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Julian Tang, PhD Trevor Lane, PhD
Author Success Workshop:
Effectively Communicate Your Research 1
Gunma University
26 March 2016
Skills needed on the path to publication success
Preparation
Journal Selection
Writing
Submission
Peer Review
Publication Success
• Training in reading papers, ethics, writing, presenting
• Expert Scientific Review
• Expert Scientific Review
• Journal Selection & submission strategy
• Training in ethics, writing, presenting
• Revising • Editing • Reformatting
• Training in ethics, writing
• Editing • Abstract
Development • Cover Letter
Development • Reviewer
Recommendation
• Training in navigating peer review
• Review Editing • Point-by-point
checking • Response
Letter Development
• Reformatting
• Press release, news writing
• Media & presentation training
• Training for early career researchers
• Training in writing grant proposals
• Grant proposal editing
S
Be an effective communicator
Your goal is not only to be published, but also to be widely read and highly cited
Preparing well
Logically communicating your ideas in your manuscript
Avoiding common mistakes
Section 1
Prepare well: clinical research design & ethics
Coverage and Staffing Plan Prepare well
Increase impact
High quality research
Logical, engaging, useful message for
readers
Original and novel research
Well-designed, well-reported,
transparent study News value, importance, timeliness
What editors want
High scientific & technical quality, appropriate & clear methods,
sound research & publication ethics
High readability & interest; clear, real-
world relevance
Impact factor (past 2 years) = No. of citations / No. of articles
Coverage and Staffing Plan Prepare well
Know your impact and study design
Systematic
reviews of RCTs
Randomized controlled
trials (RCTs)
(Non-randomized) Controlled
studies/trials
Observational studies (cohort, case-control,
surveys/audits/interviews, diagnostics)
Hypothesis
testing
{ Descriptive/
Qualitative/
Hypothesis
generating
Methodological {
{
Secondary
research
Primary
research
{ } Experimental (exposure assigned)*
}
} Non-
experimental
*
Register clinical trials in advance!
Case studies, case series, technical notes,
computer models (in silico), animals (in vivo), in vitro
Coverage and Staffing Plan Prepare well
Know your impact and study design
+/– Exposure
Controlled trial (treatment) or
prospective cohort study (risk factor)
? Exposure Case-control study
(retrospective study)
Disease ?
+/– Disease
+/– Exposure Retrospective
parallel cohort study Disease ?
Coverage and Staffing Plan Prepare well Use reporting guidelines
PRISMA Systematic reviews & Meta-analyses
STROBE Observational studies
CARE Case reports
CONSORT Randomized controlled trials
ARRIVE Animal studies
http://www.equator-network.org/
QOREC Qualitative studies
Coverage and Staffing Plan Prepare well Use reporting guidelines
CONSORT
http://www.equator-network.org/
Coverage and Staffing Plan Prepare well
Where to start?
Your findings form the basis of your manuscript
First organize your findings
Logic, then English language
Figure 1
Figure 2
Table 1
Figure 3
Logical flow • Chronology • Most to least
important • General to
specific • Whole+parts
Is anything missing?
? Additional analyses?
Your illustrations guide your story
Coverage and Staffing Plan Prepare well Prepare an outline
I. Introduction A. General background B. Related studies C. Problems in the field D. Aims
II. Methods A. Subjects/Samples/Materials B. General methods C. Specific methods D. Statistical analyses
III. Results A. Key points about Figure 1 B. Key points about Table 1 C. Key points about Figure 2 D. Key points about Figure 3 E. Key points about Figure 4
IV. Discussion A. Major conclusion B. Key findings that support conclusion C. Relevance to published studies D. Limitations E. Unexpected results F. Implications G. Future directions
Write key ideas in bullet points, as IMRaD (=Introduction, Methods, Results and Discussion)
No need for full sentences Use reporting guidelines Draft title/abstract; draft article by
IMRaD section; get feedback Revise content/logic before language Get help: presubmission peer review
& editing by a native English speaker
When using information from other articles:
Paraphrase with citations!
