Scientific Writing: Getting Started Arash Etemadi, MD PhD Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences

Why Publish? contributes knowledge ensures scientific rigor allows feedback (improves work) Promotes career document productivity document impact on field/reputation Advertises your lab for future trainees improves chances of funding fulfills an obligation (public monies)

Evaluating a CV - Paper Emphasis number of papers rate of publication quality of journals length of papers position in list of authors focus

Publish or Perish!

TUMS workshops on scientific writing Level 1: Basics Level 2: Focus on international publications Level 3: Practice in writing

An overview

The traditional IMRaD Introduction Methods Results Discussion

Introduction: Why did you start? Methods: What did you do? Results:What did you find? Discussion: What does it all mean?

A full paper consists of: Title Authors and Affiliation Abstract Introduction Methods Results Discussion Acknowledgments (optional) References Title Authors and Affiliation Abstract Introduction Methods Results Discussion Acknowledgments (optional) References

How to write a paper Most papers are not that exceptional Good writing makes significant difference Better to say little clearly, than saying too much unclearly

Types of Medical articles Editorial Original Article Review Article Short Communication (short papers) Case Reports Letter to Editor Personal Views

Letter Stick to the point State the problem, issue or hypothesis Give the context Outline your comment, solution, viewpoint Give a strong conclusion Note limitations

Editorial Write for your readership (broad?) Be controversial and thought provoking Being subtle is often more powerful

Short communication Increasingly common Concise introduction Present data and discuss it shortly Only a few tables or figures Number of words limitations

Is your paper a paper, a brief or a research letter? Easier to get letters & briefs accepted (space). They are indexed! Decide whether you should submit it as a brief or letter

Case Reports Medical history of a single patient in a story form. Lots of information given which may not be seen in a trial or a survey. Often written and published fast compared to studies e.g. Thalidomide

Secondary Studies

The Hierarchy of Evidence 1.Systematic reviews & meta-analyses 2.Randomised controlled trials 3.Cohort studies 4.Case-control studies 5.Cross sectional surveys 6.Case reports 7.Expert opinion 8.Anecdotal

Start Here!

Planning the study Identifies the problem Formulates the hypothesis Thinks about the design of the study

Design of the study Involve a methodologist Study type Sample size Interventions Outcomes Ethics

Politics first!

Authorship Decide on authors, and their order, as early as possible Preferably before starting the project Authors should only include those who made substantive intellectual contribution to the project reported, and can defend the data and conclusions publicly.

Authorship credit should be based on 1) substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data; 2) drafting the article or revising it critically for important intellectual content; and 3) final approval of the version to be published. Authors should meet conditions 1, 2, and 3.

Choosing a journal Choose an appropriate journal (not always the most prestigious). Check which journals have an interest in the particular topic. This will probably be apparent from the references you have already read in the field, but sometimes editorials identify topics that the journal would like to cover more deeply. Diabetes Care vs. Diabetologia vs. Diabetic Medicine

How do I decide where to publish? Is it the right area? Is my paper appropriate to the journal? Does it reach the right audience?

Publishing in good journals

Read a few recent papers from that journal for ideas of the style of the papers. Are they provocative? Or are they Short and pithy? Or long and detailed? Importantly… Read and follow the journal’s instructions.

What else should I check? The editor and their reputation The speed of publication – how long will it take to publish my paper? Links to societies Coverage in A&I databases

Target your paper at a particular journal Familiarise yourself thoroughly with potential journals what sort of papers do they publish? (original articles, briefs, reviews, commentaries, iconoclastic pieces?) What is the “culture” of the journal? National or international focus? Write for that journal

The editorial process

Editorial decision 1. Accepted as it is (rare) 2. Accepted on the condition of certain amendments (back to cycle) 3. Reconsidered if reviewers’ comments met (back to cycle) 4. Rejected

Rejection rate: 15% (pay journals) to 60% (specialist journals) to 90% (NEJM, The Lancet) How long does it take? (Choice of journal) BMJ: 70 days JAMA: 117 days Iranian journals?

