--- name: jama-internal-medicine description: Use when targeting JAMA Internal Medicine or deciding whether an internal-medicine clinical study fits this venue. Encodes the journal's fit, the clinical-evidence and methodological-rigor bar, reporting-guideline and trial-registration requirements, JAMA Network house style, official-submission re-check, and desk-reject heuristics. Venue-fit aid only, not clinical advice. --- # JAMA Internal Medicine (jama-internal-medicine) ## Journal positioning JAMA Internal Medicine is a JAMA Network specialty journal for clinical research, evidence synthesis, and health-policy scholarship relevant to the practice of adult internal medicine. It favors rigorous, clinically important work — randomized trials, high-quality comparative-effectiveness and observational studies, and analyses that challenge low-value care or inform practice and policy — with a strong emphasis on methodological soundness and direct relevance to patient care and clinical decision making. Underpowered single-center studies, descriptive case series, and analyses with no clear practice implication 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 Internal Medicine author instructions. ## When to trigger - The author names JAMA Internal Medicine for an internal-medicine clinical or health-services study and wants a fit/framing check. - A clinical study must be re-framed around a clear practice-changing or policy-relevant question for a general internal-medicine readership. - The author is choosing between JAMA Internal Medicine, JAMA, and a subspecialty journal. - The author needs the journal's reporting-guideline, registration, and desk-reject expectations. ## Scope & topic fit - Randomized clinical trials in adult internal medicine, including pragmatic and de-implementation ("less is more") trials. - Comparative-effectiveness, cohort, and large database studies with rigorous design and confounding control. - Diagnostic, screening, and prognostic studies with clinically meaningful endpoints. - Health-policy, quality, value-of-care, and health-services research relevant to internal medicine. - Systematic reviews and meta-analyses that answer a focused clinical question. ## Method & evidence bar - Studies must be adequately powered with prespecified, patient-centered primary outcomes; surrogate-only endpoints need strong justification. - The applicable reporting guideline must be followed and its checklist supplied: CONSORT for trials, STROBE for observational studies, PRISMA for systematic reviews. - Trials require prospective registration; the trial-registration number and a protocol/statistical-analysis plan are expected. - Observational claims must address confounding, bias, and missing data explicitly; causal language must match the design. - Effect estimates should be reported with confidence intervals and absolute as well as relative measures; clinical (not just statistical) significance must be argued. ## Structure & house style - JAMA Network format with a structured abstract and a Key Points box; re-check current article types (Original Investigation, Research Letter, etc.) and limits on the live guide. - The introduction frames a focused clinical question and its importance; the discussion states the practice or policy implication plainly. - Tables/figures follow JAMA Network statistical-reporting standards; a CONSORT/STROBE flow diagram is expected where applicable. - Supplements carry the 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 and JAMA Network anchors, then cite the current JAMA Internal Medicine page you checked. - Search the live site for "JAMA Internal Medicine 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), data-sharing statement, and protocol/SAP submission. - Re-check IRB/ethics and consent statements, 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 a focused, clinically important question with a clear practice or policy implication. - [ ] The primary outcome is prespecified and patient-centered; the study is adequately powered. - [ ] The correct reporting checklist (CONSORT/STROBE/PRISMA) is completed and attached. - [ ] Trials are prospectively registered with the number in the manuscript; protocol/SAP provided. - [ ] Confounding, bias, and missing data are addressed, and causal language matches the design. - [ ] IRB/consent, ICMJE disclosures, and a data-sharing statement are prepared. ## Common desk-reject triggers - Underpowered or single-center studies with limited generalizability and no clear practice change. - Observational analyses with inadequate confounding control or overstated causal claims. - Missing trial registration, protocol, or the required reporting checklist. - Surrogate-only endpoints presented as clinically definitive. - Narrow subspecialty interest better served by a specialty journal, or limited general-internal-medicine relevance. ## Re-routing decision - Practice-changing, broadly significant trial → general medicine (`jama` / NEJM / The Lancet in the natural-science bundle). - Oncology focus → `jama-oncology` / `annals-of-oncology`. - Cardiology / neurology / nephrology subspecialty → `jama-cardiology` / `jama-neurology` / `journal-of-the-american-society-of-nephrology`. - Population-health or policy intervention → `the-lancet-public-health`. - Psychiatry / surgery focus → `jama-psychiatry` / `jama-surgery`. ## Output format ```text [Fit] High / Medium / Low (one-line reason) [Target] JAMA Internal Medicine [Specialty tags] <2–3 closest internal-medicine topics> [Study design / reporting guideline] [Method/evidence] [Top risk] [Official items to re-check]
[Re-route suggestion] ```