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Learn why rejection isn't the end, key aspects for acceptance, elements of a good study, and tips for successful publication in scientific journals. From study design to writing, this guide covers it all.
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Even when a manuscript has been rejected,the author should not be discouraged because there is great value derived from the review process.
The Review Process • Blinded • At least two PEER reviews • Constructive criticism
WHICH PAPERS ARE ACCEPTED?Those that advance our knowledge and especially those that will enhance patient care (new and better treatment of musculoskeletal conditions)
How is this accomplished? • Good idea • Well designed study • Focused, clear report
Should I write it? • Is the topic relevant? • Will it benefit the orthopaedic patient or community? • Is it already in the literature? (Oops!) • Does our institution have adequate resources to carry it out? • Do I have time to complete the entire project? • Does it require the buy in or support of another party?
The single most important characteristic that distinguishes between acceptance and rejection is the prospective nature of a study
We must be moving beyond retrospective reviews and all of their inherent problems to design and conduct prospective studies
PLAN, PLAN, PLAN • “Plans are nothing, planning is everything” • Have a mentor
1. A WELL DEFINED QUESTION • Relevant
RELEVANCE • Find out how relevant your question really is • The first step in the peer review process • Use colleagues, mentors, cynics, enemies
1. A WELL DEFINED QUESTION • Relevant • Focused • Has a high degree of certainty that an answer will result when study is completed • State the hypothesis • Write the Introduction
2. Formulate a Study DesignWhat is the best way to address this question (clinical, lab,etc)?
Statistics • There will be an adequate number of study subjects to achieve an answer (power) • The most simple yet appropriate statistical tools will be used • A statistician should always be involved
Useful Measurements • Commonly used measurements (do not invent your own) • Go beyond xray and physician derived information • Use accepted,patient based,outcome measurements for clinical studies
Unbiased assessment • Use independent observers to record and evaluate data in a blinded fashion • No vested interests : industry, surgeons
3.Do the Experiment • Have a finish line and date • Have an alternative plan • Keep good records • Timely and accurate recording (lab notebook)
3.Do the Experiment • When data collection nears completion, write Methods (in sufficient detail so that anyone could repeat the experiment) and Materials
4. Present the Results • Clear, concise • Good graphics • Significant only • Distinguish statistical and clinical significance
5. Write the Discussion • Hypothesis: prove or disprove • Compare with other studies in the literature (pro and con) • Brief conclusion : A ‘take home message’ • Most papers only have one message
6. Write clearly • Focused • Concise
I have only made this [letter]longer because I have not had the time to make it shorter Pascal,1627
6. Write clearly • Focused • Concise • Timely • Follow ‘Instructions to Authors’ • Independent review of manuscript before submission
Local Peer Review • What is not clear? • Heckman test • Abjure pride of authorship
The RCT • Represents good science • Prospective • Currently fashionable (popular,accepted) • Enduring credibility • Provides basis for metaanalysis • Very satisfying for investigator • It will get published!!!
Problems with RCTs • Cost • Time • Narrowness of Question • Recruitment (patients, physicians,especially surgeons) • Institutional resources
Important steps in any RCT • Prospective design • Randomization (needs statistician) : by patient,by surgeon, or by institution • Controls (must follow the Helsinki Agreement guidelines) • Multi-institutional • Must follow all local IRB and informed consent rules
OBSERVATIONAL STUDIES: better than traditional descriptive studies
OBSERVATIONAL STUDIES • Still prospective design • Meet IRB approval at the start • Comparisons should always be made: historical controls, concurrent(but not random) controls, or case controlled • Multi-institutional • Use unbiased observers to collect and analyze data
Case Reports and Case Series • Must be truly unique • Must advance our ability to treat patients • Should be interesting to the reader
Authorship • Significant ongoing contribution • More than technical • Can defend entire paper in a public forum • No courtesy authorship
HELPFUL HINTS • Follow the Instructions to Authors • Brevity • Focus on Subject • Limit speculation/opinion • Use easy to read format • Use a few key illustrations
The Final Word of Advice • Never give up • All papers can get published!!!