JCI Insight 'Under Review': What Each Status Means and When to Expect a Decision

Before the paper reaches external reviewers, the Associate Editor, together with a Science Editor or the Editor in Chief, evaluates whether the study significantly advances the field and fits the journal's readership. The journal's metrics page reports that 26.0% of first submissions between June 2025 and May 2026 were sent for review, and an average of 2.0 days to a first decision for manuscripts that were not.

A desk rejection means the editors concluded that the study does not significantly advance the field or that the subject material is inappropriate for the readership, which the journal states in its author information center. Re-routing to a specialty journal or sharpening the translational framing are the usual next moves.

At submission the journal asks for a PDF of the entire manuscript including figures, legends and tables, a Word or RTF text file identical to the PDF, supplemental material, a Supporting Data Values file, and, for Clinical Research and Public Health, ICMJE disclosure forms and a flow diagram and checklist appropriate to the study type.

The Associate Editor reads the paper with a Science Editor or the Editor in Chief and evaluates whether it significantly advances the field and fits the readership. For manuscripts the journal does not send for review, it reports an average of 2.0 days from submission to this first decision.

The journal does not describe an internal discussion stage. The route between the two ASCI journals is the Dual-Journal Submission option, chosen when a manuscript is first submitted, and the JCI's invitation to transfer a manuscript to JCI Insight, which stays open for 60 days.

When papers are sent for external review, the Associate Editor chooses the reviewers, and the choice may include reviewers the authors suggested; at least two, and generally three, expert referees are asked to review. The journal does not publish how many reviewers it invites or how long recruitment takes.

Reviewers are asked to assign a priority based on content, originality, quality, relevance, and interest, and to say whether they know of relevant published work that is not yet cited. The journal reports an average of 35.9 days from submission to first decision for reviewed manuscripts (June 2025 to May 2026). It does not publish a per-reviewer review period or report lengths.

After reports return, authors are informed of the decision by email with applicable comments from reviewers and editors. The journal reports an average of 246.3 days from submission to acceptance (June 2025 to May 2026), including revision rounds.

• Rejection within a few days: The journal's average to a first decision without external review is 2.0 days, so a rejection within a few days is typically an editor's decision on scope or significance.

• Rejection within about 2 weeks: Most likely an editor's decision without external review.

• Still Under Review after 2 weeks: Strong signal. The paper has most likely passed the desk screen, since the journal's average for decisions without external review is 2.0 days.

• Still Under Review after 10 weeks: Roughly double the journal's 35.9-day average to first decision for reviewed manuscripts, so reviewer recruitment or a delayed report is possible. A polite inquiry to staff@insight.jci.org, quoting your tracking number, is appropriate.

• A status change after review: If the portal shows that reports are in, expect a decision soon; the journal does not publish a timeline for this step.

This is the most common anxiety we hear from JCI Insight authors during the active editorial window. The honest answer: no. The journal's average from submission to first decision for reviewed manuscripts is 35.9 days (about 5 weeks), so 6 weeks is only a little past that average. Reports may already be in editorial synthesis with the editor preparing the recommendation.

Delays beyond the average can come from reviewer recruitment or late reports; the journal does not publish what drives them.

If the portal still says Under Review at the 10-week mark, the likely explanations are that reviewers are still being recruited or that a reviewer asked for an extension; the journal does not publish which.

Between week 6 and week 10, the useful distinction is whether you have new information the editor needs. A short portal message is reasonable for an ethics update, corrected data-availability statement, related-paper disclosure, preprint status change, or a material authorship or conflict-of-interest correction. A general timeline request is better held until week 10 because the journal's average first decision for reviewed manuscripts is 35.9 days.

If your JCI Insight paper is rejected after review, the natural cascade depends on what the reviewers and editors cited:

JCI flagship is the natural JCI cascade for top-tier mechanistic clinical investigation papers.

Cell Reports Medicine is the external Cell Press clinical-translation cascade. Cell Press uses Editorial Manager at Editorial Manager submission portal; editorial contact crmed@cell.com.

Science Translational Medicine is the external AAAS clinical-translation cascade. AAAS uses the Centralized Tracking System at Science family CTS submission portal; editorial contact stm@aaas.org.

Nature Medicine is the external Springer Nature top-tier clinical cascade. The Nature Medicine Manuscript Tracking System at mts-nmed.nature.com handles submission; nmed@nature.com handles publisher-level inquiries.

