The process of submitting the manuscript and communicating with the journal will be reviewed. The factors considered by journal editors and reviewers in deciding to accept a manuscript will also be presented. Problems in submitting articles, the purpose and oddities of guidelines for authors, and how to respond to reviewers will all be described. Depending on the audience, differences between journals reporting basic and clinical research will be pointed out. This Webinar is based on Chapters 7 and 8 of your expert presenter’s book, How to Write, Publish, and Present in the Health Sciences. 5 Key Take-Aways: The importance of following the journal’s instructions for authors The criteria defining authorship, plagiarism, and duplicate publication Specific approaches to writing titles, abstracts, introductions, and discussions An understanding of the factors influencing a journal editor in accepting an article Awareness and location of reporting guidelines for evidence-based medicine

1. What Journal Editors Want You to
Know about Scientific Publishing
Tom Lang, MA
Tom Lang Communications and Training International

2. A presentation based on
How to Write, Publish, and Present
in the Health Sciences
Thomas A. Lang, MA
Foreword by Stan Lemeshow, PhD, MSPH
(American College of Physicians, 2010)
2

3. Questions for Consideration
• Do you know how to stop people from
reading a well written article?
• Where in your article you will usually
make the most mistakes?
• Do you know how scientific journals
are like television?
3

4. The First Secret
Before you start, ask “How will
medicine be different if I
answer my research
question?

5. The Second Secret
Write your article before
you do the research

6. The Third Secret
Follow the Journal’s
Instructions for Authors

7. Authorship
Purpose
• To give credit to those who did the
research
• To tell who is responsible for the
research (if things go wrong)
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8. Authorship should be based only on:
1) Important contributions to the
research process
2) Important contributions to writing
the article
3) Approving the final version of the
article (taking responsibility for the
research)
8

9. Authorship
All three conditions
must be met
Just getting grants, referring patients,
collecting data, or supervising the
research does not justify authorship
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10. Authorship
• List authors by their contributions to
the research, from most to least
• To protect themselves, authors
should decide who will be authors
and the order of authorship:
 Before starting the research
 Before starting to write the paper
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11. 11

12. Authorship
• Do not allow guest (“gift”) authors
who do not meet the criteria for
authorship:
 Senior researchers; directors
 Those providing only patients or
samples
 Famous people
12

13. Plagiarism
Plagiarism: taking credit for the written
or creative work of another
Science builds on the work of others,
so it is the intentional misattribution
of the work that is plagiarism, not
necessarily the use of the work itself
13

14. Plagiarism
• “Citation plagiarism” (or “citation
amnesia”): the failure to credit other
authors and thus implying that their
work is your own.
14

15. Scientific Journals
“The Journal was invented for the
relief of those either too indolent [lazy]
or too occupied to read whole books . .
. It is a means of satisfying curiosity
and becoming learned with little
trouble.”
Denis De Sallo, 1626–1669
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16. 16

17. What Journal Editors Want
Editors want to publish research that is:
New
True (valid)
Important
Clearly Reported
17

18. What Journal Editors Want
• Readership: what journals (and TV
stations) want: to sell an audience to
advertisers
• Leadership: being the first to break
the news: research that has not been
presented before (the Ingelfinger-
Relman rule)
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19. What Journal Editors Want
Manuscripts
prepared according
to the Instructions
for Authors!
19

20. Unexpected Instructions for Authors
• Do not use "we" or "our" or split
infinitives
• Number tables with Roman numerals
• Tables must fit on a half page
• Use no more than 5 abbreviations and
limit them to words used in titles

21. Mulford Library of the Medical College of
Ohio, Toledo; links to Instructions for
Authors for most biomedical journals
http://mulford.meduohio.edu/instr/
Uniform Requirements for Manuscripts
Submitted to Biomedical Journals
(The Vancouver Style) for formatting
references, among other topics
www.icmje.org/
21

22. Titles
Purpose
• To help readers find and decide
whether to read the full article
• To help readers NOT read the article
if it will NOT be of interest
22

23. Titles
• Most important part of the article!
 The part most often read
 Often the only part read
• Must stand alone: no abbreviations
• Keep short; most journals have
character limits for titles
23