Coverage and Staffing Plan Prepare well
Submissions
Plagiarism
Data manipulation
Authorship
Submit to only one journal at a time; do not republish the same paper; no salami
Paraphrase and cite all sources
Do not fabricate or falsify data Do not manipulate parts of images
Study design or data acquisition/analysis; Writing/revising; Approval; Accountability*
Publication ethics
Conflicts of interest
Disclose funding and any financial/personal relationships that could bias the work
Safety Ethics approval; animal & environmental
safety; humans: signed consent, data privacy
* http://www.icmje.org/recommendations/browse/roles-and-responsibilities/defining-the-role-of-authors-and-contributors.html
Coverage and Staffing Plan Prepare well
Fabrication, Falsification & Plagiarism
Sun S, Zhang G, Wu Z, Shi W, Yang B, Li Y (2014) MicroRNA-302a Functions as a Putative Tumor Suppressor in Colon Cancer by Targeting Akt. PLoS ONE 9(12): e115980. doi:10.1371/journal.pone.0115980 Published: December 26, 2014
Zhang G-M, Bao C-Y, Wan F-N, Cao D-L, Qin X-J, Zhang H-L, et al. (2015) MicroRNA-302a Suppresses Tumor Cell Proliferation by Inhibiting AKT in Prostate Cancer. PLoS ONE 10(4): e0124410. doi:10.1371/journal.pone.0124410 Published: April 29, 2015
Coverage and Staffing Plan Prepare well
Singapore Statement on Research Integrity 2nd World Conference on Research Integrity, 21-24 July 2010
Principles of research integrity
• Honesty in all aspects of research • Accountability in the conduct of research • Professional courtesy and fairness in working with
others • Good stewardship of research on behalf of others
http://www.singaporestatement.org/downloads/singpore%20statement_A4size.pdf
Coverage and Staffing Plan Prepare well Studies with participants
Human studies need:
• Approval from ethics board (institutional review board, IRB)
• For studies with prospective assignment: trial registration before enrollment
• Informed consent for enrollment • Informed consent for publication
Safety, transparency & publishing conflicting data
clinicaltrials.gov; who.int/ictrp/network/en; controlled-trials.com; umin.ac.jp/ctr
Coverage and Staffing Plan Prepare well Studies with participants
Participants need to be informed of:
• Study objectives (and freedom to leave) • Potential benefits or risks involved • Confidentiality
This is usually written informed consent
Human safety/benefit, not exploitation Nuremberg Code 1947, Declaration of Helsinki 1964
Templates: http://www.who.int/rpc/research_ethics/informed_consent/en/
Coverage and Staffing Plan Prepare well
Science is “self-correcting”…
Responsible conduct of research
• Helps society/humanity • Objective search for Truth • Tests hypotheses; adjusts theories • Relies on transparency & reproducibility • Responsible use of resources • Based on trust and honor code • Based on publishing in peer-reviewed journals:
Correction notices made public and linked
Coverage and Staffing Plan Prepare well
Flawed/fraudulent articles are retracted, with permanently linked public Retraction notices
Guidelines of the Committee on Publication Ethics, COPE Good Publication Practice 3, GPP3 International Committee of Medical Journal Editors , ICMJE) Responsible Research Publication: International Standards for
Authors*
Always follow ethics guidelines
Consequences of unethical behavior
• Unable to publish • Rejection/retraction • Public notices • Repay grants • Loss of employment
*http://publicationethics.org/files/International%20standards_authors_for%20website_11_Nov_2011.pdf
Coverage and Staffing Plan Prepare well
How does your study contribute to your field?
What did you find?
What did you do?
Why did you do the study?
Introduction
Methods
Results
Discussion
Transparency & complete reporting
Participants/materials, appropriate techniques, appropriate analyses (full protocol online?)
Including unexpected/negative results; data records & accessibility!
Including similarities and differences, limitations
After doing a thorough literature review
Coverage and Staffing Plan Prepare well Share negative results
Negative results are useful?
Yes!
• Allows complete evaluation of your study
• Prevents others from repeating those experiments
• Allows others to modify those experiments
• Prevents funding agencies from wasting money
Supplementary info; Data repositories / Data journals
Pitfalls on the path to publication
Preparation
Journal Selection
Writing
Submission
Peer Review
Publication
• No ethics board approval
• Human trial unregistered
• No consent • Citation
stacking/cartels • Fabrication • Falsification
• Questionable journals
• Hijacked journals
• Questionable publishers
• Guest/gift/ ghost authorship
• Plagiarism • Undisclosed
conflicts of interest
• Undisclosed funding
• Non-transparent/ incomplete reporting
• Simultaneous/repeated submissions in same or other language
• Salami slicing • Presubmission
publication • Questionable
conferences • Publicizing too
early
• Self-review • Fake review • Peer review
rings • Editor/
reviewer conflicts of interest or plagiarism
• Publicizing too early
• Multiple publication in same or other language
• Exaggerating claims to public / funder
• Undisclosed conflicts of interest of post-publication reviewer
Coverage and Staffing Plan Prepare well
Makes readers think others’ words or ideas are your own
Copying published text even with a citation
Stating ideas of someone else without citing the source
Text plagiarism
Coverage and Staffing Plan Prepare well
Copying text that you have published before into your manuscript
Self-plagiarism
May violate copyright
Makes readers think you are presenting something new
Coverage and Staffing Plan Prepare well
Expressing published ideas using different words
Paraphrasing
Tips on paraphrasing:
• Write the text first in first language, and then later translate back into English
• Verbally explain ideas to a colleague • Always cite the source in your notes • Name and cite published methods
Coverage and Staffing Plan Prepare well Good paraphrasing
24. Li et al. PLoS ONE. 2013; 8: e68372.
“The magnitude of the change in carbon storage depends on how physical, chemical, or biological processes are altered over time under different land uses.”
