Medical Writing How to get funded and published November 2003

The key to successful writing is organisation and planning It is NEVER too early to start For example use a reference manager system from the beginning and make notes about all papers you read

Know what you are writing Original article (IMRaD) Case report Review/commentary Book review Letter Grant

Know what you are writing Message Market Length Co-authors Set a deadline

Original articles IMRaD Introduction –3 paragraphs –Don’t state the obvious –state hypothesis and aims Methods –Succinct –Web section? –Answer how? –Stats Results –Logical (simple to complex) –Don’t duplicate text/tables –3-4 tabs/figs Discussion –What are the implications?

Know your journal Read the “instructions for authors” Read the journal Remember the editor is under a number of pressures Think marketing!

How good is your journal? Impact factors Cell 40 Nature 27 NEJM 23 Lancet 18 BMJ 6 AJRCCM 5 Thorax 4 ADC 3

Now the pain… First author takes the responsibility Write a plan Start with methods & results then discussion, introduction, abstract Editing Co-authors Independent

Peer Review

Like democracy peer review is the worst way to assess research apart from all the others Peer review is sensitive to the basics of good presentation, structure, language and style. Badly presented papers or grants will not do well Obey “instructions for authors” or grant instructions!!!

Grant Review Usually grants are awarded by a committee of 10 or more. The majority will not have much working knowledge of your specialist area. One member will be allocated your application. Two or more peer reviewers You may have an opportunity to address reviewers comments by mail or at interview.

Grant Review Your grant may be discussed for minutes There is usually some form of marking system Decisions are usually final but occasionally you will be asked to re-submit.

Peer Review - Abstracts

Reviewers Responsibilities Honest assessment of the MS Usually works to a structure (eg Thorax / Blue Journal) Ask to recommend acceptance or not and often to grade the paper Usually has a confidential note to the Editor Should reviewer be identified?

Manuscript Review Author MS Submitted Editors Associate Editor 2 or 3 Peer Reviewers Recommendations - Accept - Minor - Major - Revise + Resubmit - Reject Statistical review

Reviewers Responsibilities Honest assessment of the MS or grant Usually works to a structure (eg Thorax / Blue Journal) Ask to recommend acceptance or not and often to grade the paper Usually has a confidential note to the Editor Should reviewer be identified?

Critical appraisal Is it of interest? Why was it done? What was found? Are the stats ok? What are the implications? Will it be cited?

Statistical review Sample size Are the outcome measures valid? Is the basic data well described? Are the analyses valid? How was significance assessed? Have confounders/bias been considered?

Major Criticisms Nothing new No hypothesis Over stating results Under powered Poor statistical analysis Wrong journal Methodology of assays etc

Minor Criticisms Too long –Introduction: 1 side –Methods: 1-2sides –Results: 1-2sides –Discussion: 3-4sides –References <30 –Too many figs/tables Poor English Spelling mistakes Over statement of results No acknowledgement of limitations Missed refs

Don’t take it personally Don’t dissect comments until you have cooled down Most rejections are justified Appeal? Modify MS before resubmission – the same reviewer may get it again! Do resbmit Responding to Reviews reject

Responding to Reviews accept/resubmit Be honest and true to what you believe Address all the issues raised Don’t be aggressive or wounded Concede about % of the issues raised as they are usually correct. Return the revised MS promptly

Paper accepted Celebrate Wait for the proofs (pdf) and respond quickly Start the next paper!