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1 Writing an Outstanding Scientific Paper for Journal of Clinical Oncology D aniel G. Haller, MD Editor-in-Chief Journal of Clinical Oncology.

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Presentation on theme: "1 Writing an Outstanding Scientific Paper for Journal of Clinical Oncology D aniel G. Haller, MD Editor-in-Chief Journal of Clinical Oncology."— Presentation transcript:

1 1 Writing an Outstanding Scientific Paper for Journal of Clinical Oncology D aniel G. Haller, MD Editor-in-Chief Journal of Clinical Oncology

2 Attributions David J Kerr Editor-in-Chief, Annals of Oncology Robert J Mayer Associate Editor Emeritus, NEJM Joe Simone George Canellos Editors Emeriti, JCO Ed Huth Editor Emeritus, Annals of Internal Medicine

3 Publications Represent: accomplishment in academic medicine primary documentation of research data evidence of expertise through writing an authoritative review paper or book chapter a major determinant in achieving academic promotion and career development

4 4 Submission and Publishing Statistics

5 5 New Manuscripts Submitted, Pages Printed All Material Submitted Original Reports Only Pages Printed Year 20042,7311,9605,011 20053,7162,4559,466 20064,1022,7795,790 20074,3712,8345,845

6 6 New Original Report Submissions by Month 2007 2006 2005

7 7 New Manuscript Submissions by Manuscript Type 200520062007 Review Articles153186174 Biology of Neoplasia41115 Total Reviews157197189 Editorials144118135 Correspondence458405473 Art of Oncology324247 Diagnosis in Oncology 397429554

8 8 Total Submissions 2004200520062007 USA1,0741,4231,681 1,750 Non-USA1,3592,0952,3382,295 Initial manuscript submissions based on corresponding author’s country of origin (if indicated).* Submissions by Country * If no country indicated, then the manuscript was not counted

9 9 Final or current decisions rendered on Original Reports by year 200520062007 90010511070 863916861 153147 01177 0019 535547460 Manuscript Decisions Note: Assuming Minors and Majors will be accepted, the Acceptance Rate for Original Reports submitted in 2007 is 21% * Estimate for 2007 * Priority Reject Reject Door Ajar Major Rev Minor Rev Accept

10 10 Average Time for Manuscript Processing 200520062007 Submission to first decision 44 3.4 (weeks) Acceptance to print publication13 1313 (weeks) Submission to print publication676 (months) Note: Only Original Reports submitted within that year are calculated

11 11 Publish Ahead of Print Currently: Accepted manuscripts are prioritized for publication at the time of acceptance, some papers are designated “fast track”, 1/3 are published online ahead of print Now: Eliminate fast track and prioritization designations All material will be published online ahead of print at weekly intervals Original papers with editorials will not be placed online before the accompanying editorial.

12 12 Impact Factor 2006 IF measures citations in 2006 of papers published in 2004 and 2005 Numerator: every detectable citation Denominator: only those designated as reviews or original reports IF is a mean, not a median –Number may be skewed by one or two pivotal papers –JCO: large number of citations, but very large denominator  In 2006, 85% of citations were from original reports, 10% from reviews, 4% from editorials. See: Rossner M et al. J Cell Biol 179, number 6, December 17, 2007

13 13 Impact Factor Trends: Peer-Reviewed Oncology Journals Journal20052006Change # 2006 Articles Journal National Cancer Inst15.17115.2710.100156 Journal of Clinical Oncology11.81013.5981.788734 Blood10.13110.3700.2391189 Lancet Oncology9.60810.1190.51191 Cancer Research7.6167.6560.0401493 Clinical Cancer Research5.7156.1770.462946 Cancer4.8004.582(0.218)675 International Journal Cancer4.6604.6930.033837 Annals of Oncology4.3195.1790.860337

