Staff Education & Training Command Clinical Investigations Department

1. Staff Education & Training CommandClinical Investigations Department Scientific Writing By Dr. Brian Deevey, Medical Editor, National Naval Medical Center, Bethesda, MD Presented by: Annette Nahin National Library of Medicine National Institutes of Health “The National Naval Medical Center is an approved provider of continuing nursing education by the Navy Medicine Manpower, Personnel, Training and Education Command, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.”

2. Disclosure Statement This CE/CME activity does nothave commercial support, and has noconflicts of interest. Research Course

3. Learning Objectives • To learn a few general principles of good writing. • To understand the structure of a scientific paper. • Learn how to write for publications. • To understand how to comply with the NIH Public Access Policy. • To introduce the protocol template to apply for permission to do research. Research Course

4. Learning Objective 1:To learn a few general principles of good writing • Clarity in scientific writing is the most important consideration. Having an interesting style is less important. • Organize according to recommended format but consider: • Organize in the order the reader needs the information • Put important information first • Organize chronologically • Consider how the sentence connects backward and forward. • The structure of the sentence is very significant. Research Course

5. Avoid Run-on Sentences • Use short sentences where possible. • The longer the sentence, the more work the reader has to do. Be kind to the reader. • If writing longer sentences, use punctuation for clarification. Research Course

6. Active Voice • Avoid using the passive voice. PASSIVE: All technical documents will be reviewed in final draft by program managers. ACTIVE: Program managers will review all technical documents in final draft. • Active Voice: Actor (Subject) – Verb – Object • Passive voice can be used - provides variety. Research Course

7. Base Verbs • Use “base” verbs rather than “hidden” verbs. 1. We conducted an analysis of the data. 2. We analyzed the data. • What was the action? Stress it, don’t hide it. Research Course

8. Your Audience • Do you want only specialists (like you) reading your work? • Context controls meaning. Research Course

9. Learning Objective 1 (cont.) • “As” should not overused. Use “because” at least occasionally. • Watch for internal consistency in superficial things—capitalization, hyphens, fonts, punctuation, and so on. Such simple things may just be cosmetic, but errors won’t impress the editors and reviewers. Research Course

10. Which vs. That Research Course • “…However, there was a significant difference in the number of UK amputations …versus the number of US amputations…, which/that? required excision of symptomatic lesions.”

11. Learning Objective 1 (cont.) • References should be consistent and appropriate for the type of publication. For protocols, maybe take a favorite journal and copy their style exactly, in order to be consistent. • Run spell check after everything is finished. If you make any changes, run it again. • Don’t rely on spell check. Research Course

12. Learning Objective 1 (cont.) • After you finish your writing, set it aside for a few days if possible so you can look at it later with a fresh eye. Otherwise it is so familiar that you can’t see the mistakes. Have a co-author look at it who has not participated in the writing--another set of eyes always helps. Research Course

13. Suggested sources on writing in general • U.S. Army Center for Health Promotion and Preventive Medicine **used to:** provide information on SIX-STEP WRITING PROCESS New URL: http://phc.amedd.army.mil/Pages/default.aspx Research Course

14. Suggested sources on (creative)writing in general 2. Writer’s Helper has some good tips URL: www.writershelper.com/writingtips.html 3. WritingClasses.com http://www.writingclasses.com/InformationPages/index.php/PageID/300 Research Course

15. Sources on writing a research paper 1. The Online Writing Lab (OWL) at Purdue University Provides FREE writing help and writing resources 24/7. Writing a Research Paper http://owl.english.purdue.edu/workshops/hypertext/ResearchW/1draft.html This site is strongly recommended for graduate students. Research Course

16. Examples of good and bad writing Original: In a setting where one anticipates exposures may occur, having a short-term supply of PEP is recommended. Better: We recommend keeping a short-term supply of PEP on hand if you anticipate that an exposure might occur. Mine: Keep a short-term supply of PEP on hand if there is a possibility of exposures. Research Course

17. Examples of good and bad writing Original: Despite their generic appearance on CT and MRI, it is advantageous to utilize these two modalities to assess bony destruction and soft tissue components respectively. Better: CT and MRI results may look similar, but we need both to assess bone loss and soft tissue damage, respectively. Mine: CT and MRI results may look similar, but use both to assess bone loss and soft tissue damage. Research Course

18. Examples of good and bad writing Original: Specifically, most hyperlipidemia was drug-induced with the most notable difference seen in the median triglyceride values of 164mg/dL in those with normal diastolic function and 240mg/dL in those with diastolic dysfunction (p=0.09). Better: Most hyperlipidemia was drug-induced. Notably, patients with normal diastolic function showed median triglyceride values of 164mg/dL. Those with diastolic dysfunction, however, showed values of 240mg/dL (p=0.09). Research Course

