This report summarizes the journal’s editorial activity, peer-review processes, and publication outcomes for the year 2025. It provides an overview of manuscript submissions, article types, authorship characteristics, peer-review performance, and reviewer contributions, with the aim of promoting transparency and accountability in the journal’s editorial operations.

We gratefully acknowledge the continued support and dedication of our authors, reviewers, and editorial board members. Their collective efforts are essential to maintaining the scientific rigor, integrity, and impact of the journal, and to advancing its mission of disseminating high-quality, clinically relevant research.

Published Articles

Consistent with the journal’s mission to advance the application of clinical questions, articles were classified by question type. Foreground clinical questions are specific and focused, arising from patient care and directly informing clinical decision-making, such as treatment effectiveness, diagnostics, and outcomes. Background clinical questions are broader, addressing general aspects of disease, including etiology, pathophysiology, and epidemiology, and primarily support foundational knowledge rather than immediate clinical practice.

In 2025, a total of 42 articles were published, including 22 meta-analyses, six original research articles and reviews, and eight case reports. These publications addressed 32 foreground clinical questions and 10 background clinical questions(Figure 1).

Figure 1. Overview of Published Articles and Clinical Question Types

Authors’ Geographic Distribution

Authors of 29 articles were affiliated with institutions from a single country, while 13 articles involved authors from multiple countries. In total, researchers from 13 countries contributed to the published articles. The top three contributing countries were Japan, China, and the United States of America, accounting for 20 (35%), 18 (31%), and 6 (10%) of the published articles, respectively(Figure 2).

Figure 2. Geographic Distribution of Article Authorship by Country

Editorial Contributions and Funding

Four articles (10%) were submitted by members of the editorial board. Sixteen articles (38%) were supported by various sources of funding.

Peer Review

All manuscripts underwent single-blind peer review and similarity screening. The median similarity index, as assessed by iThenticate, was 17% (IQR, 15–21). A median of 41 reviewers was invited per manuscript (IQR, 31–45). Each manuscript was evaluated by at least two reviewers, with a median of two reviewers (IQR, 2–3), and underwent a median of two rounds of revision (IQR, 2–3).

The median time from submission to acceptance was 54 days (IQR, 43–67 days), reflecting the co-editors’ efforts to invite multiple potential peer reviewers during the initial round of the review process. In total, 99 reviewers contributed to the published articles, 78 of whom disclosed their names and affiliations in the Peer Reviewer Acknowledgments. Reviewers’ comments and authors’ responses are available in the Supplementary Information for accepted articles.

We extend our heartfelt gratitude to all authors for entrusting their work to the journal, to our reviewers for their rigorous and timely evaluations, and to the editorial board for their guidance and commitment.