Writing for Scientific Medical Manuscript: A Guide for Biomedical Journals PDF

SPECIAL ARTICLE Writing for Scientic Medical Manuscript: a Guide for Preparing Manuscript Submitted to Biomedical Journals Siti Setiati, Kuntjoro Harimurti ABSTRACT conducted a clinical trial according to good clinical Pub...

SPECIAL ARTICLE Writing for Scientic Medical Manuscript: a Guide for Preparing Manuscript Submitted to Biomedical Journals Siti Setiati, Kuntjoro Harimurti ABSTRACT conducted a clinical trial according to good clinical Publishing a manuscript of study results in a medical or practice. While for the reader, publication of a study may biomedical journal is not as easy as we imagine. There are provide greater knowledge on research of medical/health some components that should be noticed in publishing a care science which may bring advantages to enhance medical scientific journal. Although every journal has medical services for patients. different manuscript format, in general, a manuscript contain Nancy Dixon indicates several special advantages some components, which consist of: introduction, methods, of the published study result, i.e.: results, and discussion. Before submitting the manuscript, be There is current knowledge which will enhance sure that it has been consistent with instructions to authors of the desired journal. Submitted manuscript should be medical practice and will be usefull for doctors who enclosed by a cover letter, a statement about any sponsor work in an organization or other countries; or other potential relationship that may cause conict of Other people will be able to analyze the study result interest, a statement that the manuscript has been read carefully and will be able to give constructive critics and agreed by the author(s), and any information about and suggestions to the writer; a corresponding author. Writing skills is very important to A study result may change the existing medical obtain a good manuscript of study result, in order to achieve practice or at least may encourage a debate or greater possibility for publication. Writing skills can be further study; learned through various books or electronic sources such as It may create a network of similar interest or internet which discuss about writing techniques. colleagues. Key words: manuscript, biomedical journal, writing skills. On the other hand, publishing a manuscript of study result in medical or biomedical journal is not as easy INTRODUCTION as we imagine. For novice investigators in Indonesia, it is still difcult to have their manuscript published in “The amount of writings of a profession is a measure of its vitality and activity, whilst their quality is a rough prestigious journals either at national, regional or interna- indication of its intellectual state”- Sir Robert Hutchison tional level. There are many reasons for it, starting from a (1871-1960) Lancet 1939;2:1059. bad or insufcient substance or study methods to lack of When a doctor decides to conduct a study, at the condence to submit their manuscript of study result. same time the doctor should decide to write and publish There is a reason for unpublished or refused the study result as well. manuscript, which is frequently forgotten by most of Michael Faraday, a physicist, declares an adagium investigators, i.e. incorrect and inappropriate way of “Work; nish; publish”. If you start to work but you writing. Most of them consider their task as investiga- will not nish it, why do you start it? Moreover, if tors are to collect and analyze data with patches of you nish the work but you will not publish it, why sentences in their reports, and consider that creating do you nish it? Writing and publishing a study result is important a good and comprehensive reading as the task of the either for the investigator or the reader. For the investiga- concerned journal editor. For a new journal which still tor or writer, publication is evidence that he/she has has a small number of manuscript contributions, these considerations may be acceptable, but for an established journal which has received many manuscripts, it is very Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine University of Indonesia-dr. Cipto Mangunkusumo Hospital, Jakarta easy for the editor to diagnose of manuscripts with inappropriate writing without any consideration for the substance and study methods. 50 Vol 39 Number 1 January - March 2007 Writing for Scientic Medical Manuscript Most journals always provide a special page for PREPARING A MANUSCRIPT FOR SUBMISSION TO “Instructions to Authors”, as absolute prerequisites for A MEDICAL JOURNAL manuscipt submitted to the journal editors. In addition to Editors and reviewers of a scientic medical journal the minimal prerequisites, other principles of medical/ spend a lot of time to read the submitted manuscripts, biomedical scientic writing should also be recognized therefore, they will extremely appreciate a manuscript by investigators who propose to write and to publish which is easily read and has been edited. “Instructions their study result. This article will explain in brief about to Authors” is made to standardize the submitted principle and techniques of scientic