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Editorial—Getting published
Editorial-Getting
published
different, in that research is concerned with discovering the right thing to do, whereas audit is intended to make sure that the thing is done right.5 It is important that the methodologies of audit arc scientilically sound. utilising adequate sampling methods and appropriate analyses. Audit can make contributions by identifying questions that research must address. There is now a broadening base for research, encompassing not only the traditional basic science or clinical research, but expanding into health services research with a more patient-focused approach, including quality of life estimation, patient satisfaction and needs assessment.
It is becoming more competitive for authors to have their papers accepted for publication in the medical literature. With most specialist journals, the acceptance rate is around 25-500/o. Our own journal publishes less than half of the articles submitted. So, how can you impress the editor? Most editors look for quality manuscripts which describe work which is sound, original, interesting and possibly controversial.’ The first stage in the process of getting published is to undertake the research or collect the case material: and then to write the paper. Planning the work Papers should be based on sound clinical research methods. There is a hierarchy in terms of strength of evidence for the assessment of treatment efficacy:‘s3 1. Anecdotul case report is the lowest order. Although it may signal important new developments, it does not provide sufficient evidence for widespread change, unless there are other supportive series. 2. Case series rank higher. They demonstrate that new procedures can be reliably performed with few complications, but rarely provide convincing evidence of the superiority of one technique over others. 3. Retrospective comparative study compares two or more treatments, but there is the risk of selection bias and unmatched groups. 4. Inter-centre retrospective comparison will generate larger patient numbers more rapidly, and allow a more detailed analysis of the treatment results. However, a larger number of variables may be introduced. 5. Randomised controlled prospective study has traditionally been considered as the epitome of scientific validity.’ Randomisation avoids conscious or unconscious bias in treatment allocation. Prognostic factors tend to be balanced between treatment groups. Randomisation guarantees the validity of statistical tests of significance. Patients arc treated and are followed-up prospectively according to a clearly defined protocol. resulting in less missing data. The editor of a journal is looking for papers which fall into category 5 rather than 1. Indeed, it has been suggested that as few as 15”/0 of interventions in medicine have been adequately evaluated.4 There is a need to know more about the effectiveness of care so that ‘health gain’ can be identified and measured. Health services research is now receiving a high priority with the establishment of the NHS Research and Development Programme. In addition, clinical audit has much to contribute to research. However, it should be remembered that audit and research are
Writing the paper Before commencing the task of writing, it is advisable to select the appropriate journal, ensuring that the topic falls within its scope. Most journals publish their aims; for our own journal, these appeared in the Editorial in February 1992.6 It seems obvious to advise writers to read the instructions to authors, including the reference system used. By following the instructions, many common errors and omissions can be avoided, thereby maintaining the editor’s interest and empathy. The paper should be written in simple direct English, using nouns and verbs and not adjectives and adverbs.’ Words should be used accurately, and cliches and jargon avoided, such as ‘situation’, ‘disease process’ and ‘the patient presented to hospital’. It should be remembered that an article written for publication is quite different to one written for oral presentation: a speaker can get away with a conversational style, using jargon and imprecise words, and considerable repetition. The printed word should be direct and accurate. Useful comments about the style of writing have been published by Dr Alex Paton.* He emphasised the importance of brevity, but also the avoidance of a staccato style: the writing should be correctly ‘paced’. The layout of the text and the headings will vary depending on the nature of the paper. In general these for investigative reports follow the usual convention; others can be subdivided as the author desires. The title of the article should attract the reader’s attention, and be descriptive, informative and concise. It will be listed in Index Medicus and other data bases, and may well determine whether the article will be read in the future. The summary is a brief and informative review of the paper, covering the aims: methods and results. It should be capable of being understood on its own, 20.5
206
British
Journal
of Oral
and Maxillofacial
Surgery
