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As publications are the principal method of distributing research, journal editors serve as the gatekeepers of emerging knowledge. Here, we provide a “case–control study” to examine the role of editorial bias in the New England Journal of Medicine, a major medical journal, by investigating author demographics of case reports that are either under editorial or meritorious selection. Our results indicate that editorial bias promoting the publication of authors from select high performance countries is declining, although there is increasing editorial preference for university-based authors. These findings are relevant to efforts aiming to increase transparency in scientific publishing.