1. How to Write a Friendly Reader Manuscript
Dr. Shorouk El-Shennawy
Lecturer Faculty of Physical Therapy- Cairo University
Executive Editor- Journal of Advanced Research

2. The objectives of this session are to understand how to:
Write an attractive title
Construct a neat abstract
Write an effective introduction

3. Level of Evidence

4. Standardized reporting Guidelines:
Standardized guidelines for reporting certain types of studies
Such As
CONSORT
MOOSE
STARD

5. Standardized reporting Guidelines:
CONSORT
The Consolidated Standards of Reporting Trials ( CONSORT ) guidelines were developed by an expert group of researchers, epidemiologists, journal editors, and statisticians. The International Council of Medical Journal Editors ( ICMJE ) recommends the use of CONSORT guidelines whenever the results of randomized controlled trials are reported. The CONSORT guidelines were first published in 1996, and an updated version has recently been published.
The CONSORT guidelines were established because of the growing recognition that randomized controlled trials are the best way to measure the effectiveness of treatments. These studies therefore need to be reported to an exceptionally high standard so that readers can judge whether the results are reliable.
CONSORT

6. CONSORT
The CONSORT Statement, a 22-item checklist and flow diagram, is a set of guidelines intended to improve the reporting of RCTs.
However, some specific issues that apply to trials of nonpharmacologic treatments ( for example, surgery, technical interventions, devices, rehabilitation, psychotherapy, and behavioral intervention) are not specifically addressed in the CONSORT Statement. Therefore, the CONSORT group developed an extension of the CONSORT Statement for trials assessing nonpharmacologic treatments. 11 items were extended from the CONSORT Statement, added 1 item, and developed a modified flow diagram.
CONSORT

7. CONSORT

8. CONSORT
The checklist ensures that readers are well informed about the study methods, the results, and the analyses of the trial data, including the methods used for randomization and allocation concealment.
CONSORT

9. CONSORT
The flow chart diagram explains the flow of participants through each of four phases of a trial, that is enrolment, intervention allocation, follow up, and analysis in a flow diagram. They provide comprehensive counts of participants who pass through the various stages of recruitment.
The flow diagram is designed to track patients through these stages to ensure that the number eligible for the trial, recruited, randomized to groups, and who completed the trial or were lost to follow up, is clear.
CONSORT

10. CONSORT
CONSORT

11. Standardized reporting Guidelines:
MOOSE
Other guidelines are also available for assessing the quality of controlled clinical trials. A statement has also been written for the reporting of meta-analyses of data from cross-sectional, case series, case–control, and cohort studies. This statement is called Meta-analysis of Observational Studies in Epidemiology (MOOSE). The MOOSE checklist outlines details of how background and search strategies as well as methods, results, discussions, and conclusions should be reported in meta analyses of observational studies. Use of this checklist will improve the value of meta-analyses to everyone who uses them.

12. Standardized reporting Guidelines:
Websites
CONsolidated Standards Of Reporting Trials
The STARD statement (2003) Guidelines for studies of diagnostic accuracy STAndards for Reporting of Diagnostic Accuracy
The TREND statement (2004) Checklist/flow diagram for reporting non-randomised trials Transparent Reporting of Evaluations with Non-randomized Designs
The STROBE statement (2007) Checklist/flow diagram for reporting observational studies STrengthening the Reporting of OBservational studies in Epidemiology
Extensions to CONSORT:

13. Checklist questions for reviewers and writers
General
Is the work original? Is the information important? Was the study ethical? Does the work add enough to what is already in the literature? Is the title accurate and informative? Does the abstract include the most important results? Does the paper read well and make sense? Are the results of interest to the readers of this journal?
Introduction
Is the length of the introduction reasonable? Does the introduction adequately review the background and state the aims?
Cont.

14. Checklist questions for reviewers and writers
Methods
Are the methods well documented and detailed enough? Are the participants adequately described and their conditions defined? Was a satisfactory response rate achieved? Is the equipment used adequately described? Are the techniques used adequately described and validated? Were the methods suitable for the study? Is a calculation of the required sample size given? Are all statistical methods adequately described and referenced?
Results
Is the description of the results clear and detailed? Are the results credible, valid, and well presented? Are the statistical methods appropriate? Are confidence intervals given where necessary? Are the numbers in the text independent of the numbers in the figures and tables? Are the stated results supported by the statistical analyses? 
Cont.

