How to get a paper published, and what journals

look for

Dr Kirsten PatrickClinical reviews editor, BMJ

What I aim to cover

What editors look for in a research paperHow to write a research paper for the BMJ

Publication ethics and why it is importantSystems of peer reviewImpactUseful resources

Why conduct and publish research?

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

How to please editors and reviewers

What do editors want?

importanceoriginalityrelevance to their audiencethe right study for the research questionreal potential to improve decision makingtruth and transparencyclear writing that people want to readexcitement/ “wow” factor

What is the research question?

What do I mean by ‘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 doesn’t matter

one that emerges from routine clinical data/records– records will be biased and confounded– they’ll lack information you need to answer your

question reliably, because they were collected for another reason

one that emerges from a fishing expedition/data dredging – where researchers gather lots of new data and hope a question will emerge

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 helphttp://www.bmj.com/collections/statsbk/13.dtl

What is the study design?

Study designs

Descriptive studies answer “what’s happening?” research questionsAnalytic observational studies answer “why or how is it happening?”Analytic experimental studies answer “can it work?”

Centre for Evidence Based Medicine, Oxford, UK www.cebm.net

Is it well conducted and well written?

Minimising bias and confounding

Chance - measurements are nearly always subject to randomvariation. Minimise error by ensuring adequate sample size andusing 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 outcomeseg people who carry matches are more likely to develop lungcancer, but smoking is the confounding factor – so measure likelyconfounders too

More on study methods and reporting

Centre for Evidence Based Medicinehttp://www.cebm.net/

Statistics at Square Onehttp://www.bmj.com/collections/statsbk/index.dtl

BMJ advice to authorshttp://resources.bmj.com/bmj/authors

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 research paper

Writing a paperIMRaD style

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

Writing a paper* 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 paper*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 paper*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

Writing a paper*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

• Should follow a structure. (S)• Contains all the important information

(I) enough for a reader to be able to judge the quality of the research

•Objective/question•Essential features of the study design•Main results

• Clearly written (C)• As concise as possible (C)• The reader should feel that they know

what the study is about after reading it

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)

Common problems with abstracts

• Written in a hurry with too little thought• Too vague – “what on earth did they do?”• Odd, ‘cherry-picked’ results• Main results not properly described• Difficult to tell what the main results were• P values without supporting data• Results that aren’t presented in the paper• Overblown conclusions

Who has contributed to the paper?

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 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.

Competing interests?

Conflicts of interest

A person has a competing interest when he or she has an attribute that is invisible to the reader or

editor but which may affect his or her judgement.

Why should it matter?• Because it may have a profound effect on

judgement of authors.• Because of the perception that this can happen,

whether it does or not.• Best policy? Always declare a conflict of

interest, particularly one that would embarrass you if it came out afterwards.

Is our journal the right journal for this paper?

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?

BMJ (impact factor 13.66)

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 BMJ asks 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

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 appeals

Serious appeals welcomed

Criticisms addressedUp to 20% accepted

But only one appealMake it good

Thanks…kpatrick@bmj.com