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NEJM engagement report

@NEJM - 1.0M followers on X

Measured over 226 original posts from a 30-day window, last computed on October 25, 2026.

Engagement

Middle of its size range
Per follower
0.006%
of 1.0M followers
Per impression
0.355%
17K views on a typical post
Reach
1.65%
of its followers see a post
Typical post
61
interactions (median)
Saved
0.058%
10 bookmarks on a typical post
Posting rate
8.07/day
active 103% of days
Peak time
21:00 UTC
Wednesday

A typical post picks up 61 interactions against 1.0M followers, an engagement rate of 0.006%. Measured over 226 original posts, its engagement rate beats 27% of 20,444 tracked accounts of a similar size, which puts it in the middle of its size range rather than at either end. Posts are seen about 17K times each, and 0.355% of those impressions turn into an interaction. That is about 1.65% of the follower count, which is the gap between an audience on paper and an audience in a timeline. Posting runs at about 8.1 posts a day over the last 30 days, with activity on almost every day in the window. Most posts go out around 21:00 UTC, and Wednesday is the busiest day of the week. Of the 226 posts sampled, 100% carry an image or video and 100% link out. The account's strongest tracked post pulled 1.5K interactions, about 25x its own typical post. Recurring topics include #esmo26, #globalhealth, #healthpolicy.

Measured over 226 original posts from a 30-day window, last computed on October 25, 2026. Recurring tags: #esmo26, #globalhealth, #healthpolicy.

Compared with accounts its own size

NEJM's engagement rate beats 27% of the tracked X accounts closest to it in follower count (20,444 accounts, accounts of similar size (decile 10 of 10)). A percentile is spread evenly by construction, so 50 really is the middle of that group and 90 really is its top tenth.

On engagement per impression rather than per follower it beats 24% of the same group. When those two numbers disagree, the gap is about how far its posts travel rather than how people react to them.

Where this sits in the catalog

At 0.006%, NEJM sits above the 10th percentile of the 204,694 accounts in this comparison. That places it in the bottom 25% band, which runs below 0.024%.

p100.004%
p250.024%
p50 (median)0.143%
p750.677%
p902.55%
p9982.4%
Engagement rate as a share of followers, across the 204,694 accounts we have scanned enough to measure. The axis is logarithmic, because the top and bottom of this population are about 22,880 times apart and a linear axis would flatten everything below the median into a single point.
Show the percentile table
Engagement rate percentiles
PercentileEngagement rate
10th percentile0.004%
25th percentile0.024%
50th percentile0.143%
75th percentile0.677%
90th percentile2.55%
99th percentile82.4%

This ruler is the whole measured catalog, not a size-matched group: it shows where the raw rate falls across every account we can measure, all of which are large. For a like-for-like comparison, read the size-band percentile above instead. See how the bands are built

Posting timing

This account posts most often around 21:00 UTC, and Wednesday is its busiest day of the week. The bars below are the catalog-wide pattern, with this account's own busiest slot marked. They do not show how this account performs at each hour: we keep one aggregate per account, not one per hour, so that measurement does not exist in our data.

Engagement by hour posted, UTCTwenty-four bars, one per UTC hour. Each bar shows how posts published in that hour compare with their own authors' median engagement. Bars above the centre line ran higher than the median, bars below ran lower. A marker flags Busiest hour: 21:00 UTC.
0003060912151821
Above the authors' own mediansBelowScale: plus or minus 111%Busiest hour: 21:00 UTC
Show engagement by hour posted, utc as a table
Engagement by hour posted, UTC
Hour (UTC)Vs author medianPosts
00:00 UTC-1%89K
01:00 UTC-2%90K
02:00 UTC-3%88K
03:00 UTC-4%94K
04:00 UTC-5%76K
05:00 UTC-4%75K
06:00 UTC-5%86K
07:00 UTC-5%93K
08:00 UTC-4%108K
09:00 UTC-4%124K
10:00 UTC-3%129K
11:00 UTC-3%141K
12:00 UTC-3%154K
13:00 UTC-3%167K
14:00 UTC-4%173K
15:00 UTC-2%176K
16:00 UTC-3%171K
17:00 UTC-3%159K
18:00 UTC-2%149K
19:00 UTC-2%141K
20:00 UTC-1%131K
21:00 UTC0%116K
22:00 UTC-2%100K
23:00 UTC-1%90K
Engagement by day of weekSeven bars, one per weekday, Sunday first. Each bar shows how posts published on that day compare with their own authors' median engagement. Bars above the centre line ran higher than the median, bars below ran lower. A marker flags Busiest day: Wednesday.
SunMonTueWedThuFriSat
Above the authors' own mediansBelowScale: plus or minus 111%Busiest day: Wednesday
Show engagement by day of week as a table
Engagement by day of week
DayVs author medianPosts
Sunday+5%393K
Monday+1%483K
Tuesday-2%520K
Wednesday-3%472K
Thursday-2%430K
Friday-3%447K
Saturday+2%393K
See what moves engagement across the whole catalogWhat counts as a good engagement rate at this size

