Why do researchers want to publish?

say something important share your workchange practicepromote thought or debateeducateget into high impact journaladvance your career keep your jobmake moneyentertain/divert/amuse

Which journal should you choose?

audiencegeneralists or

specialists?national or

international?

impactnot just Impact Factornot just prestigewill people read your work?respond to it? debate it?replicate it? tell others of it? will anyone use it?will it reach the public?

What do editors want?

importanceoriginalityrelevance to the audiencereal potential to improve decision makingtruth and transparencyclear writing that people want to readexcitement/ “wow” factor

Why does BMJ publish?

Pure academic interest isn'tenough for most BMJ readers,who mainly comprise doctors –

- whether they're practisingclinical medicine, working inpublic health, developing andimplementing health policy, orworking mostly as researchers

We aim to provide our readers

with articles that will help them

to make better decisions

What does BMJ ask authors to do?

All explained at:

bmj.comresources for authors

Writing a research paper

General guidance on writing papers

International Committee of Medical Journal Editors uniform requirements for manuscripts submitted to biomedical journals

http://www.icmje.org/ reporting guidelines for research, at the

EQUATOR network resource centre

http://www.equator-network.org/

Writing a paper1. The message

What…is the research question?…is the right article format for your

study?…does the audience need to know?

Writing a paper2. Title: style

descriptive: Number of heads in adults: auditdeclarative: Most adults have one head journalistic: Heads you winquestioning: How many heads do adults have?

Carefully check the journal’s instructions to authors andlook at other articles in that journal

Writing a paper2. Title: study design

cross sectional surveyauditcase seriescase control studycohort study (retrospective or prospective?)clinical trial (controlled? randomised? crossover?)systematic review/meta-analysiseconomic evaluation (cost of illness? cost

effectiveness?cost benefit? modelling?)

Writing a paper3. IMRaD

Introduction: why ask this research question?Methods: what did I do?Results: what did I find?Discussion: what might it mean?

Writing a paper4. The introduction

brief background for this audience3-4 paragraphs onlywhat’s known, and what’s not, about your research

questiondon’t bore readers, editors, reviewersdon’t boast about how much you have read

the research questionstate it clearly in the last paragraph of the introductionsay why it matters

Writing a paper5. Methods

like a recipemost important section for informed readersdescribe:

inclusion and exclusion criteriaoutcome measuresintervention or exposure

give references for standard methods follow reporting guidelines as explained at(http://www.equator-network.org/ explain ethics issues

Writing a paper6. Results

include basic descriptive datatext for story, tables for evidence, figures for

highlightsconfidence intervalsessential summary statisticsleave out non-essential tables and figuresdon’t start discussion here

Essential summary statistics

clinical trial: – absolute event rates among experimental and control groups– relative risk reduction– NNT or NNH (number needed to treat or harm) and its 95%

confidence interval (or, if the trial is of a public health intervention, number helped per 1000 or 100,000)

cohort study: – absolute event rates/time for exposed and non-exposed

groups– relative risk reduction

case control study: – odds ratio for strength of association between exposure and

outcomestudy of a diagnostic test: 

– sensitivity and specificity– positive and negative predictive values

Writing a paper7. Structured discussion

don’t simply repeat the introductioninclude

– statement of principal findings – strengths and weaknesses of the study – strengths and weaknesses in relation to other studies

(especially systematic reviews), and key differences– meaning of the study: possible mechanisms and

implications for clinicians or policymakers – unanswered questions and future research

go easy on the last two

Abstract: general rules

important

all authors mustapprove it

editors may screen by

abstract

for BMJ:

usually 300-400 words use active voice p values need data too%s need denominatorsno referencestrial registration details

Structured abstractobjectives - research question

design –prospective, randomised, placebo controlled, case control, etc

setting – primary or secondary care? number of centres, country

participants – entry and exclusion criteria, numbers entering andcompleting the study, sex, ethnic group as appropriate

interventions - what, how, when and for how long

main outcome measures - those planned, those finally measured

results - main results, 95% confidence intervals, statistical significance,number need to treat/harm 

conclusions – primary conclusions, implications; don’t go beyond data

trial registration - registry and number (only for clinical trials)

BMJ picoabridged articles for print BMJ

eg Cohort study

study question summary answer participants and setting design, size and durationmain results and the role of

chancebias, confounding, other cautions generalisability to other

populationsstudy funding/competing

interests

Clinical trial registration and results reporting

Clinical trial registration – ICMJE rules

drug/device trials* that startedafter July 2005 must have beenregistered before participantsare recruited

for older trials retrospectiveregistration is OK, as long as it’sbefore submission to the journal

for trials of non-drug interventionsthe rules started in 2008**

trials* since 1 July 2005: "where human participants areprospectively assigned toinvestigate the cause and effectrelationship between a medicalintervention and health

outcome".

trials** since 1 July 2008:“…prospectively assigned to one

ormore health-related interventions[including health services andbehavioural interventions] toevaluate the effects on healthoutcomes"

FDA rules on results posting: FDA Amendment Act 1. Which trials?

any ongoing trial of adrug, biological

product,or device regulated byFDA must be registered

at

clinicaltrials.gov

from September 2008 theresults of such trials must

alsobe posted there

applies to all trials except phase

I drug trials and small feasibility

studies of devices

FDA Amendment Act2. Which results have to be posted online when?

