~ Practical advice on writing scientific articles

 

This document aims to help aspiring authors write an article that is likely to be accepted for publication and that will be read by and influence others.  It combines direct suggestions of a practical nature relating to the process of publication with general suggestions that relate to the process of writing effectively.  Other documents on this web site cover matters such as the submission and handing of documents and the more technical aspects of preparing documents for submission.

 

The primary messages are:

v     You are telling a story, so make it interesting and have a logical sequence

v     Your reader is like you, and prefers simple clear sentences using plain language

v     Your article should be as short as possible, but as long as necessary

 

This document discusses:

v     Structure of scientific articles; why and what

o       The title; make it interesting

o       The abstract; make it informative

o       The introduction; why did you do the study (and why should the reader read it)?

o       The methods; what actually happened?

o       Ethics; were actions morally acceptable?

o       Results; what did you find?

o       Discussion; what does it mean, and what does it not mean?

o       Clinical messages; so what?

o       Accompanying statement; thanks, who influenced us, who did what?

o       References; the historical context

o       Illustrations; tables and figures

v     Writing style

v     Some (otherwise) unwritten rules;

o       Length of article

o       Authorship (see also our separate document)

o       Copyright?

o       Malfeasance (immoral or illegal behaviour)

§         Plagiarism

§         Duplicate publication

§         Misrepresenting data or data analysis

 

 

 

 

 

Structure

A good story has a beginning (a puzzle is put forward), a middle (taking you towards the resolution of the puzzle), and an end (the solution of the puzzle).  Scientific articles are no different.

 

Most scientific journals have a similar structure for their articles.  This is not just chance!  The structure has evolved to be currently the most efficient and effective way to communicate.  Please use the suggested structure unless you have good reasons not to; articles will be considered with other layouts but most readers are familiar with the standard format given below.

 

A clear structure within each section is also important.  Please make the article flow in a logical and coherent way so that the reader can understand both what he has learned so far and where the article is going.

 

The title

A book has a title that is aimed to grab your attention and tell you what to expect inside.  Do the same with your title.  The priority is for the title to be informative, but it should not be too long and if it can also attract attention then that is a bonus.

 

Books also give you some boring factual information, and so your article will start with the title page, which should give the title of the paper; a running title; the names and initials of all authors; and the name and address of the author to whom correspondence, proofs and offprint order are to be sent should be given, together with an email address, telephone and fax numbers if possible.

 

The abstract

Most books have a synopsis somewhere easy to find, hoping to entice you to buy the book.  Your abstract fulfils that purpose.  Your abstract is also going to be available in electronic data-bases and will be subject to searches.  Make your abstract as informative as you can.  This is achieved by using a structured abstract of no more than 250 words if possible.

 

The abstract is important for many reasons.  Editors often reject papers on the abstract alone, and research shows that this is fair in most cases.  Many readers will only read the abstract, especially if undertaking searches of computer data-bases.  They help the reader (and the author) establish the main messages.  Therefore Clinical Rehabilitation requires structured abstracts wherever possible, because research shows that structured abstracts are usually more informative.

 

A structured abstract involves using some or all of the following headings; not every heading is appropriate in every case, and other headings may be used.  See specific guidance on systematic reviews for structure to be used when reporting a systematic review.

 

            Objective.      The purpose of the study; what did you hope to discover?

                Design.      How was purpose achieved?

                Setting.      Where was study undertaken?; a general not specific description.

              Subjects.      Who was studied?; what types of patients?

     Interventions.      What was done?          

  Main measures.      Outcome measures and other measures.

                Results.      Main data. Please always give number of patients, and some hard facts.

      Conclusions.      Should be related to the objective.

 

Thereafter most research articles should follow the standard layout and be presented in this order.

 

Introduction - why did you ever start on this study?

This sets up the puzzle; why was this study necessary?  The first sentence should attract the reader.  The introduction should encourage the reader to continue reading.