medical writing manuscripts and also to simplify the workload of editors (especially for original article) which may be used as and reviewers. Therefore, read it carefully before a basic principle for investigator and novice writer in you write or submitt any manuscript to the journal order to have a manuscript which, according to the editorial staff. common principles and if it is submitted to a scientic Although every journal has different manuscript medical journal for publication, at least will be interest- format, in general, a manuscript contains some compo- ing to the editor or peer-reviewer to read it. nents, which consist of: introduction, methods, results, and discussion. WHAT DO THE READER AND EDITOR WANT? The structure known as an acronym of IMRAD is Before starting to write an article of study result or not always used by all journals with similar term, but other article and submitting it to a certain journal, there essentially the structure reects a process of scientic are a basic questions that should be considered by an evidence-based study conducted by an investigator. A investigator who wishing to write his/her work: long manuscript occasionally needs several subtitles for a. Who will be the main readers of my article? some components (especially in result and discussion b. Who else will read the article? section) in order to clarify meaning. c. What are the backgrounds of the main readers and Manuscript is a double-spaced article with sufcient other readers? What are they? space margins which will facilitate editorial staff to make d. What will make the readers interested in this article? editorial changes for every lines and to add comments or What will be the main concern of the readers? questions directly on the same paper. If the manuscript e. How great is experience of the readers about is submitted in the form of electronic media (disc, subjects that will be written? compact-disc, e-mail, etc), it should be in double spaces, f. Do the readers understand the situation and because it may be printed for editorial changes and condition explained in this article? reviewing. g. Why should they read this article? In the writer’s Components that commonly exist in a manuscript opinion, what will be learned by the readers from prepared to be submitted to medical journal are as this article? follows: h. What does the writer expect after the reader has Title Page nished reading this article? Title page should contain information as follows: Most readers expect details of what have been done. a. Title of article. Title should be simple, concise and not They do want to know why the study was conducted, complicated. However, occasionally, an extremely and why there is the brief review about previous concise title may provide lack of information. In the studies, approach and method used in the study result, current electronic era, the title of an article should interpretation and conclusion of the study. include some information that will give a sensitive An editor of a medical journal has more expecta- and specific result if electronic search is per- tions than the readers, craves for interesting and formed. amusing article for the readers. The editor also hopes an b. Author, name of department(s) and institution(s). an important article that may enhance knowledge and Some journals include authors with their degrees provide novel thought or ideas of certain study subjects. while others do not. Author(s) is person(s) who gives Editor also craves for an article which is appropriate to substantive intelectual contribution of the conducted the aim (or: mission) of the journal, according to the research. The International Committee of Medical predetermined “Instructions to Authors” and a well Journal Editor (ICMJE) declares that an author written article. Finally, an editor loves to publish an should meet all of the following conditions: (1) has a article which gives a correct and accurate illustration substantial contribution on proposal and design, or of the conducted study. data accuracy, or analysis and data interpretation, 51 Siti Setiati Acta Med Indones-Indones J Intern Med (2) critically prepare or revise important manuscript tion, observation method and analysis), the main result contents through intelectual ability, and (3) provide (mentioning about the importance of effect and statistical nal agreement on the revised article for publication. significance, if possible), and principal conclusion. People involved in the study but do not meet Abstract should be able to present the novel and all of requirements as mentioned above can be important aspects of the conducted study. regarded as “clinical investigator” or “participating Since there are some important parts of an abstract investigator”, and will have their name on “Acknow- commonly used as index of various electronic database legdement” section. and most of the readers only have abstract of the study, c. Disclaimer, if any. it should be assured that the abstract reveals overall d. Corresponding author. Author’s name, correspon- study report accurately. Unfortunately, there are many dence adress, telephone number, fax and e-mail are abstracts inappropriate to