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How to write the paper Rhinology will not refuse Wytske Fokkens Year 2011: Rhinology submitted: 271 Rhinology accepted: 53 Chance: 53/271 = 20% references Good paper • • • • • • Novelty Good review of the literature Good data Strong statistics Clear presentation Though provoking discussion (Co-) Editor • After rapid screening, the paper : + Is acceptable as it is + Cannot be accepted for publication because of : - Fatal flaw in experimental design (10-20% of papers) - Findings are largely repetitive of previously published information - Findings represent minor incremental advance over previous information - Trial of a new drug closely related to a previously described one, with no significantly different features or advantages - Poor english, leading to incomprehensible manuscript + Has been sent to reviewer Title, abstract and keywords • title = advertisement for your paper – do not promise things you can not deliver • write the abstract last • title and abstract are used by the reviewer and reader to have a general idea about the paper • keywords are essential to find your paper: use MESH terms and try them out in pubmed General comments • Although the manuscript is well written and interesting I think it would better fit in a Journal with the main focus ................... Review Summary Top 10% Significance of research Originality of Research: Experiment al Design and Quality of Data: Top 25% Top 50% Lower 50% Lower 25% General questions Is there any question of violation of the journal's policy on research involving animals and human beings? Yes No Is an editorial needed? Yes No If yes, will you volunteer to write the editorial within a month? Yes No Recommendation Recommendation Accept Manuscript Requires Revision Reject Would you be willing to review a revision of this manuscript? Yes No Comments COMMENTS FOR THE EDITOR Please enter the reasons for your recommendations as to the acceptability or rejection for this paper COMMENTS FOR THE AUTHOR(S) Do not include any statement that will indicate your judgment as to the acceptability of the paper. If possible, submit your comments in the following order: 1)General comments 2)Specific comments for revision: a) major; b) minor. Review Summary Top 10% Significance of research Originality of Research: Experiment al Design and Quality of Data: Top 25% Top 50% Lower 50% Lower 25% Significance of research High: • Deviated nasal septum hinders intranasal sprays: A computer simulation study • Sinonasal malignant melanoma:an analysis of 115 cases • Endoscopic Sinus Surgery Training Courses: Benefit and Problems • A Multicenter Evaluation to Systematically Improve Surgical Training Low: • Different Reactions of Human Nasal and Eustachian Tube Mucosa After Hyperbaric Oxygen Exposure – A Pilot Study • Is There Any Difference In Sexual Function Scores In Patients With Pollen and Mite Induced Allergic Rhinitis? • University of Pennsylvania smell identification test: Application to Turkish population Originality of Research: • • • • • The added value is rather limited. It looks to me as an open door, which is explicited. In which type of setting could this questionnaire be useful? This study is well performed but the novelty of the results is not very high I do not see how this work may improve knowledge or clinical practice. As of a first impression, the subject has no novelty to show nor does the therapeutic modality described. • • • • This is a very important paper in the clinical setting. This is groundbreaking reseach for learning more about central olfactory processing The paper will add to the literature in a useful way. This is a well written paper describing a study that I wish I had done myself! Experimental Design and Quality of Data: • It is a real pity to waste so much energy and resources to perform this study because results are of no real value due to a flawed study design. Experimental Design and Quality of Data: • the study design does not allow to answer the hypothesis put forward • Several major methodological concerns arise when reading the manuscript • I think the paper is well written and ambitious. However, there are some major flaws in the design and presentation of the data. M&M • What has to be written down to repeat the experiment with the same outcome or understandable other outcome • Why, Who, what, where, when, and how • Use (cochrane) checklists M&M follow the international standards or statements • • • CONSORT The CONSORT statement is intended to improve the reporting of RCT’s, to enable readers to understand the trial design and correctly interpret the results (www.consort-statement.org) PRISMA Prisma stands for Preferred Reporting Items for Systematic Reviews and Meta-Analyses (www.prisma-statement.org/) STROBE statement The STROBE statement: Strengthening the Reporting of Observational Studies in Epidemiology is a good checklist for preparing a publication of an observational study (www.strobe-statement.org). www.emgo.nl (in english!) WHY • Unfortunately, I cannot recommend publication of this paper, as I really am not sure what it is trying to do. • The reason(s) why the authors decided to look for a correlation between nasal eosinophils and nasal airflow in children with only rhinitis and rhinitis and asthma cannot be found neither in the introduction nor in the discussion. M & M WHO • • • • The study population is ill-defined Too little subjects per group Groups are not comparable Almost half of the patients in the data base were excluded from the analyses • Definitions of the disease groups, inclusion and exclusion criteria, • There is no indication of exclusion criteria for this study • The heterogeneity of the patient population represents a draw-back of the study hampering strong conclusions of the study. M & M WHAT • Please define what you mean by `no recurrence?