Transcript Slide 1

Tricks for Improved Abstract and
Manuscript Preparation
Eamonn M. M. Quigley, MD, FACG
Houston Methodist Hospital
Weill Cornell Medical College
Objectives
By the end of this presentation, you will be able
to:
• Prepare and submit and abstract
• Explain the rationale for selecting a particular
journal for your submission
• Describe common problems with papers
submitted for publication
• Formulate an approach to preparing a manuscript
for submission to a particular journal
Format
• This is the general
scheme BUT ALWAYS
read the specific
instructions carefully
and completely
• TITLE, authors and
affiliations
• Background
• Aims
• Methods
• Results
• Interpretation / Summary
• Conclusions
What your trainee is up against?
• Reviewer(s) who have a pile of abstracts to
review in a short time and must select a
few from the many
• This decision will be based entirely on
what is before them
• Author and Institution names may be
removed (anonymyzed)
General Rules
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Stick to the Rules!!!
Fill the space but do not clutter it
Use a good figure or table if you have one
Avoid abbreviations
Assume the reader has never heard of you or
of your wonderful work
• Make sure that it fits the template
• Keep it simple!!!
The Most Important (Ignored) Rule
• Allow time for:
 Preparation
 Review
• For content
• For patentability
 Revision
 And further review and revision!
STEPS
Target
• Choose the meeting
 Where should your trainee present for the first time?
• Choose the section (in that meeting); is this the
audience you really want to reach?
• Will the reviewers for this section have real
insight into the value of your work?
• Oral or poster?
• Eligible for an award ? (“you won’t win if you are
not in”)
Title
• Must accurately summarize the findings of your
study
• Should be easily read and remembered; even
better if eye-catching
• Keep as short as possible
 There may be a character limit!
Content
• Must be complete; avoid presenting “works in
progress”
• If the abstract is published, others will refer to this and
NOT to what you presented, until the full manuscript is
published; they should be similar
• Avoid the temptation to clone abstracts; some will be
rejected – it may be the best one!
• NEVER obfuscate; saying “results will be presented” is
an invitation for rejection
Background
“The irritable bowel
syndrome (IBS)is a chronic
disorder associated with a
significant impact on quality
of life (QOL)in hospitalized
patients (Talley et al Am J
Gastro 1999); studies to date
have not defined the impact
of IBS on QOL on patients
seen in a general practice”
• One, or, at most, two
sentences that state the
background to the issue
that you are uniquely
addressing
• Add a reference if you
have space; implies
knowledge of the area
Aims
“Our aim was to define the
impact of IBS symptoms on a
disease specific measure of
QOL in a clearly defined
general practice population”
• A single sentence that
succinctly states your
aims
Aims
“Our aim was to define the
impact of IBS symptoms on
a disease specific measure
of QOL in a clearly defined
general practice population”
• Key terms that imply
that you know what
you are doing
Methods
• Population, age, gender,
location; how selected?
• Study type:
Prospective/retrospective
controlled/double blind
• What were the interventions?
• What were the outcome
measures?
• How was it analysed?
• MUST accurately and
completely describe
what you did
Results
• Begin with the
general descriptors
• Then the major
findings i.e. the key
endpoints (refer to a
table or figure, if
available, and of
excellent quality)
• Positive before
negative!
• Confirmatory or
secondary endpoints
last
• This MUST be readable in a
fraction of a minute
• Always include appropriate
statistics
Are the results:
• NOVEL?
• IMPORTANT?
• CREDIBLE?
Summary / Interpretation
• “This study has failed
to confirm that…..”
• “In this select
population….”
• “While demonstrating
that ….. is associated
with……, we did not
confirm….”
• May / may not be
space available
• Should focus on the
specifics of your
study
Conclusion
• “IBS patients seen in general
practice demonstrate a
significant impairment in QOL”
• “General practice IBS patients
suffer an impairment of QOL
which is as severe as
hospitalized patients”
• “IBS impairs QOL regardless of
location of care”
• “IBS impairs QOL in all
patients”
• “IBS is BAD!!!”
• The crucial one-liner
• Be bold; be general!
You get the good news!
• Your abstract has been accepted
 It’s an oral/plenary
 It’s a poster
• But it deserved an oral!!!!
