Professional Development II

Writing for & targeting peer-review journals for research & scholarship

Presented by: Elena M. Andresen, PhD

Chief, Disability & Health Research GroupInstitute on Disability & Development Oregon Health & Science University CDRC room 1272A Office: 503-494-2275email: andresee@ohsu.edu

Sponsored by OHSU Department of Public Health &

Preventive Medicine, School of Nursing, & the Institute on Disability &

Rehabilitation

adding strategy to good scholarship & science

Goals Today

1. Targeting & selecting - Products/manuscripts for peer-review

journals2. Writing skills

– Specific techniques & suggestions– Consideration of writing as ongoing skill

development

Setting the Scene with a Personal Anecdote

• Undergraduate, University of Washington (‘71-’75) – Oceanography (one year) – Dual degree in history & Spanish

• In my last year, a senior woman returned my paper (Modern Spanish History) with the following words:– “You are too smart to write this badly. I want you to take a

formal writing course from the English Department & become a better writer.”

• I was startled, & then reflected – I had often received papers with two grades

(A for content, B- for writing)– As a Seattle high school honors student, I had advanced

placement credits & had no required college English course

Background, Limits, & Disclaimers

• Training: – The English class was too basic; I found some

basic ideas about paragraph construction useful– I took a one-week science writing course at

Columbia University School of Journalism– I continue to work on writing clearly. I know it is

one of my problem areas.• Most importantly: colleagues & collaborators

provide exceptional role-modeling, constructive criticism, & encouragement

My Background, Limits, & Disclaimers

• Professional Service– Editorial Boards J Gerontology; Dis Health J– Associate Editor Qual Life Res (Springer). Cumulative

portfolio ~120 manuscripts – Frequent manuscript reviews: medical/clinical, public health

journals (~ 8-15 manuscripts/year)– Frequent U.S. grant reviews: ad hoc & standing panels

Service generates experience & exposure to really good writing &

really bad writing • Research & Scholarship

– Author/Coauthor of 100+ peer-review publications, chapters, book editing

Your Formal Writing Training

If you have experiences on this list, you have some preparation for peer review publication. Have you…

• Had pre-college writing preparation courses? • Taken writing courses at undergraduate or graduate

levels? • Participated in writing workshops or seminars?• Worked with a trained editor on your publications?• Written non-science for publication (fiction, non-

fiction, poetry)?• Published scientific papers or books, chapters, etc?

Part 1: Targeting your manuscripts

Picking a Target Journal

Selecting Among Target Journals: Prestige & Impact Factors

• “Senior” coauthor (or your mentor’s) opinion

• ISA Web of Knowledge, Journal Citation Reports© – This provides a guide to journal ranking

(importance”), based on average citations of articles in the journal

Picking a Target

• Look at your reference list – where are the best articles you cited published?– by methods, discipline, or content/topic

• Look for content – general public health vs. specific clinical content (e.g., arthritis)

• Can you make an interdisciplinary statement? – Consider your coauthors, mentors, & their

publication records• Are there politics or expectations that shift

you away from a target journal? – E.g., USA-based research not common,

surveillance data not typical in the journal

Picking a Target

Look at the journal’s prior year’s publications • Lag time between: 1) submission &

acceptance; 2) accept & publication• Can you…

– cite a good article from the journal? – Mention it as a precursor to your article?– Suggest an article author as a reviewer of

your manuscript?

Picking a Target

Read the journal’s Instruction to Contributors

• They may impose limits or make suggestions or list policies that exclude or limit– your topic, length of paper, citations, tables,

acceptable methods

• Check their criteria for authorship & signoffs – do you need written agreement for acknowledging

study personnel?

Example

• I am working on an article about the impact of neighborhoods on incident depression. This is a cohort study, where people were interviewed 4 years ago & their neighborhoods were rated by the interviewer who visited their home. They were interviewed again & if they had incident depression, data about their individual & neighborhood characteristics are analyzed as risk factors.

• I will start with some of the key ideas/terms to describe my study that I will look for in journal & articles I might use as a model for mine…Aging/elderly, minority health, environment, epidemiology, mental health/depression, socioeconomics, community, cohort

Example

• I should think about targeting by content, and also by journal characteristics

• Typically, one of the most relevant, among a selection you find, is the journal's impact factor (based on average citations of the journal’s articles)At the OHSU library site, this is ISA Web of Knowledge, Journal Citation Reports©

http://admin-apps.webofknowledge.com/JCR/JCR?SID=4AOliDjNbpjJoCjFOn5

Example My key references to consider target journals:

1. Kubzansky LD, et al. Neighborhood Contextual Influences on Depressive Symptoms in the Elderly. Am J Epidemiol. 2005;162:253-260.

