difference between research article and journal

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Understanding the Difference Between Research Papers and Journals

Research papers and journals are two of the most important forms of academic writing, yet they remain misunderstood by many students. While there are distinct differences between research papers and journals, both share common features that contribute to their overall purpose in academia. This article aims to provide a comprehensive overview of these two types of written works in order to help professors effectively guide their students through the process of understanding them. It will discuss how each is structured, what kinds of information they contain, as well as provide examples for comparison purposes. In addition, this article will highlight the importance for researchers and instructors alike when considering appropriate methods for evaluating research papers and journals in an educational setting.

I. Introduction

Ii. definition of research papers and journals, iii. difference in content between a research paper and journal article, iv. length of a research paper compared to that of a journal article, v. difference in formatting between research papers and journals, vi. audience for the different types of writing pieces, vii. conclusion.

The Scope of Research

We are witnessing an unprecedented shift in the way research is conducted. With the increased availability of digital tools, researchers have new avenues to explore and harness information from a variety of sources. This shift has necessitated that our understanding of how best to access, analyze, and present data must be continually updated as well. In this paper we will examine one particular form: academic journals. By exploring what constitutes an effective journal article we can understand more about how modern research is disseminated and utilized by practitioners within various disciplines.

Features which Make Journals Special

Academic journals are unique among other forms of research presentation for several reasons; firstly they tend to feature a higher level analysis than popular media such as newspapers or magazines may provide. Journal articles also allow for peer-reviewed content which means topics featured are often discussed at length with multiple perspectives taken into account when forming conclusions or making recommendations related to topics under study . Additionally, due their greater depth and rigor authors who publish in journals can command much larger attention compared to works presented elsewhere thus resulting in potential impact not seen outside these publications.

Extended discussion on topical issues.
Peer review process before publication.

Definition of Research Papers and Journals Research papers are typically scholarly works published in academic journals or as stand-alone documents. They are often based on original research conducted by a student or scientist, providing new insights into an area of study. Generally, they include detailed literature reviews summarizing existing knowledge on the topic being discussed, present new data collected from primary sources such as experiments and surveys, discuss findings from both quantitative and qualitative analysis methods, and offer recommendations for future study.

Journals serve to document developments in science over time by publishing articles with information about experimental procedures used to conduct research studies. Unlike research papers which generally focus only on one particular piece of work at a time; journals publish several different types of content including short reports (‘mini-reviews’) book reviews conference proceedings editorials letters opinions interviews photographs charts diagrams tables etc., all related to advances within their field. So is “research paper” a journal? The answer depends upon how the term “journal” is defined: if it refers simply to any type of periodical publication then yes; however if it more specifically denotes peer reviewed publications that contain empirical data obtained through original investigations than no – because most research papers do not go through the same rigorous review process required for journal submissions.

Research Paper: scholarly works published in academic journals or as stand-alone documents.
Journal: publishes several different types of content including short reports mini reviews books conferences editors letter opinion interviews photos chart diagram table etc.

When considering the distinction between a research paper and journal article, two main points stand out. Firstly, the focus of each publication is different; secondly, there are also differences in content.

Focus : While both publications may contain similar information on an academic topic or area of study, their purpose for existence differs greatly. The primary intent behind writing a research paper , often conducted by students at university level to fulfil certain requirements within a course program, will be directed towards improving understanding of particular theories or concepts and exploring any unresolved issues related thereto. On the other hand, journal articles , which have typically been written after more comprehensive analysis has taken place by experts in that field (and sometimes even over several years), are generally published with the intention of presenting new findings to peers – providing an opportunity for rigorous evaluation before wider acceptance as part of scholarly knowledge base.
Content: The content contained within these types of publications follows along this same path. As such while research papers (especially those completed during undergraduate studies) may offer some basic results alongside general discussion based upon existing literature references; journal articles will include much deeper insights into any experiments performed (including details surrounding methodology used) along with far more comprehensive interpretations and conclusions from actual data generated during such processes – all intended to give greater clarity onto the subject matter being studied.

Length of Scholarly Writing: A research paper typically has longer content than a journal article. It usually covers much more detail and includes a wide range of sources, making it difficult to condense into the same length as an article. Research papers may also contain graphs and charts which can add length to the document too.

The other difference between research papers and journal articles is that journal articles are often written with the intention of being published in academic journals. Journals tend to have strict guidelines on word count or page limits, meaning they require concise writing for publication. In contrast, there is no set limit for how long a research paper should be – though most undergraduate papers will still be shorter than graduate-level work due to fewer resources available at this level.

A common question asked by students researching their topics is whether or not a research paper counts as a journal itself; unfortunately, no! While some student work may end up published one day in academic journals after rigorous review processes conducted by professionals within each field’s respective discipline, until then these works remain classified only as ‘research’ papers – unique pieces of scholarly writing created from personal investigations into specific topics using various resources throughout its development.

Formatting between research papers and journals

Research Papers and Journals have a few differences in terms of formatting, such as style, citation methods, structure etc. These two kinds of academic writing differ from each other based on their intended purpose.

The typeface used for Research Papers is typically 12 point Times New Roman while the font size for Journals can vary.
Another difference is that different citation methods are used; MLA format might be expected to be used with Research Paper whereas AMA or APA may be preferred by Journals.

Furthermore, there are some variations in the structure too. For instance, many Research Papers will include an abstract section which summarises what’s been written about before introducing the author’s findings but it isn’t necessary in a Journal article. It’s also important to note that although both involve using evidence-based information – such as quantitative data – they approach this differently when addressing topics: While almost all journals tend to focus on offering solutions derived through scientific experimentation/data analysis research paper focuses more heavily on critically analysing existing theories & concepts before considering possible solutions or suggestions towards improvement . So essentially when one wonders ‘is a research paper a journal?’ The answer would likely depend upon context & usage since these two types of documents serve distinct purposes despite having certain overlaps depending upon their subject matter

What Are the Different Types of Writing Pieces? Writing pieces come in a variety of forms and genres. We can categorize them into three main categories: academic writing, creative writing, and business/professional writing.

Academic writings are usually essays or research papers written for college classes.
Creative writings include short stories, novels, poetry, plays, etc., that are made up from imagination rather than based on facts or research.
Business/professional writing is used to communicate information such as memos, reports and letters within an organization.

Who Is the Audience for Each Type of Writing Piece?

The audience for each type of piece varies depending on what it is being used for. For example:

In sum, this research paper has discussed the critical role of a journal in one’s learning journey. With its rich and diverse content, a journal can be used to track knowledge learned over time while also providing an invaluable opportunity for reflection on personal experiences. Through analysis of both existing literature and primary data collected from interviews conducted with experienced practitioners, it was found that journals offer individuals greater opportunities to gain deeper understanding of complex topics.

The evidence presented here provides us with valuable insights into how we can maximize our learning potential through the regular use of journals. Ultimately, by embracing this practice as part of our daily routine we will become better equipped to tackle any challenge or difficulty life throws at us; making it easier for us to achieve success in all areas including academic studies.

Self-Awareness: Regularly writing allows people to look back on their thoughts objectively and thereby increase self-awareness.
Creativity: By reflecting upon past ideas written down earlier creativity is unlocked allowing new possibilities.

English: This article has presented an overview of the difference between research papers and journals. By understanding these differences, students can develop strategies for more effectively reading and writing within these contexts. It is important to note that further study into the nuances of each format is needed in order to gain a comprehensive knowledge base. With this information, readers are better equipped to determine which type of document serves their particular needs most effectively.

Key Differences

Know the Differences & Comparisons

Difference Between Article and Journal

On the contrary, Journal is a periodical publication in a specific field of study, which is often reviewed by experts in the concerned area. Journal publications are regarded as one of the highly honoured forms of publications, because of its high standards in reviewing and publishing.

Come let’s discuss the differences between article and journal.

Content: Article Vs Journal

Comparison chart, definition of article.

The article implies an independently written composition, usually short and precise, which is traditionally included in the newspaper, magazines, websites, journals, etc. It is written for a large audience in an entertaining manner, so as to grab and retain their interest and attention. The name of the person who wrote the article is always mentioned.

An article not just integrates facts, but the thoughts and opinions of the writer and experts, and balanced arguments are also included. A well-drafted article often brings out topics of interest into the limelight.

An article may cover fascinating stories, reported speech, information, suggestions and other descriptions. It can also describe any event, experience, person or anything else. Articles are classified on the basis of need or preference:

News Articles : Articles containing breaking news, information, happenings, events of public interest, what will happen in the near future or a trending topic. It may contain photographs, charts, interviews, debates, etc. Its objective is to report on when, how, where and why the event took place and who is involved in it.
Feature Articles : One that is written creatively and descriptively so as to entertain, engage and influence the reader. The article can be based on anything, i.e. from people to place or from event to experience.
Editorial Articles : These are commonly found in newspapers and magazines, which often showcase a new outlook or opinion, on a current issue. It often expresses a distinctive angle or approach about someone or something and provokes the reader to think that way.
How-to Articles : Such articles are instructional in the sense that they offer complete guidelines on how-to-do something.
Marketing Articles : A short piece of writing, which is actually an advertisement, written to catch the attention of the reader towards the company’s product or service.
Question-Answer Articles : As the name suggest, these articles are in question-answer format, based upon an interview with the famous personality. It does not contain an introductory paragraph.
Profile Articles : Profile articles are all about a specific person, which requires research and interview, to gather relevant information about that person.

Definition of Journal

Journal can be defined as a professional or academic publication, which features a number of educational articles, written by researchers, experts or someone having academic qualifications in the concerned subject, which presents original and new research, book reviews, feedback, review articles and so forth. It includes references and targets academic audience only.

A journal is always on a specific discipline, that targets a particular group of people, typically students pursuing that discipline and not the general public. It must be noted, the journals are usually peer-reviewed (refereed) and so they undergo an extensive editorial process. However, all the journals are not peer-reviewed.

They focus on current developments in the field of study. It is available in both offline (printed form) and online mode. One can use journal articles for the purpose of research as they are authoritative, up to date, topic-specific and understandable.

Journals are published periodically, i.e. weekly, bi-monthly, monthly, quarterly, semi-annually or annually. Each copy is termed as an issue, and a set of issues are called volume.

Key Differences Between Article and Journal

The points given below are noteworthy so far as the difference between article and journal is concerned:

An article is a written composition on a topic of interest, which forms a separate part of a book, magazine or newspaper. On the other hand, Journal is a type of magazine which contains articles and other descriptions on a particular discipline or professional activities.
While the article is a work of literature, the journal is a form of publication.
An article is non-fictional and informative in nature. As against, the journal is educational and academic.
The article can include news, stories, information, facts or writer’s experience, opinion, suggestion, facts, etc. Conversely, a journal contains articles, book reviews, editorial content, achievements, feedback, recent developments in the field of study and many more.
An article is written on the topic of interest of the writer or any burning issue. In contrast, a journal is all about the specific field of study or professional course and developments thereon.
The main objective of writing an article is to influence the reader and urging them to think. On the flip side, a journal aims to provide relevant information relating to the professional course.

