Background: The West African Ebola crisis of 2013-15 is the largest outbreak since Ebola was first identified; Ebola has high case fatality. Sources of data: Pubmed with terms 'Ebola' and 'EVD' from January 1976 to June 2015. Public domain material. Areas of agreement: The emergence of Ebola virus, virology, clinical features and the major elements of the 2014 outbreak and the public health response. Ebola is only transmitted by direct contact with infected individuals (including dead bodies) and their body fluids. Methods of control in hospitals and burials, and protection of healthcare workers are well established if difficult to achieve. Areas of contention: There remains uncertainty surrounding specific public health interventions and novel therapies (including vaccines). How best to reduce transmission in the community during major outbreaks remains unclear. Future directions: The potential of vaccine and therapeutic candidates in the event of another outbreak on this scale. . Search strategy: We searched all entries on the MedLine database/PubMed from 1976-2015 with the MeSH terms 'ebola', 'EVD', 'haemorrhagic fever'. We also reviewed publically available information via institutional websites from Governmental, NGOs and news organizations pertaining to the above search terms.
    No preview · Article · Feb 2016 · British Medical Bulletin
  • Emma K Nickerson · Rohitashwa Sinha
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    ABSTRACT: Introduction: The incidence of vertebral osteomyelitis is increasing, attributed to an ageing population with inherent co-morbidities and improved case ascertainment. Sources of data: References were retrieved from the PubMed database using the terms 'vertebral osteomyelitis' and 'spondylodiscitis' between January 1, 2009 and April 30, 2014 published in English as checked in May 2014 (>1000 abstracts checked). Areas of agreement: Blood cultures and whole spine imaging with magnetic resonance imaging are essential investigations. Thorough debridement is the mainstay of surgical management, although placing metalwork in active infection is becoming increasingly common. Areas of controversy: The extent of pursuing spinal biopsies to determine aetiology, antimicrobial choices and duration, monitoring the response to treatment, and surgical techniques and timing all vary widely in clinical practice with heterogeneous studies limiting comparisons. Surgery, rather than conservative approaches, is being proposed as the default management choice, because it can, in carefully selected patients, offer faster reduction in pain scores and improved quality of life. Areas timely for developing research: Further studies are needed to define the most effective technique for spinal biopsies to maximize determining aetiology. High-quality trials are required to provide an evidence base for both the medical and surgical management of vertebral osteomyelitis, including challenging medical management as the default option.
    No preview · Article · Feb 2016 · British Medical Bulletin
  • James E Clark · W Fai Ng · Stuart Watson · Julia L Newton
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    ABSTRACT: Background: Chronic fatigue syndrome is a common condition characterized by severe fatigue with post-exertional malaise, impaired cognitive ability, poor sleep quality, muscle pain, multi-joint pain, tender lymph nodes, sore throat or headache. Its defining symptom, fatigue is common to several diseases. Areas of agreement: Research has established a broad picture of impairment across autonomic, endocrine and inflammatory systems though progress seems to have reached an impasse. Areas of controversy: The absence of a clear consensus view of the pathophysiology of fatigue suggests the need to switch from a focus on abnormalities in one system to an experimental and clinical approach which integrates findings across multiple systems and their constituent parts and to consider multiple environmental factors. Growing points: We discuss this with reference to three key factors, non-determinism, non-reductionism and self-organization and suggest that an approach based on these principles may afford a coherent explanatory framework for much of the observed phenomena in fatigue and offers promising avenues for future research. Areas timely for developing research: By adopting this approach, the field can examine issues regarding aetiopathogenesis and treatment, with relevance for future research and clinical practice.
    No preview · Article · Feb 2016 · British Medical Bulletin
  • Kieran Heil · Rachel Thomas · Greg Robertson · Anna Porter · Robert Milner · Alexander Wood
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    ABSTRACT: Introduction: The debilitating impact of cold weather on the human body is one of the world's oldest recorded injuries. The severe and life-changing damage which can be caused is now more commonly seen recreationally in extreme outdoor sports rather than in occupational settings such as the military. The diagnosis and treatment of these injuries need to be completed carefully but quickly to reduce the risk of loss of limb and possibly life. Therefore, we have conducted a systematic review of the literature surrounding cold weather injuries (CWIs) to ascertain the epidemiology and current management strategies. Sources of data: Medline (PubMED), EMBASE, CINHAL, Cochrane Collaboration Database, Web of Science, Scopus and Google Scholar. Areas of agreement immediate field treatment: The risk of freeze thaw freeze injuries. Delayed surgical intervention when possible. Different epidemiology of freezing and non-freezing injuries. Areas of controversy: Prophylatic use of antibiotics; the use of vasodilators surgical and medical. Growing points: The use of ilioprost and PFG2a for the treatment of deep frostbite. Areas timely for developing research: The treatment of non-freezing CWIs with their long-term follow-up.