14 14 On-line Reader Tracking Information

15 Usage Statistics Home Page Visits1,477,8421,433,2761,507,251 Abstracts Only Access2,461,3352,729,6583,457,337 Full-Text HTML Access3,954,5303,122,2333,673,330 PDF Access2,361,6662,216,6292,539,979 Total Usage10,255,3739,501,79611,177,897 2005 2006 2007

16 16 Top Ten Articles March ’07 – December ‘07 “American Society of Clinical Oncology Guideline for Antiemetics in Oncology: Update 2006” Kris et al (Jun 20, 2006: 2932-2947) (Read 14460 times) “2006 Update of Recommendations for the Use of White Blood Cell Growth Factors: An Evidence-Based Clinical Practice Guideline” Smith et al (Jul 01, 2006; 24: 3187-3205) (Read 9434 times) “American Society of Clinical Oncology/College of American Pathologists Guideline Recommendations for Human Epidermal Growth Factor Receptor 2 Testing in Breast Cancer” Wolff et al (Jan 01, 2007: 118-145) (Read 8381 times)

17 17 Top Ten Articles March ’07 – December ’07 (Continued) “Initial Hormonal Management of Androgen-Sensitive Metastatic, Recurrent, or Progressive Prostate Cancer: 2007 Update of an American Society of Clinical Oncology Practice Guideline” Loblaw et al (Apr 20, 2007; 25: 1596-1605) (Read 8210 times) “Erlotinib Plus Gemcitabine Compared With Gemcitabine Alone in Patients With Advanced Pancreatic Cancer: A Phase III Trial of the National Cancer Institute of Canada Clinical Trials Group” Smith et al (May 20, 2007; 25: 1960-1966) (Read 7761 times) “American Society of Clinical Oncology Treatment of Unresectable Non– Small-Cell Lung Cancer Guideline: Update 2003” Pfister et al (Jan 15, 2004; 22: 330-353) (Read 7734 times)

18 18 Top Ten Articles March ’07 – December ’07 (Continued) “Sunitinib: From Rational Design to Clinical Efficacy” Chow et al (Mar 01, 2007; 25: 884-896) (Read 7724 times) “Clinical Cancer Advances 2006: Major Research Advances in Cancer Treatment, Prevention, and Screening -- A Report From the American Society of Clinical Oncology” Ozols et al (Jan 01, 2007; 25: 146-162) (Read 7676 times) “Phase II Study of Sorafenib in Patients With Advanced Hepatocellular Carcinoma” Abou-Alfa et al (Sep 10, 2006; 24: 4293-4300) (Read 7239 times) “American Society of Clinical Oncology Guideline: Recommendations for Venous Thromboembolism Prophylaxis and Treatment in Patients With Cancer” Lyman et al (Oct 29, 2007; doi: 10.1200/JCO.2007.14.1283.) (Read 6987 times)

19 19 Editorial Roster Daniel HallerEditor-in-Chief Nora DisisDeputy Editor: Translational Research David KhayatDeputy Editor: International Editions

20 20 Editorial Roster (Continued) Associate Editors Judith AbramsBiostatistics George BoslGenitourinary / Solid Tumors Stephen CannistraGynecologic / Breast Cancer Bruce ChesonHematologic Malignancies Arlene ForastiereHead and Neck / Solid Tumors Patricia GanzBreast Cancer / QOL / Supportive Care Bruce HafftyRadiation Stephanie LandBiostatistics Mark LevineBreast Cancer / Cost Effectiveness / Epidemiology Michael LinkPediatric Eleftherios MamounasBreast Cancer / Surgical Oncology Nicholas PetrelliSurgical Oncology / GI Joan SchillerThoracic Oncology Jaap VerweijPhase I & Clinical Pharmacology

21 21 Editorial Roster (Continued) Consultant Editors Marc BuyseBiostatistics Daniel NormolleBiostatistics Stephen CannistraBiology of Neoplasia Charles LoprinziThe Art of Oncology Arthur SkarinDiagnosis in Oncology

