Presentation on theme: "How can I get my paper published in the BMJ?"— Presentation transcript:
1 How can I get my paper published in the BMJ? Tony Delamothedeputy editor, BMJWith a little help from Trish Groves and Richard Smith
2 What I want to talk about Knowing me, knowing youWhy do you want to publish?What do journals want to publish?What is the publication process?How is publishing changing?
3 What’s the BMJ? In print since 1840 Online since 1995; full text since 1998Research articles remain Open Access.Recent changesDirection: “to help doctors make better decisions”Look and feel of print journal: more magazine-likeNew online model: publishing oblivious to print.
4 General medical journals Annals of Internal MedicineBMJJAMALancetNew England Journal of MedicinePLoS Medicine
5 Why do you want to publish? Answers please on a flip chart
6 Why publish? Because you have something important to say To change practiceTo promote thought or debateTo allow examination of your workTo get your work in a high impact factor journal (aka “Fame andthe love of beautiful women” or men)To make moneyTo advance your career/keep your jobTo entertain/divert/amuseTo educate
7 What do medical journals want to publish? Remember journalistic valuesnewtrueimportantof interest to our readers
8 Medical journals want to publish material that is: newtrueimportantof interest to our readersOur commonest reasons for rejection are:Too well knownToo specialistToo inconsequentialToo far removed from patient care or public policy
9 The brutal realityA mismatch between what you as authors/researchers want and what we as medical journal editors want(and guess who gets to decide?)In journalism readers take precedence over authors
10 Published and be damned? “Why is medicine so obsessed with those who can convince others to read what they have written? Other professions- dentists, lawyers, accountants - are judged on what they can do, rather than how many papers they have published…“Ultimately our love of publications comes from the misguided belief that being scientists and researchers is a critical part of the practice of medicine. While this may indeed have been true during the past – Paul Langerhans discovered the pancreatic islets while at medical school – the professionalisation of medical research means that such discoveries are unlikely to be replicated in the future…
11 Writing that paper: before you begin What do I have to say? (“The message”)Is it worth saying?What is the right format for the message?Who is the right audience for the message?Where should I publish the message?Select journal on basis of its audience, not its impact factor or “reputation”
12 Writing that paper: before you begin newtrueimportantof interest toour readersWho is the right audience for the message?Where should I publish the message?Select journal on basis of its audience, not its impact factor or “reputation”
13 What do I do next? Find out what the journal wants from its: Instructions to authorsAdvice to contributorsResources for authors
16 Not just research articles.. EditorialsLettersAnalysis articlesEducational articles (from Clinical review to case reports)Personal views, reviews
17 BMJ - general guidance to follow Guidelines for reporting research, at the EQUATOR network resource centreInternational Committee of Medical Journal Editors uniform requirements for manuscripts submitted to biomedical journalsThe code on good publication practice produced by the Committee on Publication Ethics
20 COPE guidelines on good publication practice cover Study design and ethical approvalData analysisAuthorshipConflicts of interestPeer reviewRedundant publicationPlagiarismDuties of editorsMedia relationsAdvertisingDealing with misconduct, including sanctions
21 Ethics: not an optional extra Think about the wider ethical aspects of your research, even if the study was approved by an ethics committee:might the paper allow patients’ identities to be revealed?does the paper say enough about the information participants were given before consenting?how much does this deviate from current normal (accepted, local) clinical practice?what was the full burden imposed on participants?what total risks were participants or others exposed to?what benefit might accrue to participants or others? what are the potential benefits to society and future patients?Do you have an ethical obligation to report research on humans?
22 Good reporting is part of good scientific practice Manuscripts should present sufficient data for readers to:Reproduce the studyFully evaluate the information and reach their own conclusions about the resultsSo the key sections are: Methods and ResultsMisrepresentation of studies and misleading information abound
23 Writing that paperStructure is all.Make sure that readers know where they are, where they are going, and why.
24 Writing that paper: IMRaD Introduction—Why did I do it?Methods--What did I do?Results--What did I find?andDiscussion-- what might it mean?
