--- 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] [Method/evidence] [Top risk] [Official items to re-check]
[Re-route suggestion] ```