Publishing in Medical Journals Richard Saitz MD, MPH Section of General Internal Medicine, BMC Professor of Medicine & Epidemiology, BUSM and BUSPH Associate Director, Office of Clinical Research Special thanks to Howard Bauchner, incoming JAMA editor, for connecting me with the BMJ Group and for sharing his talks and experience on this subject with me

My background in publishing As a researcher As a researcher –120 journal articles (not editorials, case reports, reviews of other articles) As a writer As a writer –Book chapters, books –Article summaries and comment (JW) As a peer reviewer As a peer reviewer –For several dozen journals NB easy to get started and good experience NB easy to get started and good experience

My background in publishing As an editor As an editor –Journal Watch (‘97-‘10) –Physicians’ First Watch (‘06-) Mass Med Soc Mass Med Soc –Alcohol, Other Drugs & Health (‘04-) –Principles of Addiction Medicine –Evidence-Based Medicine (‘10-) BMJ Group BMJ Group –Addiction Science & Clinical Practice (‘11-) BioMed Central BioMed Central

Why publish? Forces you to organize thoughts Forces you to organize thoughts Product worthy of publication Product worthy of publication To impact science To impact science To impact clinical care To impact clinical care Recognition and satisfaction Recognition and satisfaction Promotion Promotion

Publish what? Primary research article Primary research article Synthesis research article (systematic review, simulations) Synthesis research article (systematic review, simulations) Review article Review article Case report (and review) Case report (and review) Letter Letter

Choose the journal What is the journal aim? What do they usually publish? Ask a knowledgeable colleague… What is the journal aim? What do they usually publish? Ask a knowledgeable colleague… Is your paper of interest to their audience (generalist v. specialist)? Is your paper of interest to their audience (generalist v. specialist)? Journal prestige and impact? Journal prestige and impact? –Often cited in press? Web hits? Other impact? –Impact factor # citations this year/articles in prior 2 years # citations this year/articles in prior 2 years NEJM-47.05; Annals Int Med 16.2; JAIDS 4.21 NEJM-47.05; Annals Int Med 16.2; JAIDS 4.21 Open access journals Open access journals Should you aim high? Should you aim high? –Is your paper hot? Journal Finder JANE

Submitting Instructions. Follow them. For the correct paper type. They (e.g. word limits) apply to your paper. Instructions. Follow them. For the correct paper type. They (e.g. word limits) apply to your paper. Authorship Authorship The abstract The abstract Paper structure Paper structure Use reporting guidelines Use reporting guidelines –EQUATOR, CONSORT Writing style (clear, brief, consistent) Writing style (clear, brief, consistent) Caution re: plagiarism, duplicate publication Caution re: plagiarism, duplicate publication Proofread! Proofread! Reviewer suggestions Reviewer suggestions

Plagiarism and duplicate publication Plagiarism detectors Plagiarism detectors – – – –eTBLAST ( – –and the freeware which is listed in this Wikipedia article Editors search google, google scholar, CRISP/NIH Reporter, Medline, other databases. Editors search google, google scholar, CRISP/NIH Reporter, Medline, other databases.

Abstract and paper Abstract Abstract –A good one is critical. Structured. Clear. Concise. Minimize jargon and abbreviations. Conclusions related, in fact based on, results. Paper Paper –Introduction, methods, results, conclusions, references –Justify and state hypothesis/aim, method appropriate to aim, results related to aim, conclusions related to aim…

Rejection without review JAMA, BMJ – two-thirds JAMA, BMJ – two-thirds Why? Why? –Wrong journal/audience –Low impact –Not original –Methods fatally flawed/results don’t support conclusions –Bad abstract

Sent for review By associate editor (who can also reject) By associate editor (who can also reject) 1-3 reviewers, maybe statistical; from suggestions or lists or search 1-3 reviewers, maybe statistical; from suggestions or lists or search –takes 1-3 months –Blinded vs unblinded review Associate editor reviews and takes peer reviews into account Associate editor reviews and takes peer reviews into account Makes recommendation to editor or editorial board member panel Makes recommendation to editor or editorial board member panel

Decision: what is it? “We regret to inform you that your paper is not acceptable for publication in its present form.” “We regret to inform you that your paper is not acceptable for publication in its present form.” –A. Rejection –B. Revise and resubmit (major, minor) –C. Accepted with minor revision –D. Accepted

(major or minor) “Revise and Resubmit” Good news. Good news. No guarantee (revision may shed light on fatal flaws) No guarantee (revision may shed light on fatal flaws) Put the reviews in a drawer Put the reviews in a drawer Do what they ask…with grace—respectful disagreement iis fine but don’t argue Do what they ask…with grace—respectful disagreement iis fine but don’t argue Reviewers may disagree: editor guides, or you choose Reviewers may disagree: editor guides, or you choose Cover letter: Follow instructions (format) and answer every query Cover letter: Follow instructions (format) and answer every query Make changes in paper (long explanations not usually helpful) Make changes in paper (long explanations not usually helpful)

Acceptance You aren’t finished You aren’t finished Proofs-read carefully and return quickly (examples) Proofs-read carefully and return quickly (examples) Submission to PubMed Central (and review of formatting) Submission to PubMed Central (and review of formatting) Tell the press (respect embargo) Tell the press (respect embargo) Response to letters… Response to letters…

Rejection after review Consider major comments and revise Consider major comments and revise Appeals-not usually fruitful Appeals-not usually fruitful Submit elsewhere Submit elsewhere

Summary Publishing is a good thing Publishing is a good thing It involves art and science—best to get guidance from someone with experience who will invest time in your writing product It involves art and science—best to get guidance from someone with experience who will invest time in your writing product Journal articles take years (to do studies, and then to write numerous drafts and then requested revisions) Journal articles take years (to do studies, and then to write numerous drafts and then requested revisions) Try it! But don’t underestimate… Try it! But don’t underestimate…