How to Review (…and Read…and Write) Scientific Papers

1. How to Review (…and Read…and Write) Scientific Papers

2. Peer Review Background • Editor, Journal of Vascular and Interventional Radiology (since January 2006) • Have served as a reviewer for JVIR, AJR (including editorial board), Journal of Clinical Ultrasound, Journal of Interventional Radiology

3. Reviewer’s Role • The reviewers are extremely important to any journal. • Arbiters of quality of submitted manuscripts • Role twofold • Does the manuscript merit publication? • Advisory role: Provide constructive criticism (help make a manuscript better) Provenzale and Stanley, AJR 2005

4. Does a manuscript merit publication? • Accept • Rare decision, nearly every manuscript could use some work • Accept with Revision • If authors address queries and criticisms, will generally be accepted • [Conditional Acceptance] (Editor only) • Will accept but authors MUST address certain key issues • Reject Request Resubmission • Not suitable now, and may not ever be, but could be worth a second look--undergoes repeat formal peer review • Reject • Poor science, report without value, redundant or duplicate publication, “me too” reports, clear bias, too esoteric even for lab rats, or good/great paper but wrong audience

5. Peer Review • Caveat: the tips and suggestions I will bring up are based on my own personal preferences and biases, and these may not be applicable to all journals

6. Common Sense Rules • Be polite. Avoid insults, sarcasm, demeaning statements (the Editor will generally remove these anyway) • If there is something that the reviewer feels needs to be transmitted to the Editor but not the authors, there is generally a “comments to Editor” box • Direct comments to “the authors” or even better “the manuscript” (I avoid “you” sentences) Provenzale and Stanley, AJR 2005

7. Systematic Approach • To what category does the manuscript belong? • Clinical Study • Laboratory Study • Brief Report • Letter to the Editor • Other (special communication, standards, editorial, etc.) • Is there potential for reviewer bias (positive or negative)? • Does the reviewer have sufficient expertise for this topic? nb: to me this is important, but NOT critical • Does the reviewer have time to do the review? Provenzale and Stanley, AJR 2005

8. How to “Read” a Manuscript • No set right answer, depends on your style • Many do a quick survey (e.g. read abstract, skim remainder) to start to address the following generaly questions • Why are the authors reporting this? What was their intent? • Is the topic of interest to readers of the journal? • Does the study try to answer important questions that have not been answered adequately? Provenzale and Stanley, AJR 2005

9. How to Review A Manuscript • As an Editor I prefer a structured, numbered approach • Highlight very important points with asterisks • [Brief Summary] • General comments • Section by Section Review (Title, Abstract, Introduction, M&M, Results, Discussion/Conclusion, Tables, Figures/Illustrations/Graphs and Legends, References) • Summary: Why you feel this article should be accepted/revised/rejected **Provenzale and Stanley, AJR 2005

10. Peer Review • The most important criteria are • The importance of the study or report to the existing body of knowledge • The scientific merit of the study

11. The Scientific Manuscript Section by Section • (Title) • Abstract • Introduction • Materials and Methods • Combined with Results for Brief Reports • Results • Discussion • Figures/Graphs • Tables • References Provenzale and Stanley, AJR 2005

12. The Scientific Manuscript Title • Should truly reflect purpose and findings of study • Not too long • Watch abbreviations

13. The Scientific Manuscript Abstract • The summary of the manuscript’s most important features • For many readers, this is the ONLY part that they will read. • Therefore, the abstract should be able to stand alone as a summary of the work • Ideally, should contain a well-articulated purpose and hypothesis (not just “report our experience with…”)

14. The Scientific Manuscript Abstract • Purpose (avoid vague objectives) • Materials and Methods • Results • Conclusion

15. The Scientific Manuscript Abstract • There should be no major discrepancies between the body of the paper and the Abstract! • The most important features of each section should be the focus of the Abstract • There are word count limits to the Abstract for each type of manuscript--should not be overly lengthy