In a nutshell, an article differs from a journal in the sense that an article is a written composition, which is just a small part of the journal, while the journal is itself a publication containing a number of articles and other relevant material.

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Types of journal articles

It is helpful to familiarise yourself with the different types of articles published by journals. Although it may appear there are a large number of types of articles published due to the wide variety of names they are published under, most articles published are one of the following types; Original Research, Review Articles, Short reports or Letters, Case Studies, Methodologies.

Original Research:

This is the most common type of journal manuscript used to publish full reports of data from research. It may be called an Original Article, Research Article, Research, or just Article, depending on the journal. The Original Research format is suitable for many different fields and different types of studies. It includes full Introduction, Methods, Results, and Discussion sections.

Short reports or Letters:

These papers communicate brief reports of data from original research that editors believe will be interesting to many researchers, and that will likely stimulate further research in the field. As they are relatively short the format is useful for scientists with results that are time sensitive (for example, those in highly competitive or quickly-changing disciplines). This format often has strict length limits, so some experimental details may not be published until the authors write a full Original Research manuscript. These papers are also sometimes called Brief communications .

Review Articles:

Review Articles provide a comprehensive summary of research on a certain topic, and a perspective on the state of the field and where it is heading. They are often written by leaders in a particular discipline after invitation from the editors of a journal. Reviews are often widely read (for example, by researchers looking for a full introduction to a field) and highly cited. Reviews commonly cite approximately 100 primary research articles.

TIP: If you would like to write a Review but have not been invited by a journal, be sure to check the journal website as some journals to not consider unsolicited Reviews. If the website does not mention whether Reviews are commissioned it is wise to send a pre-submission enquiry letter to the journal editor to propose your Review manuscript before you spend time writing it.

Case Studies:

These articles report specific instances of interesting phenomena. A goal of Case Studies is to make other researchers aware of the possibility that a specific phenomenon might occur. This type of study is often used in medicine to report the occurrence of previously unknown or emerging pathologies.

Methodologies or Methods

These articles present a new experimental method, test or procedure. The method described may either be completely new, or may offer a better version of an existing method. The article should describe a demonstrable advance on what is currently available.

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Journal Article vs Research Paper: Difference and Comparison

A journal article presents original research findings in a concise format, focusing on a specific topic within a broader field. It undergoes peer review before publication, ensuring quality and validity. On the other hand, a research paper is a comprehensive document that may include multiple experiments, analyses, and discussions, aimed at contributing to the advancement of scientific knowledge.

Key Takeaways A journal article is a shorter scholarly writing published in a specific academic journal. A research paper is a more extended, comprehensive academic writing presenting original research. Journal articles are more focused and present specific findings, while research papers are broader and present a more comprehensive study.

Journal Article vs Research Paper

A journal article is a piece of published work that presents the research findings and may include analysis, remark, or discussion. A research paper is a detailed account of the research that may be published or unpublished and includes an introduction, literature review, methods, results, and conclusion.

Comparison Table

What is journal article.

A journal article is a scholarly publication that presents the findings of original research, analysis, or review within a particular academic field. These articles serve as fundamental units of scholarly communication, disseminating new knowledge, theories, and insights to the academic community and beyond. Here’s a detailed breakdown:

Content and Structure

1 Abstract: A journal article begins with an abstract, a concise summary of the study’s objectives, methods, results, and conclusions. The abstract provides readers with a quick overview of the article’s content and findings.

2 Introduction: Following the abstract, the introduction sets the context for the study by reviewing relevant literature, identifying gaps or controversies in existing knowledge, and stating the research objectives or hypotheses.

Peer Review Process:

1 Submission: Authors submit their articles to scholarly journals for publication consideration, adhering to the journal’s guidelines and formatting requirements.

2 Peer Review: Upon submission, the journal’s editor assigns the manuscript to peer reviewers—experts in the field—who evaluate the article’s quality, originality, methodology, and significance. Peer review helps ensure the rigor and credibility of the research.

3 Revision: Based on the reviewers’ feedback, authors may revise their article to address any concerns or criticisms raised. This iterative process of revision and reevaluation continues until the article meets the journal’s standards for publication.

4 Acceptance and Publication: If the article meets the journal’s criteria, it is accepted for publication and undergoes final editing and formatting. Once published, the article becomes part of the journal’s archive and is accessible to readers worldwide.

What is Research Paper?

A research paper is a comprehensive document that presents the findings, analysis, and interpretations of original research conducted by the author(s) within a specific academic discipline. These papers serve as a means for scholars to contribute new knowledge, theories, and insights to their respective fields. Here’s a detailed breakdown:

1. Content and Structure

1 Introduction: The introduction of a research paper provides background information on the topic, reviews relevant literature, and outlines the research objectives or hypotheses. It establishes the context for the study and justifies its significance.

2 Methods: The methods section describes the procedures, materials, and techniques employed in the research. It should provide sufficient detail to enable other researchers to replicate the study and verify its results.

3 Results: This section presents the empirical findings of the research, using tables, figures, or graphs to illustrate data. Authors report their observations or measurements objectively, without interpretation or speculation.

4 Discussion: In the discussion section, authors interpret the results in light of the research questions or hypotheses, comparing them to previous studies and addressing their implications. They may also explore alternative explanations, limitations of the study, and avenues for future research.

5 Conclusion: The conclusion summarizes the main findings of the research and highlights their significance. It may reiterate the study’s contribution to the field, offer final reflections, and suggest directions for further inquiry.

Characteristics and Scope

1 Original Research: Unlike review papers or essays, research papers are based on original research conducted by the authors. They contribute new data, insights, or interpretations to the academic discourse.

2 Rigorous Methodology: Research papers adhere to rigorous scientific or scholarly methodologies, employing systematic approaches to data collection, analysis, and interpretation. They prioritize objectivity, validity, and reliability in their findings.

3 Length and Complexity: Research papers vary in length and complexity, depending on the scope of the study and the requirements of the target publication venue. They may range from concise reports of preliminary findings to comprehensive analyses of multi-year research projects.

4 Contribution to Knowledge: Research papers aim to advance knowledge within their respective fields by addressing research gaps, testing hypotheses, or generating new theories. They contribute to the cumulative growth of scholarship through the dissemination of original research findings.

Main Differences Between Journal Article and Research Paper

Journal articles focus on a specific aspect or finding within a broader topic.
Research papers provide a comprehensive analysis of a research project, including multiple experiments, analyses, and discussions.
Journal articles are concise, containing essential findings, methods, and interpretations in a limited space.
Research papers tend to be longer and more detailed, offering exhaustive exploration of the research topic, methodology, results, and implications.
Journal articles undergo peer review by experts in the field before publication, ensuring quality and validity.
Research papers may or may not undergo formal peer review, depending on the publication venue or academic requirements.
Journal articles present findings objectively, without extensive interpretation or speculation.
Research papers include in-depth interpretation of results, discussion of implications, and exploration of potential limitations or biases.
Journal articles contribute to the scholarly conversation by presenting new findings, analyses, or reviews within a specific topic area.
Research papers advance knowledge within a field by offering comprehensive analyses, testing hypotheses, or generating new theories through original research.

Difference Between Journal Article and Research Paper

https://gssrr.org/index.php/gssrr/How-to-Publish-Research-Paper
https://www.springer.com/gp/authors-editors/journal-author/types-of-journal-manuscripts/1356
https://owl.purdue.edu/owl/general_writing/common_writing_assignments/research_papers/index.html

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21 thoughts on “journal article vs research paper: difference and comparison”.

The characteristics of a journal article outlined in the article shed light on the structured nature of these scholarly publications. It’s important to understand the components that make up a journal article to effectively communicate research findings.

Agreed, knowing the key components of a journal article is essential for researchers aiming to publish their work in reputable academic journals.

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This article provides a clear and concise comparison between journal articles and research papers. It’s informative and well-structured. I appreciate the detailed explanation of the characteristics of each type of publication.

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Absolutely, the article offers a comprehensive comparison that highlights the unique features of journal articles and research papers.

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I find the comparison table provided in the article particularly helpful. It offers a quick reference for distinguishing between journal articles and research papers based on publication outlet, content, target audience, peer review, length, structure, emphasis, and impact.

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The structure of a research paper outlined in the article serves as a helpful guide for researchers looking to compose comprehensive and well-organized scholarly documents. It offers a clear framework for presenting original research findings.

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The detailed explanation of the structure and content of a journal article and a research paper is beneficial for researchers seeking to refine their academic writing skills and publish their work.

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What is the difference between an article and a journal?

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Answered By: Laura Marek Last Updated: Dec 07, 2023 Views: 2635

An article is a nonfiction writing that forms an independent part of a publication like a journal.

A journal is a collection of articles and is published periodically throughout the year. Examples would be the Journal of the American Medical Association or American Journal of Public Health . You would find articles in a journal.

Let's take a look at a citation to see where the article title and journal name appear:

Wright, C.V., Perez, S., Johnson, D.M. (2010). The mediating role of empowerment for African American women experiencing intimate partner violence. Psychological Trauma: Theory, Research, Practice, and Policy, 2 (4), 266-272.

The article is: The mediating role of empowerment for African American women experiencing intimate partner violence.

The journal it is published in is: Psychological Trauma: Theory, Research, Practice, and Policy

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Distinguishing between different types of journal articles

When writing a paper or conducting academic research, you’ll come across many different types of sources, including periodical articles. Periodical articles can be comprised of news accounts, opinion, commentary, scholarly analysis, and/or reports of research findings. There are three main types of periodicals that you will encounter: scholarly/academic, trade, and popular. The chart below will help you identify which type of periodical your article comes from.

Text and chart adapted from the WSU University Libraries' How to Distinguish Between Types of Periodicals and Types of Periodicals guides

What makes information peer-reviewed vs. scholarly vs. non-scholarly? Which type of source should I use?

What makes information peer-reviewed vs. scholarly vs. non-scholarly?
Which type of source should I use?

There is a nuanced distinction between peer-review and scholarship, which typically doesn't matter when evaluating sources for possible citation in your own work. Peer-review is a process through which editors of a journal have other experts in the field evaluate articles submitted to the journal for possible publication. Different journals have different ways of defining an expert in the field. Scholarly works, by contrast have an editorial process, but this process does not involve expert peer-reviewers. Rather, one or more editors, who are themselves often highly decorated scholars in a field, evaluate submissions for possible publication. This editorial process can be more economically driven than a peer-review process, with a greater emphasis on marketing and selling the published material, but as a general rule this distinction is trivial with regard to evaluating information for possible citation in your own work.