15. Checklist questions for reviewers and writers
Discussion
Is the length of the discussion appropriate? Does the discussion adequately consider the limitations of the study? Does the discussion fairly review previous work? Do the conclusions answer the aims set out in the introduction? Are the conclusions justified and logical?
Tables and figures
Are the figures of adequate quality? Are all of the tables and figures necessary? Do the legends and titles of the tables and figures provide adequate information?
Discussion
Are all of the references relevant? Do the references fairly represent current knowledge in this field of research? Is any major literature omitted? Are there any misquotations or incorrect citations?

16. When you are writing a journal article, it is logical to begin by writing the methods and then the results sections. The introduction and discussion can be pieced together as you progress, and finally you will need to condense it all into an abstract.

17. TITLE The basic functions of a title are:
Titles take up only a few words but are of importance in persuading clinicians and researchers to read your paper.
The basic functions of a title are:
To describe the content of your paper in a succinct way.
Also, in these days of database searching, keywords in the title make your paper immediately accessible to workers in your field.
TITLE

18. Characteristics of effective titles (6): 1- Concise and informative
Use the fewest possible words; avoid words like “A study of…”, “Investigations of…”, “Observations on…” etc.
If limited to a specific region, name the region in the title.
Example; the following two journal articles relating to the human genome were published about the same time:
The sequence of the human genom Initial sequencing and analysis of the human genome
Although both are concise, the first title is shorter and thus more appealing. Attractive titles are always concise and to the point. However, a scan of some medical journals shows that many titles are long and boring, and give the impression of being just another journal article that will be tedious to read.
TITLE

19. Characteristics of effective titles:
2-Identify the main issue of your paper (Accurate, and specific )
Do not extend your title beyond the scope of your paper.
For example, a review entitled Respiratory health of Australians would be expected to contain a broad scope of information about many subjects relating to respiratory health, including information about infections, allergies, smoking outcomes, asthma, and chronic lung disease in both adults and children. On the other hand, a title such as Asthma and atopy in Australian children is more specific and may more accurately describe the scope of the review.
TITLE

20. Characteristics of effective titles:
3-Begin with the subject of your paper
Consider the two titles below: - The effect of parental smoking on the development of asthma and other atopic diseases in children: evidence from a birth cohort study in NSW, Australia - Parental smoking and the development of childhood asthma
SO title is much improved by the deletion of the unimportant and unnecessary words.
TITLE

21. Characteristics of effective titles:
4-Do not contain abbreviations
5-The titles of a journal article should have minimal punctuation. Writers often use punctuation to add a subtitle describing the study design (unnecessary). For example, in the title Risk factors for birth defects in premature babies: a case–control study, the study design could be removed. While study design is of fundamental importance for any clinical or epidemiological research study, it is better described in the Abstract and the Methods rather than in the title, unless the journal suggests otherwise.
6-Attract readers
TITLE

22. Short titles are usually best; Examples of journal requirements:
Some journals set a limit on the length. For example, some journals ask that the title does not exceed 10–15 words, whilst other journals ask that the title does not exceed two printed lines or a specified number of characters that includes the white spaces.
Journals sometimes have specific requirements for titles. For example, Archives of Diseases in Childhood asks that the title does not contain the words child, children or childhood because these are implicit in the journal title.
TITLE

23. TITLE
3 Different ways of writing titles:
Titles that give independent variable, dependent variable, and population
- 1 -
The classic way of writing a title is to begin with a word that describes the main topic or the independent variable in your analyses. Effect of asthma on linear growth in children Asthma and linear growth in children Final height attainment of asthmatic children
If the paper is submitted to a respiratory journal, either of the first two titles would suffice, but for a journal concerned with growth, the third title would be more appropriate.
The problem with these types of titles is that they can be boring, especially if they are not short and concise.
TITLE