 

The introduction can usually be covered in three or four paragraphs which should:

• Specify the general topic and field of study which a broad brief outline of its relevance
• Outline important earlier work, including any systematic reviews or meta-analyses (but the introduction is not the place for a detailed review of previous work).
• Identify gaps or uncertainties in existing knowledge that require more research.
• Conclude with a brief statement of the main hypotheses you are testing, or your research questions?

 

Common mistakes are:

• To make the introduction too long, giving detailed reviews of all previous work, and/or
• To start giving information about the methods used and/or results found.

 

Methods – what did you actually do?

You now describe how you set about solving the problem posed in the introduction.  It is a necessary if slightly boring part.  It should allow the reader to understand exactly what you actually did.

 

Therefore this part should describe what you did in sufficient detail to enable replication, at least in principle.  You do not need to justify in detail every choice made, nor should you describe in detail every data collection tool used.  Use references to allow readers access to details.  Only give detail if you are using a technique or tool that is new or difficult to find using references.

 

Please ensure that you describe the methods in a logical order.  You should cover how subjects were recruited and selected, the design of study, the measures used, how measures were taken (who did it), how bias was countered, and types of analysis. Describe the statistical methods used. State (if true and relevant) that the study had the approval of local ethical committees. Flow diagrams are often helpful, and should be given for all studies of interventions. (see Rennie, Jama 1996; 276: 637-39 or Altman, BMJ 1996; 313: 570-71). Note that results should not be given in the methods section; this is a common error.

 

If you are evaluating an intervention (treatment) then Clinical Rehabilitation is happy to give you reasonable space to describe both the experimental and control intervention either within the text or, if long, in an appendix.

 

Ethics – were your actions morally acceptable?

Clinical Rehabilitation only wants to publish ethically sound research.  This basically means that the subjects (patients or healthy people) must be treated with respect.  They should be informed of the nature of the project, given choices, especially on whether to participate, and subject to as little risk or unpleasant procedures as possible on account of the research.  Usually protocols are considered by ethical committee (Institutional Review Boards) before being started, but the journal’s view is that consideration by an ethics committee does not guarantee ethically sound research nor does failure to seek help from an ethics committee inevitably imply unethical practice.  The journal will always consider the ethical aspects of submitted papers.  Discussion of ethical issues relating to a project may legitimately be included in an article.

 

Results – what did you discover?

This is the denouement, where the reader finds the answers.  Of course most people skip over this, but you should try to attract their attention.  Relate the presentation of results back to your questions.  Present results in a logical order.

 

This is where you present your data.  Think carefully about how you present your data.  Give actual numbers; all percentages should be accompanied by actual numbers.  Tables are often a good way to show data.  Figures, such as scatterplots and other graphs, are informative but histograms rarely are.  Always give a title to each figure and table, and always enlarge upon all abbreviations under the table.

NB please place all tables and figures on separate sheets, at the end, but show in the text where they belong.

 

The results of complex statistical analysis are not results in themselves.  They help the reader understand the data, and inform the reader how much weight can be given to an interpretation.  Tables and text should primarily contain summarised data such as means (which should always be accompanied with standard deviations), medians and ranges, modes or whatever.  The text can give the results of more complex analysis.

 

Discussion – so was it worthwhile?

Stories do not have discussions!  But story tellers usually try to include a moral within the story itself.  You have an opportunity to make that more explicit. Note that research shows that most readers start with the discussion.

 

The first paragraph should summarise the whole study, explaining what you have discovered and what the major strengths and weaknesses are.

 

You must then discuss:

v     Weaknesses and limitations.  Avoid the temptation to over state your study.  You will, or certainly should know the main weaknesses of your own study.  Tell the reader, so that they do not draw inappropriate conclusions.  You also have an opportunity to respond to potential criticisms, and to point out any relative strengths.  The major flaw in articles submitted is a total failure to acknowledge any weaknesses.

v     Context.  Set your findings in the context of other knowledge.  You do not need to consider every single other study, but do point out how your findings support, develop, or refute previous research findings.

v     Implications.  You may also take the opportunity to speculate on the consequences of your findings.  This should be restrained, and realistic.  For this journal, Clinical Rehabilitation you should certainly relate your findings to the clinical practice of rehabilitation.  You may also consider what next research step is needed.  Sometimes there may be implications for theory.

