1. PUBLICATION OF ARTICLES IN SCIENTIFIC JOURNALS:

2. Even when a manuscript has been rejected,the author should not be discouraged because there is great value derived from the review process.

3. The Review Process Blinded At least two PEER reviews
Constructive criticism

4. WHICH PAPERS ARE ACCEPTED
WHICH PAPERS ARE ACCEPTED? Those that advance our knowledge and especially those that will enhance patient care (new and better treatment of musculoskeletal conditions)

5. How is this accomplished?
Good idea
Well designed study
Focused, clear report

6. Should I write it? Is the topic relevant?
Will it benefit the orthopaedic patient or community?
Is it already in the literature? (Oops!)
Does our institution have adequate resources to carry it out?
Do I have time to complete the entire project?
Does it require the buy in or support of another party?

7. The single most important characteristic that distinguishes between acceptance and rejection is the prospective nature of a study

8. We must be moving beyond retrospective reviews and all of their inherent problems to design and conduct prospective studies

9. PLAN, PLAN, PLAN “Plans are nothing, planning is everything”
Have a mentor

10. KEY ELEMENTS OF A GOOD PROSPECTIVE STUDY

11. 1. A WELL DEFINED QUESTION
Relevant

12. RELEVANCE Find out how relevant your question really is
The first step in the peer review process
Use colleagues, mentors, cynics, enemies

13. 1. A WELL DEFINED QUESTION
Relevant
Focused
Has a high degree of certainty that an answer will result when study is completed
State the hypothesis
Write the Introduction

14. 2. Formulate a Study Design What is the best way to address this question (clinical, lab,etc)?

15. Statistics
There will be an adequate number of study subjects to achieve an answer (power)
The most simple yet appropriate statistical tools will be used
A statistician should always be involved

16. Useful Measurements
Commonly used measurements (do not invent your own)
Go beyond xray and physician derived information
Use accepted,patient based,outcome measurements for clinical studies

17. Unbiased assessment
Use independent observers to record and evaluate data in a blinded fashion
No vested interests : industry, surgeons

18. 3.Do the Experiment Have a finish line and date
Have an alternative plan
Keep good records
Timely and accurate recording (lab notebook)

19. 3.Do the Experiment When data collection nears completion,
write Methods (in sufficient detail so that anyone could repeat the experiment) and Materials

20. 4. Present the Results Clear, concise Good graphics Significant only
Distinguish statistical and clinical significance

21. 5. Write the Discussion Hypothesis: prove or disprove
Compare with other studies in the literature (pro and con)
Brief conclusion : A ‘take home message’
Most papers only have one message

22. 6. Write clearly
Focused
Concise

23. I have only made this [letter] longer because I have not had the time to make it shorter Pascal,1627

24. 6. Write clearly Focused Concise Timely
Follow ‘Instructions to Authors’
Independent review of manuscript before submission

25. Local Peer Review What is not clear? Heckman test
Abjure pride of authorship

26. The Ideal Study is The Randomized Clinical Trial (RCT)

27. We are in the age of Evidence Based Medicine

28. The RCT Represents good science Prospective
Currently fashionable (popular,accepted)
Enduring credibility
Provides basis for metaanalysis
Very satisfying for investigator
It will get published!!!

29. Problems with RCTs Cost Time Narrowness of Question
Recruitment (patients, physicians,especially surgeons)
Institutional resources

30. Important steps in any RCT
Prospective design
Randomization (needs statistician) : by patient,by surgeon, or by institution
Controls (must follow the Helsinki Agreement guidelines)
Multi-institutional
Must follow all local IRB and informed consent rules

31. OBSERVATIONAL STUDIES: better than traditional descriptive studies

32. OBSERVATIONAL STUDIES
Still prospective design
Meet IRB approval at the start
Comparisons should always be made: historical controls, concurrent(but not random) controls, or case controlled
Multi-institutional
Use unbiased observers to collect and analyze data

33. Case Reports and Case Series
Must be truly unique
Must advance our ability to treat patients
Should be interesting to the reader

35. Authorship Significant ongoing contribution More than technical
Can defend entire paper in a public forum
No courtesy authorship

36. HELPFUL HINTS Follow the Instructions to Authors Brevity
Focus on Subject
Limit speculation/opinion
Use easy to read format
Use a few key illustrations

37. The Final Word of Advice
Never give up
All papers can get published!!!