How to get a paper published, and what journals look for Dr Kirsten Patrick Clinical reviews editor, BMJ

What I aim to cover What editors look for in a research paper How to write a research paper for the BMJ Publication ethics and why it is important Systems of peer review Impact Useful resources

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

How to please editors and reviewers

What do editors want? importance originality relevance to their audience the right study for the research question real potential to improve decision making truth and transparency clear writing that people want to read excitement/ wow factor

What is the research question?

What do I mean by 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 doesnt matter one that emerges from routine clinical data/records –records will be biased and confounded –theyll lack information you need to answer your question reliably, because they were collected for another reason one that emerges from a fishing expedition/data dredging – where researchers gather lots of new data and hope 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

What is the study design?

Study designs Descriptive studies answer whats 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

Is it well conducted and well written?

Minimising bias and confounding Chance - measurements are nearly always subject to random variation. Minimise error by ensuring adequate sample size and using statistical analysis of the play of chance 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

More on study methods and reporting Centre for Evidence Based Medicine Statistics at Square One BMJ advice to authors

General guidance on writing papers International Committee of Medical Journal Editors uniform requirements for manuscripts submitted to biomedical journals reporting guidelines for research, at the EQUATOR network resource centre

Writing a research paper

Writing a paper IMRaD style Introduction: why ask this research question? Methods: what did I do? Results: what did I find? Discussion: what might it mean?

Writing a paper * The introduction brief background for this audience 3-4 paragraphs only whats known, and whats not, about your research question dont bore readers, editors, reviewers dont 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 *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 ( explain ethics issues

Writing a paper *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 dont start discussion here

Writing a paper *Structured discussion dont 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 Should follow a structure. (S) Contains all the important information (I) enough for a reader to be able to judge the quality of the research Objective/question Essential features of the study design Main results Clearly written (C) As concise as possible (C) The reader should feel that they know what the study is about after reading it

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; dont go beyond data trial registration - registry and number (only for clinical trials)

Common problems with abstracts Written in a hurry with too little thought Too vague – what on earth did they do? Odd, cherry-picked results Main results not properly described Difficult to tell what the main results were P values without supporting data Results that arent presented in the paper Overblown conclusions

Who has contributed to the paper?

agree authorship before starting the study!

Authorship and contributorship these denote credit and accountability but many authors on papers have done little peoples 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, 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 science1 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.

Competing interests?

Conflicts of interest A 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 judgement. Why should it matter? Because it may have a profound effect on judgement of authors. Because of the perception that this can happen, whether it does or not. Best policy? Always declare a conflict of interest, particularly one that would embarrass you if it came out afterwards.

Is our journal the right journal for this paper?

Which journal should you choose? audience generalists or specialists? national or international? impact not just Impact Factor not just prestige will people read your work? respond to it? debate it? replicate it? tell others of it? will anyone use it? will it reach the public?

BMJ (impact factor 13.66)

BMJ peer review process annually rejected Approx 1000 for open review 500 then rejected 500 with Editor and adviser, statistician, BMJ team 4-7% with Open access No word limits BMJ pico Editorials Screen Research submitted External review Editorial meeting Accept

What BMJ asks reviewers to do be open and honest be constructive, and help the authors to improve the paper even if the BMJ rejects it most importantly, reviewers advise editors on: the articles originality the articles importance

What happens during peer review BMJ ask reviewers to sign their reports and declare any competing interests relevant to manuscripts reviewers advise the editors, who make the final decision (aided by an editorial manuscript committee meeting for some articles, including original research)

BMJ appeals Serious appeals welcomed Criticisms addressed Up to 20% accepted But only one appeal Make it good

Thanks…