Getting to the Finish Line: How to get your article published'

1
Getting to the Finish Line How to get your
article published.

• Brian H. Rowe, MD, MSc, CCFP(EM), FCCP
• Professor and Research Director
• Canada Research Chair
• Department of Emergency Medicine
• University of Alberta

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Disclosure

• I do have an affiliation (financial or otherwise)
  with a commercial organization that may have a
  direct or indirect connection to the content of
  this presentation
• Senior Associate Editor, CJEM

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Outline

• The decision to publish.
• The manuscript process.
• Submission requirements.
• Decision Editors and how to appease them.
• Approaches to rejection.
• How to learn along the way.
• Summary.

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Why is this important?

• Outcomes of scientific activity
• Operations research (2006) 69 CCTs
• RCTs
• Of 383 identified as SAEM RCTs between 1995-03
• 194 (50.7 95 CI 45.7 to 55.7) were
  subsequently published up to May 2004.
• Ospina M, et al. Academ Emerg Med 200
• Other research lower results.
• 79 reports (29,729 abstracts) weighted mean full
  publication rate of 44 (95 CI 44 to
  45).Scherer RW, et al. CDSR. 2007 Apr
  18(2)MR000005

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How do others compare?

• Australia (2001)
• Of the 207 free paper abstracts identified, 73
  (35) had been published as full articles.
• UK (2007)
• Of the 404 abstracts identified, 124 (30) had
  been published as full articles
• For abstracts presented in the oral sessions, 83
  (57) resulted in publication.

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Reasons for non-publication

• Survey of authors from the SPR meeting 114 (43)
  of 393 RCT authors responded.
• The majority (83) of unpublished RCTs were never
  submitted for publication
• Non-significant results.
• Reasons for non-publication
• Not enough time (56.4 responded important or very
  important)
• Trouble with coauthors (28.9)
• Journal unlikely to accept (26.3).
• Hartling et al. Arch Pediatr Adolesc Med. 2004
  Oct158(10)1014-5.

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It is unethical to conduct research and not
publish it.., there is simply not good reason
today to have this result.

• Sir Ian Chalmers,
• Cochrane Collaboration

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Session Preparation

• E-mailed (n 19) successful authors with whom I
  have collaborated
• Emergency Medicine 16
• GIM 3
• Pharmacist 1
• US/International 5
• Journal Editors 2.
• Responses
• n 16 (84 95 CI 70, 98)
• Median response time 1 day (IQR 0.1, 10 days).

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Rule 1

• You cant beat quality!

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RCT Quality

• Key features
• Justification through SR
• Concealment of allocation
• Randomization
• Levels of blinding (multiple)
• Describe follow-up and losses
• Sample size calculation and reporting
• Funding source(s).

Key consult the CONSORT Guidelines.
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SR Quality

• Key features
• PICO-D
• Efforts to address publication bias
• Multiple search strategies
• Non-English language and unpublished data.
• Efforts to avoid selection bias.
• Examining and reporting quality using appropriate
  tools (Cochrane, Jadad, Risk of Bias tool)
• Pooling methods/appropriateness
• Sub-group and sensitivity analysis
• Funding source(s).

Key consult the QUOROM Guidelines.
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Quote

• Its hard to make a silk purse out of a
• sows ear.
• Member of CJEM Editorial Board
• Canada

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Rule 2

• Deciding on the project.

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Deciding on a project

• PICO-D question format
• Population
• Intervention
• Control/Comparison
• Outcome
• Design.
• Focus on methods!
• Protocol and planning is important from the start.

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Quote

• Read all you can find on your topic before you
  begin so you don't reinvent the wheel.
• What will your study add to our understanding?
• Arthur Kellerman, Emory University
• Atlanta, GA

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Quote

• Look for ideas that you think are likely to
  result in counter-intuitive findings. Editors
  love these.
• Michael Schull, University of Toronto
• Toronto, ON

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Rule 3

• Playing nice in the sand box!

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Get some friends

• Collaborate with many! Examples
• Librarians
• Avoid repetition and read your competition.
• Statisticians
• Sample size analysis
• Data analysis and presentation.
• Methodologists
• Survey methods, outcome measurement, etc.
• Study coordinators
• Experience.
• Clinicians
• Relevance.

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Rule 4

• Develop a publication philosophy.

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Some of mine

• Every paper has a home, its my your job to find
  that home.
• Aim high, youll be surprised sometimes what
  happens.
• Always match the topic to the journal (dont be
  surprised by subtle mis-matches)
• When unsure use your papers reference list to
  decide where to submit.

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Rule 5

• Preparing the document

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Preparing a manuscript

• Read the _at_ instructions to the authors
  section (please!).
• Sit down to write when you have time and try to
  prepare a draft.
• Use a reference management program for your own
  sanity.
• Always get input from other authors (especially
  an experienced writer).
• Revise, revise, revise!