16. The Scientific Manuscript Abstract • Purpose should mirror end of Introduction • Actual data with P values should be included in Results as appropriate • Conclusions should be justified by and follow directly from Methods and Results and NOT simply be a reiteration of Results • Conclusions should not be overstated, esp. on the basis of a small number of patients and observations

17. The Scientific Manuscript Introduction • Explains, via background information, why the authors bothered to perform the study • Should be brief (save rest for Discussion) • What is the rationale of the study? • Show that an important problem or question exists • Show that prior published work has failed to adequately address the problem • What are the goals of the study? • Introduce any unusual terms used for the study • Make sure all data/claims referenced

18. The Scientific Manuscript Materials and Methods • The “blueprint” of the study (What subjects were included? How was the study performed?) • Should give sufficient information to allow another investigator to repeat the study • Also provides an outline of statistical methods used, if appropriate • Give definitions (e.g. outcomes measures such as patency results)

19. The Scientific Manuscript Materials and Methods • Subsection headings may be useful for major papers (Patient group, technique, study endpoints and definitions, statistical analysis) • Patient group: demographics, comorbidities, proof of disease, etc. Technically, for prospective studies, should be in Results, but I (and many others) prefer this in the M&M anyway for readability/clarity/flow of the paper. • Make sure numbers add up (here and in results) • IRB approval or equivalent (or statement that it is not necessary at the authors’ institution for this type of study)

20. The Scientific Manuscript Materials and Methods • Details of imaging techniques may be important; routine steps of procedures generally aren’t, but be sure there is no question regarding major technical aspects esp. if unusual or important • There should be corporate attribution for devices, etc. • Complications should be defined (ideally categorized per SIR standards) • Stats: Worthwhile to develop a working knowledge of important statistical tests

21. The Scientific Manuscript Results • Should follow directly from the Materials and Methods section (the Materials and Methods section should tell what types of Results are to be looked for); no “new” or unanticipated results should be presented that don’t follow from the M&M • The order of presentation of results should parallel the order of presentation of the methods • Section headings may be useful if lots of complex data

22. The Scientific Manuscript Results • Follow guidelines for significant figures • Patency and survival data should be done by Kaplan Meier analysis

23. The Scientific Manuscript Discussion • State whether hypothesis was verified or proven untrue, or (if no hypothesis) what questions were answered or why the report is important • Should comment as to whether the results are in line with prior studies. If not, an attempt should be made to explain the discrepancies. • Review only those parts of the medical literature relevant to the study. • Note (preferably in a separate paragraph) limitations of the study • Should have a concluding paragraph that summarizes the study

24. The Scientific Manuscript Figures and Graphs • Should illustrate important features of the methods and results • Many authors have trouble limiting figures to those essential for the understanding of the MS--should ask yourself whether each figure necessary • Watch for HIPAA issues/patient identifiers • Decide also whether color necessary (color expensive in print, we can choose color on web, gray scale in print for JVIR) • Should be highest possible quality and should have figure legends that adequately explain the meaning (supplemented by appropriate arrows)

25. The Scientific Manuscript Tables • A Table summarizes complex collections of data in order to make it more understandable and in order to allow the reader to more easily make comparisons • Tables are not necessary if the information can be adequately presented in the text (the latter is preferable)

26. The Scientific Manuscript References • Should be timely, accurate, and should follow the journal citation format • Should support claims made in the text of the manuscript • The support for the study should be based on evidence that is as strong as possible • Evidence given from articles should be cited accurately--in other words, the results of other articles should not be misinterpreted to buttress the authors’ case • Be sure in journal format

27. Why Do Articles Get Accepted? • The study is considered timely and relevant to a current problem • The manuscript is well-written, logical, and easy to comprehend • The study is well designed with appropriate methodology Bordage G, Acad Med 2001

28. Why Do Articles Get Rejected? • Incomplete or insufficiently described statistics • Overinterpretation of the results (e.g. stating that a technique is “safe and effective” on the basis of a single case report) • Suboptimal or insufficiently described means of measuring data (again, could another investigator duplicate the study?) • Sample population too small or biased • Text difficult to follow (grammar/syntax vs. complex, highly specialized language insufficiently explained for readers) • Insufficient problem statement Bordage G, Acad Med 2001

29. How to Get Your Paper Published • Assuming that you have a good study, a number of other steps can be taken to help improve the likelihood of acceptance • Some of these are remarkably easy to implement (yet even more remarkably, often ignored by authors)

30. How To Get Your Paper Published Tip 1 • Highlight the Importance of the Manuscript

31. How To Get Your Paper Published Highlight the Importance of the Manuscript • Each acceptable study or report should add to the literature in an important and unique way. Don’t make the reviewer guess this.

