1. Tips on Writing Your Biomedical Research Paper and New Journal Policies to Know About Mary Kemper Medical Editor Mayfield Medical Communications

2. Mini quiz  Which part of a paper is most often read?  In an abstract, give ~% for each section (Introduction, Methods, Results, Conclusions)  Who is credited with the modern IMRAD format?  What section should you usually write first?  What 3 criteria constitute authorship?  Cost to reuse your figure if published by JNS?

3. The goal is clear writing  Marshal the details of your biomedical research into a story with a clear message  Write clearly so that readers understand your message  Examine IMRAD components  Briefly look at supporting parts  Reveal some tips that make writing your next paper easier  New journal policies and copyright issues

4. IMRAD a mirror of your research process Introduction Material & Methods Results And Discussion Ask a question Attempt to answer the question Obtain and compile data Answer the question

5. Rejection rates for select journals Journal~% rejected NEJM96 Neurosurgery80 to 90 The Laryngoscope75 Journal of Neurosurgery60 to 66 Surgical Neurology52

6. Title identifies central topic  Most often read  Title and key words to index  Title (general topic): subtitle (specific topic)  Independent and dependent variables  Name of species if not human  Do not use abbreviations, jargon, chemical formulas, series identifiers  Identify central topic: be creative

7. Running Title  Use independent and dependent variable  Omit species  Be creative  Adhere to journal guidelines

8. Abstract most important part of your paper  Introduction/background: what was the purpose (10%)  Material and methods: what was the study design, techniques, and statistical methods (30-35%)  Results: what are the most important findings (35-45%)  Conclusions: why are the results important (20-25%) Cornett, 2001

9. Goals of abstract maximum info into minimum space Structured  Use headings to identify  Follows IMRAD format  Typical in North American journals  250 words Unstructured  Arranged in 1 paragraph  Follows IMRAD format  Typical in European journals  125-150 words

10. What makes a good abstract?  Follows guidelines of the journal or meeting  Stands alone (no references, use key words, give abbreviations, avoid jargon)  Is an independent unit of information, even with a paper  Is accurate (check for inconsistencies and omissions)  Is readable and coherent  Includes specific data Cornett, 2001

11. 6 steps for writing your abstract 1. Identify guidelines, meeting or journal 2. Highlight key features 3. Insert sentences into abstract format 4. Write, revise, and condense 5. Edit sentences and words 6. Check final

12. IMRAD  Concept originated by Pasteur  Established by American Standards Institute in 1972  Serves as an organizational format  Know the nuances of your journal’s format  IMRAD is a format, each paper differs

13. Introduction begin to tell a story Part 1Begin with what is known 2State what is unknown 3End with what your study will answer

14. Introduction, Part 1 what is known  Begin with a background statement or 2 to describe scope of study  Give enough background to introduce the problem, but not overwhelm  Give background specific to your topic  Move your story forward

15. Introduction, Part 2 what is unknown  Describe what gaps your paper fills  Mention other abstracts and preliminary reports  Avoid using names of other investigators  Keep references to a minimum  Omit unnecessary detail

16. Introduction, Part 3 what your study will answer  State your specific research question  Precede with a phrase that the answer is coming, “In this study, we…” or “To answer this question, we…”  Repeat key terms: title, objectives, independent and dependent variables, species, etc.  Be sure what is new and what is important are evident  Awaken interest

17. Material and Methods reads like a cookbook  Write this section first!  How was the problem studied  Usually arranged chronologically  Subdivided into subsections according to type of information  Material: chemicals, experimental materials, animals or humans  Methods: preparation, protocol, purposes of protocol and methods, methods, data analysis

18. Example Material & Methods Clinical  Patient population  Protocol (independent, dependent, control)  Methods for each  Analysis of data Anatomical  Materials  Sample preparation for each  Procedures for the dependent variables  Analysis of data

19. Study Design Include sentence about compliance  Example: “The protocol was approved by the IRB of each participating hospital…”  Example: “The study was a double-blind, randomized, placebo-controlled designed to compare…”  Provide IRB protocol number Important: Patient Authorization or Waiver of Authorization from IRB required to view patient charts

20. Study Protocol what was done  Repeat description of study population  Give inclusion and exclusion criteria  Explain how study was randomized for a randomized trial  Explain how you project target sample size and end points  Account for all materials (drugs, culture media, buffers, gases, subjects, instruments/equipment, etc.)

