NANCY CHESCHEIREDITOR IN CHIEF, OBSTETRICS AND

GYNECOLOGYPROFESSOR, UNC SCHOOL OF MEDICINE

HOW TO WRITE A PAPER

Reaso

ns to

Write

a S

cien

tific P

ap

er

RequiredComplete fellowship / sit for boardsGet a job / keep a jobGet a grant / keep a grant

Altruism to advance fieldFulfill sense of completion Research

Question

Research Team

Develop Protocol

ApprovalCollect Data

Analyze Data

Write, submit and revise

paper

Principles of Science WritingHertzel Gerstein

Start writing earlyWarm up firstStart with the basicsTell a storyUse jargon sparinglyMinimize

abbreviationsKeep it shortKeep metaphors

simple

Don’t fall in love with your text

Don’t make the reader decipher your document

Get the critical opinion of someone you respect

Only write when you have something important to say

Principles of Writing (Gerstein)

Get facts right & present them clearlyConcepts should get more space and

attention than factsExpect to write 10 or more drafts—deleted

content is infrastructureWho was your senior English teacher in High

School? Can she understand this?

Style…..and content matter Guyatt, Haynes

Short paragraphs

3-5 sentences

Delete unnecessary words

There are many factors that may influence an outcome aside from the intervention being tested.

vs

Many factors, aside from the intervention being tested, may influence outcome.

Avoid “To be”

There is evidence…

Evidence suggests….

Passive Voice Active voice

Patients were asked to provide

Longitudinal validity is not influenced by standardization

More than 40 candidate HIV vaccines have been tested

Patients provided

Standardization does not influence longitudinal validity

Trials have tested more than 40 candidate vaccines

Passive v Active Voice Guyatt

AVOID LADY GAGA MANUSCRIPTS

SALALMI SLICING

MEAT EXTENDERS

Getting Started (Kotz, Cals)

First author and collaborators have shared understanding of primary research objective and key findings of THIS paper

Same group must have shared understanding of authorship and order

Pick a journal and target audience

Chernick, Guyatt

Determinants of publication? Who reads the journal?

Look through recent issues. Clinical? Basic Science? General or

Subspecialty topic?Rejection rateRecent publication on topicAre findings positive or negative? Are findings newsworthy for editor?

Which reviewers will receive your manuscript?

Quality of writingDumb luck

Shoot High or Shoot Low?

NEJM, Lancet, BMJ, Annals of Internal Medicine, JAMA

How patient are you? If competing for grant, job may need to shoot lower

How do you deal with rejection? Would a review if rejected help you?

Scientific writing not a solitary adventure

Writing group with co-authorsSchedule dead linesInternal peer-review (Byard)

READ INSTRUCTIONS FOR AUTHORS.

 “If you have read this and call or fax our office, we will send you a gift worth twenty dollars.” Pitkin, 1998. Letter to reviewers

READ INSTRUCTIONS TO AUTHORS

Determine authorship

Click icon to add pictureThis should be done when the study is planned!!

Avoids all sorts of hurt feelings, unmet expectationsmisunderstandings

Getting Started (Kotz, Cals)

THINKINGSkeletonize intro and

discussion Single-word topics or

one liners with main message for each paragraph

Gather key publications and add notes under each section

WRITINGReplace notes with

rough sentences of 6-8 sentences per paragraph

Rewrite sentencesTopic sentence,

content and lead in to next paragraph?

Create empty tables and figures

Kotz & Cals

Order of writing doesn’t need to be order of paper

Consider writing methods and introduction sections first

Telling a storyCreate empty tables and

figuresChunk your time

Set aside at least 2 hours per session

Schedule deadlines with team

Methods Results

If your research has dense methodology, consider publishing as a methods paper first

Results paper can then reference the methods paper and conserve page count for important results

TITLE & ABSTRACT Kotz, Cals, Byard

Most important part of getting people to read your paper

Key words for search enginesActive wordsAvoid abbreviationsInformative title: Drug X effectively treats

GDMDescriptive title: Drug X for treatment of

GDMEncapsulate the aim in the title & keep

coming back to it

ABSTRACT Cals, Kotz

Each section per journal’s instructionsShort phrases, simple languageActive voiceClearly state your hypothesis or purposeResults section most importantClearly: what is answer to research questionGive absolute as well as effect sizes for the GreenCan you answer the following from abstract

What is known and why is study needed? What did we do? What did we find? What does it mean?

So WHAT?