What is perhaps a more salient way of thinking about the peer-review / scholarship distinction is to recognize that while peer-reviewed information is typically highly authoritative, and is generally considered "good" information, the absence of a peer-review process doesn't automatically make information "bad." More specifically, the only thing the absence of a peer-review process means is that information published in this manner is not peer-reviewed. Nothing more. Information that falls into this category is sometimes referred to as "non-scholarly" information -- but again, that doesn't mean this information is somehow necessarily problematic.

Where does that leave you in terms of deciding what type of information to use in producing your own work? That is a highly individual decision that you must make. The Which type of source should I use? tab in this box offers further guidance on answering this question, though it is important to be aware that many WSU instructors will only consider peer-reviewed sources to be acceptable in the coursework you turn in . You can ask your instructor for his or her thoughts on the types of sources s/he will accept in student work.

Image: Martin Grater. (2017, Nov. 1). Deep Thought. Retrieved from https://www.flickr.com/photos/152721954@N05/24304490568/. Used under the Creative Commons License.

Your topic and research question or thesis statement will guide you on which resources are best. Sources can be defined as primary, secondary and tertiary levels away from an event or original idea. Researchers may want to start with tertiary or secondary source for background information. Learning more about a topic will help most researchers make better use of primary sources.

While articles from scholarly journals are often the most prominent of the sources you will consider incorporating into your coursework, they are not the only sources available to you. Which sources are most appropriate to your research is a direct consequence of they type of research question you decide to address. In other words, while most university-level papers will require you to reference scholarly sources, not all will. A student in an English course writing a paper analyzing Bob Dylan's lyrics, for example, may find an interview with Dylan published in Rolling Stone magazine a useful source to cite alongside other scholarly works of literary criticism.

The WSU University Libraries' What Sources Should I Use? handout, as well as the other sub-tabs under the Evaluating information section of this guide (which is indeed the section you are currently viewing) offer further guidance on understanding and identifying scholarly resources, and comparing them against different criteria to evaluate if they will be of value to your research. How many non-scholarly works (if any) you are at liberty to cite alongside scholarly ones is often a question to ask of your professor. Some may not want you to cite any, whereas others may be ok with some non-scholarly works cited alongside scholarly ones.

Image: Brett Woods. (2006, Jan. 6). Deep Thoughts. Retrieved from https://www.flickr.com/photos/brettanicus/87653641/. Used under the Creative Commons License.

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Expert Commentary

White papers, working papers, preprints, journal articles: What’s the difference?

In this updated piece, we explain the most common types of research papers journalists will encounter, noting their strengths and weaknesses.

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This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License .

by Denise-Marie Ordway, The Journalist's Resource February 25, 2022

This <a target="_blank" href="https://journalistsresource.org/media/working-papers-research-articles/">article</a> first appeared on <a target="_blank" href="https://journalistsresource.org">The Journalist's Resource</a> and is republished here under a Creative Commons license.<img src="https://journalistsresource.org/wp-content/uploads/2020/11/cropped-jr-favicon-150x150.png" style="width:1em;height:1em;margin-left:10px;">

This tip sheet, originally published in May 2018, has been updated to include preprint research, a type of research featured often in news coverage of the coronavirus pandemic.

Journalists rely most often on four types of research in their work. White papers, working papers, preprints and peer-reviewed journal articles.

How are they different? And which is best?

Below, we explain each, pointing out its strengths and weaknesses. As always, we urge journalists to use care in selecting any research to ground their coverage and fact-check claims.

Peer-reviewed article

Peer-reviewed research — the kind that appears in academic journals and that we highlight here at The Journalist’s Resource — has undergone a detailed critique by scholars with expertise in the field. While peer-reviewed research is generally the most reliable, journalists should keep in mind that publication in a prestigious journal is no guarantee of quality and that no single university or research organization always does the best research on a given topic.

It is safe to assume, however, that articles published in top-tier journals have been reviewed and given a stamp of approval by a number of accomplished scholars. For journalists who are uncertain, we’ve put together a list of 13 questions to ask to gauge the quality of a research article.

Keep in mind that not everything that appears in a scholarly journal has been peer reviewed. Journals publish various types of content, including book reviews, editorials, letters to the editor and, sometimes, even poetry.

Working paper

This broad category describes research papers that have not been peer reviewed or published in a journal. Working papers can be in various stages of completion. One might be ready for publication in a prestigious journal while another requires significant editing and other changes that could actually alter its main findings. Sometimes, working paper findings are so preliminary, authors will advise against citing their work .

Even so, working papers are a great way for journalists to gain access to new research quickly. The peer-review and publication process can take months to a year or longer, which means that by the time studies get published, their findings are sometimes not as useful or the data are old.

In choosing working papers, journalists should communicate with scholars about the progress of their research and how confident they are in their findings. It’s a good idea to seek corroboration from peer-reviewed research and to ask other researchers for help assessing a study.

A preprint is similar to a working paper in that it has not been vetted through a formal peer-review process. However, preprints tend to be more complete . Also, preprints submitted to public servers such as the Social Science Research Network and the health sciences server medRxiv get a cursory screening before they’re published online for public view.

Preprints, like academic journal articles, are assigned a Digital Object Identifier , or DOI, and become a permanent part of the scientific record.

White paper

A white paper is a report, often compiled by government agencies, businesses and nonprofit organizations, that outlines an issue and often explores possible solutions to a problem. For example, in November 2021, the federal Office of Community Oriented Policing Services released a white paper looking at factors that help or hinder law enforcement recruitment of Black Americans. Earlier in the year, the Advanced Technology Academic Research Center published a white paper on the American Rescue Plan ‘s widespread implications for government agencies.

In the business world, white papers also are used for marketing purposes — to describe a new product or approach, for instance, or diagnose a problem.

While a white paper can help journalists get up to speed quickly on an issue, it’s important to note some white papers advocate a specific position or policy change. Some rely on incomplete research or research that has not been peer reviewed.

Looking for more guidance on writing about research? Check out our tip sheets on covering biomedical research preprints amid the coronavirus and what journalists should know about peer review .

The Journalist’s Resource would like to thank Matthew Baum , the Marvin Kalb professor of global communications and professor of public policy at Harvard Kennedy School, for his help preparing this tip sheet.

About The Author

Denise-Marie Ordway

Core Differences

We Provide Comparison for All Terms

14 Difference between Article and Journal (With Table)

What is the main difference between article and journal? An Article is a written piece of content that focus on a specific topic or subject matter while a journal is a publication comprising of multiple articles or research papers within a specific discipline.

Articles and journals are popular among individuals conducting research study or writing academic papers. The styles of writing between these publications are different. But many people use journal article term to refer to an individual article in a journal.

We recommend understanding the difference between these two entities before navigating in the world of scholarly publications. This blog post shed light on the disparities between articles and journals for better understanding.

Difference between Article and Journal with Table

What is an article.

An article is a concise written piece of content that conveys information, ideas, or opinions on a specific topic. Articles are designed to inform, educate, entertain, or persuade a wide audience. They are often found in newspapers, magazines, blogs, websites, and other media outlets.

Articles vary widely in style and purpose. Some are news articles, reporting current events and facts, while others are feature articles, offering in-depth analysis or storytelling. They can be authored by individuals, journalists, or subject matter experts.

Articles may or may not include citations and references, depending on their context and intended audience. Articles are not always subjected to rigorous peer review, making them more accessible for general readers.

They serve as valuable sources of information and commentary on a broad spectrum of topics, from news and entertainment to education and opinion.

What Is A Journal?

A journal is a specialized, scholarly publication that serves as a repository of original research, academic studies, and in-depth analyses within a particular field of knowledge. Journals are published periodically and they adhere to a structured format.

These publications are written by experts, researchers, and scholars in their respective fields, with the content organized into sections like abstracts, introductions, methods, results, discussions, and conclusions.

Journals often require rigorous peer review before acceptance, ensuring the quality, accuracy, and validity of the research presented. Journals are essential for the dissemination of new knowledge and the advancement of academic disciplines.

They provide a platform for researchers to share their findings, contribute to existing scholarship, and engage in scholarly discourse. Access to journal articles is often restricted, with subscriptions or institutional access required, reflecting their significance in academic and research.

Main Difference between Article and Journal

An article is a written piece found in books, magazines, or newspapers, typically non-fictional and informative. Conversely, a journal is a specialized magazine focused on a specific discipline or profession, containing articles, reviews, and academic content.
Articles encompass a wide range of topics and can include news, stories, opinions, and facts. In contrast, journals feature articles, book reviews, editorial content, and updates in the field of study.
While articles aim to influence and engage readers, journals primarily provide educational and professional information. Articles are often driven by writer’s interests or current issues, whereas journals are centered on a particular field or course of study.
Articles are individual written compositions that appear in books, magazines, or newspapers. They are typically non-fictional and serve to inform, entertain, or persuade. In contrast, journals are specialized publications, often focusing on a specific academic or professional field, containing scholarly articles, reviews, and research.
Articles cover a broad spectrum of topics, including news, stories, opinions, and factual information. In contrast, journals encompass articles, book reviews, editorials, achievements, feedback, and updates relevant to their respective fields.
While the primary purpose of an article is to engage and influence readers, encouraging thought and discussion, journals primarily exist to disseminate educational and academic content.
Articles are often driven by the writer’s interests or current events, whereas journals are dedicated to advancing knowledge within a specific domain or profession.

Similarities between Article and Journal

Both contain written content on various topics.
Both can be published in print or online formats.
Both may be authored by individuals or experts in the field.
Both serve as platforms for sharing knowledge and ideas.
Both aim to communicate and convey information to readers.

Final Thoughts from Experts

Articles and journals serve different purposes in the world of written content. Articles are shorter, versatile pieces often found in newspapers, magazines, or online sources. They can cover a wide range of topics and are accessible to a broad audience. Journals are specialized publications, emphasizing academic or professional content, backed by rigorous peer review. They are typically longer, structured, and focus on specific fields of study.

Articles aim to inform, entertain, or persuade with a diverse range of content, while journals prioritize scholarly research and educational information within their respective domains. Articles are more varied in authorship and review processes, whereas journals adhere to standardized formats and strict peer review.

In essence, articles are like quick reads for general knowledge, while journals are the deep dives into specialized expertise and research, catering to different information needs and audiences.

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Article Types: What's the Difference Between Newspapers, Magazines, and Journals?

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Article : Much shorter than a book, an article can be as short as a paragraph or two or as long as several dozen pages. Articles can address any topic that the author decides to explore and can reflect opinion, news, research, reviews, instruction, nearly any focus. Articles appear in newspapers, magazines, trade publication, journals, and even in books. Because of their relative brevity, articles typically are used to provide up-to-date information on a wide variety of topics.