21. Study Protocol (continued)  If questionnaire, tell how administered and by whom  Include methods that failed to lead to desired conclusion  If method is not well established, explain and give references  Use tables (e.g., patient characteristics) and figures (e.g., surgical step) to clarify  Explain limitations in brief

22. Study Protocol (continued)  Last paragraph is statistical analysis -how data are summarized, statistical test, measurements compared, P value  Consult statistician early  Use subheadings  Write in past tense  Use either passive or active voice or both

23. Results what were the findings  Functions: state results of experiments and present data that supports results  Content: results and data  Consistency: check this in results, discussion, and abstract  Organization: chronological or from most to least important

24. Results uses the same order as Methods Material & Methods  Study subjects  Study protocol  Calculations  Statistical analysis Results  Clinical characteristics  Systemic effects  Specific effects  Adverse effects

25. Results see the forest through the trees  Be brief and uncluttered  Mention species and material again  Use past tense  Give specific comparisons  Present detailed data in figures and tables to keep written data to a minimum  Express results, give data  Provide appropriate statistical details  Begin each paragraph with a result

26. Visual data Type of visualWhat it summarizes Flow charts (algorithms)Protocols TablesComplex data Line graphsResponse to treatment Bar graphsComplex data to compare categories Pie chartsPercentage of the whole Diagrammatic illustrations Simplify or enhance figures

27. Discussion what do your findings mean  Answers the question posed in Introduction  Explain the significance of your results  Explain the findings, relationships, and generalizations of your results  Explains how results support answers and how answers fit with existing knowledge on the topic  Has a beginning, middle, and end

28. Discussion Part 1, beginning The question posed in Introduction… “… to test whether abnormal vasospasm before angioplasty increases the likelihood of restenosis.” Is answered in your Discussion… “…the presence of abnormal vasospasm before angioplasty was associated with an increased likelihood…”

29. Part 1, Beginning present strongest evidence first Begin with significance of your results  Never begin with background information  Never repeat information from Introduction  Never begin with historical overviews This is what everyone is waiting for!

30. Part 2, Middle interpret your results  Show how your results fit into the literature and how they support your answer  Give in descending order of importance  Compare your results with other studies, your work or others  Use one idea per paragraph

31. Part 3, Ending be strong  Restate answer to question, and signal this ending  Mention possible applications, implications, or speculations  Pull out as a separate Conclusions section  Suggest future work if needed

32. Authorship an ethical consideration Included in acknowledgments List as author NOT included in acknowledgments: NOT listed as author Included in acknowledgments Involvement in Study Involvement with Manuscript High Low Cramer and Rieger, 2001

33. Final checklist  Author affiliations correct (include TNI)?  Is your story clear?  Do abstract and paper agree?  Each method has a result?  Each result has a method?  Each reference cited?  Tables and figures numbered consecutively?  Do you meet journal requirements? *

34. Response to peer review strategies for success  Follow the journal editor’s instructions  Carefully answer each point, whether you agree or not (cut and paste into your rebuttal)  Stay focused  Be polite, sincere, and generous  Be timely  Check your paper again for completeness, accuracy, and consistency in each section

35. $, conflict of interest, disclosure, and IRB requirements  Who pays for your paper?  Identify conflict of interest  Make your disclosures  Provide IRB protocol number  Provide HIPAA waiver  Mayfield Clinical Trial review

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