the manuscripts. included. Corresponding author may be the author Key words are 3 to 10 words or concise-phrase that who “guarantee” integrity of overall manuscript, but may reveal the main topic of the study, usually it is may be not. Corresponding author should noticeably stated along with the abstract. Keywords should include declare that he/she does not mind if the above words registered in the list of Medical Subject Heading information is published. (MeSH) of index medicus. e. Available author’s name and contact address if there Introduction is a request of manuscript copy, or a statement that Introduction contains the study background manuscript copy cannot be provided by the author. (revealing the importance of a problem so that it should f. All of aid sources and assistance such as fund, be studied, supported by data of available literatures), equipment, medicines, etc. study objective and hypothesis that will be tested or g. Running head. Some journals ask for running head questions that will be answered by the study. Parts of or a brief title of article which has been condensed introduction is written as a narative arranged in logic into less than 40 characters (including letters and sequences in 1 or 2 paragraphs. spacing) on the footer of title page. This running As an analogy of a building, introduction is a head may appear on the published article, but it may “door” to get into the “house” of all part in study be only used by the editorial staff for manuscript report. Therefore, introduction section should be able documentation. to ‘drive’ the readers to understand and agree the h. Word count. Word count for all of manuscript investigator’s/writer’s idea that the study performed is content (abstract, acknowledgments, gure explana- necessary and reasonable. tion, title of tables and references are excluded) will help the editor or reviewer to determine whether the Methods information is appopriate to the length of manuscript Methods only contain available information at the and to decide whether the submitted manuscript does time of planning and study protocol; therefore, other not exceed the limited word count determined by the information obtained after the study performed should journal. Separated word count for abstract is also be included in results section. useful for similar reason. In this section, the study design should be explained i. The number of illustrations and tables. (along with relevant explanation for each design), time and place of the study conducted, subject selection Special Page for ‘Conict of Interest’ Statement (including the control group), inclusion and exclusion To anticipate any potential conict of interest among criteria as well as study population. Variables of study the writer, editor or reviewer (either because of the and correlation among the variables should be clear. received fund or other facilities, or writer, editor and Technical information about measurement (examina- reviewer come from the same institution); therefore, if tion) including the executor, equipment and medicine necessary, the writer may explicitly state whether there used (if possible, mention about the brand-name and is any potential conlct of interest occurred. manufacture), informed-consent of the subject, etc Abstract and Key words should also be included in details. An abstract is a substantial part of overall Analytical statistic which is used in the study (such manuscript in brief. Although there are various abstract as hypothesis test, signicance test, statistic power and forms–which depend on each journal-, generally, abstract condent interval) should also be included in details, so should include the context of background of study, the that other people who have data access may clarify the study aim, basic procedures or methods (subject selec- reported result. The common analytical method may 52 Vol 39 Number 1 January - March 2007 Writing for Scientic Medical Manuscript not be explained. However, if there is certain new or exaggerating sentences about the study result, as well as occasional hypothesis test or statistical test, then it should hesitant sentences. be explained or references should be provided. Explain At the end of discussion section, mention about about statistical terms, abbreviations and symbols. the conclusion of the study. Indicate correlation between Mention about the computer program used in the the conclusion and the aim of study, avoid statements study. and conclusions which are not supported by data adequately. Results Present the study result with logical sequences References through texts (naration), tables, and illustration; starting References should be numbered in the order in from main result or the most important result rst. Do not which they are mentioned in the text. References of text, repeat any information that has been presented in tables tables and illustration are numbered by Arabic number in and illustration into text, except for emphasizing or parentheses. Style of references of various literatures highlighting important ndings. Additional information can be seen on examples recommended by ICMJE and technical details may be put in the appendix section (www.nlm.nih.gov/bsd/bsdhome.html), while the data so that it can be revealed without disturbing the naration. of titles of journals can be seen in index medicus. Provide the absolute number of data not only as a Other things that should be noted in writing percentage. Avoid non-techinical statistical terms, such references: as “random”, “normal”, “signicant”, “correlations”, Try to directly refer to original research articles and and “sample”. not to the review articles because review articles do Use tables and illustrations only for information not always indicate accurate results. which has better value on tables and illustration compared Avoid using abstrats as references to text form, because usually the editor determined a Articles accepted but not yet published may be limited number of tables and illustrations. Use an added by “in press” or “forthcoming”, and it should illustration as an alternative of table with a lot of have written consent saying that the articles will be components, and do not duplicate data on illustrations referred and provide a verication that the article and tables. Tables or illustrations should be appropriate has been accepted to be published. to text. “Wild” tables or illustration that do not indicate Information of refused articles by certain journal on text should be avoided. Explain about uncommon should be written on text as “unpublished observa- abbreviations and symbols on the footnote of tions” with a written consent of the source. related tables. Usually, an editor would like a Avoid citing a “personal communication” unless it professional illustration is ready to be printed. provides essential information not available from For manuscript which will be submitted to a public source. If it should be done, name the journal, provide tables and illustrations on seperated person and date of communication on the text in pages. parantheses. Be careful about details of number writing, numerical Although some of journals conduct accuracy check- accuracy, terms, and statistical symbols, and technical ing of citation and references, the author should details of tables and illustration production, which assure that nothing is missed. are reffered to as a guide to ICMJE (can be seen on www. icmje.org, 2006) and Sastroasmoro monogram FINAL PREPARATION OF MANUSCRIPT (1999). After the manuscript has been written according to Discussion “instruction to authors”, let it be (do not read it) for Reveal novel and important ndings of the study. Do several days, and give it to other people to be read not repeat every details of data presented on introduction before submitting it to the desired journal. As a result of or Result section. In experimental study and some of not ‘touching’ your manuscript for a few days, you will observational studies, discussion usually begins with get inputs and questions from the people who read your concise and clear explanation about main result of the work and after you read it once more, usually there study, and followed by analysis of possible mechanism or will be additional ideas about something that should be explanation of such ndings, compare and differ it with added, deleted or briey revised. other relevant studies, and mention about drawbacks Read over the whole manuscript, starting from the of the study, and analysis of implication in clinical title to the references. Check every word and sentence practice and possibility of further studies. Avoid carefully, avoid typing error. Revise any complicated 53 Siti Setiati Acta Med Indones-Indones J Intern Med sentence by expressing your ideas through the least reviewer which will be important for revision. Use it number of words. If you are able to delete words to revise the manuscript, and submit it to other journal without changing the meaning, then do it. Avoid adjacent afterwards. word repetition, but repetition on some ideas can be made necessary. Keep in mind that there is limited pages SEVERAL NOTES ON ‘WRITING’ in the journal and the editor will appreciate concise Refer to Sir Robert Hutchison statement cited in manuscript. The naration should ow smoothly- in every the beginning of this article, which is important for sentence and in every paragraph – with logical sequences. professional doctor to write in sufficient number But there is one importance, which is usually ignored, and quality so the vitality and intelectual state as a in performing literature review relevant to the studied profession could be acknowledged. However, there is topics since there is high possibility of many novel some experience that the enthusiasm of writing among studies that have been published during the study. Error doctors is low. Some have reason for routine activities in lliterature review will make all of the study reports and daily practice and other exclaims on inabillity become ‘obsolete’ (especially in background and of good writing. There are a lot of ideas created in discussion section), which bring small possibility to be their head, but they are unable to make it into an accepted by the journal reviewer. comprehensible article. Unfortunately, this inability After everything has been completed, the next step only exists as an emotion or