How to Write a Paper 3rd edition Edited by George M Hall How to Write a Paper Third edition How to Write a Paper Third edition Edited by George M Hall Department of Anaesthesia and Intensive Care Medicine, St George’s Hospital Medical School, London © BMJ Publishing Group 2003 BMJ Books is an imprint of the BMJ Publishing Group All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording and/or otherwise, without the prior written permission of the publishers. First published in 1994 by the BMJ Publishing Group, BMA House, Tavistock Square, London WC1H 9JR First edition 1994 Reprinted 1994, 1995, 1996, 1997, 1998 Second edition 1998 Reprinted 1999 Reprinted 2000 Reprinted 2002 Third edition 2003 British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library ISBN 0-7279-1728-5 Cover design by Dellaway Typeset by SIVA Math Setters, Chennai, India Printed and bound in Spain by GraphyCems, Navarra Contents Contributors vii Preface to the third edition ix George M Hall 1 Structure of a scientific paper 1 George M Hall 2 Introductions 6 Richard Smith 3 Methods 16 Gordon B Drummond 4 The results 22 Hans-Joachim Priebe 5 Discussion 36 Harvey Marcovitch 6 Titles, abstracts, and authors 42 Fiona Moss 7 References 51 Simon Howell 8 Electronic submissions 63 Natalie Davies 9 How to write a letter 71 Michael Doherty 10 How to prepare an abstract for a scientific meeting 79 Robert N Allan 11 How to write a case report 85 JAW Wildsmith v How To Write a Paper 12 How to write a review 92 Ian Forgacs 13 The role of the editor 99 Leo van de Putte, G Smith 14 The role of the manuscript assessor 114 Domhnall MacAuley 15 What a publisher does 126 Alex Williamson 16 Who should be an author 136 Richard Horton 17 Style: what it is and why it matters 141 Margaret Cooter 18 Ethics of publication 148 Michael JG Farthing 19 Electronic publishing 159 Craig Bingham Index 169 vi Contributors Robert N Allan Consultant Gastroenterologist, Queen Elizabeth Hospital, Birmingham, UK Craig Bingham Manager, Communications Development, Medical Journal of Australia, Pyrmont, Australia Margaret Cooter Managing Technical Editor, BMJ Publishing Group, London, UK Natalie Davies Project Manager, BMJ Publishing Group, London, UK Michael Doherty Professor of Rheumatology, Academic Rheumatology, University of Nottingham Medical School, City Hospital, Nottingham, UK Gordon B Drummond University Department of Anaesthesia, Critical Care, and Pain Medicine, Edinburgh, UK Michael JG Farthing Executive Dean, Faculty of Medicine, University of Glasgow, Glasgow, UK Ian Forgacs Consultant Physician, Department of Gastroenterology, King’s College Hospital, London, UK George M Hall Department of Anaesthesia and Intensive Care Medicine, St George’s Hospital Medical School, London, UK Richard Horton Editor, Lancet, London, UK vii How To Write a Paper Simon Howell Academic Unit of Anaesthesia, Leeds General Infirmary, Leeds, UK Domhnall MacAuley Department of Epidemiology and Public Health, The Queen’s University of Belfast, Belfast and Associate Editor, BMJ, London, UK Harvey Marcovitch Syndications Editor, BMJ Journals, London, UK Fiona Moss Associate Dean, London Deanery, London Department of Postgraduate Medical and Dental Education, and Editor, Quality and Safety in Health Care, London, UK Hans-Joachim Priebe Professor of Anaesthesia, Department of Anaesthesia, University Hospital Freiburg, Freiburg, Germany G Smith Professor of Anaesthesia, Leicester Warwick Medical School, Leicester, UK Richard Smith Editor, BMJ, London, UK Leo van de Putte Professor of Rheumatology, University Hospital Nijmegen, Department of Rheumatology, Nijmegen, Netherlands JAW Wildsmith University Department of Anaesthesia, Ninewells Hospital and Medical School, Dundee, UK Alex Williamson Publishing Director, BMJ Journals and Books, London, UK viii Preface to third edition The unexpected success of the first and second editions of this short book and the rapid progress in certain areas of publishing have necessitated a third edition. The original intention was that it would appeal primarily to authors for whom English was not their first language.
Sales in the United Kingdom, however, show that it has met a local need. For the third edition, it is a pleasure to welcome Craig Bingham, Margaret Cooter, Natalie Davies, Simon Howell, Domhnall MacAuley, Harvey Marcovitch, Fiona Moss, Hans-Joachim Priebe, and Leo van de Putte as new contributors. An additional chapter, “Electronic submissions,” has been added. I am grateful to all authors for revising their chapters and, in particular, to Robert Allan, Michael Doherty, Gordon Drummond, Graham Smith, Richard Smith, Tony Wildsmith, and Alex Williamson for contributing to all three editions.
George M Hall ix 1: Structure of a scientific paper GEORGE M HALL The research you have conducted is obviously of vital importance and must be read by the widest possible audience. It probably is safer to insult a colleague’s spouse, family, and driving than the quality of his or her research. Fortunately, so many medical journals now exist that your chances of not having the work published somewhere are small. Nevertheless, the paper must be constructed in the approved manner and presented to the highest possible standards.