25 Writing that paper: Introduction Why did we start?Tell “the story so far”Why was this study needed?Be sure that readers understand the importance of the study-but don’t overdo itDon’t try to show readers that you have read everythingShort, short, short
26 Writing that paper: Methods Should be given in enough detail to allow another researcher to repeat the studylike a recipedescribe inclusion and exclusion criteriadescribe outcome measuresdescribe interventiongive references for standard methodsexplain ethics issuesfollow reporting guidelines as explained at (http://www.equator-network.org/
27 Writing that paper: Results Stick to what is relevantBe sure to include basic descriptive dataThe text should tell the storyThe tables give the evidenceThe figures illustrate the highlightsUse confidence intervals rather than p valuesThink about absolute risk, number needed to treat, etcAvoid starting discussion
28 Essential summary statistics for results For a clinical trial: Absolute event rates among experimental and control groupsRRR (relative risk reduction)NNT or NNH (number needed to treat or harm) and its 95% confidence interval (or, if the trial is of a public health intervention, number helped per 1000 or 100,000)For a cohort study: Absolute event rates over time (eg 10 years) among exposed and non-exposed groupsFor a case control study: OR (odds ratio) for strength of association between exposure and outcomeFor a study of a diagnostic test: Sensitivity and specificityPPV and NPV (positive and negative predictive values)
29 Writing that paper: Discussion statement of principal findingsstrengths and weaknesses of the studystrengths and weaknesses in relation to other studies (especially systematic reviews), and key differencesmeaning of the study: possible mechanisms and implications for clinicians or policymakersunanswered questions and future researchgo easy on the last two
30 Topping and tailingTitle: Include design; Don’t try to be cleverAbstract: Must be structuredReferences: Keep to the essentialsCovering letter: Something very crispAuthorship, acknowledgements, competing interests
31 Pesky bits Trial registration Authorship and contributorship Competing interests(publishing in journals is definitely becoming more onerous - because the realisation that the effects of journal articles can be profound)
32 Trial registrationInclude the registration number of the trial and the name of the trial registry. Please add these to the last line of your paper’s structured abstract. The BMJ’s criteria for a suitable public trial registry are: free to access, searchable, and identifies trials with a unique number; registration is free or has minimal cost; registered information is validated; registered entry includes details to identify the trial and investigator and includes the status of the trial; and the research question, methodology, intervention, funding, and sponsorship must all be disclosed.FDAAA additions
33 Authorship and contributorship credit and accountabilitymany authors on papers have done littlepeople’s names are left off papersauthors do not know the authorship criteriacontributorship statement is more inclusive and accurate – says who did whatAuthorship The uniform requirements for manuscripts submitted to medical journals state that authorship credit should be based only on substantial contribution to:conception and design, or analysis and interpretation of datadrafting the article or revising it critically for important intellectual contentand final approval of the version to be published. All these conditions must all be met. Participation solely in the acquisition of funding or the collection of data does not justify authorship. We want authors to assure us that all authors included on a paper fulfil the criteria of authorship. In addition we want assurance that there is no one else who fulfils the criteria but has not been included as an author.We believe that the definition of authorship, produced by the International Committee of Medical Journal Editors (or Vancouver Group, see has some serious flaws. The current definition of authorship does not make clear who has contributed what to the published study, nor does it clarify who is responsible for the overall content. It also excludes those whose sole but often large contribution has been to collect data. We now list contributors in two ways. Firstly, we publish a list of authors' names at the beginning of the paper and, secondly, we list contributors (some of whom may not be included as authors) at the end of the paper, giving details of who did what in planning, conducting, and reporting the work. One or more of these contributors are listed as guarantors of the paper. The guarantor accepts full responsibility for the work and/or the conduct of the study, had access to the data, and controlled the decision to publish. See bmj.com/cgi/content/full/323/7313/588Contributorship and guarantorship are concepts that were applied first to original research papers, and are sometimes hard to define for other articles. Each contributorship statement should make clear who has contributed what to the planning, conduct, and reporting of the work described in the article, and should identify one, or occasionally more, contributor(s) as being responsible for the overall content as guarantor(s). For BMJ articles that do not report original research such as editorials, clinical reviews, and education and debate please state who had the idea for the article, who performed the literature search, who wrote the article, and who is the guarantor (the contributor who accepts full responsibility for the finished article, had access to any data, and controlled the decision to publish). For non-research articles that include case reports such as lessons of the week, drug points, and interactive case reports, please also state who identified and/or managed the case(s).Researchers must determine among themselves the precise nature of each person's contribution, and we encourage open discussion among all participants.AuthorshipPosted January 10, 2007Authorship is a way of making explicit both credit