Formats this account uses

Its own posting mix on the left, and what each of those formats does across every account we track on the right. Only formats where the effect clears our publish test appear here, so an empty row is a format we could not measure rather than one that does nothing.

This account's posting mix compared with catalog-wide effects
FormatThis accountCatalog effect95% intervalAccounts behind it
Image or video100% of posts+111%+108% to +115%34K
Outbound link100% of posts-41%-42% to -40%32K
Typical length-+15%+14% to +16%32K
  • 100% of this account's sampled posts carry an image or video. Across the catalog, posts with an image or video run 111% above the same accounts' other posts.
  • 100% of its posts carry a link off X. Across the catalog, posts with an outbound link run 41% below the same accounts' other posts, so a large share of this account's output sits in the weakest bucket we measure.
  • Its average post runs 318 characters, which falls in the over 280 characters band. Across the catalog, posts over 280 characters run 15% above the same accounts' other posts.

These are catalog-wide differences applied to this account's own posting mix, not a measurement of how each format performs for this account specifically. We keep one median per account, not one per format per account, so the second thing is not something this data can tell you.

Best tweets

  • Aug 26, 202625x their median

    GLP-1 receptor agonists are increasingly used to treat type 2 diabetes and obesity, and trials have shown reductions in cardiovascular risk and slowing of kidney failure. Adverse events are mostly gastrointestinal. Read the full review: https://t.co/UtAuMkPelr https://t.co/ZmkwPHINAx

    1.2K3598974K viewsView on X
  • Sep 29, 202624x their median

    In the phase 3 TRIUMPH-1 trial involving patients with obesity, retatrutide, a triple hormone receptor agonist, resulted in substantial weight reduction and a decrease in knee osteoarthritis pain and obstructive sleep apnea events. Full trial results: https://t.co/kzuY57bUTX https://t.co/QtAfSu5MnX

    1.1K26226112415K viewsView on X
  • Oct 14, 202622x their median

    A new Clinical Practice article summarizes the assessment and treatment of adult attention deficit–hyperactivity disorder, with an emphasis on common psychiatric and medical coexisting conditions and combined pharmacologic and psychosocial care. Read “Adult Attention Deficit–Hyperactivity Disorder” by Jan K. Buitelaar, MD, PhD, and Jeffrey H. Newcorn, MD: https://t.co/g3BLDSKOW0

    1.0K289101474K viewsView on X
  • Oct 21, 202616x their median

    The discovery of 𝘏. 𝘱𝘺𝘭𝘰𝘳𝘪 has advanced the prevention and treatment of gastritis, peptic ulcers, and gastric cancer. Progress has been made in the research of 𝘏. 𝘱𝘺𝘭𝘰𝘳𝘪 infection. These advances are discussed in a new review. Read the Review Article “𝘏𝘦𝘭𝘪𝘤𝘰𝘣𝘢𝘤𝘵𝘦𝘳 𝘱𝘺𝘭𝘰𝘳𝘪 Infection — Advances, Challenges, and the Road Ahead” by Hong Li, MD, PhD, Francis Megraud, MD, and Barry J. Marshall, MD: https://t.co/rMlsoi2ATy

    7552308736K viewsView on X
  • Aug 20, 202616x their median

    Endoscopy in a 44-year-old man with a 4-year history of choking episodes while eating revealed luminal narrowing of the upper esophagus by a pulsating, cordlike structure (arrow) in the posterior wall of the esophagus. Full case details: https://t.co/PHfaGs3NvN https://t.co/qZ9JHO6L5K