and may be the only part of the paper which is read. Few people read the whole of every article in a journal. The summary is abstracted in the Medline database, and again may determine whether the article will bc read or quoted in the future. The introduction outlines why the study was undertaken. The author should have an in-depth knowledge of the literature, but the references quoted in the text should be selcctivc and relevant, and useful to other workers. Vast numbers arc required only in review articles. The last part of the introduction should be the aims of the study or the reasons for writing the paper. The methods section should contain sufficient information to allow the study to be repeated by others. If the method has been published previously, give a brief description, including any differences in your own technique. An account should be included of the statistical methods. The results are prcsentcd in detail. If there are large amounts of data and statistical analyses, these are best listed in tables. This information need not be repeated in detail in the text. Interpretation of the results should not be included in this section; this belongs in the discussion. The discussion should contain a brief summary of the results, together with a comparison with previously published papers. A critical appraisal of the present and past findings can bc included. The meaning of the present results can be discussed, together with modest speculation about how they may advance current ideas. A separate conclusion section is not required. The references must be accurate, correctly quoted in the text, and listed in the journal format, with the correct punctuation. Mistakes with references are a common source of irritation for editors. References must be perfect. Their accuracy is the responsibility of the author. Revision of the paper is often required following review by the editor and the referees. The comments and suggestions sent back to the author arc meant to be helpful, and are intended to improve the paper prior to publication. Do not be too sensitive! The author should follow the suggestions when modifying the paper. Where there is disagreement, the writer should point this out to the editor, giving the reasons for the opinions expressed. If the paper is rejected, the author should not be too disheartened. Most articles arc eventually published in some form or another provided they contain an obvious message which is clearly and briefly expressed. Authors should avoid duplicate publication, that is, where the results of a single study appear in more than one journal. Waldron has shown that this practice is not uncommon,’ and is probably a reflection of the pressure on clinicians to publish. This may lead to “salami” publication,” where the results of a single study are parcelled out to different journals rather than being published in a single comprehensive form. In its most extreme form, similar papers may appear in different journals. Most editors subscribe to the rules set out by the Vancouver group of medical
journal editors: articles cannot be considered for publication, either in print or in electronic form, if they are under consideration or have been published elsewhere. Another topic of growing concern is fraud and misconduct in medical research.’ ’ The Royal College of Physicians defined scientific misconduct as including piracy (the deliberate exploitation of ideas from others without acknowledgement), plagiarism (the copying of ideas, data or text without permission or acknowledgement) and fraud (involving the deliberate deception, usually the invention of data). Every effort should be made to eliminate this practice. The whole process of collecting the research or clinical data and then writing the paper provides a stimulus to our clinical and surgical work, improves our understanding and treatment of disease. and allows us to provide better care and treatment of our patients. This is well recognised, and experience of research is an integral part of higher professional training. Various reports have recommended a period of full time research within the training programmc as either essential” or at the very least a highly desirable part of the education and training of all surgeons. l3 One year full time research activity could be directed towards a MSc or M Med SC degree.14 Our own journal depends for its success on the quality of the papers submitted for publication. A measure of quality is the Impact factor, and this increased from 0.38 in 1990 to 0.54 in 1991 (the latest year for which data is currently available). The future success of our journal will be dependant on our ability to publish original papers of high calibre. Professor John W. Frame Editor References I. Brcwis, A. Please an editor. In: How To Do It. Vol 3. London: BMJ. 1990: 64 70. 2. The epistemology of surgery. Lance1 1986: 656-657. 3. Scmb. G.. Roberts. C. T.. Shaw. W. C. Strategies for the advdnccment of surgical knowledge in cleft lip and palate. Paper presented at the Confcrencc on Risk Assessment in Dentistry. University of Carolina, June 2, 1989. 4. Smith, R. Where is the wisdom? The poverty of medical evidence. BMJ, 1991; 303: 798 -799. 5. Smith, R. Audit and research. BMJ. l9Y2: 305: 905-906. 6. Frame, J. W. Editorial. Brit. J. Oral Maxillofac. Surg., 1992; 30: 1. 7. Lock, S. Survive as an editor. In: How To Do It. Vol I. Second edition. London: BMJ, 19X5; 231-234. 8. Paton. A. Write a paper. In: How To Do It. Vol 1. Second edilion. London: BMJ, 1985; 207-21 I. 9. Waldron, T. Is duplicate publishing on the increase? BMJ, 1992: 304: 1029. 10. Lock, S. Publication: duplicate, salami, meat extender-all redundant. BMJ. 1989: 298: 1203- 1204. I I. Walton Lord. Action needed on research fraud. Doctor, 1991; I3 June: 23. 12. Taylor, I., Johnston I. D. A. On behalf of the Association of Professors of Surgery. Research and surgical training. Bull. Ann. R. Coil. Surg. Engl.. 1989; 71: 89-YO. 13. Blandy. J. P., Browse, I\;. L., Hardcastle, J. D. The place of research in surgical training. Bull. Ann. R. Coil. Surg. Engl.. 1989; 71: 64. 14. Taylor. I. Opportunities for research in surgical training. Bull. Ann. R. Coil. Surg. Engl., 1993: 75: 31-32.
published
different, in that research is concerned with discovering the right thing to do, whereas audit is intended to make sure that the thing is done right.5 It is important that the methodologies of audit arc scientilically sound. utilising adequate sampling methods and appropriate analyses. Audit can make contributions by identifying questions that research must address. There is now a broadening base for research, encompassing not only the traditional basic science or clinical research, but expanding into health services research with a more patient-focused approach, including quality of life estimation, patient satisfaction and needs assessment.
