How to get research published, and what journals look for

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

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 variation. Minimise error by ensuring adequate sample size and using statistical analysis of the play of chance random 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/PECO P - who are the Patients or what’s the Problem?

I or E - what is the Intervention or Exposure?

C – what is the Comparison group?

O - what is the Outcome or endpoint?

Study designs

Descriptive studies answer “what’s happening?” research questions Analytic 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

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, Griffin, post-doctoral research fellow 1, Simon J programme leader 2, A Toby Prevost, medical statistician 1, Ann-Louise Kinmonth, professor of general practice 1, David P French, reader in health behaviour interventions 3, Stephen Sutton, professor of behavioural science 1 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. 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 3. 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 4. 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 5. 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 6. 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)

How to please editors and reviewers

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