Book Review : A usually brief article that provides an evaluation and appreciation of a book. A review might assess the importance of a book's contributions to a particular field of study or might make recommendations to potential readers of the book. Reviews of fiction will usually comment on originality, style, and readability. While an important tool for helping a researcher assess the value of a book to his or her research topic, a book review, by itself, is usually not sufficient for use as a source in a research project.

Issue : A single, regular publication of a journal, magazine, newspaper, newsletter, or trade publication. A magazine or journal that publishes monthly will have twelve issues in a year. News magazines like Time and Newsweek publish weekly and will have 52 issues in a year. Newspapers might publish daily or weekly. A daily will have 365 issues in a year. Issues are usually numbered, so a journal that publishes twelve issues in a year starting with January will number each issue sequentially (issue 1, January; issue 2, February; issue 3, March; etc.).

Journal : A regularly published collection of articles that focus on topics specific to a particular academic discipline or profession. Journals might be published monthly, bi-monthly, quarterly, semi-annually, or even annually. Probably the most common publication frequency is monthly and quarterly. Journal articles are typically of substantial length (often more than 10 pages) and usually reflect research, whether it be surveys of existing research or discussions of original research. Most journal articles will be prefaced with an abstract and will include extensive documentation within the article or at the end of the article. Most research begins with a survey of existing literature on a topic and proceeds with the development of new ideas or new research into a topic. Articles are usually written by experts in their fields, although journals might also publish letters from their readership commenting on articles that have been published in previous issues. Journals might also include opinion articles or editorials. Examples of journals include Journal of the American Medical Association, American Sociological Review, Psychological Reports, Publications of the Modern Language Association, Educational Research Quarterly, and Evolutionary Biology.

Literature Review : An important part of nearly any research project, a literature review consists of a survey of previously published or non-published materials that focus on a particular subject under investigation. For example, a researcher looking into whether there is a relationship between musical aptitude and academic achievement in elementary age students would begin by looking for articles, books, and other materials that reflected previous research into this topic. The function of the review is to identify what is already known about the topic and to provide a knowledge foundation for the current study.

Magazine : A regularly published collection of articles that might focus on any topic in general or on topics of interest to a specific group, such as sports fans or music fans or home decorators. Magazines might be published weekly, monthly, semi-monthly or only several times a year. More commonly, magazines are published weekly or monthly. Articles in magazines are typically written for the general reading public and don't reflect in-depth research (an exception might be an investigative report written in a news magazine that involved weeks or months of research and interviews to complete). Most magazine articles do not list references and are written by the magazine's own staff writers. In general, magazine articles are easy to read, are fairly brief in length, and may include illustrations or photographs. Magazines also rely heavily on advertisements targeted to consumers as a source of revenue. Examples of magazines include Time, Newsweek, Rolling Stone, Popular Mechanics, Car and Driver, Interview, Good Housekeeping, Elle, GQ, and Sports Illustrated.

Newsletter : A regularly published collection of brief news articles of interest to members of a particular community. Professional associations might issue newsletters to keep their membership up to date. Businesses and schools might issue newsletters to keep their constituents up to date. Nearly any type of organization or society might have its own newsletter. Articles in newsletters are typically brief, and the entire newsletter itself might be only half a dozen pages in length. These are usually internal publications that have interest mainly to people who participate in the activities of the issuing body. They are frequently used to inform members of an organization of upcoming events. Examples of newsletters include 401(k) Advisor, Adult Day Services Letter, Black History News & Notes, Credit Card Weekly, Education Business Weekly, Music Critics Association Newsletter, and Student Aid News.

Newspaper : A regularly published collection of fairly brief articles that provide updates on current events and interests. Newspapers are generally published daily, weekly, and bi-weekly, although they may have less regular publication schedules. Most major newspapers publish daily, with expanded coverage on the weekends. Newspapers can be national or international in focus or might be targeted strictly to a particular community or locality. Newspaper articles are written largely by newspaper staff and editors and often do not provide authors' names. Many of the articles appearing in national, international, and regional papers are written by various wire service writers and are nationally or internationally syndicated. Examples of wire services are Reuters and the Associated Press. Newspapers rely on advertising for a part of their income and might also include photographs and even full color illustrations of photos. A common feature of most newspapers is its editorial page, where the editors express opinions on timely topics and invite their readers to submit their opinions. Examples of newspapers include New York Times, Times of London, Florida Times-Union, Tampa Tribune, Denver Post, Guardian, and USA Today.

Peer Reviewed/Refereed Journal : Most academic/scholarly journals use subject experts or "peers" to review articles being considered for publication. Reviewers will carefully examine articles to ensure that they meet journal criteria for subject matter and style. The process ensures that articles are appropriate to a particular journal and that they are of the highest quality.

Trade Journal : A regularly published collection of articles that address topics of interest to members of a particular profession, such as law enforcement or advertising or banking. Articles tend to be brief and often report on developments and news within a field and might summarize current research being done in a particular area. Trade journals might also include editorials, letters to the editor, photo essays, and advertisements that target members of the profession. While trade journal articles might include references, the reference lists tend to be brief and don't reflect thorough reviews of the literature. Articles are usually written with the particular profession in mind, but are generally pretty accessible so that a person wishing to learn more about the profession would still be able to understand the articles. Examples of trade journals include Police Chief, Education Digest, Energy Weekly News, Aviation Week and Space Technology, Engineering News Record, Design News, and Traffic World.

Volume : Most journals and many magazines, newsletters, newspapers, and trade publications assign volume numbers to a year's worth or half a year's worth of issues. For example, a journal that publishes four times a year (quarterly) might assign each yearly collection of four issues a volume number to help identify which issues of the journal were published during a particular year. Publications that publish more frequently than monthly might also assign volume numbers, but they might change volume numbers mid year, so that there may be two volumes in any one publishing year.

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Q. What's the difference between an article, a journal, and a database?

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Answered By: Elizabeth Galoozis (she/her) Last Updated: Sep 27, 2019 Views: 74369

In assignments, or on the library website, you’ve probably seen the three words “article,” “journal,” and “database.” How do they relate to each other, and how do they relate to searching for sources?

When you search in the libraries’ home page, you’re searching across several databases , including collections of books, e-books, and films, along with individual databases - for example, JSTOR or ProQuest Research Library. Each database includes sources such as articles, government documents, and many more. You can search for databases by name using the “Databases” search on the libraries’ home page.

One of the most common types of sources is a journal . This word may be used interchangeably in some places with periodical or serial , but basically a journal is a publication that comes out in issues on a regular basis - for example, four times a year. An example is Feminist Economics:

An issue of a journal contains individual articles . These are probably what you’re used to finding when you search for sources in the libraries or online, but you usually find them detached from their particular journal issue.

You can search for journals by title using the “Journals” search on the libraries’ home page.

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Q. What's the difference between a research article (or research study) and a review article?

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Answered By: Priscilla Coulter Last Updated: Jul 29, 2022 Views: 231690

A research paper is a primary source ...that is, it reports the methods and results of an original study performed by the authors . The kind of study may vary (it could have been an experiment, survey, interview, etc.), but in all cases, raw data have been collected and analyzed by the authors , and conclusions drawn from the results of that analysis.

Research papers follow a particular format. Look for:

A brief introduction will often include a review of the existing literature on the topic studied, and explain the rationale of the author's study. This is important because it demonstrates that the authors are aware of existing studies, and are planning to contribute to this existing body of research in a meaningful way (that is, they're not just doing what others have already done).
A methods section, where authors describe how they collected and analyzed data. Statistical analyses are included. This section is quite detailed, as it's important that other researchers be able to verify and/or replicate these methods.
A results section describes the outcomes of the data analysis. Charts and graphs illustrating the results are typically included.
In the discussion , authors will explain their interpretation of their results and theorize on their importance to existing and future research.
References or works cited are always included. These are the articles and books that the authors drew upon to plan their study and to support their discussion.

You can use the library's article databases to search for research articles:

A research article will nearly always be published in a peer-reviewed journal; click here for instructions on limiting your searches to peer-reviewed articles.
If you have a particular type of study in mind, you can include keywords to describe it in your search . For instance, if you would like to see studies that used surveys to collect data, you can add "survey" to your topic in the database's search box. See this example search in our EBSCO databases: " bullying and survey ".
Several of our databases have special limiting options that allow you to select specific methodologies. See, for instance, the " Methodology " box in ProQuest's PsycARTICLES Advanced Search (scroll down a bit to see it). It includes options like "Empirical Study" and "Qualitative Study", among many others.

A review article is a secondary source ...it is written about other articles, and does not report original research of its own. Review articles are very important, as they draw upon the articles that they review to suggest new research directions, to strengthen support for existing theories and/or identify patterns among exising research studies. For student researchers, review articles provide a great overview of the existing literature on a topic. If you find a literature review that fits your topic, take a look at its references/works cited list for leads on other relevant articles and books!

You can use the library's article databases to find literature reviews as well! Click here for tips.

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Difference Between Article and Journal

An article is a written work published in a print or electronic medium. It may be for the general public or for a specific audience, such as academics or professionals. Articles can be published in various forms, such as news articles, feature articles, or opinion pieces.

A journal, on the other hand, is a periodical publication that contains a collection of articles, often written by researchers or experts in a particular field. Journals are typically more specialized and academic in nature, and they are often peer-reviewed, which means that the articles they contain have been reviewed and evaluated by other experts in the field before they are published.

Table of Contents

Comparison Chart

Here is a comparison table that summarizes the main differences between articles and journals:

What is Article?

An article is a written work that is published in a print or electronic medium. It may be for the general public or for a specific audience, such as academics or professionals. Articles can take various forms, such as news articles, feature articles, or opinion pieces. They may be published in newspapers, magazines, websites, or other types of publications. The purpose of an article is to communicate information, ideas, or opinions to the reader. Articles can be informative, persuasive, or both, and they often include supporting evidence, such as facts, statistics, and quotes.

What is Journal?

A journal is a periodical publication that contains a collection of articles, often written by researchers or experts in a particular field. Journals are typically more specialized and academic in nature than other types of publications. They may cover a wide range of topics within a specific subject area, or they may focus on a narrow field of study. Journals are often peer-reviewed, which means that the articles they contain have been reviewed and evaluated by other experts in the field before they are published. This helps to ensure the quality and reliability of the research presented in the journal. Journals are typically published on a regular basis, such as monthly or quarterly, and they may be available in print or electronic format.