– Does not imply lesser quality; may not conveniently fit into a
symposium/theme
– This may be the ideal forum for your fellow
• Start preparing now
Write the Paper!!!!
• You will never know your data better
• The work is “hot”
• You have input from your likely reviewers
 Try to address all the criticisms, suggestions that
arose
• If you put it off, the likelihood of ever getting it
published diminishes exponentially with time
Why Publish?
• Disseminate research
• Expand C.V.
• Describe important
clinical observations
• Get promotion
• Critically review
research/clinical data
• Advertise:
• Educational
experience
• Promote new therapy
- Self
- Clinic/Hospital
- Favorite technique
Key Questions?
• Do I have something to say?
• What is it?
• Is it novel and / or worthwhile?
• Could it be better? (e.g. more data)
• Who do I want to reach?
• Is it relevant to that audience?
Characteristics of a Journal
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Focus and purpose
Audience
Review process
Acceptance rate
Publication schedule
Impact factor
Print vs on-line only
Credibility
Cost; do they charge?
Getting Started
• Publication as a means of communication
 The servant of good research
 The purveyor of excellent education
• Going through the process……….
Essential Considerations
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Ethics
Authorship
Plagiarism
Duplication
Conflicts of Interest
Ethics
• Assigning authorship
 Significant contribution (may need to be quantified)
 Ability to defend content (essential)
 Determined prior to submission – as early as possible
in the process
• Repetitive/Sequential Publications
 Differentiate clearly
 Request delayed publication when needed
• Acknowledgement of sources
 You will be found out!
• Google, Pubmed
This is what you do not want
to happen………
British doctor rebuked over research linking vaccine and autism
Britain's medical regulator finds
that Dr. Andrew Wakefield, who now
practices in Texas, conducted his
now-discredited research on the MMR
shot in an unethical and irresponsible
manner.
January 29, 2010|By Henry Chu
Wakefield AJ, Murch SH, Anthony A, Linnell J, Casson DM, Malik M, Berelowitz M,
Dhillon AP, Thomson MA, Harvey P, Valentine A, Davies SE, Walker-Smith JA.
Ileal-lymphoid-nodular hyperplasia, non-specific colitis and pervasive developmental disorder in children.
Lancet. 1998;351:637-41.
Conflicts of Interest
World Association of Medical Editors
http://www.wame.org/
International Committee of Medical Journal Editors
http://www.icmje.org/
NEJM
JAMA
Lancet
Annals of Internal Medicine
Australian, British, Canadian, Croatian, Danish, Dutch, New Zealand, Norwegian
National Journals
There are still problems…..
• 12 leading journals of gastroenterology and
hepatology; 1115 articles:
 84% reported presence or absence of funding
sources
 25% of journals reported presence or absence of
funding sources in all articles
 Only 4 journals reported conflicts of interest of
their editors
Qureshi et al, APT 2011
Choose your Journal
• Scientific Quality
• Audience
– scientists vs. clinicians
– local/regional/global
• Relevance
– broad vs. specialized
How to really annoy a reviewer
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Bad English
Disorganized presentation
Too long
Abstract and text do not agree
Poor quality manuscript, type, tables, figures
References inaccurate and/or inadequate
Fail to acknowledge prior work in the area
There are many types of manuscripts
• Original article :
 basic science
 clinical research
 systematic review/meta-analysis
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Review
Editorial/commentary
Case report
Literature review/synopsis
Letters-to-the-editor
Problems with Clinical Trial Papers
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Single center (should have been multi-center)
Selected population(s)
Underpowered
Primary endpoints not defined
Inappropriate dose comparisons
Inadequate design
Not true placebo
Short duration
Post-hoc analyses
Problems with Mechanism of Action
(MOA) Studies
• Inappropriate model(s)
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Not validated
Over-interpreted
Irrelevant
Inadequate safety evaluation
No hypothesis; “fishing expeditions”
Wrong targets!
Inadequate methods
Underpowered
Problems with Mechanism of Action
(MOA) Studies
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Not needed (by medical science, at least)
Implausible
Not enough data!
Too short!
Inadequate power to detect AE’s
Human Trials
• Register
 clinicaltrials.gov
 Lancet
 others
• Ethics
• Conflicts of Interest
 Declare and manage!
