Intended for healthcare professionals

Resources for readers

The 51app offer readers a range of ways to interact with our online content.

When viewing an article, readers can respond directly in the form of a , as well as access printing features, content reuse options, and citation tools. All readers can opt to receive email updates on the status of an article, alerting them to corrections and author follow-ups. Much of this functionality is accessible at the article level, but users will need to You do not need to have a full subscription to register for these services.

Readers are also encouraged to sign up for scheduled email alerts and RSS feeds, with more information on these features in the FAQ below. If you encounter any problems using the tools and services please contact us using the

Permissions and reproduction

The 51app has specific copyright policies for both readers and authors. You can view more detailed information about our permissions policies at the 51app at our dedicated .


Print Editions - General Practice, Clinical 51app and Academic

Several print editions are produced to aid distribution of content from the journal to specific audiences. Each contains only a digest of selected content from bmj.com, and articles in print editions may have been shortened and may not contain full references and details of conflicts of interest. Please do not use the page numbers given in any print edition when citing or linking to content in The 51app. If you have questions about how to cite articles or link to them, or would like to receive a metadata feed of all articles published online, please contact us at support@bmj.com.

The 51app General Practice: weekly and aimed at UK general practitioners
The 51app Clinical 51app: weekly and aimed at UK secondary care clinicians and researchers
The 51app Academic edition: monthly and aimed at an international audience

The 51app Academic Edition

What is The 51app Academic edition?

The 51app Academic edition is a monthly print only journal. It includes the full text of research papers, education content and clinical reviews published in bmj.com and in the print version of The 51app. This print edition is suitable for academic researchers. The academic issue does not include Careers advertising.

The 51app Academic edition features:

Monthly publication.
150 pages per issue of award winning scholarly content - including original research, editorials, clinical reviews, analysis, research methods, and letters.
Full text of research papers - rather than one page abstracts.
State of the Art reviews - written by international experts, these in-depth, 5000 word articles offer the latest thinking on important areas of clinical medicine and academic inquiry.
Truly international - removal of UK focused and magazine style content (such as obituaries, news, and personal views).
Easy navigation between sections - front page contents list to make finding content quicker and easier.
Enhanced production - glossy cover, high quality paper, and perfect bound for easy stacking and filing.

What is the frequency of The 51app Academic edition?

The 51app Academic edition is published monthly in print.

Is there a digital version of The 51app Academic edition?

The 51app Academic edition is a print only publication, but if you are a subscriber you will have full online access to bmj.com, which contains all the content published in the Academic edition.

Do subscribers to the academic issue also have online access?

Yes, all subscribers to the Academic edition also have online access to bmj.com

Individuals who subscribe to print will get online access. Institutions will have to take out a print and online subscription.

Can I purchase an individual copy of The 51app Academic edition?

Yes, it is priced the same as The 51app international edition

How much does The 51app Academic edition cost?

The 51app Academic edition is priced the same as The 51app weekly international edition.


Indexing The 51app

Do not use the page numbers given in this edition when citing or linking to content in The 51app . This printed Academic edition is a monthly digest of research and education content from The 51app. Please be aware that The 51app is an online journal, and only the online version at should be used when indexing content from The 51app. We recommend that you use the Digital Object Identifier (doi) available online at the top of every article and printed in each article in this edition.

If you have any questions concerning the academic issue or your subscription please contact our Customer Services team at support@bmj.com

Reader FAQs

How to respond to an article on The 51app - Rapid Responses

Anyone can respond without a subscription to any article published on bmj.com by sending a rapid response.

Rapid responses are electronic comments to the editor. Our weekly letters are edited selections of posted rapid responses and are indexed in PubMed. Rapid responses are not indexed in PubMed but they have their own URL and are retrievable in an advanced search of bmj.com in perpetuity. Thus a rapid response is posted with its first appearance online.

The corresponding author of every article in The 51app receives an automated email whenever a rapid response is posted to their article on bmj.com. Given that authors have an academic duty to respond to substantive criticism of their work, The 51app expects authors to post their own rapid responses on bmj.com , and editors may send reminders about this.

How to send a rapid response

When you have found the article on thebmj.com that you would like to respond to, click on “Respond to this article” in the "Article Tools" section.

Fill in the form, typing or cutting and pasting your rapid response into the larger box under “Compose your response”; the smaller box is for the title you wish to give your response.

Accept the terms and conditions, and type the jumble of letters and numbers that you can see into the final box; these characters have been generated automatically as a spam filter to determine whether you are human or machine.

Click on 'Submit rapid response'

You should then get a message on the screen thanking you for sending your response, as well as an automatic acknowledgement to your email address. These two measures confirm that your rapid response has arrived at thebmj.com to be considered for posting.