24. Titles for Clinical Research
Articles: SPICED
Setting (location)
Patients (what was studied)
Intervention (treatment; exposure)
Comparator (control group)
Endpoint (outcome of interest)
Design (study design)
24

25. Original
A Randomized Trial of Low-Air-Loss
Beds for Treatment of Pressure Ulcers
[72 characters and spaces]
Revised
Low-Air-Loss Beds vs. Foam
Mattresses for Treating Pressure
Ulcers in Nursing Home Patients:
A Randomized Trial
[111 characters and spaces]
25

26. Subtitles can be Useful
A Cost-Benefit Analysis of Low-Air-
Loss Beds vs. Foam Mattresses for
Treating Pressure Ulcers in Nursing
Home Patients
Low-Air-Loss Beds vs. Foam
Mattresses for Treating Pressure
Ulcers in Nursing Home Patients: A
Cost-Benefit Analysis
26

27. Abstracts
Purpose
• To help readers find and decide
whether to read the full article
• To help readers NOT read the article if
it will not be of interest
27

28. Problems with Abstracts
Missing information
50% to 80% are missing information on
outcomes, study design, interventions,
or comparison groups, which readers
need to decide whether to read the full
article
28

29. Problems with Abstracts
Inconsistencies with full article
20% to 65% contain information
missing from, or inconsistent with,
information in the full article: authors,
sample sizes, results, conclusions
29

30. Introduction
Purpose
• To tell why the study was done
• To tell why the study is important
Suggestion: write a
four-part introduction
30

31. Original Introduction
The spiraled curve program was written
to compute the characteristics of a
spiraled circular curve. In addition to
those characteristics, the program will
also compute the deflection angles
required to set stakes at quarter stations
(every 25 feet) along the curve.
31

32. Revised Introduction
Spiraled curves accommodate the natural
driving path of the motorist and therefore
produce a more comfortable ride.
However, engineers have not used these
curves because of the difficulty in
calculating them. The spiraled curve
program easily computes these curves.
This memo explains how highway
engineers can use the spiraled curve
program to design a curve.
32

33. 1. Background statement: describe the
context of the problem and research
2. Problem statement: state the
problem and why it is important
3. Action statement: tell what was done
to study or solve the problem
4. Forecasting statement: tell readers
what they will find if they continue to
read the article
33

34. Revised Introduction
[1] Spiraled curves accommodate the
natural driving path of the motorist and
therefore produce a more comfortable ride.
[2] However, engineers have not used
these curves because of the difficulty in
calculating them. [3] The spiraled curve
program easily computes these curves.
[4] This memo explains how highway
engineers can use the spiraled curve
program to design a curve.
34

35. Part 1: Background Statement
“In patients with atherosclerotic
vascular disease, aspirin is
recommended to prevent myocardial
infarction and graft occlusion.”
35

36. Part 2: Problem Statement
“However, aspirin is also associated
with bleeding. Patients are often
asked to stop taking aspirin before
bronchoscopy, to reduce the risk of
bleeding. The effectiveness of this
practice has never been tested.”
36

37. Part 3: Action Statement
“Thus, we sought to determine whether
aspirin really does increase the risk of
bleeding after bronchoscopy.”
37

38. Part 4: Forecasting Statement
“We report here the results of a
randomized trial comparing the
number and severity of bleeding
events in patients undergoing
bronchoscopy who continued to take
aspirin with those who did not.”
38

39. Methods
Purpose
• To permit readers to judge the
validity of the study
• To permit others to replicate the
study (nice thought, but . . . )
39

40. Guidelines for Reporting Common
Research Designs
www.equator-network.org
CONSORT: randomized trials
STROBE: observational studies
TREND: nonrandomized studies

41. Measurements
• Science is measurement! Report
what, when, where, and why variables
were measured
• Report the precision, reliability, and
validity of measurements
• Report agreement among assessors
41

42. Results
Purpose
• To tell what happened during the study
• To present the findings of the study
• Explain any deviations from the study
as planned
• Prefer figures to tables to text
42

43. Results
• Provide a visual summary or “flow
chart” of the study to:
 Show the study design
 Indicate the flow of patients
through the study
 Account for all patients
 Make denominators easier to find
43