ABSTRACT

Should be able to stand alone

The only thing most people read

Should have real content

INTRODUCTION

Typically not more than 10-15% of paperCaution about putting content for discussion

into introduction

INTRODUCTION

Establish context for work

Essential information about why you did the study

State research question

General context for the study

Topical context

Research question(s)

Aim, Purpose, Objectives

Chernick

Warm Up: Write methods section first Can another investigator repeat the work after

reading your manuscript? Statement about IRB approval How did you determine sample size? What statistical tests did you do? What level of significance rejects the null hypothesis? Never use “NEARLY SIGNIFICANT” –if not significant,

its not.

METHODS

Can another researcher read your methods and do the same study?

Ties introduction to results to continue the story line

Define research process, including statistical analysis and results structure

IRB, IOCUC approvalOnly define methods for

which there are results later Particularly important if part of

larger study

METHODS

FOUR ELEMENTS Study design

Retrospective v Prospective? RCT? Cohort? Case-control? Observational?

Setting and subjects Sample size calculation

Data collection Precise definition of exposures or interventions, outcomes and

how measured Validation of instruments, data bases

Data analysis RESULTS A priori plan of analysis

RESULTS

Mostly written in past tenseClear, concise and objective: no

interpretationFor every method, there should be a resultCommon order

Recruitment/ResponseCharacteristics of Sample (Table 1)Findings from primary analysesFindings from secondary analysesUnexpected findings

TABLES and FIGURES

Key findings should be presented in tables and figuresMust be self-explanatoryUse of Supplemental Digital ContentCopyright release if necessaryClear relationship to text of paperDon’t use a table if easy to use text Informative titles

FIGURES and TABLES

Most important data in both text and tables

Tables and figures should be planned out in advance

Give absolute numbers not just effect estimates (For the Green, these go in Abstract too!)

Be consistent in order of results Experimental then control results

Use of supplemental digital content

≤2 lines in heading

Units here so numbers in cells

TOTAL SAMPLE 27 (35%)

SUBSET

AAAAA

16 (25%)

BBBBB

10 (35%)

Be consistentIntervention Control

Use same words in table and text

Prepare in BLACK and White $$$$

DISCUSSION

Interpretation of date

NEVER present new data

Don’t repeat any but the most important results

Do not ignore or hide inconvenient results

Stress what your paper adds to what is known

Main findings

What is known?What is new?How does this fit?

StrengthsLimitations

Is this important?What do we do with findings?

Answer research question exactly as you asked it

Discussion

Make sure your discussion ends your story line clearly.

Last sentence is the “take away”—what do you want your readers to remember?

More Research is Needed

REFERENCES

Use reference management software and select appropriate formatting for journal If unknown, use Vancouver or American Psychological

Association styleProvide DOI: Digital Object IdentifiersAcknowledge sources each time referencedGo back to original source—not the reference

from reviews, other papers

Which Reference to Use?

Most recentHighest level of evidenceOpen-Access availabilityPublished in journal you

want to publish in

RESPONSE TO REVIEWERS

Don’t take it personallyPoint by point response using track changes,

italics or what ever is asked for Unless agreeing with reviewers suggestions

make the paper worse, go with itBe politeIf you have an excuse to flatter the reviewer,

use it.

Dealing with Editors

“What Editors Want. An Authors guide to scientific journal publishing” Benson and Silver . Univ of Chicago Press 2013

If uncertain about submitting—ask the editorEditors sometimes make mistakes—appeal

politely if your reviews were good and you think you can deal with the comments

Reasons for Rejection of Manuscripts

Lack of critical examination or explanation of results

Failure to formulate credible or logical conclusionsFailure to explain how results support or refute

hypothesis• BYARD

Over-reaching conclusionsRecent publication on same topicGood paper, wrong journal“Me too” with no clear benefit

• CHESCHEIR

WHY????

You will become a better writer, researcher and editor

Although you can’t borrowresearch ideas, awareness of research questions

Understand the publicationprocess better

Additional ResourcesFriday Blog on Green Journal WebSitewww.equator-network.org

SOURCES

Byard RW. Scientific writing: the process and the pitfalls Forensic Sci Med Pathol 2013

Chernick V. How to get your paper accepted for publication. Pediatr Resp Reviews. 2013

Gerstein H. Writing science that your colleagues can read. Jl Diabetes and Complications. 2013

Kotz D, Cals JWL. Jl of Clinical Epi 2013. New series on effective writing and publishing of scientific papers—12 1 page papers of writing tips

Guyatt GG, Haynes RB. Preparing reports for publication and responding to reviewers comments. J Clin Epi 2006

Kotz D, Cals JWL. Jl of Clinical Epi 2013. New series on effective writing and publishing of scientific papers—12 1 page papers of writing tips