RULES OF THUMBS bad research is almost always rejected sensational research usually accepted - even if badly written BUT most papers are neither: in gray zone

Questions journals ask Is the research question important? Is it interesting to our readers? Is it valid? A scientifically sound study.

What editors look for Short, clear, precise title Good abstract Good design and methods Clear conclusions Brevity Follow instructions

What reviewers look for Good design and methods Simple tables and figures Logical organisation Brevity Balance Appropriate statistics Their papers

What reviewers look for Good design and methods Simple tables and figures Logical organisation Brevity Balance Appropriate statistics Their papers

1. Design well 2. Decide politics 3. Choose journal 4. Read instructions to authors/papers 5. Set framework 6. Prepare drafts 7. Distribute 8. Polish 9. Submit

Order of writing? 1. Results 2. Methods 3. Introduction 4. Discussion 5. Abstract 6. References

Order of writing? 1. Methods 2. Results 3. Introduction 4. Discussion 5. Abstract 6. References

More reading Hall GM, ed. How to write a paper. London: BMJ Publishing Group. Peat J. Scientific Writing Easy when you know how. BMJ Publishing Group The Vancouver Group. Uniform requirements for manuscripts submitted to biomedial journals.

Title First thing that readers and editors see and read. Key elements that advertises the paper’s contents Informative and Specific Maybe helpful to choose the title when the paper is complete

Title Short and simple State subject, not conclusion Include study design Include time and place if necessary Begin with a keyword Avoid abbreviations Remove empty phrases such as “ A study of…” Use Subtitles (notice number of words) “Exercise and Coronary Heart Disease: Framingham Offspring Study”

Introduction General, concise description of problem background to the work previous research where that work is deficient how your research will be better State the hypothesis

Inverted pyramid Oxidative stress plays an important role in.... When LDL particles are oxidized... Antioxidants are important......Paraoxonase...

Don’t make it a review article Don’t put down every all previous studies Don’t explain pathophysiology irrelevant to your study Define specialized terms or abbreviations you want to use Introduction

Methods Allows reader to judge the quality of the work Identifies weaknesses Allows repetition of the study State the study design

Methods WWWWWH Define variables Patient inclusion Dates Randomisation Ethics/ consent Treatments Outcomes and endpoints Statistical methods power

METHODS Provide Details Enough to permit replication; or to assess validity of findings; quality of study Tell the story: “To assess xyz, we did the hoodgie-wadjie procedure, using Blatz technique (3)” if new measures or procedures, describe in detail in appendix, or from authors

A note on ethics A legal obligation Most editors refuse to publish without approval by IRB Consents: informed/oral

Check list for title Does the title reflect the topic? Is the tone objective? Are special features mentioned?

Check list for Introduction Is it clear why you did the study? How does your study add to knowledge? Is criticism justified and gentle? What can be left out?

Check list for Methods (1) Study design mentioned? Who, what, where, why, how, when? Inclusion/exclusion criteria? (chrono)logical order? Measurements appropriate? justified? detailed? referenced?

Check list for Methods (2) Sample size justified? Transformations and stats analyses clear? Any special features? New techniques validated properly?

Check list for Methods (3) Could the reader reproduce your study from the details provided?

Results Be enthusiastic Be logical Provide numbers and variability

Results Simplecomplex Describe the population Establish how comparable your groups were Use a mixture of text, tables and figures Mention units of measurement Mention what numbers, brackets, etc. refer to 9+4, 854 (12.3) Bring and explain P values

Results Provide only enough interpretation to lead the reader from one experiment to the other Avoid lengthy analysis and comparison to the work of others No need to follow chronology of study Rather, provide a logical progression and tell a story

Results “Stand alone” tables Make sure totals add to 100% Do not repeat the Tables and Figures in text Summarize: eg, there were no significant associations… Describe: eg there was a three fold increase in the risk of..