24. Titles that pose a question:
3 Different ways of writing titles:
- 2 -
Titles that pose a question:
There is an increasing tendency to use questions in titles. Questions that repeat the aim of the paper may attract readers.
Does asthma reduce linear growth? Are asthmatic children shorter than non-asthmatic children?
Fashions rarely last and question titles are probably best reserved for abstracts and talks. Journal articles need to be more conservative in the ways in which results are conveyed, and their titles need to withstand the tests of time.
However, such titles are frowned on, perhaps because they tend to suggest a positive result and are therefore misleading if the findings are negative.
TITLE

25. Titles that give the answer to the question:
3 Different ways of writing titles:
- 3 -
Titles that give the answer to the question:
The “assertive sentence title” should be avoided at all costs for journal articles ( may be used in poster rows at a conference). These titles give an answer to the study question and, as such, convey an impression of eternal truth that does not leave room for the possibility of error. Such titles tell the answer to the question and often suggest much larger differences between study groups than was actually found.
TITLE

26. Titles that give the answer to the question:
3 Different ways of writing titles:
- 3 -
Titles that give the answer to the question:
For example Asthma is negatively associated with growth in height during adolescence Linear growth deficit in asthmatic children A height deficit in asthmatic children that was minimal in magnitude and therefore of no clinical importance, but which reached statistical significance because of a large sample size, should not be reported under either of the last two titles
Assertive sentence titles is also a problem when a title turns out to be an error but remains embedded in the literature forever.
TITLE

27. TITLE
A traditional title tells readers what the journal article is about in an open way and invites them to judge the results by the contents.

28. ABSTRACT Provide a condensed history of your results
Pay particular attention to writing the abstract of your paper. Ideally, your abstract will be added to a public database such as MEDLINE or PubMed and will therefore achieve a much wider distribution than the journal article itself. People don’t read the whole article unless they have a vested interest in the topic and many people rely on reading the abstract to decide whether to obtain the entire article.
This section of your paper should only convey the most interesting and most important parts of your work.
ABSTRACT

29. ABSTRACT
Abstract should be organized by first stating the aims of the study followed by the basic study design and methods. This should then be followed by the main results including specific data and their statistical significance. Finally, finish with the conclusion and interpretation.
To ensure that the abstract contains all of the necessary information, many journals now require that you structure your abstract formally. Even if the journal does not specify any subheadings, write your abstract as though they were there (JAR).
ABSTRACT

30. Structured Abstracts (especially for RCTs)
Heading Content :
Objective.
The purpose of the study; what did you hope to discover? Specifically, in an RCT, what intervention/factor were you investigating?
Introduction
How was purpose achieved? Specify (as appropriate) randomized, non/single/double blind, parallel group, cross-over etc.
Setting.
Where was study undertaken? Not especially geography, but type of setting (home, hospital, primary or secondary care etc)
Subjects.
Who was studied? Diagnosis(es), any selection, etc
Interventions
What was done? What was main treatment or factor differentiating groups.
Main measures.
Outcome measures and other measures used. Give names and/or domains (activity or impairment) measured
Results.
Main data. Please always give number of patients, and some hard facts such as mean (SD) scores on main measure in both groups. Please focus on the comparison between groups as this is the primary purpose of this design. Change within groups is less important. Please give an estimate of the mean difference between groups with a 95% confidence interval if possible.
Conclusions.
These should be related to the objective. Ensure conclusions follow from information presented in the abstract. Do not speculate here!

31. When writing your abstract, put your most concise and important sentences on a page, join them into an abstract and then count the words.

32. INTRODUCTION What reader like & don't like in the introduction:
Readers want a quick and snappy introduction to your work. Readers like to find the information that tells them exactly why you did the study.
The introduction can be one of the hardest parts of a paper to write, but adopting this approach helps you to focus on how you want to start and what you specifically need to say.

33. Tips for writing introduction:DO
1- Before you can begin writing, you need to have an aim or a research question that is both novel and worth answering.
2- Ideally, you should have done a thorough literature search before you began the study and have updated it along the way. This will be invaluable in helping you to write a pertinent introduction. In appraising the literature, it is important to discard the scientifically weak studies and only draw evidence from the most relevant and most valid studies.

