Tips on Writing Your Biomedical Research Paper and New Journal Policies to Know About

Mary Kemper
Medical Editor Mayfield Medical Communications

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?

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

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

Rejection rates for select journals

Journal
NEJM Neurosurgery The Laryngoscope Journal of Neurosurgery Surgical Neurology

~% rejected
96 80 to 90 75 60 to 66 52

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

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

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

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

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

6 steps for writing your abstract

1.

2.
3. 4. 5. 6.

Identify guidelines, meeting or journal Highlight key features Insert sentences into abstract format Write, revise, and condense Edit sentences and words Check final

IMRAD
Concept originated by Pasteur Established by American Standards Institute in 1972 Serves as an organizational format Know the nuances of your journals format IMRAD is a format, each paper differs

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

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

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

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

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

Example Material & Methods

Clinical Patient population

Anatomical Materials

Protocol (independent, dependent, control) Methods for each

Analysis of data

Sample preparation for each

Procedures for the dependent variables Analysis of data

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

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.)

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

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

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

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

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

Visual data
Type of visual Flow charts (algorithms) Tables Line graphs Bar graphs Pie charts What it summarizes Protocols Complex data Response to treatment Complex data to compare categories Percentage of the whole

Diagrammatic illustrations

Simplify or enhance figures

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

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

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!

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

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

Authorship
an ethical consideration
Involvement in Study
High

Included in acknowledgments

List as author

Low

NOT included in acknowledgments: NOT listed as author

Low

Included in acknowledgments
High

Involvement with Manuscript

Cramer and Rieger, 2001

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?*

Response to peer review strategies for success

Follow the journal editors 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

$, 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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