It is becoming more competitive for authors to have their papers accepted for publication in the medical literature. With most specialist journals, the acceptance rate is around 25-500/o. Our own journal publishes less than half of the articles submitted. So, how can you impress the editor? Most editors look for quality manuscripts which describe work which is sound, original, interesting and possibly controversial.’ The first stage in the process of getting published is to undertake the research or collect the case material: and then to write the paper. Planning the work Papers should be based on sound clinical research methods. There is a hierarchy in terms of strength of evidence for the assessment of treatment efficacy:‘s3 1. Anecdotul case report is the lowest order. Although it may signal important new developments, it does not provide sufficient evidence for widespread change, unless there are other supportive series. 2. Case series rank higher. They demonstrate that new procedures can be reliably performed with few complications, but rarely provide convincing evidence of the superiority of one technique over others. 3. Retrospective comparative study compares two or more treatments, but there is the risk of selection bias and unmatched groups. 4. Inter-centre retrospective comparison will generate larger patient numbers more rapidly, and allow a more detailed analysis of the treatment results. However, a larger number of variables may be introduced. 5. Randomised controlled prospective study has traditionally been considered as the epitome of scientific validity.’ Randomisation avoids conscious or unconscious bias in treatment allocation. Prognostic factors tend to be balanced between treatment groups. Randomisation guarantees the validity of statistical tests of significance. Patients arc treated and are followed-up prospectively according to a clearly defined protocol. resulting in less missing data. The editor of a journal is looking for papers which fall into category 5 rather than 1. Indeed, it has been suggested that as few as 15”/0 of interventions in medicine have been adequately evaluated.4 There is a need to know more about the effectiveness of care so that ‘health gain’ can be identified and measured. Health services research is now receiving a high priority with the establishment of the NHS Research and Development Programme. In addition, clinical audit has much to contribute to research. However, it should be remembered that audit and research are
Writing the paper Before commencing the task of writing, it is advisable to select the appropriate journal, ensuring that the topic falls within its scope. Most journals publish their aims; for our own journal, these appeared in the Editorial in February 1992.6 It seems obvious to advise writers to read the instructions to authors, including the reference system used. By following the instructions, many common errors and omissions can be avoided, thereby maintaining the editor’s interest and empathy. The paper should be written in simple direct English, using nouns and verbs and not adjectives and adverbs.’ Words should be used accurately, and cliches and jargon avoided, such as ‘situation’, ‘disease process’ and ‘the patient presented to hospital’. It should be remembered that an article written for publication is quite different to one written for oral presentation: a speaker can get away with a conversational style, using jargon and imprecise words, and considerable repetition. The printed word should be direct and accurate. Useful comments about the style of writing have been published by Dr Alex Paton.* He emphasised the importance of brevity, but also the avoidance of a staccato style: the writing should be correctly ‘paced’. The layout of the text and the headings will vary depending on the nature of the paper. In general these for investigative reports follow the usual convention; others can be subdivided as the author desires. The title of the article should attract the reader’s attention, and be descriptive, informative and concise. It will be listed in Index Medicus and other data bases, and may well determine whether the article will be read in the future. The summary is a brief and informative review of the paper, covering the aims: methods and results. It should be capable of being understood on its own, 20.5
206
British
Journal
of Oral
and Maxillofacial
Surgery
and may be the only part of the paper which is read. Few people read the whole of every article in a journal. The summary is abstracted in the Medline database, and again may determine whether the article will bc read or quoted in the future. The introduction outlines why the study was undertaken. The author should have an in-depth knowledge of the literature, but the references quoted in the text should be selcctivc and relevant, and useful to other workers. Vast numbers arc required only in review articles. The last part of the introduction should be the aims of the study or the reasons for writing the paper. The methods section should contain sufficient information to allow the study to be repeated by others. If the method has been published previously, give a brief description, including any differences in your own technique. An account should be included of the statistical methods. The results