The size of the carbon storage change depends on how physical, chemical, or biological processes are changed over time under different land uses.24
How differing land uses gradually affect biological, chemical, or physical processes determines how much carbon can be stored.24
• Nouns verbs • Prepositional phrases Adverbs • Passive Active voice
• Synonyms, word order
Coverage and Staffing Plan Prepare well Paraphrasing tips
Vary sentence structure to avoid patchwriting or listing
Change voice, rhythm, style
Separate/join sentences
Discourse markers Coincidentally; Also in agreement; Indeed
Join 2 sentences (semicolon, colon for a reason/list, or by subordination); alternate short/long sentences
Active to passive, or passive to active; negative to positive, or positive to negative;
invert word, phrase, or sentence order
Sentence logic Either/or; neither/nor; not only, but also
Introductory phrase According to X’s method,…; In X’s study,…; X
showed/reported…; When X…
Change word class An altered direction -> A directional change
Please see Activity 1 in your Workbook
Activity 1: Publication ethics
Section 2a
Logically communicating your ideas in your manuscript
Manuscripts with impact The ‘write’ order
How does your study contribute to your field?
What did you find?
What did you do?
Why did you do the study?
Title/Abstract
Introduction
Methods
Results
Discussion
Manuscripts with impact
Title/Abstract
Introduction
Methods
Results
Discussion
Title/Abstract
Methods
Results
Discussion
Introduction
Abstract /Title
write
The ‘write’ order
Manuscripts with impact Introduction
Why did you do the study?
Current state of the field
Background information
Specific aim/approach Aim
Problem in the field
Previous studies
Current study
General
Specific Specific problem/solution;
importance/hypothesis
Worldwide relevance? Broad/specialized?
Recent, International references Not too many self-cites
Manuscripts with impact
“Health workforce shortages may be felt most keenly by developing nations, but are a concern for all. Developed nations are particularly worried about the number of general practitioners (GPs) available to service their ageing populations…”
BMC Family Practice: Worldwide relevance
Dwan et al. BMC Fam Prac. 2014; 15: 154.
International journal – Writing the Introduction
Effect of ageing populations on healthcare workforce
Manuscripts with impact
“All citizens in Japan are covered by a national health insurance system in which there are no official “gatekeepers”. Patients can freely choose between attending a local physician’s office (clinic) or a hospital and Japanese physicians can freely practice internal medicine. But recently, Japan has faced the problems of a rapidly aging population…”
Asia-Pacific Family Medicine: Regional focus
Tsukamoto et al. Asia Pac Fam Med. 2014; 13: 9.
Regional journal – Writing the Introduction
Effect of ageing populations on healthcare workforce
Manuscripts with impact
Cardiovascular disease (CVD) is the most important cause of morbidity and mortality in the developed world, and atherosclerosis is the central underlying pathology. Atherogenesis is a life-long process involving a range of mechanisms including lipid peroxidation and inflammation affecting the vascular wall. The clinically most relevant results of this pathology are myocardial infarction and stroke. Evidence for acute cardiovascular effects of air pollution has substantially increased in recent years…
PLOS ONE: ‘atherosclerosis and pollution’
Künzli et al. PLoS ONE 2010; 5: e9096.
Broad-focused journal – Writing the Introduction
Broad background information Important for context
Manuscripts with impact
Atherosclerosis is an inflammatory disease that accounts for nearly 50% of deaths in western societies. Initiation of atherosclerotic plaque formation is a complex process. It involves secretion of chemokines such as the Monocyte Chemoattractant Protein–1 (MCP-1) and expression of adhesion molecules on the surface of monocytes and endothelial cells. Circulating monocytes are recruited to sites of injured endothelial cells, adhere to them, and migrate into the subendothelial space. Monocytes in the arterial wall differentiate into activated macrophages…
BMC Cardiovascular Disorders: ‘atherosclerosis and pollution’
Adar et al. BMC Cardiovas Disord. 2013; 10: e1001430..
Specialized journal – Writing the Introduction
Broad background information not necessary
Manuscripts with impact Problem/knowledge gap
However, …an alternative approach… …a challenge …a need for clarification… …a problem/weakness with… …has not been dealt with… …remains unstudied …requires clarification …is not sufficiently (+ adjective) …is ineffective/inaccurate/inadequate/inconclusive/incorrect ------------------------------------------------------------------------------------------ Few studies have… There is an urgent need to… There is growing concern that… Little evidence is available on… It is necessary to… Little work has been done on…
Key phrases
Manuscripts with impact Writing the Introduction
Currently, the standard procedure used to evaluate hepatic steatosis is the histopathological examination of cross-liver sections… …this is an invasive practice that presents inherent risks... Therefore, it is essential to establish new non-invasive approaches to accurately determine hepatic fat concentration…
Aims
The purpose of our prospective study…was to evaluate the potential of multi-echo MRI to quantitate the hepatic triglyceride concentration.
Problem
Jiménez-Agüero et al. BMC Med. 2014; 12:137.
The aims should directly address the problem
Manuscripts with impact
How the study was done
• Processes, treatments, measurements, follow-up
• Variables (direct/proxy) • Outcome/endpoints (1o, 2o)
• Conversions/calculations • Statistical tests (& P level) • Consult a statistician
Who/what was studied
• Participants, controls • Enrollment, N & “power” • Materials, databases
How the data were analyzed
What did you do?