When: within 1 year of seeing last patient in trial

What:two tables of results for main outcome measures

- 2008two tables of harms – 2009lay summary of results – 2010??

FDA Amendment Act3. Penalties

If trial results aren’t posted:

US $10K per infringement, with

no upper limit

naming and shaming with non

compliance notice atclinicaltrials.gov

Publication ethics

Transparency and integrity

BMJ’s transparency policy will help you to report work honestly and fully

resources.bmj.com/bmj/authors/editorialpolicies/transparency-policy

Ethics aspects of the study

Does the paper:risk revealing patients’ identities? explain fully informed consent? explain any deviation from current normal clinical

practice?explain the full burden imposed on participants?state the total risks posed to participants or others?discuss benefits for participants, other patients, society?

It’s not always enough to state that the study was approved by an ethics committee or IRB

Who did what and why?

authors

contributors

…and competing interests

Authorship

Authorship credit should be based only on substantial contribution to:

• conception and design, or data analysis and interpretation

• drafting the article or revising it critically for important intellectual content

• and final approval of the version to be published All these conditions must be met. Participation solely in the acquisition of funding or the

collection of data does not justify authorship.  All authors included on a paper must fulfil the criteria No one who fulfils the criteria should be excluded

Contributorship

contributors (not all necessarily authors) who took partin planning, conducting, and reporting the work

guarantors (one or more) who accept fullresponsibility for the work and/or the conduct of thestudy, had access to the data, and controlled thedecision to publish

researchers must decide among themselves the precise

nature of each contribution

Who did what?

Helen C Eborall, post-doctoral research fellow1, Simon J Griffin, programme leader2, A Toby Prevost, medical statistician1, Ann-Louise Kinmonth, professor of general practice1, David P French, reader in health behaviour interventions3, Stephen Sutton, professor of behavioural science1

Contributors: SS, DPF, ATP, A-LK, and SJG conceived and designed the original protocol. All authors were involved in amending the protocol. HCE coordinated the study throughout. Data entry was carried out by Wyman Dillon Ltd, Lewis Moore, and HCE. HCE cleaned the data and ran preliminary analysis with input from Tom Fanshawe. ATP analysed the data. ADDITION trial data were supplied by Lincoln Sargeant and Kate Williams. HCE wrote the first draft of the manuscript with ATP and SS. All authors contributed to subsequent and final drafts. HCE is guarantor of the paper.

Scientific misconduct

Misconduct: the human element

“Scientists are people. Some are straightforward; others

are devious, confused, lazy, careless. Try as we might, I

don’t think we will ever cure that.”

William James, Nature 1997

What amounts to misconduct?

Research misconduct means fabrication, falsification, or

plagiarism in proposing, performing, or reviewingresearch, or in reporting research results

Fabrication: making up data or results and recording or reporting them

Falsification: manipulating research materials, equipment, or processes, or changing or omitting data or results such that the research is not accurately represented in the research record

Plagiarism: the appropriation of another person's ideas, processes, results, or words without giving appropriate credit

Research misconduct does not include honest error or differences of opinion

New tool to detect plagiarism: CrossCheck

web based tool which searches for overlapping content:

prepublicationpostpublication

specialist search engine (iThenticate) uses “text fingerprinting” and “string matching”

gets behind access controls (free tools can’t do this)9 billion articles in CrossRef database, and counting

Editors’ role in tackling misconduct

managing peer review (warning! it’s poor at spotting fraud)helping to prevent misconduct

talking with authorsproviding clear information for authors on writing papers

detecting and referring cases of misconductasking authors for explanation/raw datareferring unresolved and proven cases to author’s

institution/licensingbody/COPE/journal ethics committeepublishing notices of concernretracting articles

How to please editors and reviewers and maximise your chances of

acceptance

Before you start your study

have a clear research questionseek statistical adviceuse the right study designkeep an open mind and minimise biasagree who will be principal investigatoragree who will be authors and contributorsagree to publish even negative results

How to please editors

choose the right journalread the journalfollow advice to authorssubmit online and follow instructions

How to please editors and peer reviewers

make sure the message is clear in the paper andabstract, not just in the cover letter

include extras eg STROBE checklistcite (and send) any closely related paperssend previous peer review reports

communicate clearly and promptly

What happens during peer review

BMJ ask reviewers to sign their reports and declare any

competing interests relevant to manuscripts

reviewers advise the editors, who make the finaldecision (aided by an editorial manuscript

committeemeeting for some articles, including original

research)

BMJ peer review process

4-5000annually

3-4000rejected

Approx1000 foropenreview

500 thenrejected

500 withEditor andadviser,statisticia

n,BMJ team

4-7% with

OpenaccessNo wordlimitsBMJ picoEditorials

ScreenResearch submitted

External review

Editorial meeting

Accept

What we ask reviewers to do

be open and honest

be constructive, and help the authors to improve the

paper even if the BMJ rejects it

most importantly, reviewers advise editors on:the article’s originalitythe article’s importance

BMJ appeals

Serious appeals welcomed

Criticisms addressedUp to 20% accepted

But only one appealMake it good

Thanks

tgroves@bmj.com