19. Examples of good and bad writing Original: Unlike previous studies using echocardiography in the HIV-infected population, we were able to perform a more in-depth evaluation of diastolic function with modern tissue Doppler techniques. Better: Our study was able to perform an in-depth evaluation of diastolic function in the HIV-infected population with modern tissue Doppler techniques, unlike earlier studies using echocardiography. [The original here compares studies with people, which is not what they meant.] Research Course

20. Examples of good and bad writing Original: The patient was simultaneously evaluated by rheumatology, and underwent diagnostic arthrocentesis of his left wrist which revealed intracellular urate crystals and was switched to oral prednisone 20 mg twice daily and allopurinol 300 mg for his gout and oxycodone for pain relief. Better: The patient was also evaluated by Rheumatology. Diagnostic arthrocentesis of his left wrist revealed intracellular urate crystals. He was switched to oral prednisone 20 mg twice daily and allopurinol 300 mg for his gout, and oxycodone for pain relief. Research Course

21. Examples of good and bad writing • Original: The known topiramate side effect of hyperchloremic metabolic acidosis is thought to be due to topiramate’s weak interaction with carbonic anhydrase, it is unknown if this mechanism or an as yet undetermined mechanism may effect renal function as assessed by serum creatinine level. • Better: The known topiramate side effect of hyperchloremic metabolic acidosis is thought to be due to topiramate’s weak interaction with carbonic anhydrase. However, we don’t know if this mechanism or something else may affect renal function as assessed by serum creatinine level. Research Course

22. Learning Objective 2: To understand the structure of a scientific paper Types of Papers • Most scientific papers are of the hypothesis-testing type: a question is formulated and efforts are made to answer it convincingly, either positively or negatively. • A second type of paper is descriptive. • The third type is a methods paper, comparing several kinds of methods or inventing a new one. Research Course

23. Learning Objective 2 (cont.) TheTitle • Try to keep it short and clear. (But provide enough details to be informative.) • Include “key” words (and abbreviations) that other researchers will look for that cover your topic. • Write first, edit last. Research Course

24. Authors • Make sure the names of you and your co-authors are spelled correctly. • Especially the final copy. • Use the most “unique” form of your name for publishing. • Use middle initials! • Always use the same form of your name for all your publications. Research Course

25. Peer Review • Most journals want complete address information, degrees, and institutional info for all authors, but not in the text. They usually don’t want reviewers to know whose work they are reading, because it might prejudice them for or against the paper. They usually don’t tell the authors who their reviewers were. Keep your names and institutions out of the body of the text, and if you have any acknowledgments, keep them separate from the text also. Research Course

26. Learning Objective 2 (cont.) Abstract • The abstract comes next, but should be written last. • Abstracts are usually several hundred words in length, but may be much shorter. • Again, include important terms plus any abbreviations. • Keep in mind, searchers have access to words in the title and abstract in PubMed. Research Course

27. Learning Objective 2 (cont.) Text Four major sections: - Introduction, which establishes the research question and its importance; - Materials and methods section, describing the sample and procedures to be followed; - Results, which is what the study found; - Discussion, which hopefully makes sense of everything and points out further lines for research. Research Course

28. Learning Objective 2 • Tables and figures may be sprinkled through the text. Do not modify any photographs you submit—that is now considered fraud. • The list of references cited appears last in the paper. • Scientific papers rarely have appendices, but many journals allow supporting online material. • Supplemental material may be hard for readers to obtain. Research Course

29. Learning Objective 2 Important to remember: If you are submitting your paper for a journal, they may have a variety of structures for different types of papers. If they do, follow their instructions exactly. Research Course

30. The Publishing Process • Most of the best journals are published by learned societies. The primary editor and many of the peer reviewers (and most of the authors) are members of the society. They decide what papers get published. • Next the paper goes to the journal staff of editors to be cleaned up. The journal may have a lengthy style guide detailing the exact types of changes to make. • Next the paper goes to the production department to be laid out and the pictures and tables incorporated. • Next the paper comes back for another round of editing and proofing, and a copy is sent to the author to approve the corrections. Research Course

31. The Publishing Process (cont’d) • Next the papers are assembled to form an issue, a table of contents and other information is added, and the paper goes to the printer. • Next the printer sends back a “blueline” (galley) copy of what they have set up, and, when that is approved, the issue goes to press. Research Course