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Common writing mistakes

• Spelling mistakes.
• Formatting errors.
• Tense confusion.
• Sentences that dont make sense.
• Run on sentences.
• Saying too much and repeating yourself.

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Common methods mistakes

• Not fully describing methods.
• Statistics
• Not justifying sample size or providing power
  calculations
• Reporting p-values and 95 CIs
• Not performing appropriate and/or higher-level
  analyses.
• Writing there was a trend ( p 0.09)
• Non-congruence of results and conclusions.
• Introducing new results in Discussion section.

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My favourite quote in the world!

• I wanted to write you something succinct, but I
  didnt have time. So I wrote you something
  verbose.

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Rule 6

• Anatomy of a paper

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Writing

• If you dont write well and this will be part of
  your career, then get some training.
• Start writing the paper the day you have the idea
  of what questions to pursue.
• Some journals have a pre-submission enquiry
  system availableuse it.

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Quote

• A reviewer will make a decision on your paper
  within about 5 minutes based on the title,
  abstract and the objectives.
• Former Editor (not of CJEM)
• Canada

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Cover Letter Quote

• Pay attention to the cover letter - it needs to
  be polite, concise, and provide a really
  compelling reason why your paper is wonderful,
  important, and worthy of consideration by the
  journal.
• Riyad Abu-Laban, UBC
• Vancouver, BC

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Components

• Title
• Pithy, tells a story.
• Abstract
• Critical, yet often neglected
• Dont end abstract with more research needed.
• Introduction
• Brief and leads into the paper
• Make sure the last paragraph of the introduction
  clearly outlines the study objectives.

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Quote

• Title and abstract far more important than the
  paper in terms of getting published start with
  them, frame your paper around the abstract, and
  especially dont slap it together after the
  fact.
• Me2 Majumdar, University of Alberta
• Edmonton, AB

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Components

• Methods
• Results
• Funny thing hardly anyone mentioned anything
  about these except they should be there!

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Components

• Discussion
• What is your MAIN finding?
• How does it fit into the literature?
• Limitations section
• Acknowledge your limitations clearly and explain
  why your paper is worthwhile despite them.
• Don't try to hide flaws from reviewers or readers
  its a kiss of death.

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Quote

• Never go over the word limit.
• Too long is too long its usually a sign of
  drifting.
• The 1950s Crick and Watson paper on the double
  helix - the basis of modern molecular biology and
  genomics 2 pages!
• Don Yeally, University of Pittsburgh
• Pittsburgh, PA

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Rule 7

• Awaiting the decision

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Decision

• If they accept as is
• Be thankful and realize that is uncommon.
• If they say revise and re-submit
• Do what they ask (its accepted)
• Do it quickly
• Do what they ask!
• If they say extensive revisions required
• If you can do it, then see points above
• If you cant do it, move on to another journal.

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Quote

• Dont forget to mention sending hockey (or
  olympic) tickets in with the submission!...
• I wont see you at CAEP because I am on a
  mini-sabbatical (and watching hockey!).
• Rob Brison, Queens University
• Kingston, ON

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Rule 8

• The worst-case scenario

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Rejection

• You need to develop a thick skin and you
  shouldnt take it personally.
• Dont give up (perhaps the most common flaw
  demonstrated by junior researchers).
• Take a break and then take the criticisms
  provided constructively.
• Some reviews are unfair get over it.
• Remember, you are not alone.

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Quotes

• Given my track record of 6 rejections per
  accepted paper, I'm not sure I should be
  providing any advice at all....
• Anonymous, Eastern Canada
• No doesn't always mean no, at least not in
  publication.
• Terry Klassen, University of Alberta
• Ian Stiell, University of Ottawa

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Rule 9

• Learning along the way

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Education

• At every stage of your career, its worthwhile to
  serve as a reviewer or on a Board for a
  journal(s).
• Why
• First, its your responsibility to the profession
• Second, its often very educational
• Third, you may be asked to write an editorial
• Fourth, is there a better journal than CJEM?
• Try it, you may like it.

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Rule 10

• Closing thoughts

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Re-emphasis

• Take your time
• Hastily-written papers often get rejected.
• Papers are like wine they need time to mature.
• Obtain feedback
• Get knowledgeable, critical mentors to read your
  papers and get useful feedback before submission
• Write, re-write and re-write again!

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Summary quotes

• Learn objectivity early, the editors and
  reviewers already have.
• Philip E. Bourne, PLoS
• In the end, its worth it!
• Art Kellerman, Emory University, Atlanta

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References

• Mireles-Cabodevila E, Stoller JK. Research during
  fellowship. Chest. 2009 13513951399.
• Hall GM (Ed) (1998). How to write a paper
  (2ndEdition). BMJ Books, London.
• Bourne PE. Ten simple rules for getting
  published. PLoS Computational Biology. 2007
  1341-342.

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Thank you!

• Questions for Eddy Lang?