34. Tips for writing introduction:DO
3- Topic sentences, especially for the first introductory sentence. Begin a paragraph and explain what it will be about These sentences: -Try to hook your readers in the first line. -Creates the expectation of what the paragraph will be about and the supporting sentences fulfill that expectation. -For this reason, topic sentences are an essential tool for organizing paragraphs and for improving the readability of your paper.

35. Example of writing a paragraph by using topic sentence followed by supporting sentences   It is unlikely that bias or confounding would account for a large proportion of the clinically important differences that we found between our study groups. The participants were selected randomly from the electoral role and we used objective measurements to collect our main outcome data. Although, for safety reasons, our observers could not be blinded to the health status of the participants, objective measurements are more reliable than self-reported symptom history that is subject to recall bias. Moreover, by using multivariate analyses, we were able to adjust for any effects of major confounders. In these ways, we were able to minimize selection bias and measurement error, and we were able to control for confounding.

36. Tips for writing introduction:DO
4- Introductions should be short ( 3-5 paragraphs), the best introductions fit on one page.
5- This section should be arresting and tell the reader why you undertook the study i.e. to be brief rather than expansive and the structure should funnel down from a broad perspective to a specific aim.

37. Start writing your introduction: - The first paragraph ''What we know'' it should include a very short summary of the current knowledge of your research area This should lead directly into the second paragraph '' What we don’t know" that summarizes what other people have done in this field, what limitations have been encountered with work to date, and what questions still need to be answered.

38. Start writing your introduction: - This, in turn, will lead to the last paragraph,'' Why we did this study’’ which should clearly state what you did and why. The most essential part of the introduction is the last paragraph, which gives details of your aim or hypothesis. This sentence sets up the expectations for the rest of the paper and should be the very first sentence that you write in collaboration with your coauthors.

39. Example of a short and to the point introduction
Example of a short and to the point introduction.  People who are overweight or obese are at increased risk of developing many illnesses including hypertension, cardiovascular disease, and non-insulin dependent diabetes. However, many adults continue to be overweight. In 1995, results from the National Nutrition Survey in Australia suggested that 63% of men and 47% of women were either overweight or obese. (Paragraph 1) what we know   Despite the impact of excess body weight on health, self-perception of body mass in the general population has not been properly investigated. The only information comes from small, unrepresentative samples of women, particularly younger women, or from national studies in which self-reported weights may be unreliable. Until reliable information of self-perceptions of body mass is collected, it is difficult to design effective weight loss intervention strategies. (Paragraph 2) what we don’t know In 1998, we conducted a large cross-sectional survey of adults in which we accurately measured height and weight. In this paper, we report information about adults’ perceptions of their own body mass. (Paragraph 3) the study methods that were used

40. DON'T DO
1- In the introduction section, you do not need to review all of the literature available, although you do need to find it all and read it in the context of writing the entire paper.   2- You should avoid including a lot of material in the introduction section that would be better addressed in the discussion.   3- You should never be tempted to put “text book” knowledge into your introduction because readers will not want to be told basic information that they already know. For example, the sentence, Asthma is the most common chronic disease of childhood, must be one of the most overused phrases in the last decade. All scientists working in asthma research and most people in the community already know this and don’t want to be told it yet again. Similarly, a phrase that defines the problem such as, Asthma is a condition in which the airways narrow in response to commonly occurring environmental stimuli, is not appropriate, except in a paper about the mechanisms of airway narrowing.

41. 4- Do not be tempted to begin your introduction by quoting the literature but omitting to say what was found. For example, an introduction that begins with, Previous studies have reviewed injury rates in Australian Army. A study by Johnson et al., reviewed the medical records of Navy recruits who were unable to complete basic training suggests that previous work has been undertaken in your research area. However, the lack of information about what was actually found does not help readers to put your work in the context of what has gone before. It is always better to quote the findings from previous studies rather than the name of the first author and the details of the aims or methods “Quotes the science and not the scientist”

42. 5-Finally, you should never end the introduction section with a quick summary of your own results. For example do not write, We have undertaken a study to define the characteristics of children who become overweight. The results show that lack of exercise is a key factor and provide evidence that there has been a significant increase in overweight boys and girls in the last 12 years. The practice of putting the key results at the end of the introduction section is common in some disciplines such as basic research but should not be used in clinical research. This type of misplaced summary - stops the flow of the paper, makes it look disorganized make the reader unable to judge the validity and applicability of the results.