Methods
Manuscripts with impact Methods
Established techniques
• Cite previously published studies • Briefly state modifications • Use flow chart/table* if needed
• Explain purposes; justify choices • Give enough detail for reproducibility • Use Supplementary Information
Organization • Arrange in (titled) subsections • Keep parallel to the display items • Use topic sentences
New techniques
*Summary of study settings, flow of participants, text selection, variables, chronology of analyses…
Manuscripts with impact Results
• Efficacy/safety • Group/subgroups • Uni-/bi-/multivariable
• Each (titled) subsection corresponds to one figure and method
• Describe factually what you found, not what it means
• Use Supplementary Information
• Data accessibility
Logical presentation
Subsections
Factual description
What did you find?
Manuscripts with impact
Drug A reduced tumor volume by 32.7%, increased blood pressure by 12.3%, and increased the patient’s weight by 7.3 kg. Drug B reduced tumor volume by 22.3%, increased blood pressure by 15.6%, and increased the patient’s weight by 2.4 kg. Drug C reduced tumor volume by 38.1%, increased blood pressure by 6.9%, and increased the patient’s weight by 9.2 kg.
Describe relationships among your results
Manuscripts with impact
Patients treated with Drug C showed the greatest reduction in tumor volume (38.1%) compared with those treated with Drug A (32.7%) or Drug B (22.3%). Drug C also had the lowest increase in blood pressure (6.9%) compared with that seen after treatment with Drug A (12.3%) or Drug B (15.65). However, patients treated with Drug C had the highest weight gain among the three groups (Drug A, 7.3 kg; Drug B, 2.4 kg; Drug C, 9.2 kg).
Describe relationships among your results
Manuscripts with impact Discussion
Summary of findings
Relevance
Conclusion
Similarities/differences Unexpected/negative results Limitations (validity, reliability)
Implications
Previous studies
Current study
Future studies
Specific
General
How do you advance your field?
Manuscripts with impact
During a period when ART was routinely available in England, persons diagnosed with HIV had a 4.8-fold increased risk of invasive meningococcal disease compared with individuals not known to be HIV infected. This increased risk was almost entirely in adults aged 16–64 years (23-fold increased risk) and was significant for Men C, W and Y, while MenB was only significant in those aged 16–24 years…. These findings are consistent with the most recent study from New York City…
[Conclusion section: This study provides evidence that HIV-positive children and adults are at increased risk of invasive meningococcal disease…]
State the main findings of the study
Short Discussion – Beginning
Modified from: Simmons et al. BMC Medicine 2015;13:297.
Manuscripts with impact
GPER is an E2 binding, G-protein coupled membrane receptor that was reported to be overexpressed in breast, endometrial, ovarian and thyroid cancers. However, it is currently unclear if different types of lung cancers including adenocarcinomas, squamous cell carcinoma and large cell carcinomas express higher GPER than normal lung tissue. Here, we demonstrate for the first time that GPER is overexpressed in lung tumors and lung adenocarcinoma cell lines relative to normal lung and immortalized normal lung cell lines, although the expression of GPER transcript in HPL1D cells is higher than HBECs.
Re-introduction
Answer the study question = main conclusion
Modified from: Rao Jala et al. BMC Cancer 2012; 12: 624.
State the conclusion of the study
Restate problem / study question
Long Discussion – Beginning
Manuscripts with impact
Important limitations of our study include an inadequate sample size and duration to detect differences in the incidence of diabetes complications, such as myocardial infarction, stroke, or death. The protocol specifies further follow-up at 5 years for all patients, which should allow additional assessment of even longer-term efficacy and safety. Despite these limitations, we conclude that bariatric surgery represents a potentially useful strategy for the management of type 2 diabetes, allowing many patients to reach and maintain therapeutic targets of glycemic control that otherwise would not be achievable with intensive medical therapy alone.
Identify limitations
Discussing limitations
Modified from: Schauer et al. New Engl J Med. 2014; 370: 2002–2013.
Address limitations
End positively: put the bad news first
Manuscripts with impact
Important limitations of our study include an inadequate sample size and duration to detect differences in the incidence of diabetes complications, such as myocardial infarction, stroke, or death. The protocol specifies further follow-up at 5 years for all patients, which should allow additional assessment of even longer-term efficacy and safety. Despite these limitations, we conclude that bariatric surgery represents a potentially useful strategy for the management of type 2 diabetes, allowing many patients to reach and maintain therapeutic targets of glycemic control that otherwise would not be achievable with intensive medical therapy alone.
Identify limitations
Modified from: Schauer et al. New Engl J Med. 2014; 370: 2002–2013.
Address limitations
End positively: Good news last & in long, main clause!
