NEJM engagement report
@NEJM - 1.0M followers on X
Measured over 89 original posts from a 30-day window, last computed on August 31, 2026.
Engagement
A typical post picks up 70 interactions against 1.0M followers, an engagement rate of 0.007%. Measured over 89 original posts, its engagement rate beats 29% of 3,774 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 24K times each, and 0.298% of those impressions turn into an interaction. That is about 2.28% of the follower count, which is the gap between an audience on paper and an audience in a timeline. Posting runs at about 3.7 posts a day over the last 30 days, with activity on roughly 47% of days. Most posts go out around 21:00 UTC, and Sunday is the busiest day of the week. Of the 89 posts sampled, 99% carry an image or video and 100% link out. The account's strongest tracked post pulled 1.5K interactions, about 22x its own typical post. Recurring topics include #esccongress, #healthpolicy, #afib.
Measured over 89 original posts from a 30-day window, last computed on August 31, 2026. Recurring tags: #esccongress, #healthpolicy, #afib.
Compared with accounts its own size
NEJM's engagement rate beats 29% of the tracked X accounts closest to it in follower count (3,774 accounts, accounts of similar size (decile 9 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 23% 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 0.007%, NEJM sits above the 10th percentile of the 36,654 accounts in this comparison. That places it in the bottom 25% band, which runs below 0.012%.
Show the percentile table
| Percentile | Engagement rate |
|---|---|
| 10th percentile | 0.002% |
| 25th percentile | 0.012% |
| 50th percentile | 0.08% |
| 75th percentile | 0.433% |
| 90th percentile | 2.10% |
| 99th percentile | 160.5% |
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 Sunday 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% | 51K |
| 01:00 UTC | -2% | 52K |
| 02:00 UTC | -3% | 50K |
| 03:00 UTC | -4% | 53K |
| 04:00 UTC | -6% | 43K |
| 05:00 UTC | -4% | 42K |
| 06:00 UTC | -4% | 48K |
| 07:00 UTC | -5% | 52K |
| 08:00 UTC | -4% | 61K |
| 09:00 UTC | -3% | 70K |
| 10:00 UTC | -2% | 72K |
| 11:00 UTC | -3% | 78K |
| 12:00 UTC | -2% | 86K |
| 13:00 UTC | -2% | 94K |
| 14:00 UTC | -4% | 97K |
| 15:00 UTC | -2% | 101K |
| 16:00 UTC | -3% | 98K |
| 17:00 UTC | -2% | 91K |
| 18:00 UTC | -1% | 85K |
| 19:00 UTC | -1% | 80K |
| 20:00 UTC | -1% | 74K |
| 21:00 UTC | -1% | 66K |
| 22:00 UTC | -1% | 57K |
| 23:00 UTC | -2% | 52K |
Show engagement by day of week as a table
| Day | Vs author median | Posts |
|---|---|---|
| Sunday | +4% | 231K |
| Monday | 0% | 288K |
| Tuesday | -2% | 278K |
| Wednesday | -1% | 251K |
| Thursday | -1% | 245K |
| Friday | -3% | 253K |
| Saturday | +3% | 227K |
Best tweets
- Aug 26, 202622x 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
- Aug 20, 202614x 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
- Aug 29, 20268.6x 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
- Aug 29, 20268.5x their median
Presented at #ESCCongress: Among 16,808 adults without known cardiovascular disease, silent atherosclerosis was present in 57.1%, was detectable in early adulthood, and became more prevalent and extensive with age in a sex-dependent pattern. Full REACT trial results: https://t.co/KkNM5hC9RB @escardio
- Aug 6, 20268.3x their median
Leishmaniasis is a parasitic infection that is transmitted by sand flies and caused by multiple leishmania species, with different species capable of causing cutaneous, visceral, or mucosal forms of the disease. ๐ https://t.co/ezm9gi6ZM8 Cutaneous leishmaniasis usually manifests as slowly progressing nodules that can evolve to painless ulcers at the site of the sand-fly bite. Lesions can heal spontaneously or be treated with local cryotherapy or thermotherapy (such as a โhot metalโ), topical agents, or systemic therapy. In either case, they usually leave a residual scar. Cases can occur among family members who share the same environment and exposures. Certain species of leishmania can persist in a latent state after apparent resolution of cutaneous disease and can