Main Key Difference Between Article and Journal

Here are the main differences between articles and journals, summarized in bullet points: Article :

Short piece of writing on a specific topic
Can be found in magazines, newspapers, or academic journals
Often written by journalists, experts or freelance writers
Written in a more accessible, layman’s language
Purpose is to inform, entertain or educate the general public
Collection of articles, usually focused on a specific subject or field
Can be academic or professional in nature
Articles are usually peer-reviewed or edited by experts in the field
Written in a more technical, specialized language
Purpose is to share and advance knowledge among professionals or researchers in a particular field.

In conclusion, it is important to consider both the similarities and differences between articles and journals when deciding which type of publication is the most appropriate for your needs. While articles can provide a wide range of information and perspectives on a variety of topics, journals are typically more specialized and academic in nature, and they often present research findings that have been rigorously reviewed and evaluated by experts in the field. Ultimately, the choice between an article and a journal will depend on your specific goals and needs as a writer or researcher.

Sajius Islam is a creative writer who enjoys Blog & Content Writing. He received his Bachelor of Science (B.Sc) degree from Guwahati University, Guwahati. He loves spending time with her family and friends, traveling, and exploring new cultures.

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Difference between Thesis and Research Paper

A thesis is a comprehensive academic document that presents original research and contributes new knowledge to the field, whereas a research paper explores and discusses a topic based on existing literature. Both forms of academic writing serve different purposes and audiences, requiring distinct approaches in terms of depth of analysis, format, and completion timeline.

What is a Thesis?

A thesis is a comprehensive document written by a student pursuing a higher academic degree, such as a Master’s or Ph.D. It is the culmination of original research conducted by the student under the guidance of a supervisor or advisor. The primary purpose of a thesis is to present a scholarly argument or hypothesis on a specific topic or research question. It involves conducting in-depth research, analyzing data, and synthesizing findings to contribute new knowledge to the field of study. A thesis typically consists of several chapters, including an introduction, literature review, methodology, results, discussion, and conclusion.

Key Features of a Thesis:

Original Research: A thesis involves original research conducted by the student, contributing new knowledge or insights to the academic field.
Comprehensive Analysis: This typically includes a comprehensive analysis of existing literature, methodologies, data, and findings related to the research topic.
Formal Defense: A thesis is defended orally before a committee of faculty members or experts, who evaluate the student’s research methods, findings, and conclusions.

What is a Research Paper?

A research paper is a shorter, more focused document that presents the findings of a specific research study or investigation. It is commonly written by students at the undergraduate or graduate level as part of a course assignment or academic project. The primary purpose of a research paper is to communicate the results of research, analysis, or experimentation on a particular topic or research question. It aims to contribute to the existing body of knowledge in a given field or area of study. A research paper typically follows a standardized format, including sections such as an introduction, literature review, methodology, results, discussion, and conclusion.

Key Features of a Research Paper:

Focused Study: A research paper focuses on presenting the findings of a specific research study or investigation, often within a narrower scope than a thesis.
Standardized Format: It follows a standardized format, including sections such as introduction, literature review, methodology, results, discussion, and conclusion.
Evaluation Criteria: Research papers are evaluated based on factors such as the clarity of writing, the rigor of research methods, the relevance of findings, and the contribution to the field, often as part of a course assignment or academic project.

Thesis and Research Paper – FAQs

Is a thesis longer than a research paper.

Yes, typically a thesis is more extensive and detailed compared to a research paper due to its original research component and comprehensive structure.

Do research papers require original research?

Research papers primarily rely on existing literature and sources, providing critical analysis or interpretation without necessarily presenting new findings.

Can a research paper be published in academic journals?

Yes, research papers can be submitted for publication in academic journals, providing they meet the journal’s criteria for quality and relevance.

What is the role of a thesis advisor or committee?

Thesis advisors and committee members provide guidance, feedback, and evaluation throughout the thesis process, ensuring academic rigor and quality.

Can a thesis be revised after completion?

Yes, a thesis may undergo revisions based on feedback from advisors or committee members before final submission and defense.

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Curves were weighted for the following covariates: age, sex, attained education, baseline estimated glomerular filtration rate, number of hospitalizations during previous year and psychiatry related, number of outpatient contacts during previous year and psychiatry related, number of outpatient contacts during previous year, pregnancy in the 2 years prior, total number of medications in the previous year, comorbidities (bipolar disorder, depression, manic episode, anxiety disorder, mental disorders attributable to psychoactive substance use, schizophrenia spectrum disorders, hypertension, diabetes, acute coronary syndrome, other ischemic heart disease, heart failure, stroke, other cerebrovascular diseases, valve disorders, atrial fibrillation, other arrhythmia, hyperthyroidism, cancer, and liver disease) and ongoing medications (lamotrigine, carbamazepine, first- and second-generation antipsychotic drugs, other mood stabilizers, antidepressants, attention-deficit/hyperactivity disorder medication, drugs used in addictive disorders, opioids and pain medications, antiepileptic drugs, β-blockers, calcium channel blockers, diuretics, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, lipid-lowering drugs, and nonsteroidal anti-inflammatory drugs). Shading indicates 95% CIs.

The x-axis is truncated at 3000 defined daily dosages (DDDs) because this is the maximum DDD in the valproate group. Cumulative dose was calculated as the time updated sum of all dispensed DDDs since therapy initiation and modeled as a time-dependent covariate. Models adjusted for the following variables: age, sex, attained education, baseline estimated glomerular filtration rate, number of hospitalizations during previous year and psychiatry related, number of outpatient contacts during previous year and psychiatry related, number of outpatient contacts during previous year, pregnancy in the 2 years prior, total number of medications in the previous year, comorbidities (bipolar disorder, depression, manic episode, anxiety disorder, mental disorders attributable to psychoactive substance use, schizophrenia spectrum disorders, hypertension, diabetes, acute coronary syndrome, other ischemic heart disease, heart failure, stroke, other cerebrovascular diseases, valve disorders, atrial fibrillation, other arrhythmia, hyperthyroidism, cancer, and liver disease), and ongoing medications (lamotrigine, carbamazepine, first- and second-generation antipsychotic drugs, other mood stabilizers, antidepressants, attention-deficit/hyperactivity disorder medication, drugs used in addictive disorders, opioids and pain medications, antiepileptic drugs, β-blockers, calcium channel blockers, diuretics, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, lipid-lowering drugs, and nonsteroidal anti-inflammatory drugs). Shaded areas indicate 95% CIs. HR indicates hazard ratio.

eMethods. Definition of Study Outcomes and Statistical Analysis

eTable 1. Definition of Study Covariates, Comorbidities

eTable 2. Definition of Study Covariates, Ongoing Medications

eTable 3. Baseline Characteristics of Additional Variables (Beyond Those Reported in Table 1) Used in the Propensity Score Calculation of Patients Initiating Lithium or Valproate Treatment Between 2007 and 2018 in Stockholm

eTable 4. Annual eGFR Decline and Mean Difference in eGFR Decline by Treatment Assignment, Overall and by Subgroups

eTable 5. Baseline Characteristics of Patients Initiating Lithium or Valproate Treatment Between 2007 and 2018 in Stockholm Before and After Overlap Weighting (OW)

eTable 6. Number of Events, Incidence Rates, Adjusted Hazard Ratios and 10-Year Absolute Risk Reduction for the Association Between Valproate vs Lithium and Kidney Outcomes Applying Overlapping Weights

eTable 7. Sensitivity Analyses: Frequency of Creatinine Measurements During Follow-up, Overall and Within Yearly Intervals

eTable 8. Baseline Characteristics of Patients Who Initiated Lithium Therapy Between 2007 and 2018 in Stockholm and Stayed on Therapy for at Least One Year, Overall and by Serum Level Categories

eFigure 1. Study Design Diagram

eFigure 2. Flowchart of Study Inclusion

eFigure 3. Pattern of Lithium and Valproate Prescriptions Over Time

eFigure 4. Distribution of the Time Elapsed Between First and Last Lithium Dispensation (Panel A) and Valproate (Panel B)

eFigure 5. Distribution of Routine Lithium Measurements Among 3518 Individuals Who Stayed on Lithium Therapy for at Least One Year

eReferences

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Bosi A , Clase CM , Ceriani L, et al. Absolute and Relative Risks of Kidney Outcomes Associated With Lithium vs Valproate Use in Sweden. JAMA Netw Open. 2023;6(7):e2322056. doi:10.1001/jamanetworkopen.2023.22056

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Absolute and Relative Risks of Kidney Outcomes Associated With Lithium vs Valproate Use in Sweden

1 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
2 Department of Medicine and Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
3 Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
4 Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
5 Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
6 Department of Neuroscience and Physiology, Gothenburg University, Gothenburg, Sweden
7 Renal Medicine, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden
8 Division of Nephrology, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden

Question How is lithium therapy, compared with valproate therapy, associated with kidney outcomes?

Findings In this cohort study of 10 946 patients followed up for up to 10 years in Sweden, no significant differences in relative and absolute risk of chronic kidney disease progression, albuminuria, or acute kidney injury (AKI) were found among patients who received lithium compared with those who received valproate. However, high levels of lithium were strongly associated with AKI risks.

Meaning Initiation of lithium therapy was not associated with risk of chronic kidney disease, albuminuria, or AKI, but the association between higher lithium levels and AKI calls for continuous patient monitoring and lithium dose adjustment to avoid toxic levels.

Importance Among patients with bipolar disorder, discordant findings have been published on the nephrotoxic effects of lithium therapy.

Objective To quantify absolute and relative risks of chronic kidney disease (CKD) progression and acute kidney injury (AKI) in people who initiated lithium compared with valproate therapy and to investigate the association between cumulative use and elevated lithium levels and kidney outcomes.

Design, Setting, and Participants This cohort study had a new-user active-comparator design and used inverse probability of treatment weights to minimize confounding. Included patients initiated therapy with lithium or valproate from January 1, 2007, to December 31, 2018, and had a median follow-up of 4.5 years (IQR, 1.9-8.0 years). Data analysis began in September 2021, using routine health care data from the period 2006 to 2019 from the Stockholm Creatinine Measurements project, a recurrent health care use cohort of all adult residents in Stockholm, Sweden.

Exposures New use of lithium vs new use of valproate and high (>1.0 mmol/L) vs low serum lithium levels.

Main Outcomes and Measures Progression of CKD (composite of >30% decrease relative to baseline estimated glomerular filtration rate [eGFR] and kidney failure), AKI (by diagnosis or transient creatinine elevations), new albuminuria, and annual eGFR decrease. Outcomes by attained lithium levels were also compared in lithium users.