Discussing limitations
Manuscripts with impact Making claims
Chiswick Chap, https://commons.wikimedia.org/wiki/File:Toulmin_Argumentation_Example.gif, CC-BY-SA-3.0
Toulmin model of argumentation
Qualifier
Manuscripts with impact
Patients’ perspective of safety incidents showed both overlaps and additional aspects from outpatient care professionals’ opinions….Patients’ statements brought insight on…
Most of the included studies have been conducted in US-American outpatient care settings; thus, the transferability of results to other health care settings is limited…. Integrating patients’ perspective broadens the existing understanding of adverse events in outpatient care and should therefore be considered as a complimentary measuring tool….
Start of Discussion: summary of findings
Conclusions: main conclusion & implication
Modified from: Lang et al. BMC Family Practice 2016; 17: 6.
Match extent, confidence, precision
Limitations
Making claims
Data
Claims
Qualifier
Rebuttal
Warrant
Manuscripts with impact Discussion – End
In conclusion, we found an independent, graded association between lower levels of the estimated GFR and the risks of death, cardiovascular events, and hospitalization. These risks were evident at an estimated GFR of less than 60 ml per minute per 1.73 m2 and substantially increased with an estimated GFR of less than 45 ml per minute per 1.73 m2. Our findings support the validity of the National Kidney Foundation staging system for chronic kidney disease but suggest that the system could be further refined, since all persons with stage 3 chronic kidney disease (GFR, 30 to 59 ml per minute per 1.73 m2) may not be at equal risk for each outcome. Our findings highlight the clinical and public health importance of chronic kidney disease that does not necessitate dialysis.
Conclusion
Key result
Implications
Future directions
Importance
Go et al. N Engl J Med. 2004; 351: 1296–1305.
Why is your study important?
Manuscripts with impact Story line and consistency
General background
Aims
Methodology
Results and illustrations
Summary of key results
Conclusion & implications
Relevance of findings
Problem in the field
Current state of the field Introduction
Methods
Results
Discussion
Solution
Situation/Problem
Evaluation/Comment
Section 2b
Logically communicating your ideas in your manuscript:
titles and abstracts
Customer Service Marketing your work Title and abstract
First impression of paper: clear/concise/convincing
Importance of your results
Validity of your conclusions
Relevance of your aims
It sells your work: Readers judge your style & credibility
Often first/only part that is read by
readers & reviewers
Your title & abstract summarize your study
Customer Service Marketing your work Your title
Important points
Only the main idea Accurate, simple Population/model Include keywords Fewer than 20 words Hanging title:
method/study type
Avoid
Unneeded words (“A study of”) Complex or sensational words Complex word order Abbreviations “New” or “novel”
Customer Service Marketing your work Your title
Interrogative Can ischemic preconditioning
improve prognosis after coronary artery bypass surgery?
Indicative/ Descriptive*
Prognostic effects of ischemic preconditioning in coronary artery
bypass patients
* + Method (subtitle)
Xxxxxxx: randomized controlled trial
Assertive/ Declarative*
Ischemic preconditioning improves prognosis after coronary artery
bypass / Improved prognosis after coronary artery bypass by ischemic
preconditioning
Question form
Key finding
Key topic/aim
Customer Service Marketing your work Structured abstract
Context Background, problem, aim
Results Outcomes, effects,
properties, statistics
Conclusion Relevance, implications Learning points, future
Methods Patients/materials/animals Treatments, measurements
No references, unusual abbreviations, figures/tables Clinical: funding & trial registration number after abstract
Customer Service Marketing your work Structured abstract
Modified from: Van Kempen et al. BMC Medicine. 2015;13:287.
Background EASY-Care Two step Older people Screening (EASY-Care TOS) is a stepped approach to identify frail older people at risk for negative health outcomes in primary care, and makes use of General Practitioners’ (GPs) readily-available information. We aimed to determine the predictive value of EASY-Care TOS for negative health outcomes within the year from assessment. Methods A total of 587 patients of four GP practices in and around Nijmegen (The Netherlands) consented to participate in a longitudinal primary care registry based cohort study… Results Follow up information was available for 520 of 587 participants. In the non-frail group 9% showed any negative health outcomes (death, ADL decline, institutionalisation, too ill to undergo assessment), against 30 % in the frail group (95 % confidence interval of the difference (CI): 14 %–28 %). Area under the receiver operating curve (AUC) of the EASY-Care TOS frailty judgement for a composite of negative health outcomes mentioned was 0.67 (95 % CI: 0.62-0.73)…. Conclusions GPs applying the EASY-Care TOS procedure, where they only perform additional assessment when they judge this as necessary, can predict negative health outcomes in their older populations efficiently and almost as accurately as a complete specialist CGA.
Customer Service Marketing your work Unstructured abstract
Modified from: Cannegieter et al. Blood. 2015; 125: 229‒235.