44. Patients
approached
n = 89
Patients
excluded
n=5
Patients
assigned
n = 84
Treatment Group Control Group
n = 43 n = 41
Complete healers Complete healers
P =0.03
n = 21 n=5

45. Discussion (Comment)
Purpose
• To explain the nature and importance
of the findings
• To explain how the results relate to
similar studies from the literature
45

46. Write a 7-Part Discussion
1 Summarize the study and the main
results
2 Interpret the results and suggest an
explanation for them
3 Compare the results with what else
is known about the problem; review
the literature
46

47. Write a 7-Part Discussion
4 Generalize the results other patients
or diseases if possible
5 Speculate on the implications of the
results on health care delivery
47

48. Write a 7-Part Discussion
6 Critique the study’s strengths and
limitations
• Larger sample?
• Longer follow-up time?
• More precise measurements?
• Substantial losses to followup?
• Weaker study design?
• Low agreement among assessors?

49. Write a 7-Part Discussion
6 Strengths and limitations the study
If they are not described:
• Did the author know about them?
• Were they being kept secret?
If they are described:
• The author did know about them
• There was no attempt to deceive
49

50. Write a 7-Part Discussion
7. Itemize the conclusions to make
them more specific
 Limited evidence supports relationships
between richer nurse staffing and lower rates
of needle-stick injuries and nurse burnout.
 The evidence neither confirms nor rules out
inverse relationships between nurse staffing
and the incidence of pneumonia and urinary
tract infections.
50

51. Conclusions
We conclude that Tamoxifen reduced the
incidence of DMH-induced colon cancer in
rats. We also showed that DMH induced the
expression of estrogen receptors in colonic
mucosa, but that the number of estrogen
receptors in the colonic mucosa was not
correlated with blood levels of estradiol,
polyamine, or ornithine decarboxylase.
Finally, we found no relationship between
blood levels of estradiol and tumor
incidence.
51

52. In conclusion, we found that:
• Tamoxifen reduced the incidence of
DMH-induced colon cancer in rats.
• DMH stimulated the expression of
estrogen receptors in colonic mucosa.
• Blood levels of estradiol, polyamine, or
ornithine decarboxylase were not
correlated with the number of
estrogen receptors in the mucosa.
• Tumor incidence was not related to blood
levels of estradiol.
52

53. Write a 7-Part Discussion
1 Summarize
2 Interpret
3 Compare
4 Generalize
5 Speculate
6 Critique
7 Itemize
53

54. Common Problems
• Not answering the research question
• Repeating the results rather than
discussing their implications
• Confusing fact with speculation
54

55. Common Problems
• Confusing statistical significance
with biological importance
Claiming to be the first to have done
something is considered poor form
55

56. References
Purpose
• To allow readers to verify authors’
claims and arguments
• Cite only necessary references
• Most mistakes in an article are in the
references
56

57. Lau J, Ioannidis JP, Balk E, Milch C, Terrin N, Chew
P, et al. Evaluating cardiac ischemia. Ann Emerg
Med. 2001;37(5):453-60. Review.
Lau, J.; Ioannidis, J.P.; Balk, E.; Milch, C.; Terrin, N.;
Chew, P.; et al. Ann. Emerg. Med. 2001, 37, 453-60.
J. Lau, J.P. Ioannidis, E. Balk, C. Milch, N. Terrin, P.
Chew, D. Salem, “Evaluating cardiac ischemia,”
Annals of Emergency Medicine, vol. 37, pp. 453-460,
2001.5757
Joseph Lau, John P. Ioannidis, Ethan Balk, Cathy
Milch, Phyllis Chew, and D. Salem. Ann. Emerg.
Med. 37, 453 (2001)

58. The Secret to Successful
Scientific Publishing
Have something to say.
Say it.
Stop.
58

59. How To Report Statistics in Medicine:
Annotated Guidelines for Authors,
Editors, and Reviewers
Thomas A. Lang, MA
Michelle Secic, MS
Foreword by Ed Huth, MD, MACP
(American College of Physicians,
second edition, 2006)
59

60. Tom Lang, MA
Tom Lang Communications &
Training International
10003 NE 115th Lane, Kirkland, WA 98033
tomlangcom@aol.com • 425-636-8500
www.TomLangCommunications.Com
60