CRITICAL PRINCIPLES OF MEDICAL WRITING

1. VERNON TOLO, MD CRITICAL PRINCIPLES OF MEDICAL WRITING

2. MEDICAL WRITING PRINCIPLES • WHY WRITE? • TO REMEMBER • FORGOTTEN IF NOT WRITTEN • DO YOU REMEMBER PODIUM PRESENTATIONS? • TO BETTER UNDERSTAND • CRITICAL THINKING NEEDED TO PUT INTO WORDS • TO GAIN PERSPECTIVE • APPRECIATION OF LITERATURE REVIEW • WHERE DOES YOUR WORK FIT INTO LITERATURE ON THIS?

3. MEDICAL WRITING PRINCIPLES • WHY WRITE? • TO INCREASE SCIENTIFIC KNOWLEDGE • YOU’VE DONE THE RESEARCH…LET OTHERS KNOW • PROTECTION OF INTELLECTUAL PROPERTY • PUBLICATION PUTS DATE ON RESEARCH REPORT • DOCUMENTS IDEA OR CONCEPT GENERATION

4. MEDICAL WRITING PRINCIPLES • WHY WRITE? • REPUTATION GAIN AND ACADEMIC PROMOTION • PEER REVIEWED PUBLICATIONS KEY • PODIUM PRESENTATIONS MINOR ROLE IN PROMOTION • PUBLICATION CITATION BUILDS REPUTATION • UNETHICAL NOT TO REPORT RESEARCH DATA • PATIENTS HAVE CONSENTED TO PARTICIPATE • WASTE OF TIME AND FUNDING $$ IF NOT REPORTED

5. MEDICAL WRITING PRINCIPLES • WRITING FOR PUBLICATION • READ INSTRUCTIONS FOR AUTHORS • VARIES BETWEEN JOURNALS • WRITE FOR A SPECIFIC JOURNAL AUDIENCE • WHAT JOURNAL FOR SUBMISSION? • WHO READS THAT JOURNAL? • LEVEL OF EVIDENCE MAY PLAY A ROLE

6. MEDICAL WRITING PRINCIPLES • WRITING FOR PUBLICATION • EXTENSIVE LITERATURE REVIEW MANDATORY • BEFORE STARTING TO WRITE • ALLOWS PERSPECTIVE TO DEVELOP • WHERE DOES YOUR RESEARCH FIT? • CONFIRMATION OF FINDINGS OF OTHER REPORTS • COMPLETELY NEW IDEA • META-ANALYSIS OR SYSTEMATIC LITERATURE REVIEW • REVIEW ARTICLE

7. MEDICAL WRITING PRINCIPLES • MEDICAL WRITING NOT LITERARY WRITING • WRITE FOR THE READER, NOT FOR YOU • MEDICAL WRITING IS TECHNICAL WRITING • CONCRETE STATEMENTS NEEDED • NO PLACE FOR SELF-EXPRESSION • BACK UP ALL STATEMENTS • YOUR RESEARCH RESULTS • CITATIONS OF PRIOR RESEARCH REPORTS

8. MEDICAL WRITING PRINCIPLES • METHODS AND STATISTICS ADVICE BEFORE YOU START YOUR RESEARCH

9. MEDICAL WRITING PRINCIPLES • TECHNIQUES AND TIPS • GOOD GRASP OF WRITING RULES • SYNTAX • GRAMMAR • SENTENCE STRUCTURE • ACTIVE VOICE PREFERRED OVER PASSIVE • “The patients were shown to have had few complications” • “The patients had few complications.”**** • USE OF “WE” PREFERRED TO “I”

10. MEDICAL WRITING PRINCIPLES • TECHNIQUES AND TIPS • KNOW YOUR SUBJECT VERY WELL • KNOW YOUR AUDIENCE • READER AND EDITORIAL ASPECTS • FULL STRUCTURE OF ARTICLE BEFORE STARTING

11. MEDICAL WRITING PRINCIPLES • TECHNIQUES AND TIPS • A SINGLE PAPER SHOULD ADDRESS ONE THEME • BEST IF ONE HYPOTHESIS TESTED • BE SIMPLE AND CONCISE • READERS VALUE SUCCINCTNESS (as do editors) • 3500 WORD LIMIT NOW FOR JBJS, SOME ALLOW LESS • IF SOMETHING IS UNCLEAR, STATE THAT • “JUST THE FACTS” • FROM YOUR RESEARCH • FROM CITED REFERENCES

12. MEDICAL WRITING PRINCIPLES • TECHNIQUES AND TIPS • FRONT-LOAD IMPORTANT INFORMATION • AT BEGINNING OF SENTENCE PREFERRED • AVOID LONG QUALIFYING STATEMENTS FIRST • EACH PARAGRAPH ABOUT SINGLE CONCEPT • EASIER FOR READER TO PICK OUT DATA