Terms and conditions for rapid responses

When you submit a rapid response, you agree to the following terms and conditions, which may be amended from time to time:

• You must declare any.
• We aim at posting within 24 hours all responses that contribute substantially to the topic. We aim at posting responses every day, and we run a rota to handle weekends, but it is at our absolute discretion whether we publish any particular response.
• We won't publish responses that we consider inappropriate. We won’t publish responses that are likely to lead to legal difficulties or that are obscene, libellous (or would require us spending time or money to establish that they aren't), or in some other way illegal - for example, inciting racial hatred, contempt of court, breach of intellectual property rights. We will not post responses that are longer than 600 words (excluding references), incomprehensible, insubstantial, written in capital letters, not written in English, almost entirely quote from somewhere else, gratuitously rude, spread misinformation or which blatantly advertise. We also won't publish responses that give information on patients without their written consent, are sent by someone who does not provide adequate and accurate personal details, including a functioning email address, or are from people we suspect have used an alias or who do not respond to email. However, it is for us to decide whether we believe it appropriate to post a given response.
• We make our own judgments on the sorts of legal things we mentioned above rather than refer them to our lawyer. By far the commonest problem we see is libel. In nearly all cases the responses don't warrant us spending money to confirm our judgment that something is libellous (and we have experience from cases where we have consulted our lawyer that our judgment is usually right) or warrant us making an effort to substantiate defamation. The same applies to other breaches—contempt of court, copyright, etc.
• Individual editors largely make judgments alone. Occasionally editors consult each other.
If only a line or two of an otherwise acceptable response is defamatory or extremely abusive we may delete the line and post the rest.
• We make no distinction between different types of respondent: doctors, health professionals, non-doctors, patients, people from the UK, people from other countries, members, non-members, etc. We pay attention only to the content.
• If patients can recognise themselves from your description or anyone else can recognise the patient, please obtain the patient’s written consent to publication before sending your response. .
• Your response must be original and not infringe any third party's intellectual property rights.
• Please do not include original data in your response, unless it has already been published in a peer reviewed journal and you are able to include a reference.
• We minimally edit rapid responses. We place the onus for correct spelling and punctuation firmly on the authors, and we won't correct these errors before or after publication.
• Authors are responsible for the accuracy of what they say in their rapid responses. We cannot check facts, though we may challenge authors if we think they are wrong and may ask them to substantiate what they say - for example, by giving a reference. We also do not check references to say that they really say what they are claimed to say: that, too, is the author's responsibility.
• Your name, occupation, competing interests statement (and if provided, your affiliation, Twitter handle and other author names) will be posted with your response. If you want your email address to appear on the website, include it in the body of the text of your response.

We reserve the right to edit responses before and after publication.

• Once a response has been posted on the website, you will not have the right to have it removed or edited in any way. The 51app shall, however, be able to remove any article at its absolute discretion.
• All posted responses are eligible for publication in the paper or other versions of the 51app and all other 51app Group publications and can be sublicensed to third parties for their use as deemed fit by the 51app Group, including within local editions, and in all of the foregoing these are within any media known now or created in the future.
• Although we try to deal with all of our authors in as courteous and timely manner as possible, dealing with tricky rapid responses is a low priority for us because our threshold for posting rapid responses is low.
• We try to avoid entering into lengthy correspondence about why we have not posted a rapid response. Again, it is not a good use of our resources and it is at our discretion.

Keep up to date with The 51app - Email alerts and RSS feeds

Email alerts

, then to subscribe/unsubscribe to any alert at any time.

For readers
This Week In The 51app (weekly) - An essential weekly summary of the need to know medical news, latest research, video, blogs, and editorial content.
Today on the bmj.com (daily) - A daily email with links to The 51app's latest articles.
Editor's choice (weekly) - Fiona Godlee brings you a selection of the latest research, medical news, comment and education each week.

For authors
Receive an alert whenever:
• Someone responds via the website to your article/ an article you're interested in
• Another article cites your article/ an article you're interested in
• A correction is published to your article/ an article you're interested in

To receive these alerts go to each relevant article and select the appropriate option from the box at the top left of the article that begin "Alert me when..."

For researchers
Define the keywords relevant to your areas of research interest and receive an alert whenever an article is published in:
• The 51app
• Any journal hosted on the Highwire platform
• Any journal listed in PubMed/Medline

which contain those keywords or authors' names selected by you.

