JAMA Cardiology 'Under Review': What Each Status Means

Before the paper reaches external reviewers, a JAMA Network deputy editor at JAMA Cardiology evaluates whether the broad-clinical-consequence threshold is met for JAMA Cardiology's selective editorial slots. With 2200+ submissions per year and a 6 percent acceptance rate, roughly 85 to 90 percent of submissions are rejected at this stage with scope problems surfacing within days. A desk rejection most often means the deputy editor concluded that the work would fit better at a sister JAMA Network title (JAMA Network Open, JAMA) or that the broad-clinical-cardiology audience appeal is uncertain.

The JAMA Network editorial office confirms files are complete: manuscript with figures embedded, supplementary information separate, reporting checklists where applicable (CONSORT for clinical trials, STROBE for observational cardiology studies, PRISMA for systematic reviews, STARD for diagnostic-accuracy studies), cover letter directed to the editor, conflict-of-interest declarations, ethics-statement documentation, IRB approvals for human-subjects research, trial-registration documentation (JAMA Network requires registered clinical trials), and statistical analysis plan for clinical-trial submissions.

The senior and deputy editors read the paper and evaluate broad-clinical-consequence, novelty over the existing literature, basic-quality threshold for JAMA Cardiology, and broad-clinical audience fit. Scope problems surface within days per JAMA Network editorial guidance.

In parallel with the deputy editor's primary read, clinical-trial submissions are routed to JAMA Network in-house statistical reviewers who evaluate trial design, pre-specification compliance, statistical methods, and reporting completeness. This statistical-review stage runs alongside the external reviewer recruitment and adds rigor that contributes to JAMA Cardiology's reputation for methodological discipline.

JAMA Network deputy editors at JAMA Cardiology typically invite 2 to 3 external reviewers. The recruitment window can take 7 to 14 days because clinical-cardiology reviewers with topic-matched expertise are scarce.

Once reviewers agree to review, the typical JAMA Cardiology peer-review cycle lasts 2 to 3 weeks per reviewer. Reviewers are asked to evaluate broad-clinical-consequence, trial design and rigor, statistical methodology, and reproducibility. Reviewer reports for JAMA Cardiology tend to be thorough; 2000 to 4000 word reports are typical.

After reports return, the deputy editor synthesizes them and consults with statistical reviewers for clinical-trial papers. Average submission-to-acceptance exceeds 100 days because multiple revisions are often necessary per JAMA Network guidance.

• Rejection within 1 to 3 days: Scope problem surfaces within days per JAMA Network editorial guidance. Most rejections happen here.
• Rejection within 1 to 2 weeks: Deputy editor desk rejection.
• Still Under Review after 3 weeks: Strong signal. Paper passed the steepest JAMA Network filter.
• Still Under Review after 10 weeks: Reviewer-recruitment or reviewer-report delay. A polite inquiry via the submission portal is appropriate.
• Status changes to "Reports Received": Reports are in; expect a decision within 1 to 2 weeks.

This is the most common anxiety we hear from JAMA Cardiology authors during the active editorial window. The honest answer: no, 6 weeks at Under Review means your paper passed the deputy editor desk screen (which is fast at JAMA Cardiology, with scope problems surfacing within days) and is now in active external peer review. JAMA Cardiology's reviewer-assignment plus reviewer-response stages typically span 3 to 5 weeks combined. Most reviewer-driven delays come from reviewer-recruitment timing for clinical-cardiology specialists rather than slow reviews. If the portal still says Under Review at the 8-week mark, the most likely explanation is that one of the assigned reviewers asked for an extension and the deputy editor granted it. This is normal practice at JAMA Network.

What you should NOT do during the 6-to-8-week window is email the editorial office. JAMA Network deputy editors at JAMA Cardiology are managing 50+ active papers; an inquiry at 6 weeks adds friction without accelerating the timeline.

If your JAMA Cardiology paper is rejected after review, the natural cascade depends on what the reviewers and deputy editor cited:

JAMA Network Open is the most natural JAMA Network cascade because JAMA Network supports manuscript-transfer where the receiving editor can request reviewer reports from JAMA Cardiology, preserving substantial peer-review work. JAMA Network Open has a broader scope and an open-access publishing model. The transfer process takes 5 to 10 days.

Circulation is the AHA cascade option for cardiovascular papers where the broad-clinical-cardiology framing fits AHA's flagship clinical title. AHA operates independently; reports do not transfer, but Circulation editors may recognize JAMA Network reviewer reports informally.

Journal of the American College of Cardiology (JACC) is the ACC cascade option for cardiology papers with strong clinical-practice implications. ACC operates independently with its own reviewer pool.

European Heart Journal (EHJ) is the ESC cascade option for European-cardiology-focused work. ESC operates independently.

JAMA Network asks reviewers at JAMA Cardiology to evaluate four things specifically. The table below maps each to actionable preparation.

Three patterns generate the most consistent reviewer concerns we see at JAMA Cardiology.

CONSORT-compliance gaps surface as reviewer requests for clarification. When CONSORT checklist items are incomplete or trial-pre-registration alignment is unclear, JAMA Network in-house statistical reviewers consistently flag for revision. The strongest revisions add complete CONSORT documentation with pre-registration alignment.

Statistical analysis plan under-documented. When the pre-specified statistical analysis plan is thin or post-hoc analyses are not clearly distinguished from pre-specified analyses, JAMA Network statistical reviewers consistently request expanded methods documentation.

Broad-clinical-consequence under-stated in framing. When the abstract and discussion do not clearly establish the broad-clinical decision that would change, deputy editors and reviewers flag general-clinical-interest concerns. The strongest manuscripts frame the abstract around the specific cardiology decision the paper affects.

This page was created from JAMA Network's public author guidance at jamanetwork.com/journals/jamacardiology/pages/instructions-for-authors, JAMA Network editorial-process documentation, JAMA Cardiology submission-and-acceptance data (2200+ annual submissions, 6 percent acceptance, 100+ days submission-to-acceptance average), and Manusights pre-submission review experience with JAMA Cardiology-targeted manuscripts.

For the JAMA Network cardiology landscape beyond JAMA Cardiology, see JAMA Network Open (broader open-access), JAMA (top general-medicine), JAMA Internal Medicine (internal medicine focus), and sister cardiology titles (Circulation, JACC, EHJ). The choice across these titles depends on whether the central contribution is broad-clinical-cardiology (JAMA Cardiology), basic-cardiovascular (Circulation Research), AHA-clinical-practice (Circulation), ACC-clinical (JACC), or European-cardiology (EHJ).

Reviewers at JAMA Cardiology typically draw from one clinical cardiologist and one methodologist or statistician (in addition to the JAMA Network in-house statistical reviewer for clinical trials). Preparing a response template that addresses both perspectives accelerates revision rounds substantially.

For a pre-upload check of your manuscript against the JAMA Cardiology broad-consequence-plus-statistical-rigor bar before submission, our JAMA Cardiology pre-submission diagnostic flags the CONSORT-compliance gaps and statistical-methodology weaknesses most likely to surface in reviewer reports.