13. MEDICAL WRITING PRINCIPLES • TECHNIQUES AND TIPS • MAINTAIN FLOW OF INFORMATION • NOT TOO MANY PARENTHESES • KEEP LOGICAL PROGRESSION • AVOID COLLOQUIAL WORDS • THINK OF ‘REPUDIATE’ or ‘SIMPLEXITY’ • USE OF ACRONYMS • USUALLY NOT IN TITLE, OK IN TEXT AFTER DEFINITION • SOME EXCEPTIONS LIKE ‘ACL’

14. MEDICAL WRITING PRINCIPLES • TECHNIQUES AND TIPS • READ AND CITE PRIMARY SOURCE • LIMIT CITATIONS FROM REVIEW ARTICLE • CONFIRM CITATION ACCURACY • CITATION AND QUOTATION ERRORS COMMON • 4 ORTHOPAEDIC PEER-REVIEWED JOURNALS EVALUATED • 200 ARTICLES • CITATION ERROR = 26% • MOST MINOR • QUOTATION ERROR = 38% • Davids, et al., JBJS-A, 2010

15. MEDICAL WRITING PRINCIPLES • TECHNIQUES AND TIPS • PRESENT DATA CLEARLY • USE TABLES TO CONDENSE DATA FOR READER • USEFUL TO HIGHLIGHT SIGNIFICANT FINDINGS • TOO MANY TABLES CAN BE CONFUSING • PREFER TO WRITE ON COMPUTER OR BY HAND • DICTATION STYLE OFTEN MORE INFORMAL

16. MEDICAL WRITING PRINCIPLES • TECHNIQUES AND TIPS • HAVE ONE OR MORE REVIEW FIRST DRAFT • WANT THEM TO BE CRITICAL AND HONEST • THINK OF THEM AS THE FIRST JOURNAL REVIEWERS • WILL STRENGTHEN YOUR SUBMISSION • ILLUSTRATIONS NEED TO BE PERTINENT • SHOULD BE ESSENTIAL TO CONVINCE THE READER • MANY JOURNALS NOW PLACING SOME ONLINE ONLY

17. MEDICAL WRITING PRINCIPLES • TECHNIQUES AND TIPS • SUPPLEMENTAL MATERIAL USE INCREASED • VIDEO CLIPS • APPENDIX USE • MORE DETAILED EXPLANATION OF METHODS • SURGICAL TECHNIQUE • STATISTICAL • ADD e-TABLES AND FIGURES • IN GREAT BRITAIN, ALL DATA NEEDS TO BE AVAILABLE • TO READER AND TO REVIEWERS • SOME JOURNALS ACCEPT NO SUPPLEMENTAL MATERIAL • EVEN SUPPLEMENTAL MATERIAL NEEDS COPY-EDITING

18. MEDICAL WRITING PRINCIPLES • TECHNIQUES AND TIPS • ALWAYS CITE WORK OF OTHERS • AVOID ‘SALAMI-SLICING’ • PRACTICE OF MAKING 2+ PAPERS FROM 1 DATASET • CONSIDERED DUPLICATE SUBMISSION AT TIMES • MAY RESULT IN JOURNAL NOT REVIEWING EITHER

19. MEDICAL WRITING PRINCIPLES • PLAGIARISM DICTIONARY DEFINITION • to steal and pass off (the ideas or words of another) as one's own • to use (another's production) without crediting the source • to commit literary theft • to present as new and original an idea or product derived from an existing source

20. MEDICAL WRITING PRINCIPLES • TECHNIQUES AND TIPS • SOFTWARE PROGRAMS TO DETECT PLAGIARISM • USED BY MANY JOURNALS, INCLUDING JBJS • HOW MUCH OF A MATCH = PLAGIARISM? • SELF-PLAGIARISM MAY BE OK IF CITE SOURCE • MAINLY FOR MATERIALS AND METHODS • RESULTS SECTION NEEDS TO BE UNIQUE

21. MEDICAL WRITING PRINCIPLES • CROSS-CHECK USED BY JBJS • WHAT TO DO WITH INFORMATION? • NOW DUELING PROGRAMS FROM SAME COMPANY • GOOD OR NOT?

22. MEDICAL WRITING PRINCIPLES • TECHNIQUES AND TIPS • DON’T JUST PRESENT AT MEETING, WRITE IT UP • USUALLY ADDED 10% TO 20% WORK, MUCH BENEFIT • BE PERSISTENT • IF REJECTED, USE REVIEWER COMMENTS TO IMPROVE • SUBMIT TO ANOTHER JOURNAL • GET METHODS/STATISTICS ADVICE BEFORE START • STUDY DESIGN, POWER, SIGNIFICANT CLINICAL DIFF.

23. MEDICAL WRITING PRINCIPLES • METHODS AND STATISTICS ADVICE BEFORE YOU START YOUR RESEARCH