are prcsentcd in detail. If there are large amounts of data and statistical analyses, these are best listed in tables. This information need not be repeated in detail in the text. Interpretation of the results should not be included in this section; this belongs in the discussion. The discussion should contain a brief summary of the results, together with a comparison with previously published papers. A critical appraisal of the present and past findings can bc included. The meaning of the present results can be discussed, together with modest speculation about how they may advance current ideas. A separate conclusion section is not required. The references must be accurate, correctly quoted in the text, and listed in the journal format, with the correct punctuation. Mistakes with references are a common source of irritation for editors. References must be perfect. Their accuracy is the responsibility of the author. Revision of the paper is often required following review by the editor and the referees. The comments and suggestions sent back to the author arc meant to be helpful, and are intended to improve the paper prior to publication. Do not be too sensitive! The author should follow the suggestions when modifying the paper. Where there is disagreement, the writer should point this out to the editor, giving the reasons for the opinions expressed. If the paper is rejected, the author should not be too disheartened. Most articles arc eventually published in some form or another provided they contain an obvious message which is clearly and briefly expressed. Authors should avoid duplicate publication, that is, where the results of a single study appear in more than one journal. Waldron has shown that this practice is not uncommon,’ and is probably a reflection of the pressure on clinicians to publish. This may lead to “salami” publication,” where the results of a single study are parcelled out to different journals rather than being published in a single comprehensive form. In its most extreme form, similar papers may appear in different journals. Most editors subscribe to the rules set out by the Vancouver group of medical
journal editors: articles cannot be considered for publication, either in print or in electronic form, if they are under consideration or have been published elsewhere. Another topic of growing concern is fraud and misconduct in medical research.’ ’ The Royal College of Physicians defined scientific misconduct as including piracy (the deliberate exploitation of ideas from others without acknowledgement), plagiarism (the copying of ideas, data or text without permission or acknowledgement) and fraud (involving the deliberate deception, usually the invention of data). Every effort should be made to eliminate this practice. The whole process of collecting the research or clinical data and then writing the paper provides a stimulus to our clinical and surgical work, improves our understanding and treatment of disease. and allows us to provide better care and treatment of our patients. This is well recognised, and experience of research is an integral part of higher professional training. Various reports have recommended a period of full time research within the training programmc as either essential” or at the very least a highly desirable part of the education and training of all surgeons. l3 One year full time research activity could be directed towards a MSc or M Med SC degree.14 Our own journal depends for its success on the quality of the papers submitted for publication. A measure of quality is the Impact factor, and this increased from 0.38 in 1990 to 0.54 in 1991 (the latest year for which data is currently available). The future success of our journal will be dependant on our ability to publish original papers of high calibre. Professor John W. Frame Editor References I. Brcwis, A. Please an editor. In: How To Do It. Vol 3. London: BMJ. 1990: 64 70. 2. The epistemology of surgery. Lance1 1986: 656-657. 3. Scmb. G.. Roberts. C. T.. Shaw. W. C. Strategies for the advdnccment of surgical knowledge in cleft lip and palate. Paper presented at the Confcrencc on Risk Assessment in Dentistry. University of Carolina, June 2, 1989. 4. Smith, R. Where is the wisdom? The poverty of medical evidence. BMJ, 1991; 303: 798 -799. 5. Smith, R. Audit and research. BMJ. l9Y2: 305: 905-906. 6. Frame, J. W. Editorial. Brit. J. Oral Maxillofac. Surg., 1992; 30: 1. 7. Lock, S. Survive as an editor. In: How To Do It. Vol I. Second edition. London: BMJ, 19X5; 231-234. 8. Paton. A. Write a paper. In: How To Do It. Vol 1. Second edilion. London: BMJ, 1985; 207-21 I. 9. Waldron, T. Is duplicate publishing on the increase? BMJ, 1992: 304: 1029. 10. Lock, S. Publication: duplicate, salami, meat extender-all redundant. BMJ. 1989: 298: 1203- 1204. I I. Walton Lord. Action needed on research fraud. Doctor, 1991; I3 June: 23. 12. Taylor, I., Johnston I. D. A. On behalf of the Association of Professors of Surgery. Research and surgical training. Bull. Ann. R. Coil. Surg. Engl.. 1989; 71: 89-YO. 13. Blandy. J. P., Browse, I\;. L., Hardcastle, J. D. The place of research in surgical training. Bull. Ann. R. Coil. Surg. Engl.. 1989; 71: 64. 14. Taylor. I. Opportunities for research in surgical training. Bull. Ann. R. Coil. Surg. Engl., 1993: 75: 31-32.