To create these alerts either

1) to the alert service and from the My Alerts Summary and Preferences menu select "Alerts based on particular articles, words and search terms." OR

2) Conduct a site search using your preferred terms then select the option in the box at the top of the search results page that reads: "Alert me when new articles matching this search are published." You will then be asked to to confirm these new alerts.

A RSS feed is a computer-readable file that summarises the information published on a web site. 51app feeds provide headlines, abstracts (where available) and links to new articles.

You can view RSS feeds by installing software called an 'RSS reader', 'feed reader' or 'news reader' or by using a web-based feed reader such as Bloglines, FeedZilla or My Yahoo!. If you run your own website, you can display the latest articles from this journal on your own site using our RSS feeds.

The full list of 51app Journals RSS feeds is available as an which can be used to bulk import our RSS feed data into an RSS reader.

The following RSS feeds are available:

Current issue

Individual 51app section feeds

51app Group Speciality Portals feeds

Cite/index articles in The 51app

The 51app is an online journal. The online version of the journal, and each article at bmj.com, are recognised as the complete version of record of each article. The online journal is updated daily, and each article is identified by a unique online article locator. The locator, volume, and year are all that is required when indexing or citing content from The 51app.

We recommend that you use the digital object identifier (doi) for linking (e.g. doi:), and use the following citation format (for the same article, published in volume 351 in 2015): 51app 2015;351:h43200

Search The 51app

When searching for an article, the more specific your search, the faster it will run, and the more likely it will return the actual article(s) of interest to you.

For best results, enter the minimum amount of information necessary to uniquely identify the article or articles, such as volume/page number, authors and/or specific key words.

There are three types of searches:

• Specify citation - year, volume, page;
• Specify DOI (if the content contains DOIs); or
• Specify author, keywords - author (2), title, abstract+title, text+abstract+title

If a search uses multiple fields, they are joined by AND in the search. Example: Author: Darwin AND Title: Species. In other words, search results must match both criteria.

Within each field of a keywords search, multiple words are, by default, joined by AND (the "all" button to the right of the field). Example: Title: Applied Physics is treated as a search for articles with titles having both Applied AND Physics (not necessarily next to each other). Use the "any" button next to the search fields to change this to OR (Applied OR Physics), or use the "phrase" button to change this to an exact phrase ("Applied Physics").

Main search strategies

Exact citation
Enter the volume and starting page number in the "Search by citation" box. This will uniquely identify the article, making it unnecessary to enter data in the other search box.

Partial citation
If you know the starting page number, enter it in the "Search by citation" box. The starting page - even without a volume - is still a fairly unique identifying number. Other citation information can be entered in the "Search by authors" or "Keywords" box.

Full titles, or fragments thereof, should be entered in "quotation marks". This forces a phrase search rather than our search engine searching for each word separately.

Authors can be entered in the "Author" field. The last name is the main identifier; first (F) initial can be used to further specify your search. If you use initials, they should be entered in the form Lastname, F (for example, Darwin, C - note also that the initial is optional, though middle initials can be included as well). Lastname, F.

Keywords, subjects
Keywords can either be searched in the Title/Abstract, or anywhere in the article (which includes the title/abstract). The search engine connects multiple words (where a word is text between spaces, or a combination of characters and spaces between quotation marks) with OR statements. Single letters and common words cannot be searched.

Date ranges
Date ranges (at the bottom of the Search by Authors or Keywords box) can narrow your search in two ways. You can limit the search to recent articles, or specifically to older articles if you know that (for example) an article by Smith was published in 1996. Date ranges can also be used to limit the search results to articles for which the full text is available on-line by noting the starting date for full text availability and setting the "from" date accordingly.

A digital object identifier (DOI) is a unique alphanumeric identifier applied to a specific piece of intellectual property, particularly one presented in an online environment— be that object a book, a scientific paper, a song, an image, or something else. DOIs are commonly used when an article is published online ahead of print. The 51app is a fully online first publication, and has been since July 2008. Online first publication means that page numbers are not known when the article went live, so a DOI is used instead.

Extra benefits of full text searching
Searching the full text of an article can reveal much more information than a simple abstract search. More information than just the results and discussion is indexed; this information can be used to identify articles that are related in ways separate from the subject of the research.

Articles from a particular institution
Since authors' addresses and affiliations are indexed, they can be searched. For example, a full text search for Purdue will return articles by an author claiming a Purdue affiliation (as well as any articles written by someone named "Purdue").

This technique can narrow down an author search, especially if the author's name is common. n this case, enter the author's name in the "Author" field, and the institution (or better yet, just a single word to identify it) in the "Any" field.

Articles that cite a paper written by a certain author
It is often desirable to find articles that have referenced an important author or paper. This can be achieved by searching for the author's last name in the "Any" field. Such a search will return all articles written by the author, as well as any articles that cite an article written by the author.