32. Example: Paper #1 One recently reviewed paper is a hypothesis testing article of the effects of different types of spectacles and goggles. The abstract - 1 page. The introduction - 2 pages to explain the variety of types of protective eyewear and the need to test different combinations to see if some work better. Research Course

33. Example: Paper #1 The methods – 4 pages to describe the subjects in the experiment and the types of equipment and tests they were put through. About 30 subjects were tested for central and peripheral vision on 12 types of goggles. Research Course

34. Examples: Paper #1 (cont.) The results – 2 pages To describe what they found, which was that all of the goggles worked well for looking straight ahead, but that all of them restricted peripheral vision to some extent. One type worked noticeably worse than the others, and some subjects had less peripheral vision than others, which could be dangerous while driving or in combat. . Research Course

35. The discussion - 2 pages To describe the significance and implications. They conclude that people wearing goggles should turn their heads more than usual while looking around, and not rely on eye movements to detect objects on the periphery Research Course

36. Examples: Paper #2 Another recent paper is a case report being presented as a poster. The text - a page and a half, with sections for introduction, case presentation, discussion, and conclusion. Research Course

37. Paper #3 Another recent paper is a case report being presented as a short article. The abstract and introduction are brief paragraphs. The case report Results section itself takes about a page, but the discussion is 3 ½ pages long. Research Course

38. Learning Objective 3: Writing for publication Resources • The Belmont Report: Ethical Principles and Guidelines for the protection of human subjects of research http://ohsr.od.nih.gov/guidelines/belmont.html • The Requirements for Manuscripts Submitted to Biomedical Journals by ICMJA at http://www.icmje.org Research Course

39. Learning Objective 3: Writing for publication Choosing a Journal for Publishing Try to decide on a journal which regularly publishes in your area. While you are writing your paper reference several of their articles so that the editors will realize your topic is one that their readers are following. Match your style as much as possible to theirs to camouflage your paper to look like theirs. Research Course

40. Learning Objective 3: Writing for publication Choosing a Journal for Publishing • Each journal has instructions for authors. • Raymon H. Mulford Health Science Library at The University of Toledo, Ohio provides links to instructions for authors for 6K+ journals http://mulford.meduohio.edu/instr/ • If you think you will be scooped find the fastest method for publishing. • If you are not worried about being scooped and know you have something important, shop at the top and work down. Research Course

41. Learning Objective 3: Writing for publication Abbreviations • Most journals will ask that you abbreviate journal titles in the references section. • Example: New England Journal of Medicine = N Engl J Med • No periods. • Example: Arana A, Wentworth CE, Ayuso-Mateos JL, Arellano FM. Suicide-related events in patients treated with antiepileptic drugs. N Engl J Med. 2010 Aug 5;363(6):542-51. • The National Library of Medicine (NLM) provides a list of the abbreviations: • ftp://nlmpubs.nlm.nih.gov/online/journals/lsiweb.pdf • Make sure to list references consistently. Research Course

42. Create Your Bibliography with PubMed • Create a personal Bibliography and other Collections with PubMed. • It will use the correct journal title abbreviation and other preferred citation data. Research Course

43. Sample Collection in PubMed’s My NCBI Tool Research Course

44. Learning Objective 3: Writing for publication Sending a paper to a journal If you are sending a paper to a journal which does peer review, put all information that would identify you or other authors or your institutions in the title page. When the journal sends the paper out for review, they don’t want the reviewers to know who you are—that might influence their decision. Research Course

45. Article: Getting Published in Scientific Journalsby Elisabeth PainScience, April 06, 2007 • Links to: • Tips for Publishing in Scientific Journals • Writing Science: The Story's the Thing http://sciencecareers.sciencemag.org/career_development/previous_issues/articles/2007_04_06/caredit_a0700045 Research Course

46. Web site: Bates College, Lewiston, ME “Self-Revise Your Paper: Most authors revise their papers at least 2-3x before giving it out for peer review. Go back over your paper now and read it carefully; read it aloud.” http://abacus.bates.edu/~ganderso/biology/resources/writing/HTWgeneral.html Research Course

47. Web site: CTS Net. http://www.ctsnet.org/sections/journalsandbooks/writersresource/articles/article-3.html Research Course

48. Learning Objective 4: How to comply with the NIH Public Access Policy. • What is the NIH Public Access Policy? • If NIH funds your work (whole or part), deposit your article in PMC • Submit final, peer-reviewed manuscripts accepted for publication • Not covered: book chapters, editorials, or conference proceedings Research Course

49. http://publicaccess.nih.gov/ Research Course

50. NIH Public Access Policy Compliance Research Course