The use of online supplements is increasing, 1 and standards have been published to guide their format, length, and appropriateness. 2,3 However, the value of supplements has been questioned. [4][5][6] We assessed whether research manuscripts with supplements have a higher likelihood of peer review, acceptance, and online use after publication than research manuscripts without supplements.Methods | This cohort study assessed the numbers and types of supplements with research manuscripts submitted between January 1 and December 31, 2016, to the 3 journals in The JAMA Network with the highest volume of research submissions: JAMA (general medical journal) and 2 specialty journals, JAMA Internal Medicine (JIM) and JAMA Pediatrics (JPED). Research manuscripts included randomized clinical trials (RCTs), meta-analyses, and other observational studies. Research Letters, which do not permit supplements, were excluded.We compared the rates of obtaining peer review and acceptance for manuscripts with and without supplements and analyzed the peer reviewer comments about the supplements. In addition, we evaluated all research articles and the numbers and types of supplements published in these journals between January 1 and December 31, 2016. We compared online use (views and downloads) of articles vs the supple-
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