43. Thank You

44. Practical Tips for Scientific Writing Sentences should never begin with an abbreviation. 2- Chemical elements are not proper nouns, so do not capitalize them.  Only the first letter of the symbol is a capital letter: nitrogen (N), carbon (C), calcium (Ca).   3- In formal writing, you should never use contractions (didn't, can't, haven't...).

45. Practical Tips for Scientific Writing 4-Pay attention to tenses
Practical Tips for Scientific Writing 4-Pay attention to tenses. Abstract  Past tense when describing and giving results  Present tense for conclusions   Introduction  Past or present tense Methods & Results  Past tense (What you did and what you found( Discussion  Past and/or present tense   -When a fact has been published or is established: use Present -If a fact is not generalized or from a specific experiment: use Past -When observations have been repeated or go from past to present: use Present Perfect We have shown that…. -When referring to figures or tables: use Present Figure 2 is a mass spectrometry analysis of…..

46. 5- Voice: active vs passive Active voice: when subject performs the action of the verb Passive voice: when subject undergoes the action of the verb Usually consists of part of verb “to be” and past participle of verb Passive voice: Makes sentences more wordy & complicated Used to be recommended for scientific writing NOT ANY MORE!!! Use when agent is not important Cells were cultured ..Does not matter who cultured them!   Active voice: Adds action to the sentence Adds interest Makes sentences shorter We analyzed…..

47. 6- Two of the most common errors made in scientific writing…
6- Two of the most common errors made in scientific writing…. Subject-verb disagreement and Dangling participles Subject-Verb Disagreement Singular subject uses singular verb. Plural subject uses plural verb.   Dangling Participles Participle: form of verb that acts as an adjective e.g., hanging, trapped Dangling when the implied subject of the participle is not the same as the subject of the sentence Wrapped around the spinal cord, the surgeon found a large tumor. Was the surgeon wrapped around the spinal cord? Or the tumor? Sentence says the surgeon was. Change to: The surgeon found a large tumor wrapped around the spinal cord. Dangling participles often occur in passive voice Solution: use active voice

48. 7- Person It is perfectly good to use the first person in scientific writing: We and others have shown….. Or the third person: Jones and colleagues reported that… But….be careful…. Do not use informal speech in scientific writing

49. 8- Words Very, really, quite, basically, generally These words seldom add anything useful. Try the sentence without them and see if it improves. Watch out for the verb “to be” Often “there are” is extra weight. There are many students who like writing. Many students like writing.  Avoid abusing word forms  Do not use more words where fewer will do. in the event that, in the nature of, it has been estimated that, it seems that, the point I am trying to make, what I mean to say is, it may be argued that, in the case of , in the final analysis

50. Wordy. To the point A majority of. most A number of
Wordy To the point A majority of most A number of many At the present moment now By means of by Less frequently occurring rare All three of the the three Fewer in number fewer Give rise to cause In all cases always In a position to can In close proximity to near In order to to Assistance help Utilize use Numerous many Facilitate ease Individual man or woman Remainder rest Initial first Implement do Sufficient enough Attempt try Referred to as called With the possible exception of except Due to the fact that because

51. He totally lacked the ability to he couldn’t Until such time as
He totally lacked the ability to he couldn’t Until such time as until For the purpose of for Investigate study Optimum best Indicate show Initiate start Currently now Facilitate help Ascertain find out 3 am in the morning am a person who is honest an honest person a total of 14 birds 14 birds biography of her life biography circle around circle close proximity proximity completely unanimous unanimous consensus of opinion consensus cooperate together cooperate each and every each end result result he is a man who he in spite of the fact that although in the event that if new innovations innovations one and the same the same period of four days four days personally, I think/feel I think/feel personal opinion opinion refer back refer repeat again repeat revert back revert shorter/longer in length shorter/longer had been previously found had been found

52. Avoid words that express a subjective impression (very, extremely, …)

53. 9- Once you have finished with your rough draft, take a break before rereading your paper. Then start to fiddle with the details (cleaning up the prose etc).Let a friend or colleague read your draft. Listen to what they say. Write your second draft. Ask for criticism from co-authors and friends