• Details, details
 CONSORT
CONSORT
Flow
Diagram
Original Articles
• The core of all main-stream journals
• High Impact
Follow the Rules
• Style
• Length
 Now a major issue for major print journals but
not for on-line only journals
 Decide what goes into “supplementary material”
• References
• Figures B&W, Colour
• Tables
TITLE
ABSTRACT
Follow the rules
An abstract of not more than 250 words should
accompany each manuscript. Abstracts for
original contributions should be divided by
individual headings into paragraphs entitled:
Objectives,
Methods,
Results, and
Conclusions.
ABSTRACT
This is exactly what will appear on Pubmed
RUNNING HEAD
KEY WORDS
• Irritable Bowel Syndrome
• Inflammatory Bowel Disease
• Chronic Fatigue Syndrome
• Fibromyalgia
• Premenstrual Dysmorphic Syndrome
• Cytokines
• Il-6
• IL-8
• TNFα
• IL-1β
This is what search engines and abstractors will pick up!
How To Write
• Imagine yourself as the reader
• Attract and sustain attention
• Describe Methods clearly and precisely;
imagine that the reader is going to repeat the
experiment
• Be certain that the most important
conclusions are given due prominence; do not
overshadow them with minor observations
How To Write
In the Discussion, summarize and interpret
results in the light of current observations; be
succinct, do not over-interpret!
Common Pitfalls
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Not new!
Stating the obvious
Not interesting
Not powered to answer primary objectives
Inappropriate statistics
Common Pitfalls
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No controls, inappropriate controls
Unrepresentative population
Retrospective
“Salami slicing”
How To Write
• Make sure that you know the References
• Refer to up-to-date key original articles; refer to
reviews/editorials for opinion not fact
• Include only those Figures and Tables that are
necessary; do not duplicate data in the text
• Ensure that Figures and Tables are legible and
not crowded
Know Your References!
Barney Chir: a forgotten giant of motility?
Dent J, Chir B. (1976) A new technique for continuous
sphincter pressure measurements.
Gastroenterology 71:263–267.
Dent J, PhD, MB, B Chir. (1976) A new technique for
continuous sphincter pressure measurements.
Gastroenterology 71:263–267.
How To Write
• It should be possible to read and follow
Figures and Tables on their own
• Keep it simple!
Figure 2: Annual diagnostic radiation exposure per patient 1999–2009
N=2,509 patients; CT, computed tomography;
CED, cumulative effective dose; mSv, milli-Sievert.
Case Reports
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Never read
Never referenced
Kill Impact Factor
Rarely of any true value
But now there
is an option!
Reviews
• Very popular
• Make it clinically relevant; what will be the
readers key questions?
• Define the goals of the exercise
• Must be a review! Not a just catalogue of
quotations; synthesize information; give your
interpretation
• Original, complete and up-to-date references
The New Challenge!
• Evidence-based Medicine
• Meta-analysis
• Systematic reviews
• For some topics, these approaches have become
de rigeur:
 Diagnostic strategies
 Therapy
• There are still some areas that merit conventional
reviews
Editorials
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Keep it brief and to the point (or just a few!)
Interpret the related article
Give an informed opinion
Avoid personal bias and destructive criticism
Submission
• Will usually be electronic
• Know the rules, copyright assignment, author
permissions, etc
• Many journals now have severe restrictions on
space
 Use supplementary material
• It takes time and patience
• Monitor progress (on-line?) but do not annoy!
Responding to Reviews
• Read the Cover Letter carefully; be sure that you
know what it means!
• Is it really possible to provide an adequate
response?
• Respond with cover letter and point-by-point
response to every item
• If you are rejected; wait a day and then revisit
• Do not take it personally
• If you re-submit, make sure you address prior
reviews
Questions?
Summary
• Keep the publishing impulse under control!
• Know what you want to say and why you
should say it
• Target your audience and the journal
• Adhere to all of the rules
• Pay attention to details
• Revise according to reviews
• Be realistic!
Keep on Writing
“This manuscript of yours that has just come
back from another editor is a precious
package. Do not consider it rejected.
Consider that you have addressed it ‘to the
editor who can appreciate my work’ and it has
simply come back stamped ‘Not at this
address.’ Just keep looking for the right
address.”
(B. Kingsolver)