Corso di clinical writing

What to expect today? Core modules IntroductionIntroduction Correction of abstracts submitted by participantsCorrection of abstracts submitted by participants Practical session 2 – Abstract draftingPractical session 2 – Abstract drafting Results draftingResults drafting Discussion draftingDiscussion drafting Tables and Figures draftingTables and Figures drafting Peer review and publicationPeer review and publication Synthetic example – database creation, analysis and Results draftingSynthetic example – database creation, analysis and Results drafting

Tables  Tables are useful, especially to clarify important points for the busy reader  Try to lump similar data together  Do not replicate in the text but a few numbers that you have reported in the Tables  May be subdivided in: -Baseline (or Patient) characteristics -Lesion and procedural characteristics -Outcomes -Additional (eg multivariable) analyses

Tables

Tables O’Brien et al, Ann Intern Med 2006

Tables Ceelen et al, Ann Surg 2003

Tables

Tables

Tables

Tables Schneider et al, AJS 2008

Figures  Figures are also useful, especially to clarify important points for the busy reader  In many cases the figures help you document that what you say you did is true (eg angiograms, microscopy, etc.)  Remember that they should be professionally prepared  Bear in mind that color figures may be expensive!

Figures O’Brien et al, Ann Intern Med 2006

Figures Visser et al, AJS 2008

Figures Miyoshi et al, Surg 2005

Figures Miyoshi et al, Surg 2005

Figures Lough et al, AJS 2008

Figures Lough et al, AJS 2008

Figures O’Brien et al, Ann Intern Med 2006

Figures Kukkonen et al, EJVES 2006

Figures Silva et al, CCI 2004

Figures Suter et al, Ann Surg 2005

Figures Ng et al, BJS 2006 WHAT ABOUT P VALUES???

Figures Adam et al, EJVES 2006

Figures Silva et al, CCI 2004

Figures O’Brien et al, Ann Intern Med 2006

Figures Zehetner et al, Surg Endosc 2005

Figures O’Brien et al, Ann Intern Med 2006

Figures Zehetner et al, Surg Endosc 2005

Figures Adam et al, EJVES 2006

Figures Miccoli et al, AOHNS 2006

Figures COLOR, Lancet Oncol 2005

Figures Suter et al, Ann Surg 2005

Figures Ceelen et al, Ann Surg 2003

Figures Nelson et al, NEJM 2004

Figures Nelson et al, NEJM 2004

Figures Siddiqui et al, AJS 2008

Figures

Authorship The paper is finished, but… Now you have to address the most dangerous issue…

Authorship The paper is finished, but… Now you have to address the most dangerous issue… Authorship!

Authorship Agree about authorship issues early on in the project Here is the usual arrangement… 1. First author is the person who wrote the first draft. Should be the student if paper arises from the thesis 2. Corresponding author is the person who can best address queries of reviewers and readers 3.Last author is the person responsible for the facilities were research was undertaken 4.Anyone who has made a substantial contribution to the study should be an author and should have an opportunity to contribute to the manuscript 5.Have you left anyone off?

Authorship Criteria for authorship* Participate sufficiently to take responsibility for the content, ie, be able to defend the content and conclusions Make substantial contributions to each of the following areas: –Conception and design or analysis and interpretation of data –Drafting the manuscript or revising it critically for important intellectual content –Approving the version of the manuscript to be published *Uniform Requirements for Manuscripts Submitted to Biomedical journals. International Committee of Medical Journal Editors.

Acknowledgments Include: - Intellectual assistance - Technical help, including writing and data analyses - Special equipment or materials - Outside financial assistance (including grants, contracts, or fellowships)

Acknowledgments  Remember the funding body  It may help to have consulted and acknowledged an expert  Name the people who have provided help with equipment or testing  Everybody who is quoted should forward a signed letter in which he consents to being quoted!

References Include only significant, published works –Remember the reviewers Use the correct format. Consult a current copy of the journal Use EndNote or Reference Manager whenever possible Check original sources In text, cite references at names of authors and after ideas, eg, “Jones et al 8 agree with others that people with a high BMI have an increased risk of access site complications 9 and treatment failure. 10

References Cite grouped references in chronological order Number references in tables and figures according to where they are cited in the text In text, name 2 authors; use et al (or “and colleagues” for more than 2) Obtain permission for citing unpublished data Beware that an oft quoted author may become a reviewer!

Citation styles Harvard style – social sciences Ebenezer, C M (2001) The trials of life: the work of a mental health librarian. Health Information and Libraries Journal 18(4) Vancouver style – biomedicine Ebenezer C M. The trials of life: the work of a mental health librarian. Health Information and Libraries Journal 2001; 18(4) … more on citation styles at

Citation styles Citing electronic sources: Styles less established than for citing printed formats Need to include: –Bibliographic details (as applicable): author, title, etc. –URL –Date downloaded eg Ebenezer, C M (2001) From nether hell thy people save: BMA Library open day 12/09/2001. London-I At [17/01/2002].

References Ng et al, BJS 2006

Plagiarism and copyright infringement Learn about Italian laws (plagiarism, copyright infringement, fair use), which differ from laws and practices in other countries Avoid direct plagiarism, mosaic plagiarism, unacceptable paraphrasing, and insufficient acknowledgment –Do not use the exact wording from another paper in your paper─even when you cite the source –Use quotation marks when you borrow blocks of text –If in doubt, quote extensively and kindly!

Cover (submission) letter Identify the paper Describe the paper Repetitive publication and duplicate submission Conflict of interest Corresponding author Suggest reviewers

Choosing a target journal 1.Make a choice prior to beginning manuscript preparation 2.What journals do you and your co- authors read most often? 3.In what journals were the articles you used for background for this project published? 4.New versus established journals?

Choosing a target journal Consider: 1. Appropriateness for your message 2. Type and length of articles published 3. Impact factor (Thomson Scientific, Journal Citation Reports: ) 4. Circulation 5. Likelihood of publication 6. Journal style

Impact factors in surgery (2006) RankJournalTotal citesImpact factor 1Ann Surg Am J Transplant Liver Transplant Am J Surg Pathol Brit J Surg Transplantation Obes Surg J Neurol Neurosurg Ps Endoscopy J Thorac Cardiov Sur Ann Surg Oncol Shock J Vasc Surg

Submitting to a specific journal  Follow the instructions for authors - check you have the most recent version!  Take care in proofreading the uploaded draft - sometimes problems arise with figures  Follow-up often your paper online  Get ready to submit it to another journal in case of rejection

Learn to enjoy the road… Biondi-Zoccai et al, Lancet 2000 Number of citations 0 Biondi-Zoccai et al, J Am Coll Cardiol 2003Number of citations 60 (2 February 2008)

Further reading AMA Style Manual CONSORT, MOOSE, STARD and QUADAS guidelines Guyatt G, Rennie D. Users’ guide to the medical literature. A manual for evidence-based clinical practice Zieger M. Essentials of writing biomedical research papers Slide set by Clark NB ( Slide set by Ebenezer C Slide set by El-Serag HB Slide set by Hopkins WG Slide set by Mallia-Hughes M Slide set by Tudiver F et al

Interested in more? Our integrated program on clinical research methods: corso “Come scrivere un lavoro scientifico” corso “Creazione del procotollo clinico” “Corso teorico e pratico di statistica biomedica” corso “Revisione e interpretazione di un lavoro scientifico”

Questions?

Take home messages 1.Tables and Figures should complement your work, not distract from it 2.In any case, if you can’t provide a professionally looking figure or table, it is better to avoid it

And now let’s move to peer review…