later lead to mucosal leishmaniasis. This manifestation is most commonly associated with, although not exclusive to, ๐๐ฆ๐ช๐ด๐ฉ๐ฎ๐ข๐ฏ๐ช๐ข ๐ฃ๐ณ๐ข๐ป๐ช๐ญ๐ช๐ฆ๐ฏ๐ด๐ช๐ด and other members of the viannia subgenus, which are endemic in parts of Latin America, particularly Bolivia, Brazil, and Peru (seen in figure). Because local therapies may not completely eradicate the parasite, systemic treatment is recommended for known or suspected cutaneous infections with these species in order to reduce the risk of subsequent mucosal disease. Mucosal leishmaniasis may occur concurrently or emerge months to decades after inadequately treated cutaneous infection. Learn more in โA 37-Year-Old Woman with Persistent Nasal Ulceration,โ a Case Record of the Massachusetts General Hospital (@MassGeneralNews), by Stacey T. Gray, MD, Carolina D. Geadas, MD, and Peter M. Sadow, MD, PhD: https://t.co/ezm9gi6ZM8
- Aug 29, 20268.1x their median
Presented at #ESCCongress: Among patients with STEMI, prasugrel monotherapy initiated before PCI was not noninferior to dual antiplatelet therapy with prasugrel plus aspirin for a composite of death, stroke, or myocardial infarction at 12 months. Full PREMIUM trial results: https://t.co/RPI2SAUh9X @escardio
- Aug 28, 20265.7x their median
Presented at #ESCCongress: In patients with atrial fibrillation and intermediate stroke risk, direct oral anticoagulation led to a lower risk of stroke, systemic embolism, major bleeding, or death from cardiovascular causes than no anticoagulation. Full SINGLE-AF trial results: https://t.co/rISG8pcl17 Editorial: Anticoagulation for Atrial Fibrillation with a Single Risk Factor for Stroke https://t.co/GvgayePOoC @escardio
- Aug 23, 20265.7x their median
Amanda Randles, PhD, describes the scientific foundations of two trials comparing how noninvasive and invasive assessments of fractional flow reserve affect clinical outcomes. Learn more about the science behind the study: https://t.co/dlHc78Brtv https://t.co/SlTWIMR5R5
- Aug 29, 20265.3x their median
Presented at #ESCCongress: In patients at high risk for ischemic events 12 months after implantation of a drug-eluting stent, clopidogrel monotherapy was noninferior to extended dual antiplatelet therapy for net adverse clinical events. Full A-CLOSE trial results: https://t.co/FgSg8SXpwU @escardio
- Aug 30, 20265.0x their median
Presented at #ESCCongress: In patients with severe tricuspid regurgitation and heart failure, transcatheter tricuspid-valve repair plus medical therapy was superior to medical therapy alone in reducing hospitalizations for heart failure and deaths. Full TRIC-I-HF trial results: https://t.co/zJpLtFsASP @escardio
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 70 interactions against 1.0M followers, an engagement rate of 0.007%. Measured over 89 original posts, its engagement rate beats 29% of 3,774 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 24K times each, and 0.298% of those impressions turn into an interaction. That is about 2.28% of the follower count, which is the gap between an audience on paper and an audience in a timeline. Posting runs at about 3.7 posts a day over the last 30 days, with activity on roughly 47% of days. Most posts go out around 21:00 UTC, and Sunday is the busiest day of the week. Of the 89 posts sampled, 99% carry an image or video and 100% link out. The account's strongest tracked post pulled 1.5K interactions, about 22x its own typical post. Recurring topics include #esccongress, #healthpolicy, #afib.
- What is NEJM's engagement rate on X?
- NEJM (@NEJM) has an engagement rate of 0.007%, based on the median interactions across 89 original posts from the last 30 days against 1,033,414 followers. Replies, reposts and quote-posts of other people are excluded from that sample.
- Is that a good engagement rate?
- At 0.007%, NEJM sits above the 10th percentile of the 36,654 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 29% of the tracked X accounts closest to it in follower count (3,774 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 Sunday is its busiest day, at roughly 3.67 posts per day across the measured window.