Tables and Figures Title text - brief Convey max. amount of information Placed and punctuated uniformly Legend Fully self -explanatory Tables and figures must be mentioned at least once in the body of the text Explain abbreviations as footnotes

Figures Professionally produced Clearly labelled axes, lines etc Informative legend Appropriate plots

Figure 1. Effect of total alkaloid fraction of methanolic extract on mean survival time

Figure 1. Effect of total alkaloid fraction of methanolic extract of unripe fruit of Solanum pseudocapsicum on mean survival time (MST) in tumor bearing mice

Check list for Results Baseline data provided? Primary and other endpoints clear and complete? Does the text complement figures and tables? Are measures of uncertainty mentioned? (SD, SE, CI)

Discussion Arash Etemadi, MD PhD Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences

Function what was already known 1. To interpret your results in light of what was already known about the subject of the investigation. 2. To explain our new understanding of the problem after taking your results into consideration.

1.Do your results provide answers to your testable hypotheses? If so, how do youinterpret your findings? If so, how do you interpret your findings?

2.Do your findings agree with what others have shown? If not, do they suggest an alternative explanation or perhaps a unforeseen design flaw in your experiment (or theirs?)

3.Given your conclusions, what is our new understanding of the problem you investigated and outlined in the Introduction? 3.Given your conclusions, what is our new understanding of the problem you investigated and outlined in the Introduction?

4. Explain weaknesses, shortcomings. Be fair: this will build trust. Don’t over-criticize yourself, don’t go to unnecessary details.

5. If warranted, what would be the next step in your study, e.g., what experiments would you do next?

Discussion Reverse of Introduction (pyramid)

1. Organize the Discussion to address each of the experiments or studies for which you presented results. 2. discuss each in the same sequence as presented in the Results, providing your interpretation of what they mean in the larger context of the problem.

Do not waste entire sentences restating your results; if you need to remind the reader of the result to be discussed, use "bridge sentences" that relate the result to the interpretation: "The slow response of the lead- exposed neurons relative to controls suggests that...[interpretation]".

Do not introduce new results in the Discussion Although you might occasionally include in this section tables and figures which help explain something you are discussing, they must not contain new data (from your study) that should have been presented earlier.

Allowed Tablets and Figures in the Discussion 1. Flow diagrams 2. Accumulation of data from the literature, 3. Or, something that shows how one type of data leads to or correlates with another, etc.

Abstract Summarizes the major findings in the broad context of the work Consists of two or three sentences of topic introduction Selected results (not all but the most important) Concludes with implications of work

Check list for Abstract Background, methods, results, discussion? Key features mentioned? Anything that does not appear in full text? Results in words? Conclusion: justified? objective? Meaningful interpretation Follows the guidelines

References Appropriate format Don’t over self-cite Avoid conference abstracts Select carefully — balance authors used Only 1 or 2 references per point Use recent review articles Avoid textbooks

APA Style Now is the time for all good men to come to the aid of their country.(Alpay & Russell, 2002) Four score and seven years ago our forefathers brought forth a new nation conceived in liberty and dedicated to the proposition that all men are created equal.(Balen & Jewesson, 2004) References Alpay, L., & Russell, A. (2002). Information technology training in primary care: the nurses' voice. Comput Inform Nurs, 20(4), Balen, R. M., & Jewesson, P. J. (2004). Pharmacist computer skills and needs assessment survey. J Med Internet Res, 6(1), e11.

“Vancouver” Style Now is the time for all good men to come to the aid of their country. 1 Four score and seven years ago our forefathers brought forth a new nation conceived in liberty and dedicated to the proposition that all men are created equal. 2 References 1.Alpay L, Russell A. Information technology training in primary care: the nurses' voice. Comput Inform Nurs. 2002;20(4): Balen RM, Jewesson PJ. Pharmacist computer skills and needs assessment survey. J Med Internet Res. Mar ;6(1):e11.

معاهدة تهران شرايط مطلوب مقالات ارسالي براي نشريات علوم پزشكي ايران

Now is the time for all good men to come to the aid of their country. (citation) References - Bibliographic citation - Now is the time for all good men to come to the aid of their country. (citation) References - Bibliographic citation - Research Paper Stack of References: Journal articles Book chapters Web sites Monographs Endnote Library of References

POLISH revise, revise, and revise for: accuracy, brevity, clarity, grace accuracy: spelling, figures differ in tables and text; too many decimals brevity: empty phrases and words; excessive weak verbs and connectives clarity: first person; basic grammar grace: choice of words; vary sentences