and responsibility for the contents of published articles. Credit and responsibility are inseparable. The guiding principle for authorship decisions is to present an honest account of what took place. Criteria for authorship apply to all intellectual products, including print and electronic publications of words, data, and images. Journals should make their own policies on authorship transparent and accessible. Criteria for Authorship. Everyone who has made substantial intellectual contributions to the study on which the article is based (for example, to the research question, design, analysis, interpretation, and written description) should be an author. It is dishonest to omit mention of someone who has participated in writing the manuscript (“ghost authorship”) and unfair to omit investigator who have had important engagement with other aspects of the work. (See the WAME policy statement, “Ghost Writing Initiated by Commercial Companies”) Only an individual who has made substantial intellectual contributions should be an author. Performing technical services, translating text, identifying patients for study, supplying materials, and providing funding or administrative oversight over facilities where the work was done are not, in themselves, sufficient for authorship, although these contributions may be acknowledged in the manuscript, as described below. It is dishonest to include authors only because of their reputation, position of authority, or friendship (“guest authorship”). Many journals publish the names and contributions of everyone who has participated in the work (“contributors”). Not all contributors necessarily qualify for authorship. The nature of each contributors’ participation can be made transparent by a statement, published with the article, of their names and contributions and WAME encourages this practice. One author (a “guarantor”) should take responsibility for the integrity of the work as a whole. Often this is the corresponding author, the one who sends in the manuscript and receives reviews, but other authors can have this role. All authors should approve the final version of the manuscript. It is preferable that all authors be familiar with all aspects of the work. However, modern research is often done in teams with complementary expertise so that every author may not be equally familiar with all aspects of the work. For example, a biostatistician may have greater mastery of statistical aspects of the manuscript than other authors, but have somewhat less understanding of clinical variables or laboratory measurements. Therefore, some authors’ contributions may be limited to specific aspects of the work as a whole. All authors should comply with the journals’ policies on conflict of interest. Number of Authors. Editors should not arbitrarily limit the number of authors. There are legitimate reasons for multiple authors in some kinds of research, such as multi-center, randomized controlled trials. In these situations, a subset of authors may be listed with the title, with the notation that they have prepared the manuscript on behalf of all contributors, who are then listed in an appendix to the published article. Alternatively, a “corporate” author (e.g., a “Group” name) representing all authors in a named study may be listed, as long as one investigator takes responsibility for the work as a whole. In either case, all individuals listed as authors should meet criteria for authorship whether or not they are listed explicitly on the byline. If editors believe the number of authors is unusually large, relative to the scope and complexity of the work, they can ask for a detailed description of each author’s contributions to the work. If some do not meet criteria for authorship, editors can require that their names be removed as a condition of publication. Order of Authorship. The authors themselves should decide the order in which authors are listed in an article. No one else knows as well as they do their respective contributions and the agreements they have made among themselves. Many different criteria are used to decide order of authorship. Among these are relative contributions to the work and, in situations where all authors have contributed equally, alphabetical or random order. Readers cannot know, and should not assume, the meaning of order of authorship unless the approach to assigning order has been described by the authors. Authors may want to include with their manuscript a description of how order was decided. If so, editors should welcome this information and publish it with the manuscript. Authorship Disputes. Disputes about authorship are best settled at the local level, before journals review the manuscript. However, at their discretion editors may become involved in resolving authorship disputes. Changes in authorship at any stage of manuscript review, revision, or acceptance should be accompanied by a written request and explanation from all of the original authors.
34 AuthorshipAuthorship credit should be based only on substantial contribution to:conception and design, or data analysis and interpretation anddrafting the article or revising it critically for important intellectual content andfinal 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 criteriaNo one who fulfils the criteria should be excluded
35 Contributorshipcontributors (some of whom may not be included as authors) listed at the end of the paper, giving details of who did what in planning, conducting, and reporting the workone or more are guarantors, who accept full responsibility for the work and/or the conduct of the study, had access to the data, and controlled the decision to publishresearchers must decide among themselves the precise nature of each contribution
36 Who did what?Helen C Eborall, post-doctoral research fellow1, Simon J Griffin, programme leader2, A Toby Prevost, medical statistician1, Ann-Louise Kinmonth, professor of general practice1, David P French, reader in health behaviour interventions3, Stephen Sutton, professor of behavioural science1Contributors: 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.