Numerous systemic treatment options exist for patients with mycosis fungoides (MF) and Sézary syndrome (SS); however, the comparative efficacy of these treatments is unclear. We performed a retrospective analysis of our cutaneous lymphoma database to evaluate the treatment efficacy of 198 MF/SS patients undergoing systemic therapies. The primary end point was time to next treatment (TTNT). Patients with advanced-stage disease made up 53%. The median follow-up time from diagnosis for all alive patients was 4.9 years (range 0.3‒39.6), with a median survival of 11.4 years. Patients received a median of 3 lines of therapy (range 1‒13), resulting in 709 treatment episodes. Twenty-eight treatment modalities were analyzed. We found that the median TTNT for single- or multiagent chemotherapy was only 3.9 months (95% confidence interval [CI] 3.2‒5.1), with few durable remissions. α-interferon gave a median TTNT of 8.7 months (95% CI 6.0-18.0), and histone deacetylase inhibitors (HDACi) gave a median TTNT of 4.5 months (95% CI 4.0‒6.1). When compared directly with chemotherapy, interferon and HDACi both had greater TTNT (P < .00001 and P = .01, respectively). In conclusion, this study confirms that all chemotherapy regimens assessed have very modest efficacy; we recommend their use be restricted until other options are exhausted.
Customer Service Marketing your work
Modified from: Cannegieter et al. Blood. 2015; 125: 229‒235.
Numerous systemic treatment options exist for patients with mycosis fungoides (MF) and Sézary syndrome (SS); however, the comparative efficacy of these treatments is unclear. We performed a retrospective analysis of our cutaneous lymphoma database to evaluate the treatment efficacy of 198 MF/SS patients undergoing systemic therapies. The primary end point was time to next treatment (TTNT). Patients with advanced-stage disease made up 53%. The median follow-up time from diagnosis for all alive patients was 4.9 years (range 0.3‒39.6), with a median survival of 11.4 years. Patients received a median of 3 lines of therapy (range 1‒13), resulting in 709 treatment episodes. Twenty-eight treatment modalities were analyzed. We found that the median TTNT for single- or multiagent chemotherapy was only 3.9 months (95% confidence interval [CI] 3.2‒5.1), with few durable remissions. α-interferon gave a median TTNT of 8.7 months (95% CI 6.0‒18.0), and histone deacetylase inhibitors (HDACi) gave a median TTNT of 4.5 months (95% CI 4.0‒6.1). When compared directly with chemotherapy, interferon and HDACi both had greater TTNT (P < .00001 and P = .01, respectively). In conclusion, this study confirms that all chemotherapy regimens assessed have very modest efficacy; we recommend their use be restricted until other options are exhausted. How does your study contribute to your field?
What did you find?
What did you do?
Why did you do the study?
Unstructured abstract
Customer Service Marketing your work Keywords
Search Engine Optimization
Identify 7–8 keywords (try to use standard terms*)
Use 2 in your title, 5–6 in the keyword list
Use 3 keywords 3–4 times in your abstract
Use keywords in headings when appropriate
Be consistent throughout your paper; include synonyms
Cite this work later; cite your previous publications when relevant
*Or standard terms from PsycINFO, BIOSIS, ChemWeb, ERIC Thesaurus, INSPEC, GeoRef, MeSH etc
Customer Service Marketing your work Keywords
Examples
Predictive validity of a two-step tool to map frailty in primary care Frailty assessment, Primary health care, General practice, Available information, Predictive value Successful external validation of a model to predict other cause mortality in localized prostate cancer Life expectancy, Clinical decision support, Prediction, Radical prostatectomy
Source: BMC Medicine
Activity 2
Please see Activity 2 in your workbook
Section 3
Avoiding common mistakes in clinical manuscripts
Coverage and Staffing Plan Writing skills
Keep it simple!
Use short sentences 15–20 words; one idea per sentence
Prefer simpler/shorter words
Use active voice Simpler, more direct, and easier to read
Most writing style guides and journals prefer it… “Nature journals prefer authors to write in the active voice”
www.nature.com/authors/author_resources/how_write.html
Modern scientific writing
Coverage and Staffing Plan Writing skills Keep it simple 1
Prefer Enough Clear Determine Begin Attempt, Try Size Keep After Enough End Use
Avoid Adequate Apparent Ascertain Commence Endeavor Magnitude* Retain Subsequent to Sufficient Terminate* Utilization *OK in certain fields (magnitude of earthquakes, to terminate gene expression)
Coverage and Staffing Plan Writing skills
“A number of studies have shown that the new regimen...”
“...as described in our previous study.”
“...at a flow rate of 1.0 mL/min.”
“As a matter of fact, such an adverse drug reaction…”
“That is another reason why, we believe…”
“It is well known that most of the trial participants...”
Keep it simple 2
Delete extra words!
“It is well known that Most of the trial participants...”
“As a matter of fact, such a This adverse drug reaction…”
“A number of studies have shown that The new regimen...”
“That is thus another reason why Therefore, we believe…”
“...as described previously in our previous study.”
“...at a flow rate of 1.0 mL/min.”
Coverage and Staffing Plan Writing skills
Avoid At a concentration of 2 g/L At a temperature of 37C In order to In the first place Four in number Green color Subsequent to Prior to Future plans; past history Extremely unique At the present time
Prefer At 2 g/L At 37C To First Four Green After Before Plans; history Unique Now
Keep it simple 3
Coverage and Staffing Plan Writing skills
1. You deserve the funding, but the study design is not perfect.
Which sentence suggests that you
will get funding?
