How to get published: where to start Dr Trish Groves Deputy editor, BMJ
How to get published: where to start Dr Trish Groves Deputy editor, BMJ What I aim to cover Planning research The research question Why you need to publish What editors want How to write a paper Useful resources Publication ethics How to please editors and peer reviewers Why conduct and publish research? say something important share your work change practice promote thought or debate educate get into high impact journal advance your career Keep your job make money entertain/divert/amuse Steps in starting research turn your ideas into a research question review the literature enlist coauthors, statistician, supervisor agree who’ll do what design the study and develop your methods think about the ethics of your study design write your research proposal apply for funding and ethics approval The research question What is a research question? The researcher asks a very specific question and tests a specific hypothesis. Broad questions are usually broken into smaller, testable hypotheses or questions. Often called an objective or aim, though calling it a question tends to help with focusing the hypothesis and thinking about how to find an answer What makes a poor research question? a question that matters to nobody, even you hoping one emerges from routine clinical data/records – the records will be biased and confounded – they’ll lack information you need to answer your question reliably, because they were collected for another reason fishing expedition/data dredging – gathering new data and hoping a question will emerge What makes a good question? Feasible (answerable with a robust method) Interesting Novel Ethical Relevant FINER criteria Real research questions Does the length of time between breast conserving surgery and radiotherapy affect the risk of local recurrence of breast cancer in older women? Do hospitals with more orthopaedic specialisation have better surgical outcomes after total hip or total knee replacement than those with less specialisation? Is cardiac stress testing before elective non-cardiac surgery associated with improved postoperative survival and hospital stay? How to focus your question brief literature search for previous evidence discuss with colleagues narrow down the question – time, place, group what answer do you expect to find? Turning a research question into a proposal who am I collecting information from? what kinds of information do I need? how much information will I need? * how will I use the information? how will I minimise chance/bias/confounding? how will I collect the information ethically? * sample size – ask a statistician for help http://www.bmj.com/collections/statsbk/13.dtl Minimising bias and confounding Chance - measurements are nearly always subject to random variation. Minimise error by ensuring adequate sample size and using statistical analysis of the play of chance Bias - caused by systematic variation/error in selecting patients, measuring outcomes, analysing data – take extra care Confounding - factors that affect the interpretation of outcomes eg people who carry matches are more likely to develop lung cancer, but smoking is the confounding factor – so measure likely confounders too Ethical issues – the wider aspects • what information will you give participants before seeking their consent? • how much will the study deviate from current normal (accepted, local) clinical practice? • what full burden will be imposed on participants? • what risks will participants/others be exposed to? • what benefit might participants or others receive? • how might society/future patients benefit in time? • might publication reveal patients’ identities? Exactly what are you planning to do? PICO P - who are the patients or what’s the problem? I - what is the intervention or exposure? C – what is the comparison group? O - what is the outcome or endpoint? More on PICO Patients – disease or condition – stage, severity – demographic characteristics (age, gender, etc.) Intervention – type of intervention or exposure – dose, duration, timing, route, etc. Comparison – risk or treatment – placebo or other active treatment Outcome – frequency, risk, benefit, harm – dichotomous or continuous – type: mortality, morbidity, quality of life, etc. Study designs Population (P) Outcomes (O) Interventions (I) or Exposures (E) Centre for Evidence Based Medicine, Oxford, UK www.cebm.net Are you going to observe or experiment? • observational – cross sectional, case series, case-control studies, cohort studies – identify participants – observe and record characteristics – look for associations • experimental – before and after studies, comparative trials (controlled or head to head), randomised trials (ditto) – – – – identify participants place in common context intervene observe/evaluate effects of intervention Who will do what? agree authorship before starting the study! Authorship and contributorship these denote credit and accountability but many authors on papers have done little people’s names are left off papers authors do not know the authorship criteria contributorship statement more inclusive 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 part in planning, conducting, and reporting the work guarantors (one or more) who accept full responsibility for the work and/or the conduct of the study, had access to the data, and controlled the decision 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. 