37 Conflict of interest: a definition Conflict of interest is a set of conditions in which professional judgement concerning a primary interest (such as patients’ welfare or the validity of research) tends to be unduly influenced by a secondary interest (such as financial gain).Thompson DF. Understanding financial conflicts of interest. N Engl J Med 1993; 329:
38 Competing interestA person has a competing interest when he or she has an attribute that is invisible to the reader or editor but which may affect his or her judgment.
39 Why does a competing interest matter? it may have a profound effect on authors’ judgmentthere’s a perception that this can happen, whether it does or not
40 The best policy on competing interest Always declare a conflict of interest, particularly one that would embarrass you if it came out afterwards
41 Problems with conflict of interest Should it be just financial or personal, academic, political, religious, anything?People don’t declare it because a) it implies wickedness; b) they are confident that their judgment is not affectedMight we avoid these problems by changing “conflict of interest” to “relevant” or “competing” interests?
42 Transparency and integrity The BMJ expects authors to present their work honestly and fullyBMJ transparency policy is at:
43 The rudiments of style Short words Short sentences Short paragraphs No jargonNo abbreviationsPrefer Anglo Saxon over Latin wordsPrefer nouns and verbs to adjectives and adverbsCut all clichesPrefer active to passive tensePrefer the concrete to the abstract
46 BMJ processThe average time from submission to first decision is two to three weeks and from acceptance to publication eight to 10 weeks. These times are usually shorter for original research articles.For accepted original research articles we offer full online publication as soon as the authors have approved the proofs, with print publication a few weeks later. We aim to publish other articles within three months of final acceptance after any necessary revisions.
47 What is peer review?As many processes as journals or grant giving bodiesNo operational definition--usually implies “external review”Benefits come from improving what is published rather than sorting the wheat from the chaff
48 BMJ open peer reviewwe ask reviewers to sign their reports and declare any competing interests on any manuscripts we send themreviewers advise the editors, who make the final decision (aided by an editorial manuscript committee meeting for some articles, including original research)
49 BMJ peer review process I 7000 research papers, 7% acceptedapproximate numbers at each stage:1000 rejected by one editor within 48 hoursfurther 3000 rejected with second editorwithin one week of submission 3000 read by senior editor; further 1500 rejected1500 sent to two reviewers; then 500 more rejectedapprox 1000 screened by clinical epidemiology editor and more rejected
50 BMJ peer review process II to weekly manuscript meeting attended by the Editor, an external editorial adviser (a specialist or primary care doctor) and a statistician..…and the full team of BMJ research editors, plus the BMJ clinical epidemiology editor350 research articles accepted, usually after revisionvalue added by commissioned editorials and commentaries
51 Appealsalways willing to consider first appeals (letter first; no need to submit revised paper initially)more success if authors respond in detail to editors’ and reviewers’ criticismsperhaps 20% accepted on appealno second appeals
53 Triage questions: treatment papers Is it a randomised controlled trial or a systematic review (see later)?If it is not an RCT, is it reasonable not to have done one?Look for an answer to the question in the paper. If you can’t find one, reject.If it is an RCT, was it really randomised?If it wasn’t, reject unless you can find a good reason for not randomising
54 Triage questions: prognosis studies Is there a cohort of patients followed followed prospectively from when they were first identified with the disease?Are 80% of patients followed up?If the answer to these questions is no, we probably don’t want it.
55 Triage questions: Questionnaire survey We probably don’t want. This is people saying what they do rather than evidence on what they doBut is it telling us something important that we probably can’t get information on in any other way?Or might it be a peg for an educational article.If the response rate is below 55% we almost certainly don’t want it.
56 Triage questions: two sorts of studies we don’t want Prevalence studyBoringUsually not possible to generalise beyond the particular populationCost of illness studyValue is in the exactness, which is usually of interest to only a fewAgain hard to generalise
58 BMJ open accessevery research article published in the BMJ is immediately accessible on bmj.com to everyone at no chargethe full text of all research articles is also sent, without further intervention from the author, to PubMed Central, the National Library of Medicine's full text archive, which makes it fully accessible without delaythe BMJ immediately fulfils the requirements of the US National Institutes of Health, the UK Medical Research Council, the Wellcome Trust, and other funding bodies to make publicly funded research freely available to allSee