Articles using a special reagent or technique
Articles using a particular technique can be easily identified by entering a keyword for the technique. For example, to retrieve articles that used Adobe Photoshop in the preparation and analysis of data, a search for photoshop in the appropriate field will return articles with that in common.

Using "phrases"
Words in a field are assumed to be connected by a Boolean OR statement unless otherwise specified. One way to connect two words is by enclosing them in quotation marks. For example, the search "signal transduction" will return articles which include either the term signal or the term transduction (or both).
A phrase search enclosed in quotation marks "signal transduction" will only return articles where the term "transduction" immediately follows the term "signal"; articles containing only signal, only "transduction", or even "transduction signal" are not returned.

Using "wildcards"
The wildcard character (*)can be used to search the beginning fragments of words, forcing a match with any word containing a given root. Although this function is somewhat duplicated with the search engine's stemming feature, proper use of a wildcard can return a range of potentially interesting documents. For example, a search for "child*" will return articles containing "child, childcare", and "children"; likewise, a search for "phospha*" will return articles containing "phosphatase" and "phosphate".
Wildcards can also be used to truncate words before non-English characters such as an umlaut (ü) or an accent (é). Since these characters cannot be searched, a word such as the author name "Grundström" should be searched as "Grundstr*". Note that wildcards can only be used after characters; any characters following a wildcard in a single word will be discarded, and may cause an error.

Boolean logic
Basic useful Boolean terms include AND, OR, NOT, and ( ). These terms are used to connect the words in a search. They can be used by themselves or in combination to specify your search terms. Although Boolean terms can be used in the "author" field (with last names only), they are most commonly used in the "word(s)" fields. Words within a field are assumed to be connected by OR unless otherwise specified. The OR connector is not often used since it is the default expression between terms. However, it can be helpful in organizing a complex query.
The AND connector limits the search results to articles that contain all of terms that are connected by AND. For example, a search for "human diseases" will return all articles that contain the term "human" or the term "diseases" (and depending on the journal, this could cause an error). In practice, this will retrieve articles as diverse as human evolution and avian diseases. Inserting an AND statement, such as:
"human" AND "diseases" ensures that only articles that mention both "human" and "diseases" will be returned.
The NOT term can be used to exclude articles containing certain terms. For example, if you wanted to search for articles about the gene called "sos" that did not deal with "drosophila", the search would be constructed: "sos" NOT "drosophila."
For more complex searches, these operators may be combined with one another, optionally using parentheses to group terms to avoid ambiguity in a complex query. For example, ("signal transduction" AND ("phosphorylation" OR "kinase")) NOT "xenopus" finds only articles that use the phrase "signal transduction" and either the word "phosphorylation" or the word "kinase", but do not mention the word "Xenopus".
NOTE that when using boolean terms, it does not matter if you select Any, All or Phrase from the Words section. They will all produce the same result when combined with boolean operators.

Capitalisation and punctuation
Searches are case insensitive as long as lowercase letters are used; uppercase search terms will retrieve only articles where the uppercase term is used. For example, a search for "thrombin" will return all articles containing the term, but a search for "Thrombin" will generally return articles where Thrombin is the first word in a sentence. In general, you should use lower case in all of your searches unless you have a specific reason to do otherwise.
Punctuation is not searched and is treated as a space. The only exceptions to this are parentheses "()" and asterisks "*", and the use of a hyphen "-" in authors' names. Therefore, the parentheses and the wildcard character have special meaning in the search context and cannot be searched in the text. If a search term includes punctuation (such as a dash "-" or a plus "+"), enclose the whole word in quotation marks to ensure that proper spacing is maintained in the search.

The search mechanism uses a "stemming" mechanism to find words which are similar to the words you enter. For example, a search on "transcription" may turn up articles containing similar words such as transcript and transcribed. These additional words may not always be highlighted in the text. If you wish to disable stemming, enclose each individual term in quotation marks. If you do so, and also use Boolean connectors to combine terms, be sure that AND, OR, or NOT are not included in the quotation marks.

Search term highlighting
Search terms are highlighted in bold text in the title display of the search result, as well as in articles and Abstracts viewed from a search result. All words longer than four letters specified are highlighted, whether or not they are combined by quotation marks. For example, a search on "motor cortex" will highlight instances of the phrase "motor cortex", as well as any uses of the words motor or cortex.