2. The study design is not perfect, but you deserve the funding.
Improving readability 1
Coverage and Staffing Plan Writing skills
The study design is not perfect, but you deserve the
funding. The grant will be awarded in two stages.
Stress position
Topic position
Readers focus at the end of the sentence for what is important. Information in this stress position can also introduce
the topic of the next sentence (useful for explanations and processes).
Improving readability 1
Coverage and Staffing Plan Writing skills
The local government has been striving to introduce Information
and Communication Technology (ICT) in education. In medical
education, technology was introduced through the ICT-Connect-TED
project. The program aimed at improving the quality of lecturers
through the use of ICT. ICT-Connect-TED recently provided
computers and a networking infrastructure to all medical colleges.
idea idea idea idea
Topic link
sentence
Adapted from: Kafyulilo et al. Educ Inf Technol. 5 May 2015; DOI 10.1007/s10639-015-9398-0
Improving readability 1
Coverage and Staffing Plan Writing skills
Almost all participants indicated a high level of satisfaction with the content, sequence and relevance of the ICT professional development program they attended. Only a few lecturers reported that the duration of the professional development program was too short. However, the majority of the lecturers reported that they developed an understanding of what TPACK is, and the way technology can enhance teaching and learning of difficult medical concepts through the collaborative design of technology-enhanced clinic sessions in teams. “I developed an understanding of how TPACK can be applied in the design and teaching of a technology-enhanced lesson” said one of the pre-service lecturers. A lecturer from College C said if it was not the professional development he attended, he would not know how to use technology in teaching.
The pre-service lecturers had the opportunity to further develop learning about technology integration in teaching after the professional development program had finished. They were invited to use their TPACK knowledge in workshops organized by the Ministry of Education and Vocational Training…
Topic sentence
Stress sentence Topic sentence
Supporting sentences
Improving readability 1
Adapted from: Kafyulilo et al. Educ Inf Technol. 5 May 2015; DOI 10.1007/s10639-015-9398-0
Coverage and Staffing Plan Writing skills
Lecturers were positive about the effectiveness of technology in teaching. They reported the effectiveness of technology on students’ learning, and on simplifying their teaching process. Most of the lecturers reported to be comfortable and satisfied with the outcomes of the technology-integrated lessons they had developed and taught during the professional development program. One of the lecturers from College A said,…
idea idea idea idea
Topic link
Adapted from: Kafyulilo et al. Educ Inf Technol. 5 May 2015; DOI 10.1007/s10639-015-9398-0
Information in the topic position can introduce the topic of the next sentence
(useful for definitions, descriptions, and narratives).
Improving readability 2
Coverage and Staffing Plan Writing skills
Findings in this study are presented in four sections. The first section presents the continuation of technology use in teaching. The second section presents the factors affecting the continuation of use of technology in teaching among lecturers who participated in the study. The third section presents the college management view on the impact of the professional development program and the institutional challenges on using technology in teaching. Finally, the enabling and hindering factors affecting the continuation of technology are summarized.
idea idea idea idea
Topic link
Adapted from: Kafyulilo et al. Educ Inf Technol. 5 May 2015; DOI 10.1007/s10639-015-9398-0
Information in the stress position can introduce the topic of the next few sentences
(useful for lists and describing whole/parts).
Improving readability 3
Coverage and Staffing Plan Writing skills Improving readability 4
Logical connectors
Sequential
Causal
Adversative Although, Even though, Whereas, However, In contrast, Despite (+noun or verb -ing),…
Because (of), To (+verb), Owing to, So that, Therefore, Thus, Hence, Consequently,…
Until, After, Before, While, Since, When, Then, Next, First/Second/Third, Finally,…
Conditional If, Even if, Unless, Whether (or not), Except, Provided that, Until, Without, Otherwise,…
Coverage and Staffing Plan Writing skills
Estimate Estimation
Decide Decision
Assess Assessment
We made a/an… We conducted a/an… Extra verb
We decided… Clear, short, and direct
Avoid mistakes
Don’t hide verbs inside nouns!
Coverage and Staffing Plan Writing skills
Compared with is for saying how things are different
The toxicity of the new scaffold was reduced
compared to the previous scaffold.
The toxicity of the new scaffold was reduced compared with that of the previous scaffold.
The toxicity of the new scaffold was lower than that of the previous scaffold.
Avoid mistakes
Coverage and Staffing Plan Writing skills
Common mistakes in the Introduction
Ideas are not logically organized
Important topics in the Introduction are not mentioned again in the Results/Discussion
Important topics in the Results/Discussion are not mentioned in the Introduction
Cited studies are not up-to-date
Cited studies are geographically biased
Why study needs to be done?