2. Silver E, et al. Neighborhood structural characteristics & mental disorder: Faris & Dunham revisited. Soc Sci Med 2002;55:1457-1470.

3. Henderson C, et al. Neighborhood characteristics, individual level socioeconomic factors, & depressive symptoms in young adults: the CARDIA study. J Epidemiol Commun Health 2005;59:322-8.

4. Ostir GV, et al. Neighborhood composition & depressive symptoms among older Mexican Americans. J Epidemiol Commun Health 2003;57:987-992.

5. Ross C. Neighborhood disadvantage & adult depression. J Health Soc Behav 2000;41:177-187.

6. Galea S, et al. Urban built environment & depression: a multilevel analysis. J Epidemiol Community Health 2005;59:822-827.

7. Weich S. Absence of spatial variation in rates of the common mental disorders. J Epidemiol Community Health 2005;59:254--257.

8. Dalgard OS, Tambs K. Urban environment & mental health. A longitudinal study. Br J Psychiatry 1997;171:530-6.

9. Yen IH, Kaplan GA. Poverty area residence & changes in depression & perceived health status: evidence from the Alameda County Study. Int J Epidemiol 1999;28:90-4.

10. Weich S, et al. Mental health & the built environment: cross-sectional survey of individual & contextual risk factors for depression. Br J Psychiatry 2002;180:428-433.

11. Weich S, et al. Geographical variation in rates of common mental disorders in Britain: prospective cohort study. Br J Psychiatry 2005;187:29-34.

Journal aspects to consider

Journal Impact factor

Key concepts in addition to depression & environment

Article length

American J Epidemiology 5.7 Elderly 4000

Social Science in Medicine 2.7 ----- 8000

J Epidemiology & Community Health 3.0 Minority health 3000

J Health & Social Behavior 2.2 ---- 35 pgs

British J Psychiatry 5.9 --- 5000

International J Epidemiology 5.8 --- 3000

JCR 2010

Some Cautions on Impact Factors(Editorial) Fiddling

• Use of editorials (that cite one or more articles in the issues)

• Use of review papers (that cite the journal's works)

• New wrinkle: accessibility via “free access” on the web

• Authors’ manipulations (citing your own work)

Summarizing Suggestions

• Your science is always your first concern• Consider “packaging” your articles as a task

you perform to maximize the outcome of your science

• Consider your overall career goals early, & don’t apologize for considering these as you prepare, submit, & resubmit your work

• Don’t go against your core values & make decisions if you feel like you are selling out– Push your comfort limits a bit as you develop

your career

Additional Suggestions

• Use the information about “impact” to help you make decisions, not to direct your decisions– knowledge is power

• Use your coauthors & colleagues extensively for information & feedback– Develop a thick skin for constructive criticism– Consider criticisms in light of “style” vs.

“content” Style comments are the prerogative of the first author & the journal

• Develop patience & perseverance – keep repackaging good science if you do not first

succeed!

Part 2: Writing Well

Some Preliminary Basics

You should think about, & write for the Editors & Peer Reviewers;

• Make their job easy – You know your research, methods, the literature,

etc. They may know only one component, like “lab methods,” or “epidemiology methods.”

• Without being overly repetitive, be sure you have your basic ideas clearly written in the abstract, text, & tables.

• Details count (consistent use of terms, correct references/formats, etc).

Some Preliminary Basics: Getting Started!

Publication Using Construction StepsSneak up on the product & avoid writers block• Make a WORD file & name it

– E.g., start with topic/project/journal title & date• Do the technical details

– Acknowledgments (non-author collaborators, grant numbers & funders.)

– Bibliography of likely references (lit review from your proposal & updates)

• Construct dummy tables for salient results• Draft an abstract (minimalist issues)

Publication Using Construction Steps

• Add your methods section (change verb tense of your proposal to the past tense)

• Draft the discussion– Set the context of other literature (build on their

story)– Point out the strengths & weaknesses of your

approach & results– Add major clinical, public health, other

conclusions– Note the “next steps” needed for this line of

researchNow, you are nearly done with the draft of your

article!

Elements of Manuscripts (early decisions)

• Good informative titleno need to be provocative, but make sure others understand enough about your paper to decide if it is important for them to read

• Keywords – four to six terms Use standard terms as you encounter them in your key references & MeSH terms

Thinking about the manuscript sequence

• Use a progressive, sensible sequence in each of your manuscript sections

• Be consistent! • E.g., Measures/Variables

– Start with your outcome; move to your main exposure; then sequence other measures/ variables

– Results in the same sequence– Tables (variables) in the same sequence– Discussion in the same sequence– Terms consistent in all locations of the

manuscript

Some Very Specific Writing Tips

For (your) commonly used terms, groups, organizations;

• Write it out 1st time in your manuscript, use an (acronym), & then use the acronym to save space. Try not to overdo it & some journals require a list of acronyms.