Results The study included 10 946 people (median [IQR] age, 45 [32-59] years; 6227 female [56.9%]), of whom 5308 initiated lithium therapy and 5638 valproate therapy. During follow-up, 421 CKD progression events and 770 AKI events were identified. Compared with patients who received valproate, those who received lithium did not have increased risk of CKD (hazard ratio [HR], 1.11 [95% CI, 0.86-1.45]) or AKI (HR, 0.88 [95% CI, 0.70-1.10]). Absolute 10-year CKD risks were low and similar: 8.4% in the lithium group and 8.2% in the valproate group. No difference in the risk of developing albuminuria or the annual rate of eGFR decrease was found between groups. Among more than 35 000 routine lithium tests, only 3% of results were in the toxic range (>1.0 mmol/L). Lithium values greater than 1.0 mmol/L, compared with lithium values of 1.0 mmol/L or less, were associated with increased risk of CKD progression (HR, 2.86; 95% CI, 0.97-8.45) and AKI (HR, 3.51; 95% CI, 1.41-8.76).

Conclusions and Relevance In this cohort study, compared with new use of valproate, new use of lithium was meaningfully associated with adverse kidney outcomes, with low absolute risks that did not differ between therapies. However, elevated serum lithium levels were associated with future kidney risks, particularly AKI, emphasizing the need for close monitoring and lithium dose adjustment.

Lithium is the most effective prophylactic treatment for bipolar disorder 1 and augments the effects of other drugs in treatment-resistant depression. 2 Use of lithium is constrained by concern over its nephrotoxic effects, a potential chronic tubulointerstitial nephritis resulting in decreased glomerular filtration rate (GFR; lithium nephropathy). However, the underlying pathophysiologic mechanism is not fully understood. 3 , 4 Despite more than 5 decades of debate on the benefits and harms of this medication, the absolute and relative risks of kidney damage remain poorly characterized. 5 , 6

A meta-analysis of trials and observational studies resulted in heterogeneous and inconclusive estimates because of limitations of the original studies and differences in outcome ascertainment. 7 Subsequent studies, mostly large-scale observational studies from routine care, have provided conflicting results, potentially attributable to lack of an active comparator, 8 , 9 restriction to elderly individuals, 10 , 11 and the lack of information on serum lithium levels. 5 , 12 Studies have used administrative codes to identify chronic kidney disease (CKD), 8 , 11 , 13 which have low sensitivity; lacked information on GFR, 13 which is a key confounder; or used a single GFR value to define outcomes, 9 , 10 , 14 which introduces misclassification. The potential risk of acute kidney injury (AKI) has been studied only in case series and single-center studies. 12 We aimed to quantify the absolute and relative risks of clinically relevant CKD progression or AKI in those who initiated lithium vs valproate treatment and the impact of treatment duration and intensity. We also investigated the association between lithium levels and kidney outcomes.

For this cohort study, we analyzed the Stockholm Creatinine Measurements (SCREAM) database, a health care use cohort of all adult residents in Stockholm, Sweden. 15 Stockholm is an administrative region that had a population of 2.3 million citizens in 2021, all receiving universal health care within a unified health system. Administrative databases with complete information on demographic data, health care use, diagnoses and therapeutic surgical procedures, vital status, routine laboratory tests, and dispensed prescriptions were linked and deidentified by the Swedish National Board of Health and Welfare. Because the study used deidentified data, the requirement of informed consent was waived by the regional ethics review board. The study followed the Strengthening the Reporting of Observational Studies in Epidemiology ( STROBE ) reporting guideline. 16

We adopted a new-user active-comparator design comparing initiation of lithium therapy with initiation of valproate therapy, a drug with similar indications but no suspected nephrotoxicity. The study population consisted of all adults (aged ≥18 years) who newly initiated therapy with either drug between January 1, 2007, and December 31, 2018. We began the analysis in September 2021, using routine health care data from the period 2006 to 2019. New initiation was defined as a first registered pharmacy dispensation, with no previous dispensation of either drug since June 2005. The date of first dispensation was defined as baseline and start of follow-up. Patients were excluded if they had a history of kidney replacement therapy (KRT; maintenance dialysis or kidney transplantation).

In the primary analysis, we used an intention-to-treat design, in which patients were analyzed based on the first prescription of lithium or valproate, regardless of drug discontinuation, because the possible chronic toxic effects of lithium on kidney function may develop after many years or after stopping use of the medication. In a secondary analysis, we calculated the cumulative use of these drugs by collecting information on each subsequent dispensation over time. For any drug, defined daily dosages (DDDs) have been published: they are the mean maintenance dose per day when used for its main indications in adults. 17 We quantified the overall amount of medication dispensed by calculating the number of DDDs per dispensation: number of pills contained in the package multiplied by the amount of active principle per pill (in milligrams) and divided by the DDD (also in milligrams). We calculated the cumulative use of both lithium and valproate and treated them as time-dependent exposures, summing at each dispensation the total DDDs obtained since initiation, allowing medication switches and interruptions. This design allows us to compare similar lengths of treatment and exposure (DDDs) for patients taking the 2 medications.

To study long-term use, for participants still using lithium at 1 year after initiation, we defined a new baseline at that time. We hypothesized that high lithium levels in the long term (ie, serum concentration) would be associated with higher risk of adverse kidney outcomes compared with long-term low levels. We estimated the long-term level as the median of all levels during the first year of therapy, and at each subsequent lithium level measurement, we recalculated the median level using data from the previous 12 months. We categorized the median lithium level as chronically high according to 3 different thresholds: (1) median lithium level greater 0.8 mmol/L, based on the upper limit of our reference laboratory and consistent with a previous study 5 ; (2) median lithium level greater than 0.9 mmol/L; and (3) median lithium level greater than 1.0 mmol/L, a threshold previously associated with risk of AKI. 12 We examined median lithium levels as both fixed (baseline) and time-varying covariates.

Study covariates included sociodemographic characteristics (age, sex, and highest attained education), laboratory measurements, comorbidities, ongoing medications, and health care use (outpatient and inpatient contacts in previous year, overall and psychiatry related). The GFR was calculated with the 2009 CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) equation 18 without correction for race (it is not legal to collect information on race in Sweden), using routine isotope-dilution mass spectrometry traceable serum or plasma creatinine measurements. We defined CKD at baseline as an annual estimated GFR (eGFR) less than 60 mL/min/1.73 m 2 . Algorithms used to define study covariates are detailed in eFigure 1 and eTables 1 and 2 in Supplement 1 .

The primary outcome was CKD progression, defined as the composite of KRT or a sustained 30% or greater decrease in eGFR from baseline. The secondary outcomes were AKI, specified a priori and using clinical diagnoses, as well as inpatient and outpatient creatinine values. Two post hoc outcomes, new albuminuria and annual decrease in GFR, were added after peer review (detailed in the eMethods in Supplement 1 ). In each analysis, patients were followed up until the outcome of interest, death, moving out of the Stockholm region, or the end of follow-up (December 31, 2018), whichever occurred first.

Continuous variables are presented as means (SDs) or medians (IQRs), depending on the distribution, and categorical variables as numbers (percentages). Incidence rates per 1000 person-years with 95% CIs were computed for all outcomes. We regarded P ≤ .05 as statistically significant; all hypothesis tests were 2-tailed.

For the main analysis (initiation of lithium vs valproate therapy), we used propensity scores with inverse probability of treatment weighting to control for baseline confounding. 19 , 20 Robust variance estimation was used to calculate CIs after weighting. Weighted Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% CIs between lithium vs valproate therapy initiation and outcomes, with time since initiation as the time scale. Covariates that did not achieve balance after inverse probability of treatment weighting were included in the model as additional confounders. Weighted Kaplan-Meier curves were plotted to display the cumulative incidence of outcomes over the follow-up period. We used a linear mixed model with random intercept and slope to analyze the annual rate of change in eGFR.

As sensitivity analyses, first, we used the alternative weighting method of overlap weights, 19 and second, we explored the risk of detection bias (ie, differential outcome ascertainment) arising from differences in the frequency of testing by comparing rates of creatinine testing during follow-up in each treatment group. We explored the association between the cumulative use of lithium or valproate (ie, the number of DDDs dispensed since the beginning of therapy) and kidney outcomes through multivariable Cox proportional hazards regression with time-varying exposures and time-fixed (at baseline) confounders. We compared the risks between the cumulative use of lithium vs valproate by calculating the ratio between the HR from the single models. Thus, this HR compares kidney risks between both therapies given the same time-dependent long-term use (ie, given the same amount of DDDs dispensed).

We used multivariable Cox proportional hazards regression to explore the association between long-term lithium levels and kidney outcomes, with time-varying exposures and time-fixed (ie, baseline) confounders. There was no missingness for any of the baseline study covariates, except for attained education, which was missing in 2%. We opted to give them a missing category. Analyses were performed using R software, version 4.0.5 (R Project for Statistical Computing). 21

During 2007 to 2018, a total of 16 645 adults started lithium or valproate therapy in the region of Stockholm. After exclusion criteria were applied, 10 946 individuals (median [IQR] age, 45 [32-59] years; 6227 female [56.9%] and 4719 male [43.1%]) were included, of whom 5308 initiated lithium therapy and 5638 valproate therapy (eFigure 2 in Supplement 1 ). Their baseline characteristics are given in Table 1 . The annual median (IQR) eGFR was 99 (85-112) mL/min/1.73 m 2 , and 2% of those treated with lithium and 5% of those treated with valproate had an annual eGFR less than 60 mL/min/1.73 m 2 . The pattern of prescription did not vary greatly throughout the observation period (eFigure 3 in Supplement 1 ).

Patients who started lithium therapy were younger and more often female, with a higher prevalence of bipolar disorder, depression, and anxiety disorders than observed in those who started valproate therapy. Inverse probability of treatment weighting showed a good ability to balance measured confounders between both treatment groups, with most standardized mean differences less than 0.1 after weighting ( Table 1 ; eTable 3 in Supplement 1 ).

During a median follow-up of 4.5 years (IQR 1.9-8.0 years), 182 individuals (3% of total) in the lithium group and 247 individuals (4% of total) in the valproate group experienced progression of CKD, corresponding to an incidence of 6.9 events per 1000 person-years in the lithium group and 8.9 events per 1000 person-years in the valproate group ( Table 2 ). The median duration of lithium therapy was 4 years (IQR, 1.9-8.0 years), and the median duration of valproate therapy was 4 years (IQR, 1.8-8.0 years). Of the new users of lithium, 777 had at least 1 dispensation of valproate during follow-up; of the new users of valproate, 649 had at least 1 lithium dispensation.

Lithium therapy initiation, compared with valproate therapy initiation, was not associated with a significantly higher risk of CKD progression (adjusted HR, 1.11; 95% CI, 0.86-1.45) ( Figure 1 A). In weighted analysis, CKD progression occurred in 8.4% (95% CI, 7.0%-10.0%) of patients initiating lithium therapy and 8.2% (95% CI, 6.8%-9.8%) of patients initiating valproate therapy during 10 years of observation (weighted 10-year absolute risk difference, 0.2%; 95% CI, −2.0% to 2.4.%), which did not differ from zero throughout the follow-up period ( Figure 1 B).