    845603841.1M viewsView on X
  • Oct 7, 202613x their median

    Karl Deisseroth, MD, PhD, winner of the Nobel Prize in Physiology or Medicine 2026, describes the science behind a study of intravitreal delivery of an AAV vector encoding a light-gated ion channel in 10 blind patients with advanced retinitis pigmentosa. Read the editorial “Optogenetics in Sight”: https://t.co/efK5Hs2igp

    6032026337K viewsView on X
  • Sep 7, 202611x their median

    A video shows a patient with progressive multiple sclerosis attempting to walk before and after treatment with JY231, an off-the-shelf lentiviral vector designed for the direct in vivo engineering of CD19-targeted CAR T cells. Learn more in the preliminary results of a phase 1 trial: https://t.co/EeOVDi7GkW

    559115178108K viewsView on X
  • Aug 29, 202611x their median

    Presented at #ESCCongress: In older adults without cardiovascular disease, treatment with atorvastatin led to a lower risk of major cardiovascular events than placebo at a median of 5.9 years but did not result in longer disability-free survival. Full STAREE trial results: https://t.co/LLJtTGssg8 @escardio

    4691701837259K viewsView on X
  • Sep 11, 202610x their median

    A 3-year-old boy with chemotherapy-resistant metastatic hepatoblastoma had complete regression lasting at least 12 months after two infusions of glypican-3–specific CAR T cells coexpressing interleukin-15 and interleukin-21. Read the full correspondence: https://t.co/mygBCinUZq https://t.co/IN1T71BWYP

    4941051521146K viewsView on X
  • Oct 24, 202610x their median

    Presented at #ESMO26: In a prespecified interim analysis of a phase 3 trial involving patients with extensive-stage SCLC, the median overall survival was 21.1 months with tarlatamab–durvalumab maintenance therapy and 12.7 months with durvalumab alone. Full DeLLphi-305 trial results: https://t.co/9dEqH6apj2 @myESMO

    44213682852K viewsView on X

Ranked by total interactions across everything we have tracked for this account, which is a longer history than the 30-day window the rates above use. The multiple compares each post to this account's own median.

Recurring topics

#esmo26#globalhealth#healthpolicy#kidneywk#infectiousdisease

The most frequent hashtags in the sampled posts. They describe what this account writes about; they are not a performance signal, and the catalog-wide breakdown on the hub shows how little hashtag count moves.

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Reading these numbers

A typical post picks up 61 interactions against 1.0M followers, an engagement rate of 0.006%. Measured over 226 original posts, its engagement rate beats 27% of 20,444 tracked accounts of a similar size, which puts it in the middle of its size range rather than at either end. Posts are seen about 17K times each, and 0.355% of those impressions turn into an interaction. That is about 1.65% of the follower count, which is the gap between an audience on paper and an audience in a timeline. Posting runs at about 8.1 posts a day over the last 30 days, with activity on almost every day in the window. Most posts go out around 21:00 UTC, and Wednesday is the busiest day of the week. Of the 226 posts sampled, 100% carry an image or video and 100% link out. The account's strongest tracked post pulled 1.5K interactions, about 25x its own typical post. Recurring topics include #esmo26, #globalhealth, #healthpolicy.

What is NEJM's engagement rate on X?
NEJM (@NEJM) has an engagement rate of 0.006%, based on the median interactions across 226 original posts from the last 30 days against 1,042,312 followers. Replies, reposts and quote-posts of other people are excluded from that sample.
Is that a good engagement rate?
At 0.006%, NEJM sits above the 10th percentile of the 204,694 accounts in this comparison. Those comparison accounts are all large ones, because our scanning cadence is weighted towards big accounts, so this is a ranking among peers of similar scale rather than a ranking across X.
Does @NEJM have real engagement?
Its engagement rate beats 27% of the tracked X accounts closest to it in follower count (20,444 accounts), which puts it in the middle of its size range group. Ranking inside a size band matters because engagement rate falls as accounts grow, so a raw rate would mostly re-measure the follower count. It is a starting point for a look at follower quality, not a verdict on it.
When does @NEJM post?
Most posts go out around 21:00 UTC, and Wednesday is its busiest day, at roughly 8.07 posts per day across the measured window.

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