 

Clinical message – so what?

Many readers will simply want to know “Should this research have any impact upon my clinical practice?”

 

Therefore Clinical Rehabilitation would like all authors to provide a series of points encapsulating the main clinical message(s) arising from the article.  They should be limited to no more than 50 words and should comprise 2-5 bullet points.

 

The clinical messages must arise from the study.  They should be complete in their own right, and should not depend upon reading the article.

 

An example clinical message

 

Clinical messages

• Three months of cardiac rehabilitation in patients after coronary artery bypass grafting improves heart rate recovery and resting heart rate
• Recovery of heart rate over one minute may be a good measure of the effectiveness of cardiac exercise training

 

Accompanying statements

Unlike novels and short stories, journal articles follow from the work of many people, and often the work is paid for by others.  Clinical Rehabilitation, in common with many other journals, wants to maximise openness and to reduce the risks of hidden influences.

 

Consequently, on a new page, we would like to see the following.

 

Acknowledgements. (not essential)

This is your opportunity to say thank you to everyone who contributed to the article.  This can include people who have given advice, people who helped in the running of the study, patients and relatives, people who provided resources including money, etc.  If you have more than four authors, you could consider whether some should simply be acknowledged instead.

 

Competing interests, and source of funding. (essential)

[See separate guidance for a little more detail.]

If you feel that there are any interests that readers should be aware of, please state them; they will not affect the decision to publish.

 

Competing interests are wide.  They obviously include the source of funding and support for the reported work (which must be stated, together with a statement on what influence they had over the analysis, interpretation and reporting of data) and any financial interests that any author may have in the results.  However they also include any other influences that others might believe could affect the way you set up the study, collected and analysed the data, or interpreted the results.  Ask yourself, in relation to the paper, “would I be embarrassed if this fact became known?”  If so, report it.

 

If you do not think there are any competing interests that readers should know about, state “none declared”.

 

Contributors. (essential) (See also separate document on authorship)

Please indicate (using the initials of authors) what each author contributed to the study and paper.  The activities involved usually include writing the paper itself, initiating the study, designing it, monitoring progress, and deciding on the analytic strategy.  One author should be the guarantor, the person who takes ultimate responsibility for the accuracy and honesty of the report and the morality of the study.

 

References – where can the reader find other parts of the greater story?

References are, in one way, the earlier parts of your story.  They put your chapter in a context.  They also allow you to avoid repeating information that is readily available elsewhere.

 

They should always be condensed to those which are relevant; more is not necessarily better.

 

They should be numbered in the order in which they appear in the text in the ‘Vancouver style’ (1): for articles, give names and initials of all authors (unless more than six, in which case give the first three then et al.), the title of the article, the journal title abbreviated according to Index Medicus, year of publication, volume number and first and last page number; for chapters in books give authors, chapter title, editor(s) of the book, the book title, place of publication, publisher, year of publication and first and last page number.

 

For examples, see below (2- 4):

1    International Committee of Medical Journal Editors. Uniform requirements for manuscripts submitted to biomedical journals. JAMA 1993; 277: 927-34.

2    Lowry S, Smith J. Duplication publication. BMJ 1991; 304: 999-1000.

3    Huff D. How to lie with statistics. London: Penguin, 1991

4    Wade OL. Research ethical committee. In: Duncan AS, Dunstan GR, Welbourn RB eds.Dictionary of medical ethics, second edition. London: Darton, Longman and Todd, 1981: 371-74.

 

Illustrations – making it more interesting

Text is informative, but large expanses of text can be off-putting.  Most scientific studies have sufficient data to warrant the use of tables or figures both to break the text up, and to allow more efficient presentation of the results.

 

Tables are rarely needed for a single column of figures. Histograms are rarely needed; avoid overuse of fancy computer packages! Think carefully about how to present your data. Each table should be typed on a separate sheet with an explanatory caption, and be numbered. Indicate in the text where tables should be positioned.