22 22 International Editions JCO Chinese Edition Editor, Yan Sun, MD, Beijing JCO Greek Edition Editor, Nikolaos A. Malamos, MD, Athens JCO Hungarian Edition Editor, József Timár, MD, Budapest JCO Middle East Edition Editor, Nagi S. El Saghir, MD, Beirut JCO North African Edition Editor, Nagi S. El Saghir, MD, Beirut JCO Polish Edition Editor, Maciej Krzakowski, MD, Warsaw JCO Russian Edition Editor, Sergei A. Tjulandin, MD, Moscow JCO Spanish Edition Editor, Franco M. Muggia, MD, New York Associate Editor, Roman Pérez-Soler, MD, Bronx JCO Turkish Edition Co-Editor, Erdem Göker, MD, Bornova Izmir Co-Editor, Erhan Gokmen, MD, Bornova Izmir

23 23 International Editions David Khayat: Deputy Editor Not only a business venture, but a palpable effort to deliver current oncology practice to the world, and increase access for patients Locally published and distributed All material solely chosen from JCO; no additional materials can be added Editors given access to TOCs in advance to enhance timeliness Given varying frequency of publication, only a subset of JCO papers are selected for translation and reproduction Guidance and monitoring of selections of local editors by Deputy Editor German, French and Italian editions are in planning

24 24 Current TOC Celebrating JCO’s 25 th Anniversary Commentary Editorials Comments and Controversies Original Reports –Gastrointestinal Cancer –Phase I and Clinical Pharmacology –Hematologic Malignancies –Bone Marrow Transplantation –Genetic Testing for Cancer –Thoracic Oncology –Genitourinary Cancer –Breast Cancer –Neurooncology –Pediatric Oncology –Cost Effectiveness –Supportive Care and Quality Of Life

25 25 Current TOC (continued) Review Article Biology of Neoplasia ASCO Special Articles Art of Oncology Diagnosis in Oncology Correspondence

26 Review Series

27 27 Upcoming Reviews Series February 10, 2008 Breast Cancer April 10, 2008Stem-Cell Transplantation June 10, 2008Methods/Statistics August 10, 2008Improving the Quality of Supportive Cancer Care October 10, 2008Translational Oncology December 10, 2008Adolescent and Young Adult Oncology

28 The Editor “An editor is hired to define the journal’s terrain and direction, and set the tone. … More than anything an editor in biomedicine is there to attract, select, improve and publish the best manuscripts – to improve quality.” Rennie (Lancet, 1998)

29 The problem:

30 Pressures on a journal editor Owners Legal restraints Governments/ authorities Readers Reviewers Authors Technical editors Distributors Printers Advertisers Adapted from Albert T. Winning the publications game. 1997

31 Reporting clinical data collection WHO collected the data and from whom? WHAT data were collected? WHEN – frequency and intervals WHERE – describe the setting HOW – collection and analysis WHY was this approach taken?

32 32 Before you write Register your clinical trial—Required by JCO Remember at the initiation of the trial to consider any ongoing potential sponsor conflict of interest because JCO, like most journals, has policies concerning potential financial conflicts and authorship. For Phase 3 clinical trials, follow CONSORT guidelines closely CONSORT = CONsolidated Standards of Reporting Trial

33 CONSORT CONSORT = CONsolidated Standards of Reporting Trial A checklist and flow diagram to improve the quality of RCT reports A standard way for researchers to report trials Checklist includes items, based on evidence, that need to be addressed in the report Flow diagram provides a clear picture of the progress of all participants in the trial, from the time they are randomized until the end of their involvement

34 Why CONSORT? RCTs can have great impact on patient care Poorly conducted RCTs can be biased and bias the evidence base Analysis of published RCTs had consistently shown wide variation in reporting quality RCT reports should give meaningful data about –design –conduct –analysis –generalizability

35 CONSORT flow diagram, 2001

36 Reporting phase I trials There are no CONSORT-like reporting standards for Phase I trials Little published research on quality of Phase I reporting We might expect similar problems to those seen with other trial reports