We identified 770 AKI events ( Table 2 ). There was no difference between groups in risk (weighted HR, 0.88; 95% CI, 0.70-1.10) ( Figure 1 C). However, the 10-year absolute risk difference was −3.2% (95% CI, −5.6 to −1.1), with a lower risk among patients initiating lithium therapy than those initiating valproate therapy ( Figure 1 D).

We identified 438 (4.5% of total) new albuminuria events ( Table 2 ). There was no difference between groups in albuminuria risk (weighted HR, 0.99; 95% CI, 0.74-1.33) ( Figure 1 E). The 10-year absolute risk difference was −1.1% (95% CI, −2.7 to 2.1) ( Figure 1 F).

The annual rate eGFR decrease was −1.1 mL/min/1.73 m 2 (95% CI: −1.2 to −1.0 mL/min/1.73 m 2 ) for valproate users and −0.9 mL/min/1.73 m 2 (95% CI, −1.0 to −0.8 mL/min/1.73 m 2 ) for lithium users. There were no differences between the rate of eGFR decrease between therapies, with a nonstatistically significant annual mean difference of 0.2 mL/min/1.73 m 2 slower for lithium users compared with valproate users. Absence of statistically significant or clinically meaningful differences in eGFR slopes was observed across age and baseline eGFR strata (eTable 4 in Supplement 1 ).

Using overlap weights as an alternative propensity weighting method yielded results similar to our main analysis: lithium vs valproate therapy initiation was associated with an adjusted HR of 1.18 (95% CI, 0.92-1.50) for CKD progression, 0.96 (95% CI, 0.79-1.16) for AKI, and 0.87 (95% CI, 0.69-1.10) for new albuminuria (eTables 5 and 6 in Supplement 1 ). The frequency of creatinine testing during follow-up was similar in both treatment groups (eTable 7 in Supplement 1 ).

Patients who initiated lithium therapy had longer treatment durations (eFigure 4 in Supplement 1 ) than those who initiated valproate therapy. A total of 15% of patients in the lithium group and 12% in the valproate group had at least one dispensation of the other drug during follow up. Although increasing cumulative lithium use was associated with a graded higher risk of CKD progression ( Figure 2 A), no association was observed for the cumulative use of valproate. Compared with valproate treatment, every 500 DDDs of lithium dispensed was associated with a 30% higher risk of CKD progression (ratio of HRs, 1.30; 95% CI, 1.09-1.50). No difference was observed between therapies for the risk of AKI (ratio of HRs, 0.91; 95% CI, 0.82-0.99) ( Figure 2 B) or new albuminuria (ratio of HRs, 0.86; 95% CI, 0.75-0.98) ( Figure 2 C).

For the 3518 adults who continued to take lithium for at least 1 year (eFigure 5 and eTable 8 in Supplement 1 ), the median lithium level during the first year of therapy was 0.5 mmol/L (IQR, 0.40-0.53 mmol/L). During therapy, there were 35 443 measurements of lithium recorded, with a median of 8 (IQR, 3-18) measurements per person; most measurements (88%) were less than or equal to 0.8 mmol/L. In total, 11% of lithium measurements (in 30% of individuals) were greater than 0.8 mmol/L, and 3% (in 13% of individuals) were greater than 1.0 mmol/L.

Compared with lower lithium levels, higher levels were associated with tendencies to increasing risk of CKD, with a dose-response relation across lithium thresholds, seen in both baseline (HR, 2.86; 95% CI, 0.97-8.45) and time-varying (HR, 1.77; 95% CI, 0.50-6.31) models ( Table 3 ). The association with risk of AKI was stronger and statistically significant in time-varying models: compared with low lithium levels, the risk of AKI was 2.5-fold higher for a median lithium level greater than 0.8 mmol/L (HR, 2.56; 95% CI, 1.67-3.92) and 3.5-fold higher for a median lithium level greater than 1.0 mmol/L (HR, 3.51; 95% CI, 1.41-8.76) ( Table 3 ). There was no association between higher levels and risk of new albuminuria in either model ( Table 3 ).

We found no difference in the risk of CKD progression for new use of lithium compared with valproate and that a higher cumulative dose of lithium, compared with valproate, was modestly associated with the risk of CKD progression. The absolute risks were low, and there was no difference between therapies within a 10-year horizon. Rate of change of GFR, a post hoc outcome, was also not different between groups, with a modest annual mean difference of 0.2 mL/min/1.73 m 2 . New users of lithium were no more likely to develop albuminuria. Toxic lithium levels (>1.0 mmol/L) were uncommon. However, people with higher lithium levels were at higher risk of CKD and AKI.

Because it has been suggested 22 that modern lithium treatment (recommended levels of 0.6-0.8 mmol/L; up to 1.0 mmol/L if insufficient response and good tolerance 23 ) has minimized the risk of lithium-induced KRT since the 1960 to 1980s, we compared our results with studies after the 2012 meta-analysis. 7 In our study of more than 35 000 lithium levels, 3% were greater than 1.0 mmol/L, a very low proportion, and similar to a UK report. 5

Two studies 9 , 13 comparing use vs nonuse of lithium reached opposing results. Shine et al 9 identified 2795 patients undergoing lithium testing at a UK National Health Service trust (1985-2014). Compared with random health care users, those tested for lithium had a higher risk (HR, 1.93; 95% CI, 1.76-2.12) of having 1 detected annual GFR measurement less than 60 mL/min/1.73 m 2 during follow-up. Kessing et al 13 studied 10 591 people with bipolar disorder or manic episode in a Danish population-based register (2000-2011). Use of lithium, compared with no use, and a high number of lithium dispensations (≥60) were associated with the risk of receiving a CKD diagnosis (HR, 2.54; 95% CI, 1.81-3.57). Because the risk of starting KRT (HR, 0.32; 95% CI, 0.09-1.11) did not differ, the authors interpreted that increased surveillance among lithium users led to higher disease recognition (ie, a false-positive finding).

Two studies 5 , 10 with an active comparator also reached somewhat opposing results. Clos et al 5 evaluated 305 new users of lithium and 815 new users of another first-line drug for the treatment of affective disorders, finding that the annual decrease in eGFR during median 6-year follow-up did not differ significantly between the lithium group (1.3 mL/min/1.73 m 2 ) and the comparator group (0.9 mL/min/1.73 m 2 ). However, lithium levels greater than 0.8 mmol/L were associated with a decrease in eGFR. In our study, rates of eGFR decrease were of comparable magnitude and were not significantly different between groups. Rej et al 10 evaluated 3113 lithium users older than 65 years propensity score matched 1:1 to 3113 valproate users from Ontario, Canada (2007-2015). Lithium use was associated with a modestly increased risk of a 30% decrease in eGFR (HR, 1.14; 95% CI, CI 1.02-1.27), but absolute risks were low and similar (6.4 events per 100 person-years in the lithium group and 5.8 events per 100 person-years in the valproate group).

Our work is consistent with these aforementioned findings of low absolute risks and has some additional strengths: a focus on new users of 2 medications with similar indications and use of inverse probability of treatment weights to mitigate confounding; demonstration that both groups have similar rates of GFR testing over time, reducing the possibility of detection bias; use of a robust method to assess GFR decrease 24 ; the largest sample size to date evaluating the impact of lithium levels; the inclusion of albuminuria as a novel study outcome; and our use of rolling 1-year assessments to evaluate long-term toxic effects. Our large sample size, inclusion of all ages, and duration of follow-up improve the power and generalizability of our study.

The exploration of AKI risk in our study is novel. We attribute the reduced risk of AKI for lithium vs valproate in the intention-to-treat analysis to chance because the differences became more marked at distal time points when most patients were no longer taking the drug and because there is no association in the analysis of cumulative dose. The finding of a strong association between lithium levels and AKI is more credible and extends knowledge from a previous report. 12 , 25 In a 2018 evaluation 25 of almost 200 000 reports of possible drug-induced AKI from the US Food and Drug Administration Adverse Event Reporting System, 675 events were attributed to lithium, with a reporting odds ratio, a measure of reporting disproportionality, of 8.86 (95% CI, 8.15-9.64). Kirkham et al 12 selected 699 patients from the Norfolk database (2002-2013) to evaluate a possible association between short-term exposure to toxic lithium levels and rapid GFR decrease. They found that a single lithium level greater than 1 mmol/L was associated with a 3-month GFR decrease, compared with patients with lithium levels of 0.8 mmol/L or less. It is possible that repeat AKI episodes explain the subsequent CKD progression risk, perhaps in keeping with the histologic features of chronic tubulointerstitial nephropathy with focal segmental glomerulosclerosis. 4 Because AKI events may be unnoticed or not result in clinical diagnosis, 26 the evaluation of creatinine elevations according to current AKI classification systems is a strength of our study. 27

We also recognize a number of limitations to our study. Our study included people in Stockholm, and extrapolation to other health systems or to more ethnically diverse societies should be made cautiously. Valproate may not be a perfect comparator because it has broader indications than lithium, and we identified case reports of valproate-induced Fanconi syndrome. 28 Lithium measurements were not assessed at regular time points but by indication, and whether they were trough levels is not known. 29 We selected lithium toxicity thresholds a priori. In light of the results, examining lower thresholds and the exposure time above threshold calculated from interpolated data would be important in future work. We controlled for available covariates but cannot completely eliminate bias because of unmeasured or unknown confounding. Approximately 15% of patients in each group had at least 1 dispensation of the other drug; although this is a relatively low crossover, the effect of any crossover is to bias results toward the null. Our study cannot distinguish among different causal mechanisms; our findings could reflect low-level toxic effects manifesting in some patients or idiosyncratic rare events, such as the development of interstitial nephritis or glomerular disease. 4 , 29 In addition, the median duration of follow-up in our cohort is short relative to the natural history of lithium nephropathy and short compared with a life lived with bipolar disorder. Our results should be considered valid within a 10-year horizon, reflecting clinically prevalent patterns of lithium use during the period 2007 to 2018.

This cohort study provides, to our knowledge, the best estimates to date of the possible long-term effects of lithium therapy, supporting the hypothesis that longer duration may be a risk factor for CKD and identifying for the first time that high levels are a risk factor for AKI. However, we also found that absolute risks were low and propose that these risks need to be offset by considering the effectiveness and antisuicidal benefits of lithium. 2 These results inform starting, monitoring, and adjusting lithium therapy as recommended by guidelines and to avoid lithium toxicity. Further work is needed to understand how to manage those few patients who experience progression or new-onset CKD.

Accepted for Publication: May 13, 2023.

Published: July 7, 2023. doi:10.1001/jamanetworkopen.2023.22056

Corresponding Author: Juan Jesus Carrero, MPharm, PhD, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, 171 77 Stockholm, Sweden ( [email protected] ).

