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 40Nature 27NEJM 23Lancet 18BMJ 6AJRCCM 5Thorax 4ADC 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

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 5 - 20 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

P os te r S p oken

2 R eview ers

S orted b y C a teg ory

S u b m itted ab s trac t on lin e

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

AuthorMS 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 Reviewsreject

Responding to Reviewsaccept/resubmit

• Be honest and true to what you believe

• Address all the issues raised

• Don’t be aggressive or wounded

• Concede about 50 - 75% 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!