37 Phase II trial reporting is still evolving Reviewed 393 Phase II trials published in 1995 (n=185) and 2000 (n=208) Neither sample size nor design parameters were specified in 157 (85%) and 113 (46%) papers in 1995 and 2000, respectively. Thezenas et al. (Eur J Cancer, 2004) Journal% Reporting statistical design 19952000 Am J Clin Oncol12.536.0 Br J Cancer29.428.6 Cancer15.156.1 Eur J Cancer8.333.3 JCO20.059.3 Ann Oncol6.939.3

38 Clinical Trials Registration 1.Unique Trial number 2.Trial Registration Date 3.Secondary IDs 4.Funding Source(s) 5.Primary Sponsor 6.Secondary Sponsor(s) 7.Responsible Contact Person 8.Research contact person 9.Title of the Study 10.Official Scientific Title 11.Research Ethics Review approval 12.Condition 13.Interventions(s). 14.Key Inclusion and Exclusion Criteria 15.Study Type/ Database 16.Anticipated Trial Start Date 17.Target Sample Size. 18.Recruitment Status 19.Primary Outcome. 20.Key Secondary Outcomes

39 Clinical Trials Databases Clinical Trials Databases Currently Meeting Requirements of Registration

40 Clinical Trials Registration and the JCO The registration policy is all about public trust in clinical research. The JCO will apply the registration policy to trials whose patient enrollment begins on or after November 1, 2006. Authors will have six months from the start of patient enrollment to register the trial, but registration prior to patient enrollment is recommended. The editors will use the ICMJE definition of a clinical trial as follows: “Any research project that prospectively assigns human subjects to intervention and comparison groups to study the cause- and-effect relationship between a medical intervention and a health outcome. By ‘medical intervention’ we mean any intervention used to modify a health outcome. This definition includes drugs, surgical procedures, devices, behavioral treatments, process-of-care changes, and the like…a trial must have at least one prospectively assigned concurrent control or comparison group in order to trigger the requirement for registration.”.

41 41 Before you write Consider what you have to say: Is the paper worth writing? Apply the Editor’s questions: -“So what?” -“Who cares?” Search the literature—are your findings new? Be wary of multiple papers from same research -Avoid “salami science”—slicing data too thin -Republish only if there is substantial new data -Don’t plagiarize yourself or violate previous copyright -When in doubt, consult ICMJE and WAME guidelines

42 42 Before you write Know the target audience: will your message or findings be new and relevant to JCO readers? Is the topic within the scope of the journal? Is the topic represented in the journal frequently, or only rarely? Check out the formats (categories of papers) accepted by the journal One of the most frequent reasons for rejection is the priority of the journal for the work that is being considered.

43 How to Start Know what type of paper you are writing research report (“original article”) review paper special article editorial case report letter to the editor

44 How to Start What Is the Right Format? –The research paper the most articulate paper cannot overcome the deficiencies of an ill-conceived or poorly- executed trial requires a detailed report format, to allow the reader to assess the details of the study design and the results In general, choose the shortest format for what you have to say

45 How to Start What Is the Right Journal? –Colleagues –Quality Impact factor –Prestige journal vs. rapid publication

46 Writing the Paper Authorship: responsibility and content –Should have generated at least part of the intellectual content of the paper. –Collected and interpreted reported data –Should have taken part in writing and revising the intellectual content –Should be able to defend publicly in the scientific community the intellectual content of the paper for which responsibility is taken –NEVER submit a paper without all authors taking responsibility –If a communications firm or company writes your draft (ghostwrites), NEVER have them communicate with the journal directly, and always use their words as a draft…

47 47 Writing the Paper Writer’s block: the first draft is not the final draft— don’t obsess Start with the Materials/Methods and Results sections—don’t try to write in sequence, from Abstract to Conclusion

48 48 Writing the Paper Finish a first draft—it won’t be pretty, but it’s a working document Undoubtedly, it will be too long, redundant, and insufficiently focused Deliver the document to your senior mentor and other authors …expect it to be read and returned within 10-14 days Use professional editing services if needed to perfect writing (this is not the same as ghostwriting) Content is most important, but appearance also matters.