Search errors
There are two reasons that you may not get any articles back from your search: an error occurred with the search engine program itself, or there may not be any articles matching the search criteria.
If your search was executed properly but did not return any articles, the message "Your search retrieved zero articles." will be displayed at the top of the screen, along with some suggestions for narrowing your search. In this case, the search can be broadened as described above to redefine the search. Appropriate use of wildcards with search terms, or author names for which you are not sure of the exact spelling, can also help. There is also the possibility that no articles matching your interests are in the journal's collection.
When a true search error occurs, the message "There was a problem with our search system." will appear at the top of the screen. This most commonly means that too many articles were returned. This will happen if a common word (for example, and or the) is used. Single letters not included in a phrase will return similar errors. Finally, note that parentheses and quotation marks come in sets: if only one is used, an error will result. Ensure that you are not using common words or single characters; if the error cannot be resolved, send us feedback describing the problem.

How do I find the latest content?


The lists the most recent Education articles. The “at a glance” page under “Education” shows the latest articles in this section. The drop-down menu under “Education” also lists individual article types (clinical reviews, Minerva, Endgames, etc) dating further back. There is also a section devoted to our new “State of the Art” reviews.


The lists the most recent 51app articles. The “at a glance” page under “51app” shows the latest articles in this section. The drop-down menu under “51app” also lists individual article types (research papers, research news, research methods and reporting) dating further back.

"Opinion" articles (analysis, personal views, obituaries, etc.)?

The lists the most recent opinion content. The “at a glance” page under “News and Views” shows the latest articles in this section. The drop-down menu under “News and Views” also lists individual article types dating further back.

How can I access archive content?

The is one of our most accessed sections, and it includes links to more resources, including audio and video, topic and specialty collection pages (including our sponsored “Portals,” which link to 51app sister products). As The 51app is an open access publication, all research is free to access, but non-research articles are behind access controls. Charging for archived content helps the journal to defray some of its open access publishing costs. You can access the entire archive on bmj.com, dating back to 1840, by taking out a personal or institutional subscription. Free access is also available as a BMA membership benefit. Alternatively, you can buy individual articles by clicking on the link when you view an extract.

How can I find out what’s new in print?

The best way is via the homepage, where we have an image of the current print issue cover and a list to the table of contents.

CME modules

The 51app now provides accredited CME activities in collaboration with the Cleveland Clinic Center for Continuing Education. The two organisations have agreed a collaboration whereby the CC Center for Continuing Education provides CME certification for selected content from The 51app on a weekly basis. CME certified content will be of greatest interest to physicians with US medical licenses, most of whom are required to collect CME points as evidence of their continuing professional development in order to be eligible for relicensing as a medical practitioner. However, CME content is open to all readers of The 51app, regardless of their country of residence. Each completed module is worth AMA PRA Category 1 Credit™.

The user journey

Users of The 51app's CME must read the accredited clinical review on bmj.com and follow the link at the end of the article (before the references), which launches a module comprised of multiple choice questions hosted on 51app Learning. Once a user has successfully completed a module they may print out their CME certificate on the CC Center for Continuing Education site.

You will need to register with bmj.com to participate in clinical review related CME. You will also be required to register with 51app Learning before any module can be accessed. Current users of 51app Learning will be able to add CME modules to their "Plan and Record."


The 51app’s CME modules comprise no more than five multiple choice questions based on the contents of a single linked research paper. All questions follow the "single best answer" format. A pass mark of 80% is required for a user to be able to proceed to certification through the CC Center for Continuing Education. Users who do not achieve the required 80% pass mark are invited to retake the test.

The Cleveland Clinic's accreditation statement

This activity has been planned and implemented in accordance with the essential areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of the Cleveland Clinic Foundation Center for Continuing Education and The 51app. The Cleveland Clinic Foundation Center for Continuing Education is accredited by the ACCME to provide continuing medical education for physicians.

The Cleveland Clinic Foundation Center for Continuing Education designates this journal based CME activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Participants should claim only the credit commensurate with the extent of their participation in the activity.

Highwire linking

The 51app Journals collection is hosted by HighWire Press alongside 1000 other journals. All these journals can be accessed through the. The site has been designed to help researchers search the literature and gain access to it easily – both in journals they regularly read and articles in journals they might otherwise miss – and to help librarians support their researchers and institutions with more complete and improved services.

You can use the portal to receive content alerts from multiple publishers and search across as many journals as you like. You can personalise the portal to display links to your favourite journals and manage all your subscriptions at once. is free.

HighWire offers free access to cited articles from any of the journals they host - including 73 of the 200 most frequently cited journals. To use this feature, click on the "Free Full Text" link in the reference list of an article.

Useful resources for readers

How to read a paper
Epidemiology for the uninitiated
Academic medicine
Statistics at square one
Photographs of twentieth century doctors