Nature Medicine Pre-Submission Checklist: Clinical Readiness Check

Clinical significance

1. Does the study directly change clinical practice or clinical understanding?

This is Nature Medicine's fundamental test. A study that reveals a mechanism without clinical implications belongs in a basic science journal. A study with clinical implications that are speculative ("this could eventually lead to new therapies") is premature for Nature Medicine. The clinical impact needs to be direct and concrete.

2. Is the translational distance short enough?

Nature Medicine sits between basic science journals (Nature, Cell) and clinical practice journals (NEJM, Lancet). The ideal Nature Medicine paper has both scientific depth and clinical relevance. A purely preclinical study needs an exceptionally clear translational path. A purely clinical study needs mechanistic depth that NEJM or Lancet would not demand.

3. Does the finding matter to clinicians, not just scientists?

Nature Medicine's readership includes both researchers and clinicians. If only researchers would change their thinking based on this result, the paper may fit better in Nature or a disease-specific journal. If clinicians would change their behavior, Nature Medicine is the right target.

Study design and evidence

4. Is the study design adequate for the clinical claims?

Nature Medicine publishes clinical trials, large cohort studies, translational research, and mechanistic studies with direct clinical relevance. The study design must be strong enough for the claims being made. An underpowered pilot described as definitive evidence will be desk rejected. A retrospective analysis presented with causal language will be returned.

5. Are human data included or clearly justified as unnecessary?

Nature Medicine increasingly expects human data or a convincing explanation of why the translational path does not require it at this stage. A mouse study with "implications for human disease" needs to explain specifically what those implications are and what the next step in humans would look like.

6. Is the evidence package complete?

Multiple validation approaches. Appropriate controls. Independent replication where feasible. If the paper relies on a single experimental approach to support a major clinical claim, reviewers will flag the gap immediately.

Data and reporting

7. Is the data availability statement specific?

Nature Medicine follows the Nature Portfolio data availability policy. Data must be deposited with accession numbers. Code must be in a public repository. "Available upon request" is not sufficient without specific justification.

8. Is the Nature reporting summary complete?

Required for all submissions. Must be specific about study design, sample sizes, statistical methods, and data handling. Additionally, clinical research requires the appropriate study-specific checklist (CONSORT, STROBE, PRISMA, etc.).

Ethics and compliance

9. Are ethics approvals complete and documented?

Clinical research: ethics committee approval with institution and number. Animal research: IACUC approval. Human biological samples: consent and regulatory compliance. Clinical trials: registered before enrollment. Nature Medicine is strict about ethics documentation.

Strategic fit

10. Have you considered what the editors need to see in the first 5 minutes?

Nature Medicine editors scan the abstract and figures before deciding whether to read the full paper. In those 5 minutes, they need to see: what the clinical question is, how the study answers it, and why the answer changes practice or understanding. If the clinical significance only becomes clear in the discussion, the paper's first impression is weaker than it should be.

Check: does the abstract state the clinical implication in the first 3 sentences? Does the first figure show the clinical-relevant result, not the preliminary mechanistic setup?