49 49 Original Research Papers Used for research papers State the problem or pose the question Present the evidence Show validity of the evidence Discuss implications: initial conclusion Present additional supporting evidence Assess conflicting evidence Present final conclusion

50 50 Research Paper Elements The Introduction Tell the reader why the research was started Do not re-explain what is in any textbook in the field Make clear what question the research was designed to answer Keep it short!

51 51 Research Paper Elements Materials and Methods—the credibility of the evidence How was the study design selected? Definition of the subjects Interventions Specified measurements and methods Statistical procedures for assessment of the data CONSORT (Phase III)

52 52 Research Paper Elements Results: The initial evidence Present efficiently - Graphs and tables…don’t repeat the text Did the study design accomplish what was expected of it? Order the results from the most known to the unknown (standard to experimental) Include unequivocal statements of statistical significance; do not inflate statistically insignificant differences (“trends”) Be sure to present results with both absolute differences and relative differences as well as confidence intervals.

53 53 The review article Structured differently from research papers or case reports May be invited or submitted without invitation Must be clinically oriented What is the question that the review intends to answer? Will it be structured and exhaustive? Will it be a critical review? Are you an expert in the field? Can you find it in a standard text? Not a shopping list…. The meta-analysis - Compilation of published reports - Individual patient data »Piedbois and Buyse, JCO 2004

54 54 Consensus/Guidelines statements The editors feel that a good consensus statement should: Describe a topic that has recently changed (being sure not to rehash material not dramatically new) Come from an established, high profile cancer group made up of recognized experts on a topic Include a high level of evidence Be consistent with the current standard of care Additionally, if the statement was created in response to a meeting, then the meeting has to be an open scientific meeting.

55 Letter to the Editor What a Letter to the Editor is: A comment or question about an article that appears in (this) Journal, to which the author can respond Occasionally, an interesting observation from a study or patient that does not qualify as an original report that might stimulate further research What it is not: A CV stuffer A place to report small, non peer-reviewed clinical trial Cliff’s notes: a summary of an article, and review of the literature Remember: All LTEs do not have to start with “We read with great interest…” 55

56 56 Edit to communicate clearly The ABC’s of good prose –Accuracy –Brevity –Clarity

57 How to write a boring article…. 1. Avoid focus. Introduce so many questions, ideas, and possible relationships that you kill any hope of a clear hypothesis 2. Avoid originality and personality 3. Make the article really, really long 4. Remove any suggestion of the work's potential implications 5. Leave out illustrations, particularly good ones Chemical & Engineering News September 10, 2007 Volume 85, Number 37 p. 56

58 6. Omit necessary steps of reasoning 7. Use as many abbreviations and technical terms as possible 8. Don't even think about being funny or using flowery language. 9. Focus only on statistics 10. Support every statement with a reference How to write a boring article….

59 Orwell’s rules 1. Never use a metaphor, simile, or other figure of speech which you are used to seeing in print 2. Never use a long word where a short one will do. 3. If it is possible to cut a word out, always cut it out. 4. Never use the passive where you can use the active. 5. Never use a foreign phrase, a scientific word or a jargon word if you can think of an everyday English equivalent. 6. Break any of these rules sooner than say anything outright barbarous George Orwell, Politics and the English Language

60 60 Submitting the Paper The cover letter: Your opening argument State the title of the paper Describe the paper Name which manuscript category it best fits Divulge any (apparent) overlap or prior publication (provide reprints as needed) State conditions of publication (eg, embargo until after a meeting) Suggest reviewers

61 It’s Time to Submit Original Reports are the primary presentation mode of scientific communication in the Journal. The Editor-in-Chief and an Associate Editor generally review Original Reports. Selected manuscripts are also reviewed by at least two external peer reviewers, and, when required, a biostatistician. Comments offered by external reviewers are returned to the author(s) for consideration. Original Reports are limited to 3,000 words of body text, excluding the abstract, references, figures, and tables. Original Reports are limited to six total figures and tables, not counting panels within figures. Additional figures or tables (eg, the required CONSORT diagram) can be submitted as supplemental information. Reports may be appropriately brief.