• You have to repeat this for each section: Abstract, Main text, Tables– E.g. people with disability (PWD)– Centers for Disease Control & Prevention (CDC)– Chronic Obstructive Pulmonary Disease (COPD)

Writing Tips

For (your) commonly used terms;

• For many terms, you may only be using them once anyway (e.g., in your literature/ background), so you may want to limit the use of acronyms.

• Acronyms could obfuscate your manuscript for reviewers.

Writing Tips

Paragraphs & Sentences• A paragraph has at least 3 sentences (in a

typical paragraph). They are all linked to an idea or theme. In some reviews I conduct, I pull out a single sentence that does not link to others in a paragraph – when that happens, you may have something you do not need to include. – Introduction/linking sentence to prior paragraph– Content, exposition– Ending – conclusion of the paragraph

Writing Tips

Paragraphs & Sentences• Try breaking up your sentences into

shorter parts• Avoid too many clauses & comas – if

you find you have several comas that are for different parts of a sentence (i.e., not a list of terms) you probably have more than one sentence.

• Try using WORD to check see if you have sentences that are hard to understand (example in a few slides)

Writing Tips

Typical Organization/Content• Introduction/background

– Statement of the key question– Set into national understanding (e.g., Healthy

People 2020; national statistics)– What we already know (your background/ lit

review)– What we need to know (rationale for your work)

• Methods (might be subdivided)– Sample/setting/subjects– Measures (standards, your classifications, good

referencing)– Analysis

Writing Tips

Organization/Content• Results: don’t repeat what is in tables –

broad strokes & key issues you will reinforce in the discussion

• Discussion/Conclusions – Start with very brief “main findings,” – then set these in the context of causal inference &

prior research. – Add the limits & strengths.– Concluding remarks – future steps & needs.

Writing Tips

Specific (epidemiology) Words & Terms• Prevalence (never rate) vs. incidence• Race/Ethnicity• Gender • People first language • Suffer/suffering/victims• Age – older adults vs. elderly

Writing Tips – Tables

• Make tables “stand alone” (advice from my colleague Fred Wolinsky@Iowa)– E.g. use variable names in columns that someone

can understand – You can use abbreviated terms; but be consistent

in the manuscript (don’t introduce a new shorthand in the tables)

– E.g., use a full title with data set, state, topic, etc.– E.g., label columns, with numbers.– Make sure to be clear about %’s, means,

variances, etc.

Writing Tips – Tables

– Use acronyms & foot notes, if it saves space. Spell out what you have room for, • e.g., body mass index vs. BMI if you have

space • SE – standard error; description of coding of

variables; etc.

– Center & carefully examine your columns & rows for ease of reading• E.g., make a heading for “Age” & then (&

maybe inset slightly) add age groups. • Avoid too much space in a table (e.g., no need

to add extra rows)

Writing Tips – Tables

• Reduce/reclassify categories based on– Low numbers (e.g., ethnicity)– Distribution (e.g., days are skewed so you use categories)– If you do this, be sure it is consistent with your methods

section. – Don’t surprise the reader with a new variable in a table or

results.

• Consider dropping a row – Gender, maybe just use % women (% men is by subtraction) – History of diseases, list the “yes’s” only

• Most tables have to be submitted double-spaced so they extend across pages – make the reading easy for the reviewer!

Writing (Generally)

• Writing is hard work. The next slides presents humorous, but heart-felt quotes from professional & famous authors.

• These are intended to let you know that everyone has to work at it so you are in good company!

Writing (Quotes from famous authors)

• “I always write a good first line, but I have trouble in writing the others.” Molière (b. 1662) French dramatist

• “No pen, no ink, no table, no room, no time, no quiet, no inclination.” James Joyce (b. 1882) Irish writer

• “Let’s face it, writing is hell.” William Styron (b. 1925) American novelist

• “A pathological business, writing, don’t you think? Just look what a writer actually does: all that unnatural tense squatting & hunching, all those rituals: pathological!” Hans Magnus Enzensberger (b. 1929), German poet, critic

Writing Tips

Use your science & methods toolkit & your clinical or experiential experience. Remember:

1. Causal inference, especially for non-experimental research

2. Measures (Classification/misclassification)

3. Bias of all kinds

4. Confounding

5. Chance (p-value)

6. Generalizability

Writing Tips

• Few of us are natural writers• Take advantage of writing courses, seminars,

practice, etc.• You need to read to write well.