Editors and assessors without doubt will look adversely on scruffy manuscripts – regardless of the quality of the science. All manuscripts are constructed in a similar manner, although some notable exceptions exist, like the format used by Nature. Such exceptions are unlikely to trouble you in the early stages of your research career. The object of publishing a scientific paper is to provide a document that contains sufficient information to enable readers to: • assess the observations you made • repeat the experiment if they wish • determine whether the conclusions drawn are justified by the data.
The basic structure of a paper is summarised by the acronym IMRAD, which stands for: Introduction (What question was asked?) Methods (How was it studied?) Results (What was found?) And Discussion (What do the findings mean?) 1 How To Write a Paper The next four chapters of this book each deal with a specific section of a paper, so the sections will be described only in outline in this chapter. Introduction The introduction should be brief and must state clearly the question that you tried to answer in the study. To lead the reader to this point, it is necessary to review the relevant literature briefly. Many junior authors find it difficult to write the introduction.
The most common problem is the inability to state clearly what question was asked. This should not be a problem if the study was planned correctly – it is too late to rectify basic errors when attempting to write the paper. Nevertheless, some studies seem to develop a life of their own, and the original objectives can easily be forgotten. I find it useful to ask collaborators from time to time what question we hope to answer.
If I do not receive a short clear sentence as an answer, then alarm bells ring. The introduction must not include a review of the literature. Only cite those references that are essential to justify your proposed study. Three citations from different groups usually are enough to convince most assessors that some fact is “well known” or “well recognised,” particularly if the studies are from different countries.
Many research groups write the introduction to a paper before the work is started, but you must never ignore pertinent literature published while the study is in progress. An example introduction might be: It is well known that middle-aged male runners have diffuse brain damage,1–3 but whether this is present before they begin running or arises as a result of repeated cerebral contusions during exercise has not been established. In the present study, we examined cerebral function in a group of sedentary middle-aged men before and after a six month exercise programme. Cerebral function was assessed by … Methods This important part of the manuscript increasingly is neglected, and yet the methods section is the most common 2 Structure of a scientific paper cause of absolute rejection of a paper.
If the methods used to try to answer the question were inappropriate or flawed, then there is no salvation for the work. Chapter 3 contains useful advice about the design of the study and precision of measurement that should be considered when the work is planned – not after the work has been completed. The main purposes of the methods section are to describe, and sometimes defend, the experimental design and to provide enough detail that a competent worker could repeat the study. The latter is particularly important when you are deciding how much to include in the text.
If standard methods of measurement are used, appropriate references are all that is required. In many instances, “modifications” of published methods are used, and it is these that cause difficulties for other workers. To ensure reproducible data, authors should: • give complete details of any new methods used • give the precision of the measurements undertaken • sensibly use statistical analysis. The use of statistics is not covered in this book.
Input from a statistician should be sought at the planning stage of any study. Statisticians invariably are helpful, and they have contributed greatly to improving both the design and analysis of clinical investigations. They cannot be expected, however, to resurrect a badly designed study. Results The results section of a paper has two key features: there should be an overall description of the major findings of the study; and the data should be presented clearly and concisely.
You do not need to present every scrap of data that you have collected. A great temptation is to give all the results, particularly if they were difficult to obtain, but this section should contain only relevant, representative data. The statistical analysis of the results must be appropriate. The easy availability of statistical software packages has not encouraged young research workers to understand the principles involved.
An assessor is only able to estimate the validity of the statistical tests used, so if your analysis is complicated or 3 How To Write a Paper unusual, expect your paper to undergo appraisal by a statistician. You must strive for clarity in the results section by avoiding unnecessary repetition of data in the text, figures, and tables. It is worthwhile stating briefly what you did not find, as this may stop other workers in the area undertaking unnecessary studies. Discussion The initial draft of the discussion is almost invariably too long.
It is difficult not to write a long and detailed analysis of the literature that you know so well. A rough guide to the length of this section, however, is that it should not be more than one third of the total length of the manuscript (Introduction + Methods + Results + Discussion). Ample scope often remains for further pruning. Many beginners find this section of the paper difficult.
It is possible to compose an adequate discussion around the points given in Box 1. Common errors include repetition of data already given in the results section, a belief that the methods were beyond criticism, and preferential citing of previous work to suit the conclusions. Good assessors will seize upon such mistakes, so do not even contemplate trying to deceive them. Although IMRAD describes the basic structure of a paper, other parts of a manuscript are important.
The title, summary (or abstract), and list of authors are described in Chapter 6. It is salutary to remember that many people will read the title of the paper and some will read the summary, but very few will read the complete text. The title and summary of the paper are Box 1.1 Writing the discussion • Summarise the major findings • Discuss possible problems with the methods used • Compare your results with previous work • Discuss the clinical and scientific (if any) implications of your findings • Suggest further work • Produce a succinct conclusion 4 Structure of a scientific paper of great importance for indexing and abstracting purposes, as well as enticing readers to peruse the complete text.