feeling, which means is submitting your revised manuscript to the desired that there is feeling of inability without any journal editorial staff. Make sure that you have attempt to write it. While there is a principle guide completed every component that being asked by the for a novice author: First get it down and then get it journal. Every details, such as the number of copies right. How could we know that we are unable to write (including tables and illustrations) on demand should correctly if we never start to write? Writing skill is be completed. Do not rely on the editorial staff that they similar to other skills, if you want to write fast and will make copies of your manuscript and distributing it correctly, then you have to practice it. to editors and reviewers. Currently, there is possibility In general, there are two types of authors: ‘gatherer’ of submitting manuscript through electronic media, and ‘hunter’. A ‘gatherer’ author collects all of sources either by disc, e-mail, or directly to the desired journal that might be relevant to the article, reading all of website. Pay attention to the determined requirements for the compiled sources, use it to organize an idea then submitting manuscript through such methods. starting to write. This ‘gathering’ attitude is suitable Submitted manuscript should be enclosed by cover if you would like to make a literature review, and this letter containing statement that the manuscript is original is an attitude learned by students during their formal work of the author and has not been published before education. But this attitude is not always suitable to in a journal or other media. It also contains statements every article. ‘Gatherer’ authors may make various about any sponsor that potentially may cause conict of serious mistakes even before starting to write:they interest, the manuscript has been read and agreed by hesitate about their target reader, they do not have the author, and any information about corresponding obvious aim of writings, they are not certain about author. Other information that should be known by the important messages that will be given, and they have journal editor must be stated in the cover letter, for no attention on organizing ideas. example, if the manuscript has been submitted to other Experienced authors incline to have ‘hunter’ journal and has been refused, then you should enclose attitude in writing. They determine about what article comments of previous editor and reviewer as well as should be made and for whom it should be written. They your comments about it. know what specication should be done, and determine Finally, it is the time to wait for response. Response the strategy to achieve those specications as part of may be in the form of: (1) approved for publication outline. Subsequently, they find sources which are without any substantial revision; (2) considered for appropriate to the constructed outline. Created ideas can publication with substantial revision; or (3) refused for be written rapidly, and they are written in comprehensible publication. If the manuscript should be revised, then sentences and have the least misinterpretation. Those do it based on comments of critical appraisal from the ideas are organized in common sense so that information editor or reviewer. If the manuscript is refused, do not can be followed by the readers. This type of authors can be dissappointed. Usually, the editor will point out their perform editting on their own articles. reason on why the manuscript cannot be published in To achieve this ’hunter’ attitude is not easy. Begin addition to comments and suggestion of editors and 54 Vol 39 Number 1 January - March 2007 Writing for Scientic Medical Manuscript to write as ’gatherer’ author continually and improve REFERENCES your article quality consistently, including learning 1. International Committee of Medical Journal Editors. Uniform from other articles of ’hunter’ authors, or ask somebody Requirements for Manuscripts Submitted to Biomedical to read our article. As a result, we know whether our ideas Journals: Writing and Editing for Biomedical Publication. February 2006. (www.icmje.org) can be followed by the readers. People whom we asked to 2. Dixon N. Writing for publication – a guide for new authors. Int read and to give comments on our article are not always J Qual Health Care. 2001;13(5):417-21. experienced people. Sometimes ‘foolish questions’ 3. Naylor WP, Muñoz-Viveros CA. The art of scientic writing: of a junior may improve our judgement about the How to get your research published! J Contemp Dent Pract. drawbacks of our article. 2005;(6)2:164-80. 4. Sastroasmoro S. Panduan penulisan makalah ilmiah kedokteran. Writing skill can be learned through various books Jakarta: Bagian Ilmu Kesehatan Anak Universitas Indonesia; on writing techniques, either in general or special 1999. writing for scientic medical/biomedical journals which are greatly published recently, including electronic sources such as internet. Do not hesitate to ask or open your dictionary, and books of writing guide for special terms, so that our article are always appropriate. Thus, once more: rst get it down and then get it right. 55