The Lancet engagement report

Compared with accounts its own size

The Lancet's engagement rate beats 25% of the tracked X accounts closest to it in follower count (21,185 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 18% 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 0.005%, The Lancet sits above the 10th percentile of the 213,098 accounts in this comparison. That places it in the bottom 25% band, which runs below 0.025%.

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 11:00 UTC, and Friday 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.

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.

• 80% 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.
• 98% 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 249 characters, which falls in the 180 - 280 characters band. Across the catalog, posts of 180 to 280 characters match the same accounts' other posts almost exactly.

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.

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.

Reading these numbers

A typical post picks up 36 interactions against 766K followers, an engagement rate of 0.005%. Measured over 54 original posts, its engagement rate beats 25% of 21,185 tracked accounts of a similar size. That is a reason to look at how the audience behaves - reply depth, saves, whether the followers are recent - rather than a conclusion about it on its own. Posts are seen about 14K times each, and 0.259% of those impressions turn into an interaction. That is about 1.82% of the follower count, which is the gap between an audience on paper and an audience in a timeline. Posting runs at about 2.3 posts a day over the last 30 days, with activity on almost every day in the window. Most posts go out around 11:00 UTC, and Friday is the busiest day of the week. Of the 54 posts sampled, 80% carry an image or video, 11% are part of a thread and 98% link out. The account's strongest tracked post pulled 949 interactions, about 26x its own typical post. Recurring topics include #esccongress, #worldalzheimersday, #eano2026.

What is The Lancet's engagement rate on X?

The Lancet (@TheLancet) has an engagement rate of 0.005%, based on the median interactions across 54 original posts from the last 30 days against 766,202 followers. Replies, reposts and quote-posts of other people are excluded from that sample.

Is that a good engagement rate?

At 0.005%, The Lancet sits above the 10th percentile of the 213,098 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 @TheLancet have real engagement?

Its engagement rate beats 25% of the tracked X accounts closest to it in follower count (21,185 accounts), which puts it in the bottom quarter for its size 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 @TheLancet post?

Most posts go out around 11:00 UTC, and Friday is its busiest day, at roughly 2.27 posts per day across the measured window.