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/ More on study methods and reporting Centre for Evidence Based Medicine http://www.cebm.net/ Statistics at Square One http://www.bmj.com/collections/statsbk/index.dtl BMJ advice to authors http://resources.bmj.com/bmj/authors Writing a paper 1. The message What …is the research question? …is the right article format for your study? …does the audience need to know? Writing a paper 2. Title: style descriptive: Number of heads in adults: audit declarative: Most adults have one head journalistic: Heads you win questioning: How many heads do adults have? Carefully check the journal’s instructions to authors and look at other articles in that journal Writing a paper 3. IMRaD Introduction: why ask this research question? Methods: what did I do? Results: what did I find? Discussion: what might it mean? Writing a paper 4. The introduction brief background for this audience 3-4 paragraphs only what’s known, and what’s not, about your research question don’t bore readers, editors, reviewers don’t boast about how much you have read the research question state it clearly in the last paragraph of the introduction say why it matters Writing a paper 5. Methods like a recipe most important section for informed readers describe: inclusion and exclusion criteria outcome measures intervention or exposure give references for standard methods follow reporting guidelines as explained at (http://www.equator-network.org/ explain ethics issues Writing a paper 6. Results include basic descriptive data text for story, tables for evidence, figures for highlights confidence intervals essential summary statistics leave out non-essential tables and figures don’t start discussion here Writing a paper 7. Structured discussion don’t simply repeat the introduction include – 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 must approve it editors may screen by abstract for BMJ: usually 300-400 words use active voice p values need data too %s need denominators no references trial registration details Structured abstract objectives - 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 and completing 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 pico abridged articles for print BMJ eg Cohort study study question summary answer participants and setting design, size and duration main results and the role of chance bias, confounding, other cautions generalisability to other populations study funding/competing interests Writing up quality improvement projects Quality improvement projects what to report in publications Not necessarily completely original Describe in detail: Context, organisational changes, interpersonal interactions How did you manage and sustain change? Progress may be cyclical, iterative, not linear Message may lie in difficulties, not outcomes Guidelines SQUIRE guidelines Standards for QUality Improvement Reporting Excellence www.squire-statement.org MRC framework For developing and evaluating complex interventions www.mrc.ac.uk/complexinterventionsguidance MRC guidance for evaluation of complex interventions Craig, P. et al. BMJ 2008;337:a1655 Structure of quality improvement reports context outline of problem (patient centred) key measures of improvement process of gathering information analysis, interpretation, better understanding strategy for change effects of change - reassessment next steps - lessons learnt - message Quality improvement report: writing tips How is its message relevant to improving the quality or safety of patient care? Does it describe processes and changes that improve patient care? Is the evidence robust? Is the message generalisable? What’s in it for others to learn? How to please editors and reviewers Before you start your study have a clear research question seek statistical advice use the right study design keep an open mind and minimise bias agree who will be principal investigator agree who will be authors and contributors agree to publish even negative results How to please editors choose the right journal read the journal follow advice to authors submit online and follow instructions How to please editors and peer reviewers make sure the message is clear in the paper and abstract, not just in the cover letter include extras eg STROBE checklist cite (and send) any closely related papers send previous peer review reports communicate clearly and promptly Which journal should you choose? audience impact generalists or specialists? national or international? not just Impact Factor not just prestige will 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? importance originality relevance to the audience real potential to improve decision making truth and transparency clear writing that people want to read excitement/ “wow” factor Why does BMJ publish? Pure academic interest isn't enough for most BMJ readers, who mainly comprise doctors – - whether they're practising clinical medicine, working in public health, developing and Implementing health policy, or working mostly as researchers We aim to provide our readers with articles that will help them to make better decisions 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 originality the article’s importance 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 final decision (aided by an editorial manuscript committee meeting for some articles, including original research) BMJ peer review process Research submitted 4-5000 annually Screen 3-4000 rejected External review Approx 1000 for open review 500 then rejected Editorial meeting 500 with Editor and adviser, statistician, BMJ team Accept 4-7% with Open access No word limits BMJ pico Editorials BMJ appeals Serious appeals welcomed Criticisms addressed Up to 20% accepted But only one appeal Make it good Transparency and integrity BMJ’s transparency policy will help you to report work honestly and fully resources.bmj.com/bmj/authors /editorialpolicies/transparencypolicy What amounts to misconduct? Research misconduct means fabrication, falsification, or plagiarism in proposing, performing, or reviewing research, 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: prepublication postpublication 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 Thanks [email protected]
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