` • The definition of allergic rhinitis and asthma should be included in the study, as well as the techniques and reagents for measurement of ECP and EPO • The randomisation method is not described, as well as the blinding procedure. • What is meant by `blade baseline` M & M Where • It is not clear where the biopsies were taken • One cannot investigate if there is a higher exposure by doing measurements in one area only • Why were cultures always obtained from maxillary sinus M & M When • What provocation and symptom scoring intervals were used • it is not clear whether the study was carried on when the patients are symptomatic or not. • The time interval between the first and second lavage is not clear stated. • It would be useful to indicate how many months of the year • nasal lavage should follow acoustic rhinometry measurements to avoid generating a reaction of the mucosa by the lavage itself that may influence the measurements with the rhinometer M & M HOW • Both questionnaires are not validated • Surgical technique is not clear - how many branches have been detected in every procedure, how many branches have been clipped • How many courses were administered over what time frame before failure was determined • How does your MEMM type 2b differ from the classic Caldwell Luc operation? • How was recurrence of nasal polyps determined? M & M HOW Statistics • • • • Did the data show a normal distribution, otherwise non-parametric tests should be used You used a t-test without stating that the assumptions for this test are not violated. Many tests were done on each polymorphism and specific allergens: wouldn’t a correction for multiple testing have been appropriate in this section? You just mention 3 statistical methods without any indication on how will you use them Results • The chapter "results" is written very poorly • All 42 patients should be included in the final analysis. The remaining 17 should be responders instead of “no users”. • In the results the discussion of efficacy needs a more detailed explanation • on page "Only 15% (90) of respondents lived alone, Discussion • The discussion is solely focused on the results of the study misregarding that there may be other studies that have investigated the described issues. • Discussion is poor: it is mainly a quick list of results. A true discussion of obtained results is lacking. Negative results (eye symptoms) are not discussed • The manuscript is rewarding - however, the authors are kindly asked to moderate the respective speculations e.g. by changing the title and / or shortening the paragraph `discussion` Conclusions based on results • Cannot claim this based on these results, the small sample size and the methodological flaws of this study • The authors conclude that .... treatment attenuates the response to nasal allergen challenge with respect to PNIF. However they do not discuss the magnitude of this effect, nor have they investigate the effect on nasal symptoms such as blockage • I think this is a very questionable conclusion not backed up by the data shown in the ms. • The final conclusion should be based solely on the data presented. Tables and figures • Figure 1 cannot be read in it's present pdf format • table 2 and fig 2 are different presentations of the same data. • Figure 2 provides no further relevant information as given in the text. This figure should be omitted. • Figure1. Not clear. It should include a legend briefly explaining the results presented. Why the numbers of subjects do not correspond to those presented in the methods section. Avoidable • Unfortunately the Tables which represent an essential part of the results are not included in the manuscript, making an assessment impossible. • The numbers of patients in the tables do not match in between tables • 25 subjects were enrolled; minus 5 (ineligible), minus 2 (withdrawn) = 18 Only 16 subjects have completed the study. What happened to the other 2? • There is no mentioning of written informed consent • The literature in this manuscript is limited lacking many important papers Language • The paper has multiple errors in English grammar, which is disturbing. Please revise the text according to proper language. • Some english sentences seem to be written in less fluent english. A native speaker and writer could filter out these irregularities with ease. • In addition, a lot of typing errors or wrong words needs to be corrected and the text would benefit from comments of a medical expert native speaker. Take Home • use helicopter view • see your paper as the reviewer will see it. Review your own paper, be critical • follow the international standards or statements (consort, prisma, strobe)