Author Contributions: Mr Bosi and Prof Carrero had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Bosi, Clase, Sjölander, Fu, Landén, Elinder, Carrero.

Acquisition, analysis, or interpretation of data: Bosi, Ceriani, Sjölander, Fu, Runesson, Chang, Landén, Bellocco, Carrero.

Drafting of the manuscript: Bosi, Clase, Ceriani, Sjölander, Runesson, Bellocco.

Critical revision of the manuscript for important intellectual content: Bosi, Clase, Sjölander, Fu, Runesson, Chang, Landén, Bellocco, Elinder, Carrero.

Statistical analysis: Bosi, Ceriani, Sjölander, Fu, Chang, Bellocco.

Obtained funding: Elinder, Carrero.

Administrative, technical, or material support: Bosi, Ceriani, Carrero.

Supervision: Clase, Sjölander, Runesson, Bellocco, Carrero.

Conflict of Interest Disclosures: Dr Clase reported receiving personal fees from the Ministry of Health Ontario and serving as the editor in chief of the Canadian Journal of Kidney Health and Disease outside the submitted work. Dr Fu reported receiving grants from the Netherlands Organization for Scientific Research during the conduct of the study. Dr Landén reported receiving grants from Swedish Research Council and the Swedish Brain Foundation during the conduct of the study and personal fees from Lundbeck Pharmaceuticals outside the submitted work. Prof Carrero reported receiving grants from AstraZeneca, ViforPharma, Novo Nordisk, Astellas, and Amgen outside the submitted work. No other disclosures were reported.

Funding/Support: The study was supported by grant 2019-01059 from the Swedish Research Council and the Martin Rind’s Foundation. Dr Fu is supported by a Rubicon grant from the Netherlands Organization for Scientific Research.

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Data Sharing Statement: See Supplement 2 .

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Main article content, effects of employees’ perception of performance appraisal fairness on job satisfaction, ewnetu tadesse, habtamu dadi, mesfin lemma.

This study investigates the effect employees’ perception of fairness in the performance appraisal system on job satisfaction of an employee. The perceived fairness in appraisal system is discussed with the help of organizational justice theory which was principally derived from Adam’s equity theory and used by many researchers in organizational research. The perception of fairness in performance appraisal system consists of three main factors: Distributive justice, procedural justice, interactional justice and are used as independent variables and job satisfaction of an employee as dependent variable. Using a random sample of 297 employees from a total of 1624 population the required data is obtained through structured questionnaires. Descriptive statistics, independent sample t-test, one way- ANOVA, correlation analysis and multiple regression analysis were performed. The independent sample t-test shows that there is significant difference between genders in fairness perception in performance appraisal system, however there is no significant difference between genders in distributive and procedural fairness perception. The one way- NOVA test shows that there is significant difference among work experience groups and age level groups, however no significant difference found among educational level groups. The descriptive finding of the study shows that in ASTU employees had low level of fairness perception towards the existing performance appraisal practice, and low level of job satisfaction. The correlation analysis result also indicates that distributive, procedural and interactional fairness in the appraisal system had positive and significant relationship with job satisfaction. Whereas the finding of multiple regression analysis indicates that distributive, procedural and interactional fairness in the appraisal system had positive and significant influence job satisfaction. The human resource management of the University should create organizational climate that enhance positive perception among employees regarding distributive, procedural, and interactive justices of performance appraisal more than ever.

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Do men really sleep better than women? Experts explain

Women and men sleep differently, so their sleep disorders shouldn’t be treated the same way, suggests new research that explores the biological sex characteristics of getting shut-eye.

Men are more likely to have obstructive sleep apnea , while women are more likely to experience insomnia and report lower sleep quality. These are among the findings of a literature review published in April in the journal Sleep Medicine Reviews . The researchers hailed from Harvard University, Stanford University, and the University of Southampton in the U.K.

This research is as much about precision medicine as it is sleep disparities between the sexes, says coauthor Renske Lok, PhD , a postdoctoral fellow at the Stanford Center for Sleep and Circadian Sciences .

“We’re trying to move away from the one size fits all,” she tells Fortune . “[Medicine] needs to be more tailored.”

Understanding how and why biological sex impacts various sleep disorders is a critical step toward individualized treatment. However, the long-standing lack of inclusion of women in biomedical and behavioral research is a hindrance. The National Institutes of Health didn’t require studies to account for sex as a biological variable until 2016.

“The biggest finding is that we absolutely have to do better in including women in our research designs,” Lok says. “Historically, women have not been included as much as men, in part because it was always assumed results from men would translate automatically to women. And we’re starting to find out more and more that this is not the case.”

Sex and circadian rhythm

The mental, physical, and behavioral changes your body experiences in a 24-hour period are called circadian rhythms . Almost all your organs and tissues have their own rhythms, and together they form a kind of master biological clock that’s particularly sensitive to light and dark.

At night, your brain produces more of the sleep hormone melatonin , which makes you feel tired. In one study reviewed by Lok and her colleagues, women secreted melatonin earlier in the evening than men. This aligns with other research showing men typically are later chronotypes; that is, they go to bed and wake up later than women. As such, men tend to have worse social jetlag, when their biological clock doesn’t align with the traditional timing of societal demands, like working a 9-5 job.

Another study showed that core body temperature—which is highest before sleep and lowest a few hours before waking—also peaked earlier in women. Other research found that women’s circadian periods were about six minutes shorter than men’s: 24.09 hours compared to 24.19.

“While this difference may be small, it is significant. The misalignment between the central body clock and the sleep/wake cycle is approximately five times larger in women than in men,” Lok said in a news release about her team’s work. “Imagine if someone’s watch was consistently running six minutes faster or slower. Over the course of days, weeks, and months, this difference can lead to a noticeable misalignment between the internal clock and external cues, such as light and darkness.

“Disruptions in circadian rhythms have been linked to various health problems, including sleep disorders , mood disorders , and impaired cognitive function . Even minor differences in circadian periods can have significant implications for overall health and well-being.”

Cognitive behavioral therapy is one option for getting your circadian rhythm on track—especially if your biological and social clocks don’t match up—says Alaina Tiani, PhD , a clinical psychologist at the Cleveland Clinic Sleep Disorders Center .

“It differs patient to patient, but we have them take melatonin (supplements) earlier in the evening and then we have them use some bright-light exposure in the morning,” Tiani tells Fortune , referring to night owls who need to wake earlier. “Those two things help anchor their sleep window as they’re working on shifting things.”

Man sleeping while wearing a CPAP mask for sleep apnea.

Work-life stress may influence women’s insomnia

You’ve likely experienced bouts of acute insomnia , stressful periods throughout your life when you’ve had difficulty falling asleep, staying asleep, or getting high-quality sleep. They may have lasted just days or as long as a few weeks. Chronic insomnia, though, is when you experience these sleep disruptions at least three times a week for more than three months, according to the National Heart, Lung, and Blood Institute . In addition, chronic insomnia can’t be explained by other health problems you may have.

Insomnia is about 1.5 times more common in women , previous research has shown. Lok and her colleagues theorized this may be due to certain risk factors more prevalent in women, such as anxiety and depression.

Dr. Eric Sklar is a neurologist and medical director of the Inova Sleep Disorders Program in northern Virginia. Insomnia is one of the most common sleep disorders he treats, and he was unsurprised by the review’s findings.

“There is a high correlation with underlying psychiatric disorders and insomnia,” Sklar tells Fortune . “Some of the underlying societal stressors for men and women may be different.”

Women still are often pigeonholed into the role of family caregiver, while also clawing their way up the career ladder, Sklar notes, not to mention fielding life’s other stressors . In addition, evening downtime is essential for healthy circadian rhythms and women sometimes have to fight harder for it, he says. And when so-called “revenge bedtime procrastination” involves screen time, women may be further disrupting their body clocks.

By some objective measures, women sleep better than men, the review shows. Women have higher sleep efficiency , which refers to the percentage of time in bed actually spent sleeping . Women entered the dream-heavy rapid eye movement (REM) phase of sleep earlier, and spent about eight minutes longer in non-REM sleep . However, women self-reported poorer sleep quality than men.

While new parents face a variety of sleep disruptions, Tiani tells Fortune a swath of her postpartum patients and women with young children report diminished sleep quality.

“Almost like their brain was half-listening out for their children in the middle of the night, in case they needed something,” Tiani says. Patients who are caregivers in other capacities have reported the same thing, “that listening out in the night.”

Why do men and women sleep differently?

Women did catch a break with one common sleep disorder: obstructive sleep apnea , when the upper airway becomes blocked repeatedly during sleep. The disorder is almost three times as common in men , however, it’s only associated with an increased risk of heart failure in women , the review noted.

“It is well known that men are at a higher risk,” Sklar tells Fortune , adding that biological sex is used in sleep apnea risk assessment. “Men tend to have larger necks, and neck size is also a risk factor.”

Lok’s review also noted these sleep differences between the sexes, among others:

Women 1.5–4 times more likely to have a sleep-related eating disorder
Women have 25–50% increased likelihood of restless legs syndrome
Women self-report more fluctuation in sleep quality
Men have less consistent rest-activity schedules
Men overeat more in response to sleep loss
Men night-shift workers at higher risk of Type 2 diabetes

One key factor remained inconsistent across the nearly 150 studies Lok and her colleagues analyzed: women’s menstrual phases. Menstruation correlates to numerous changes that impact sleep, such as elevated body temperature during the luteal phase of the cycle. What’s more, some research failed to consider subjects’ oral contraception usage, which may have skewed results.

“It’s tricky because, for example, if somebody doesn’t use hormonal contraceptives, it means that you have to include women at the same menstrual phase,” Lok tells Fortune . “Otherwise, you get all kinds of variation due to changes in hormonal levels.”

Having tackled some of the hurdles standing in her team’s way—namely, thin evidence of some biological sex differences—Lok is hopeful about future research.

In some instances, “we’re not sure if there are any sex differences because, simply, nobody has ever looked at it,” Lok says. “At the same time, it’s a very encouraging article because it definitely identifies where the gaps are still present.”

For more on biological sex and health:

Alcohol-fueled hospital visits are spiking among middle-aged women, study says: ‘We simply just don’t know what’s causing this’
Women may get more health benefits from regular exercise than men—even if they work out less
A 5-minute test can estimate your odds of developing breast cancer—but not if you’re biracial
Jill Biden announces a White House initiative focused on women’s health research: This ‘has been underfunded for decades’

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Dec 07, 2023 2530. An article is a nonfiction writing that forms an independent part of a publication like a journal. A journal is a collection of articles and is published periodically throughout the year. Examples would be the Journal of the American Medical Association or American Journal of Public Health. You would find articles in a journal.
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Differences across the lifespan between females and males in the top 20
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