62 62 Information for Contributors Revisions to be in line with ICMJE/WAME Proposal: All clinical trials will be submitted with the original protocol document as a supplemental file, for both reviewers and readers when published (online access) Eligibility criteria Dose modifications Stats section/endpoints

63 It’s Time to Submit Review Articles Review Articles are usually solicited by the Editor-in-Chief. However, unsolicited Reviews are considered. Authors should contact the Editor-in-Chief in advance to determine the appropriateness of their Review for publication in the Journal Manuscript Preparation Guidelines, and will be reviewed in the same manner as Reports. The text should be limited to 4,500 words, excluding the abstract, references, figures, and tables. The editors also suggest a limit of 150 references. Editorials and Comments and Controversies Editorials are usually solicited by the Editor-in-Chief to accompany a published article or an accepted manuscript. Editorials offering an opinion on a topic not related to a specific article are published in the Comments and Controversies section. Avoid “cute” titles Special Articles Special Articles are manuscripts whose content and style do not fall under the category of Reports or Review Articles. These may include, but are not limited to, guidelines, summaries of consensus meetings, and other scholarly communications. The Editors decide on which articles are “special”;

64 DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST Relationships with pharmaceutical companies or biomedical device manufacturers or other corporations whose products or services are related to the subject matter of the submission Financial interests or relationships Disclosures of financial interests or relationships involving the authors must be addressed on the Author Disclosure Declaration. Each author must complete a declaration form online with every manuscript submission. The corresponding author may complete the form online on behalf of other authors; or authors may also complete their own forms and forward them to the corresponding author. This information will be entered as part of the online submission process, and hard copies of these forms should not be sent to the Editorial Office. Statements regarding financial support for the research must be made on the manuscript title page, and disclosed under question #6 (Research Funding) on the form. This form is available in every issue of the Journal, online, or upon request from the Editorial Office. We recommend that authors complete the Author Disclosure Declaration before starting the formal, online submission. All disclosures will be included in published

65 DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The intent of this policy is not to prevent authors with these relationships from publishing their work. It is merely intended that any relationships be identified openly so the Editors and peer reviewers may make informed decisions about submitted manuscripts, and so the readers may form their own judgments about the publication with the full disclosure of the facts. It remains for readers to determine whether the authors’ outside interests reflect a possible bias in the conclusions presented.

66 AUTHORSHIP CONTRIBUTIONS Contributions must be substantive in order to justify authorship. Each author should have participated sufficiently in the work to take public responsibility for the content. All other contributors, who do not meet sufficient criteria for authorship, should instead be noted in the Acknowledgments section. Corresponding authors are responsible for ensuring that all authors have seen and approved the final manuscript prior to submission. Every submission must include the Author Contribution Form. Author Contribution Forms must be filled out and submitted as part of the online submission process. These forms are available for reference in the print Journal, but do not need to be sent to the Editorial Office. This form is available in every issue of the Journal, online, or upon request from the Editorial Office. As part of the online submission process, the corresponding author must submit this form on behalf of every author. We recommend, therefore, that each author complete this form and forward it to the corresponding author before the formal, online submission online

67 STATISTICAL GUIDELINES All results from clinical studies should be supported by a clear description of the study design, conduct, and analysis methods used to obtain the results. The description should include the originally planned sample size and the power considerations that led to that choice of sample size. In the case of randomized clinical trials, authors should follow the guidelines of the CONSORT statement available online at For randomized clinical trials, two-sided P values should be reported. If the trial design was Bayesian, used one-sided P values, or was not based on a standard two-sided test, the primary result and conclusion may be described in terms of the original design, but the two-sided P value of a standard test must also be included. Differences may be reported in terms of odds ratios or hazard ratios, but there should also be a comparison of an absolute difference of the primary measure such as difference in survival at 5 years or difference in proportions of Reports of phase II studies should include a clear definition of the primary end point (from the protocol) and a discussion of possible weaknesses, such as comparison to historical controls.