 

Figures can present data in a clear and informative way, but equally can be badly used.  Flow diagrams showing how patients (or papers, in a systematic review) progressed through the study are often helpful.  Scatterplots and others graphs are often very informative.  Histograms are rarely useful.  Photographs may occasionally help (black and white only).  Please submit your paper with photocopies of all figures – for sending out to reviewers.

 

Writing style

Please remember that you are trying to attract and maintain the interest of a busy reader.  Make your article interesting.  Tell a story.  Do not wander from the main theme or focus of your story.  Avoid jargon, long words, long and complex sentences.

 

Abbreviations are extremely difficult to read, and are usually ambiguous.  They should be kept to a minimum and must be clearly defined when used for the first time.  We generally tolerate:

• Mean (SD) – for mean (standard deviation)
• 95% CI – for 95 % confidence interval
• IQR – for inter-quartile range
• ADL – for activities of daily living
• FIM – for Functional Independence Measure

 

There are also some more technical requirements:

 

v     Abbreviations (if used) should be typed with no full point.

v     Scientific measurements should be given in SI units, but blood pressure should be expressed as mmHg and haemoglobin as g/dl.

v     All numbers under 10 should be written as words, except when attached to a unit of quantity (e.g. 1 mm or 3 kg), and that numbers of 10 or more should be written as digits except at the beginning of a sentence.

v     Generic names should be used for drugs. Authors should be aware of different drug names and availability in the UK, North America and Australia, and give alternative names or drugs in the text.

v     Avoid excessive capitalization. For the titles of books and articles, capitals should be used for the initial letter of the first word only. However, for the titles of journals and series, the initial letter of all principal words should be capitalized.

v     Use italics for emphasis sparingly.

v     Please avoid using more than three levels of heading.

 

Some unwritten rules

There are some unwritten rules that apply to a greater or lesser extent in most scientific journals.

 

Length of articles

We do not have any rigid rule.  My advice is “Articles should be as long as necessary and as short as possible.”  As a guide for ordinary articles, 1,500 words of text is good and 3,500 seems rather too long.

 

Authorship. (See separate document for more advice)

Clinical Rehabilitation in common with most journals wishes to restrict authorship to those who warrant it. To quote the BMJ (1994; 309:1456-57): “authorship should be based only on substantial contributions to: (a) conception and design, or analysis and interpretation of data; (b) draft an article or revising it critically for important intellectual content; and (c) final approval of the version to be published.” Conditions (a), (b), and (c) must all be met and all people meeting these conditions should be included as authors. Activities such as fund-raising, collecting data, and simple supervision do not qualify for authorship on their own.  It is acceptable and best to acknowledge people in the acknowledgement section who have helped in various ways.

 

Copyright.

Authors must obtain copyright permission to reproduce all maps, diagrams, figures and photographs - forms are available from the publishers. As a rule it is also necessary to obtain permission for single passages of prose exceeding 250 words, or scattered passages totalling more than 400 words from any one work. EU copyright extends to 70 years after the death of the author or 70 years after publication of a scholarly edition, whichever is longer. Please supply the publisher with full information for all work cited, including author, date published, publisher and page references. All text (more than a few words) taken from any other published sources should be clearly identified as such by the appropriate use of quotation marks and a corresponding reference.

 

Malfeasance (See separate document for more information)

Malfeasance is practice that falls below an acceptable moral standard, and/or is illegal.

 

Clinical Rehabilitation has a responsibility to maintain a standard of science and authorship that complies with any legal requirements that apply (in the home country of the authors) and that is of a high moral standard.  We will be alert to:

• Authorial malfeasance
• Plagiarism and duplicate publication
• Data-related malfeasance
• Alteration or even fabrication of original data
• Manipulation and analysis of data knowingly to achieve results that do not reflect the truth
• Failure to report known data or results that would materially alter the conclusions
• Moral (and legal) malfeasance
• Breaking the laws in the country where the research occurred
• Treating participants without due respect for their well-being and autonomy

 

The editor asks reviewers to consider every article from this point of view, and considers it himself.  No cases have been detected yet, which is not to claim that none have occurred; we simply cannot know.  Our response to suspected malfeasance is detailed in a separate document.

 

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