The Lancet Respiratory Medicine

---
name: the-lancet-respiratory-medicine
description: Use when targeting The Lancet Respiratory Medicine or deciding whether a respiratory or critical-care study fits this venue. Encodes the journal's fit, the practice-changing trial and major-cohort evidence bar, reporting-guideline and registration requirements, Lancet specialty house style, official-submission re-check, and desk-reject heuristics. Venue-fit aid only, not clinical advice.
---

# The Lancet Respiratory Medicine (the-lancet-respiratory-medicine)

## Journal positioning

The Lancet Respiratory Medicine is a Lancet specialty journal for high-impact clinical
and population research across respiratory medicine and critical care — asthma, COPD,
interstitial and pulmonary vascular disease, respiratory infection, sleep and
ventilation, lung cancer screening, and intensive-care/critical-care medicine. It
favors **practice-changing randomized trials, major prospective cohorts, and analyses
with clear international clinical or policy consequence**, with a strong emphasis on
methodological rigor, generalizable populations, and patient-important outcomes. Small
single-center series, mechanistic/basic-science work without a clinical endpoint, and
incremental subgroup re-analyses are a weak fit and belong in a translational or
broader-scope respiratory journal. 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 The
Lancet Respiratory Medicine author instructions.

## When to trigger

- The author names The Lancet Respiratory Medicine for a respiratory or critical-care
  clinical/population study and wants a fit/framing check.
- A trial or large cohort must be re-framed around an international, practice-changing
  respiratory or critical-care question.
- The author is choosing between The Lancet Respiratory Medicine, the ATS "Blue
  Journal", and general medicine.
- The author needs the journal's reporting-guideline, registration, and desk-reject
  expectations for respiratory/critical-care evidence.

## Scope & topic fit

- Randomized trials in airways disease (asthma, COPD), pulmonary vascular and
  interstitial lung disease, respiratory infection, and sleep/ventilation.
- Critical-care and intensive-care trials and cohorts (ARDS, mechanical ventilation,
  sepsis-related respiratory failure) with patient-important outcomes.
- Large prospective cohorts and high-quality observational studies addressing
  respiratory disease burden, prognosis, or treatment effect at scale.
- Lung-cancer screening, diagnosis, and prevention studies with population-level or
  practice-changing implications.
- Pragmatic and implementation trials, and well-powered diagnostic studies, relevant to
  respiratory or critical-care practice internationally.
- Systematic reviews and meta-analyses that resolve a focused, clinically consequential
  respiratory question.

## Method & evidence bar

- Trials must be adequately powered with prespecified, patient-important primary
  outcomes (mortality, exacerbations, lung function with clinical anchoring, quality of
  life); surrogate-only endpoints need strong justification.
- The applicable reporting guideline and completed checklist are expected: CONSORT for
  trials, STROBE for observational studies, PRISMA for systematic reviews, STARD for
  diagnostic accuracy.
- Trials require prospective registration; the registration number, protocol, and
  statistical-analysis plan are expected, with an independent data-monitoring rationale
  where relevant.
- Observational and critical-care cohort claims must address confounding, immortal-time
  and selection bias, and missing data; causal language must match the design.
- Effect estimates need confidence intervals and absolute as well as relative measures;
  generalizability across settings/populations should be argued, not assumed.
- Multi-center and international evidence strengthens fit; single-center critical-care
  series rarely clear the bar without exceptional outcomes.

## Structure & house style

- Lancet specialty format with a structured summary and a Research in context /
  evidence-before-this-study panel; re-check current article types and limits on the
  live guide.
- The introduction frames the international clinical or policy gap; the discussion
  states the practice consequence and limitations plainly.
- A CONSORT/STROBE/PRISMA flow diagram is expected where applicable; tables/figures
  follow Lancet statistical-reporting standards.
- The role of the funding source statement and a data-sharing statement are expected;
  appendices carry protocol, full statistical methods, 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/EQUATOR and Lancet
  anchors, then cite the current The Lancet Respiratory Medicine page you checked.
- Search the live site for "The Lancet Respiratory Medicine information for authors" and
  follow the current version.
- Re-check article types, structured-summary and Research in context format, and
  word/reference/figure limits.
- Confirm trial registration, the reporting checklist (CONSORT/STROBE/PRISMA/STARD),
  protocol/SAP, the role-of-funding-source statement, and data-sharing statement.
- Re-check IRB/ethics and consent, ICMJE authorship and conflict-of-interest disclosure,
  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 an international, practice-changing respiratory or critical-care question.
- [ ] The primary outcome is prespecified and patient-important; the study is adequately powered.
- [ ] The correct reporting checklist (CONSORT/STROBE/PRISMA/STARD) is completed and attached.
- [ ] Trials are prospectively registered with the number in the manuscript; protocol/SAP provided.
- [ ] Confounding, selection/immortal-time bias, and missing data are addressed; causal language matches the design.
- [ ] IRB/consent, ICMJE disclosures, role-of-funding-source, and a data-sharing statement are prepared.

## Common desk-reject triggers

- Single-center or underpowered respiratory/critical-care studies with limited generalizability and no practice change.
- Mechanistic or basic-science work with no clinical endpoint, better suited to a translational journal.
- Surrogate-only endpoints (e.g., a lung-function change with no clinical anchoring) presented as definitive.
- Missing trial registration, protocol, or the required reporting checklist.
- Observational analyses with inadequate confounding control or overstated causal claims.
- Narrow or incremental scope without international clinical or policy consequence.

## Re-routing decision

- Translational, mechanistic, or basic-plus-clinical respiratory science → `american-journal-of-respiratory-and-critical-care-medicine` (ATS "Blue Journal", broader scope).
- Diabetes/endocrine or metabolic respiratory comorbidity dominant → `the-lancet-diabetes-and-endocrinology`.
- Population/policy framing without a clinical respiratory endpoint → `the-lancet-public-health`.
- Lung-cancer therapeutics as the core oncology contribution → `annals-of-oncology` / `jama-oncology`.
- Broad, practice-changing significance beyond respiratory specialty → general medicine (`jama` / NEJM / The Lancet in the natural-science bundle).

## Output format

```text
[Fit] High / Medium / Low (one-line reason)
[Target] The Lancet Respiratory Medicine
[Specialty tags] <2–3 closest respiratory/critical-care topics>
[Study design / reporting guideline] <RCT-CONSORT / cohort-STROBE / review-PRISMA / diagnostic-STARD>
[Method/evidence] <power, design, registration, generalizability — does it clear the practice-changing bar?>
[Top risk] <the single most likely reason for rejection>
[Official items to re-check] <article type / registration / checklist / role-of-funding / ethics / disclosures>
[Re-route suggestion] <if not a fit, a better-matched venue>
```