– Reading science journals may limit your ability!• Short, direct language, active vs. passive

style (think Hemingway)– “The data were analyzed…”(bad)– “The authors used an analysis technique, logistic

regression …”(good)– “We conducted analyses in progressive steps…” (good)

Writing Tips

• Rewrite! Rewrite! Rewrite!• Strunk W, White EB. Elements of Style.

New York: Macmillan; 1979.– One of my favorite tips? “Utilize (prefer use)”

• Make sure you answer these questions:– Why?– How?– What did you find?– What does it mean (a.k.a. So What?!!!)

Writing Tips

• WORD grammar check– In “Review” set your WORD “tools” setting for

spelling & grammar to “show readability statistics”– Highlight a document, paragraph, or individual

sentences, then “enter”• Provides Flesch reading ease (0-100, higher better) &

reading grade level estimates (lower is better).

– The goal is to simplify (clear language) to lower grade level, & higher “readability” scores.

– Provides you word count in sentences (longer sentences are less clear)

Writing Tips

• WORD “readability” statistics– The quickest way to make your language more readable is

to shorten sentences. Note the “words/sentence” notation.– Avoid passive voice & use “active” voice

• Examples 1. “A variety of adjustments were made to the model during analysis.”

Semi-active voice, Flesch Reading ease (41.8) Grade level (10.1)

2. “The authors used a progressive set of steps to finalize the adjusted models.”

Active voice, Flesch Reading ease (56.9) Grade level (8.5)

3. “We used a progressive set of steps to finalize the adjusted models.”

Active voice, Flesch Reading ease (60.7) Grade level (7.7)

Examples of the truly bad…

• I wrote:– “Direct costs are budgeted at $30,000 for 12 months.” Flesch

Reading ease score 28.5 [the higher the better, & above 50 is considered good, plain English], estimated grade level, 11.5.

• The grammar check of WORD wanted me to say:– “Direct costs be budgeted at $30,000 for 12 months.” Clearly this

is weird, & in fact, by making this change, the WORD program switched back to wanting the word are & kept up this back-&-forth. The sentence was just plain bad, but looks a lot like

every budget sentence I’ve ever written.• The solution:

– “Direct costs for this project are $30,000 for 12 months.” (Reading ease score 44.4, grade level 9.5) This is more direct & it reads in plain English. It adds one more word (10 vs. 9) but we can afford a longer sentence.

Examples of the truly bad…

• An example from a health services research paper (fortunately this one is not mine): – “That is, hypertension was the condition chiefly

responsible for occasioning the use of health services.”

– Flesch reading ease score 33.6, grade 12.0 (depending on your WORD version, this may be the maximum level).

• An alternative?– “That is, hypertension was the main reason

subjects came for an appointment.” – Flesch reading ease 60.7, grade 7.7.

WORD writing exampleAmerican Journal of Epidemiology

• As submitted – Words/sentence 23.8 (way too long, on average)Passive 33%, Reading ease 25.3, grade 12.0

“Public health researchers & practitioners have long noted the correlation between the social disadvantage of populations & individuals, & their health. In the U.S.A., social disadvantage is usually operationalized as socioeconomic status (SES) & measured by such individual factors as income, poverty, education, employment & job type, & other social circumstances. Reductions in the impact of individual SES factors on these & other health outcomes have been targeted by the Public Health Service as part of the of the national health goals (1). In recent years, social theories about environmental/contextual & individual influences have become much more prominent in public health (e.g., 2-7). Aspects of the built environment & broader social & economic aspects of the places people live have come under increasing scrutiny. In essence, public health researchers & practitioners embrace the concept that “place matters” in producing disparate health outcomes.”

• Revised – words/sentence 11.5 Passive 0%, Reading ease 35.1, grade 11.2Public health research demonstrates that social inequality causes poor health. We usually measure social risk factors as differences in individual income, education, & employment. However, neighborhood conditions also may cause poor health. (e.g., 2-7) The public health community now embraces the notion that “place matters” in health outcomes.

Writing Tips

• Past tense is used in scientific articles– The literature you cite represents completed

past work– Your methods & results represent completed

work.• Exceptions:

– commonly held information (“binge drinking is associated with (references)”).

– When you recommend future actions– This research demonstrates…

Writing Teams

• Having colleagues is good!• Limits to authors (e.g., AJPH = 6)• Authors have specific rules for authorship

vs. acknowledged • Assign authorships & task before the project

is begun (essentially a contract)• No free authorship• Lead author makes final decisions• Assign junior people the lead role & mentor

& assist them!

Final Thoughts

• To write well you should read– Read good literature in the language you write in.

Not just science/medical journals!

• To write well you need to learn, practice, take classes– Few are born writers– Science & technical training may hinder our

ability to write well– A good vocabulary is not the same as good

writing!

In my office window: I ward off theevil eye. (tradition from Anatolia)