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
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%.
Show the percentile table
| Percentile | Engagement rate |
|---|---|
| 10th percentile | 0.004% |
| 25th percentile | 0.024% |
| 50th percentile | 0.143% |
| 75th percentile | 0.677% |
| 90th percentile | 2.55% |
| 99th percentile | 82.4% |
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.
Show engagement by hour posted, utc as a table
| Hour (UTC) | Vs author median | Posts |
|---|---|---|
| 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 UTC | 0% | 116K |
| 22:00 UTC | -2% | 100K |
| 23:00 UTC | -1% | 90K |
Show engagement by day of week as a table
| Day | Vs author median | Posts |
|---|---|---|
| Sunday | +5% | 393K |
| Monday | +1% | 483K |
| Tuesday | -2% | 520K |
| Wednesday | -3% | 472K |
| Thursday | -2% | 430K |
| Friday | -3% | 447K |
| Saturday | +2% | 393K |
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.
| Format | This account | Catalog effect | 95% interval | Accounts behind it |
|---|---|---|---|---|
| Image or video | 100% of posts | +111% | +108% to +115% | 34K |
| Outbound link | 100% 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
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
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.