68 STATISTICAL GUIDELINES Reports focused on prognostic markers (eg, those based on clinical factors, etiologic factors, genetic factors), will receive highest priority when an algorithm obtained in a training set is applied exactly the same way in the validation set as in the training set (i.e., the factors included and the cutoffs must be determined in the training and applied to each patient in the validation set). Further fine tuning should clearly be identified as exploratory. Prognostic studies that report the results of an algorithm from the same data that were used to fit the algorithm will have lower priority, but will be enhanced by the inclusion of cross-validation analyses and a clear statement of the limitations of the study. Reports describing data from multiple studies will be considered to be a meta-analysis only if individual patient data are used for analyses and an attempt is made to include data from unpublished studies. Systematic reviews that use summary data should also include unpublished data and a discussion of the limitations of such studies. Systematic reviews will have a lower priority than meta-analyses. Reports of studies of multiple or secondary end points should address the multiple comparison issues and describe the exploratory nature of the studies

69 69 A letter (email) from JCO arrives! Outright acceptance (rare) Minor revisions requested Major revision Rejection (may occur without external peer review)

70 Remember: Every paper will get published somewhere! “There seems to be no study too fragmented, no hypothesis too trivial, no literature citation too biased or egotistical, no design too warped, no methodology too bungled, no presentation of results too inaccurate, too obscure, and too contradictory, no analysis too self- serving, no argument too circular, no conclusions too trifling or too unjustified, and no grammar and syntax too offensive for a paper to end up in print.” Rennie (JAMA, 1986)

71 Peer Review: Benefits, Perceptions and Alternatives Ware M. Peer review is an essential component of scholarly communication. It is the mechanism that facilitates the publication of primary research in respected scientific journals. In recent years there has been a good deal of debate about the effectiveness of peer review. There is, however, little reliable data to inform these discussions. 93% of academics believe peer review is necessary 90% believed that peer review improved quality of papers Majority of academics believe that current peer review is satisfactory; criticisms include speed of review and overloading of reviewers Majority agreed with double-blind review (anonymous) Most important to reviewers: methodology, relevance, importance/originality, data About 2/3 felt that reviewers should have access to authors’ data (protocol submission)

72 What we want from referees: Promptness Politeness Honesty An assessment of the quality and importance There are no absolute rules in refereeing: medical publishing thrives on variety.

73 73 Reviewers may have differing opinions Possible reasons: Complexity of manuscript assessment Divergent interests of reviewers Valid differences in the expertise of reviewers

74 74 Criteria for acceptance Relevance to the journal’s scope and audience Importance to most of the journal’s audience Newness of the message Scientific validity of the evidence supporting the conclusions Usefulness to the journal in maintaining a balance of topics (“priority”)

75 75 Reasons for rejection Unimportant issue studied Unoriginal work Research poorly done Analysis poorly done Conclusions not supported by results Data set too small Poorly written/presented Submission does not comply with Information for Contributors Priority of the journal

76 76 Responding to a rejection of your paper Don’t take it personally Did you shoot too high? Is the paper more appropriate elsewhere? Carefully read the comments; don’t be defensive!! Blatant protest to the editor is rarely successful On the other hand, even editors and reviewers are not perfect…

77 77 Responding to a rejection of your paper Appealing a decision - Contact the editor to see whether the paper is salvageable -Plead your case, but don’t whine or get angry Consider whether the paper would better be submitted to another journal -Revise using external reviewers comments (the same reviewers may see the paper again) Don’t let journal #2 know that it was an also-ran….

78 78 Responding to a major revision request Respond to the comments Provide more data (often updated) Condense—brevity is ideal Fix the figures

79 “Never miss a good chance to shut up.” Will Rogers

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