    No preview · Article · Feb 2016 · British Medical Bulletin
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    ABSTRACT: Introduction: Cartilage debridement is one of the recommended procedures for the management of chondral defects. Radiofrequency probes allow to debride the cartilage, but may induce subchondral bone necrosis. Sources of data: Medline, Cochrane and Google Scholar were searched to identify studies on arthroscopic debridement of the articular cartilage of the knee using radiofrequency chondroplasty. The methodological quality of the studies was assessed using the Coleman methodology score (CMS). Areas of agreement: Monopolar and bipolar radiofrequency devices provide significantly better clinical outcomes, especially for patients with high-grade chondral lesions, compared with mechanical shaver only. Despite the original concerns regarding subchondral bone necrosis, low complication rates are reported. Areas of controversy: Heterogeneity in terms of type of device does not allow sound comparison of the published results. There is lack of evidence on the long-term effects of radiofrequency chondroplasty. Growing points: Study methodology should be improved: the average Coleman methodology score was 56.2 out of 100. Research: More comparative, well-designed and larger cohort trials are needed to ascertain whether radiofrequency chondroplasty offers long-term benefits over other simpler and more economical alternatives.
    No preview · Article · Feb 2016 · British Medical Bulletin
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    ABSTRACT: Introduction: The Ebola Virus Disease (EVD) outbreak in West Africa raised ethical issues about structural disadvantage; the duty to care of healthcare workers; the use and study of unregistered agents; the use of restrictive measures like mass quarantine and the importance of public trust. Sources of data: WHO reports, literature on EVD and ethics. Areas of agreement: The use of restrictive measures and the testing of unregistered agents is ethical if support for individuals or communities is provided. Areas of controversy: Controversy exists over ethical trial design for the study of unregistered agents and over the limits of the duty to care. Growing points: The role of the WHO in outbreak control and research oversight needs rethinking and further support. Solidarity in global health needs fostering. Areas timely for developing research: Research is needed on how to restore and enhance health systems and public trust in EVD-affected countries.
    No preview · Article · Feb 2016 · British Medical Bulletin
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    ABSTRACT: Background: Human amniotic membrane (HAM) has been embraced as a natural wound dressing almost exclusively in ophthalmology. Only recently, emergence of commercial HAM products prompted its use in growing range of indications, especially treatment of chronic non-healing wounds. Sources of data: database and International Clinical Trials Registry Platform searched with key words 'human amniotic membrane' and 'chronic wounds'. Areas of agreement: HAM can be successfully used as a natural wound dressing to promote healing. Areas of controversy: It is still unclear, which preparation is more advantageous, cryopreserved HAM or dehydrated HAM. Growing points: There are an increasing number of commercial HAM products and clinical trials for a variety of dermatological diagnoses. Areas timely for developing research: In spite of easy procurement and low production costs, to our knowledge, there are currently only a few manufacturers of commercial HAM products tested in clinical trials for cutaneous wounds and all of them are located in the USA.
    No preview · Article · Jan 2016 · British Medical Bulletin

  • No preview · Article · Dec 2015 · British Medical Bulletin
  • Source
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    ABSTRACT: Introduction The causative agent of tetanus, Clostridium tetani is widespread in the environment throughout the world and cannot be eradicated. To reduce the number of cases of tetanus efforts are focussed on prevention using vaccination and post-exposure wound care. Sources of data Medline, Pubmed and Cochrane databases; World Health Organization and United Nations Children's Fund publications. Areas of agreement The maternal and neonatal tetanus elimination initiative has resulted in significant reductions in mortality from neonatal tetanus throughout the world. Areas of controversy Although there are few data available it is likely that large numbers of children and adults, particularly men, remain unprotected due to lack of booster immunization. Areas timely for developing research It remains unclear how HIV and malaria affect both responses to vaccination and transplacental transfer of antibodies or how this might affect timing of vaccination doses.
    Full-text · Article · Nov 2015 · British Medical Bulletin
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    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.
    No preview · Article · Nov 2015 · British Medical Bulletin
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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.
    No preview · Article · Nov 2015 · British Medical Bulletin
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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. © The Author 2015. Published by Oxford University Press. All rights reserved.
    No preview · Article · Nov 2015 · British Medical Bulletin
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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.
    No preview · Article · Oct 2015 · British Medical Bulletin