Keep focused
Write last
<5 years
International
Coverage and Staffing Plan Writing skills
Transparency in study design
Sample size not large enough (no power calculation, 1-b)
Patient enrollment, exclusion, & randomization unclear
Interventions and assessments not clearly described
Unclear how missing data (lost to follow-up) were handled
Ethical approval and informed consent not clear
Consult a statistician
Use flowchart
Reproducibility
Imputation methods
Always required
Common mistakes in the Methods
Coverage and Staffing Plan Writing skills
Distribution of data affects analysis and presentation
• Parametric tests (e.g., t-test and ANOVA) can be used only with continuous & normally distributed data with a large enough sample size
• Use the mean ± SD only for normally distributed data
Simple guide:
• If SD is ≥ mean, most likely not normally distributed • If SD is > 0.5 × mean, may not be normally distributed
Use Shapiro-Wilk’s W test for normality
Wrong statistical tests
Common mistakes in the Methods
Coverage and Staffing Plan Writing skills
2 categorical endpoints
Paired (within sample)
Unpaired (between sample)
McNemar’s test
Fisher’s exact test 2 treatment groups
*for sample sizes > 60
Chi-square test* >2 treatment groups
du Prel et al. Dtsch Arztebl Int 2010; 107: 343–8.
Common mistakes in the Methods
Coverage and Staffing Plan Writing skills
Continuous endpoints
Parametric Nonparametric
Paired Unpaired Paired Unpaired
2 groups: Paired t test
>2 groups: Repeated-
measures ANOVA
2 groups: Unpaired t test
>2 groups: ANOVA (F test)
2 groups: Wilcoxon signed-
rank test
>2 groups: Friedman
one-way ANOVA
2 groups: Mann–Whitney U test (Wilcoxon
rank-sum test )
>2 groups: Kruskal–Wallis
test
Lang and Secic 1997; 71.
Common mistakes in the Methods
Coverage and Staffing Plan Writing skills
Statistical significance does not equal clinical significance!
“When possible, quantify findings and present them with appropriate indicators of measurement error or uncertainty (such as confidence intervals).”
http://www.icmje.org/recommendations/browse/manuscript-preparation/preparing-for-submission.html
“Avoid relying solely on statistical hypothesis testing, such as P values, which fail to convey important information about effect size and precision of estimates.”
Common mistakes in the Results
Coverage and Staffing Plan Writing skills
“Drug A significantly reduced LDL cholesterol by 28% (p<0.05). Therefore, Drug A is effective in reducing cholesterol levels…”
• How much is 28%? Is this clinically relevant? • How does this effect generalize to the population? What is
the 95% CI?
Statistical significance does not equal clinical significance!
Common mistakes in the Results
Coverage and Staffing Plan Writing skills
“Drug A significantly reduced LDL cholesterol levels from 4.7±0.3 mmol/L to 3.4±0.6 mmol/L (p=0.02, 95% CI: 0.8–1.8). Because a minimal reduction of 1.4 mmol/L is required to be clinically effective, the efficacy of Drug A is still unclear.”
• Use absolute values • State exact P-value • State 95% CI and minimal clinically relevant difference
Common mistakes in the Results
Coverage and Staffing Plan Writing skills
Common mistakes in the Discussion
Do not restate your results
We showed that tumor volumes in Groups A, B, and C were 34.6, 74.2, and 53.9 mm3, respectively, after a 4-month drug treatment, reflecting only a 8.6% decrease. However, after a 12-month drug treatment, the tumor volumes in Groups A, B, and C were 16.3, 18.7, and 16.9 mm3, respectively, which reflects a 45.2% decrease (p<0.05). The results demonstrate that 12 months of treatment is necessary for Drug X to effectively reduce tumor size among the three groups.
The results presented in this study demonstrate that Drug X more effectively reduces tumor size after 12 months of treatment (45.2% reduction) than it does after 4 months (8.6% reduction).
Coverage and Staffing Plan Writing skills
Common mistakes in the Discussion
Do not overgeneralize your findings
In this study, we demonstrated that Drug A effectively reduced tumor growth. Therefore, this drug should have therapeutic applications in breast cancer treatment.
In this study, we demonstrated that Drug A effectively reduced the growth of various breast cancer cell lines. Our findings suggest that this drug may have therapeutic applications in breast cancer treatment.
Result: Drug A reduced breast cancer cell growth in vitro
Coverage and Staffing Plan Writing skills
Patient parameters …improved significantly; it is significant that… X was correlated with Y The risk* of developing X in this case-control study…
Patient variables …improved considerably/markedly; it is important that… X was associated with/related to/linked to Y The odds of developing X in this case-control study…
Don’t misuse statistical words!
Common complaints – Statistics
* OK in a retrospective study if disease is rare and causality is assumed; risk=x/total, odds=x/(total–x)
Activity 3
Homework…Please see Activity 3 in your
workbook
S
Be an effective communicator
Your goal is not only to be published, but also to be widely read and highly cited
Preparing well
Logically communicating your ideas in your manuscript
Avoiding common mistakes
Thank you!
Any questions?
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Julian Tang: jtang@edanzgroup.com Trevor Lane: tlane@edanzgroup.com
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