Nature Communications is the external Springer Nature broader cascade.

eLife is a cascade option for clinical-research work under the Reviewed Preprint model.

JCI Insight asks reviewers to assign a priority based on content, originality, quality, relevance, and interest, and to note relevant published work that is not yet cited. The table below maps four areas manuscripts are judged on to actionable preparation.

In our pre-submission work with JCI Insight-targeted manuscripts, three named patterns generate the most consistent reviewer concerns and the most common reasons papers miss the editorial bar or fail the desk screen.

Mechanism-without-disease-relevance framing flagged at the editors' desk screen. When the work presents clinical-research mechanism without connection to a specific disease area, JCI Insight desk rejection is common. The strongest manuscripts frame both the mechanistic approach and the specific disease area explicitly.

Check your mechanism and disease-relevance framing →

Reviewer-recruitment difficulty surfaces as elongated timeline. When the mechanism-and-disease-area intersection is particularly narrow, the editor may need longer to recruit the referees the journal asks for (at least two, and generally three). The strongest submissions help by suggesting three potential reviewers who span the intersection at submission.

Check your reviewer-routing package →

JCI to JCI Insight transfer offers. When the JCI editors conclude a manuscript is better suited to JCI Insight, they can invite a transfer, which stays open for 60 days and carries the existing reviews. The invitation is a decision about fit, not a rejection of the science.

Check your JCI versus JCI Insight route →

We have reviewed 50+ manuscripts targeting JCI Insight, JCI, Nature Medicine, Cell Reports Medicine, and Science Translational Medicine. The recurring JCI Insight pattern is not simply "mechanism is weak." It is that the disease relevance, model choice, patient-sample logic, or translational endpoint is not visible early enough for an editor to route the paper confidently. A paper can have strong biology and still feel mispositioned if the first page reads like a disease-adjacent mechanism study rather than mechanistic clinical investigation.

In our pre-submission review work across translational medicine and clinical-mechanism targets, we see five recurring preventable risks: mechanism and disease relevance separated into different sections, incomplete explanation of human-sample provenance, animal-model claims that overreach the model, data-availability statements that do not match the figures, and reviewer suggestions that cover the method but not the disease area. This is an internal Manusights review sample, not JCI outcome data, so it is best used as a risk map for preventable author-side issues.

Source limitation: official guidance explains JCI Insight author rules, submission package requirements, and publication ethics, but it does not show private senior-editor notes, reviewer-invitation history, or the reason a specific manuscript is still in the portal. That is why this page separates public status interpretation from manuscript-specific readiness signals.

The most useful JCI Insight preparation is often a routing audit rather than a line edit. We check whether the title, abstract, first figure, and cover letter all name the same mechanism and the same disease consequence; whether the controls support the causal claim; and whether the methods let a reviewer reproduce the central clinical-research inference. Manusights does not train AI models on customer manuscripts; we do not train on private author files.

Eligible paid manuscript reviews include the 60-day money-back guarantee. That matters for JCI Insight authors because unpublished patient-derived data, image files, and mechanistic claims should be reviewed privately.

This page was created from JCI Insight's public author information center at Insight author instructions, the journal's metrics page (2.0-day and 35.9-day average first decisions, 26.0% review rate, 20.2% accept rate, June 2025 to May 2026), and Manusights pre-submission review experience with JCI Insight-targeted manuscripts.

For the JCI clinical-research landscape beyond JCI Insight, see JCI flagship (top-tier mechanistic clinical investigation) and external clinical-research alternatives (Cell Reports Medicine, Science Translational Medicine, Nature Medicine, Nature Communications, eLife). The choice across these titles depends on whether the central contribution is broader-scope mechanistic clinical (JCI Insight), top-tier mechanistic (JCI), Cell Press clinical-translation (Cell Reports Medicine), AAAS clinical-translation (Science Translational Medicine), top-tier Nature medical (Nature Medicine), broader Nature Portfolio (Nature Communications), or Reviewed Preprint (eLife).

A JCI Insight review draws on at least two, and generally three, expert referees chosen by the Associate Editor. Editors screen and triage manuscripts before any reviewer sees them, and preparing a response template that addresses both mechanism and disease relevance accelerates revision rounds substantially.

For a pre-upload check of your manuscript against the JCI Insight mechanistic-clinical-research bar before submission, our JCI Insight pre-submission diagnostic flags the framing and methodology weaknesses most likely to surface in reviewer reports.