32. How To Get Your Paper Published Highlight the Importance of the Manuscript • Focus the Introduction on the background leading to the study and the report, and finish it with a clear statement of purpose, ideally a hypothesis. • Focus the Discussion on an explanation of why the conclusions and the purpose served by the manuscript are valuable, and place this explanation in the context of pre-existing literature (Does it corroborate existing literature, perhaps making certain conclusions more firm? Does it refute existing literature? If so, why?)

33. How To Get Your Paper Published Highlight the Importance of the Manuscript • Avoid direct statements of primacy (“This is the first report of…” or “This has not previously been described…”). • Statements of primacy are difficult to sustain. • Statements of primacy add little to a manuscript otherwise deemed worthy of publication. • Statements of primacy sometimes border on the absurd (“This is the first description of percutaneous biopsy of a left patellar angiosarcoma in a 41 year old commercial fisherman”)

34. How To Get Your Paper Published Highlight the Importance of the Manuscript • Avoid statements of purpose that simply reiterate what you are describing. E.g. “We describe our experience with the Ultimate Stent”. Add a statement that describes why the reader should care about your experience with the “Ultimate Stent”

35. How To Get Your Paper Published Tip 2 • Follow Directions!

36. How To Get Your Paper Published Follow Directions • Each scientific journal has very clearly articulated “Instructions to Authors” • Such instructions detail the types of articles a journal considers, the acceptable format for such articles, and the content requirements for the individual sections of the articles.

38. Types of ManuscriptsJVIR publishes several types of articles, each of which has a distinct format. Clinical and Laboratory Investigations are the central focus of the Journal and are based on original clinical or experimental studies. The complete format is described below. Brief Reports include descriptions of a new or modified interventional procedure or device and small clinical studies or case reports. A brief one paragraph abstract (less than 100 words) should be included. In general, limit the paper to six pages of text, 15 references, and no more than eight figure parts. Review Articles are generally invited by the Editor. Specific instructions are provided at the time of invitation. Letters to the Editor can be used to offer commentary on any material published in JVIR. Letters may also be used to convey material of more general interest to the interventional radiology community. On occasion, the Editor may offer such space for submitted case reports that do not receive high enough priority for publication as such. Letters should be no longer than three pages with no more than four references. Only one figure (with no more than four figure parts) can be submitted. Letters to the Editor are accepted for publication at the discretion of the Editor and may be copyedited for content and length.

39. Manuscript PreparationThe preferred word processing program is Microsoft Word. Manuscripts must be written with 12 point font, double-spaced throughout (including tables, references, and figure legends), and have at least 3 cm margins. The text should be ragged right (no right justification). Embedded instructions (eg, italics, underlines, boldface) should not be used or kept to a minimum Do not use coding for centering. Insert only one space after punctuation marks. Sequential page numbering should begin with the text. The order of sections is Abstract, Text, Acknowledgements, References, Tables, and Figure Legends. To ensure blinded peer-review, no direct references to the author(s) or institution of origin should be made anywhere in the text of figures.

40. How To Get Your Paper Published Follow Directions • “Instructions to Authors” also frequently provide additional suggestions for enhancing the value of submitted manuscripts • For example: JVIR lists (and gives access to) published reporting standards that, if relevant to the paper, should be followed.

41. Reporting Standards: In order to assure consistency in reporting of results of clinical research, the Society of Interventional Radiology has developed a number of reporting standards documents that authors should follow when submitting manuscripts for consideration. Links to these documents are given below. Adherence to relevant reporting standards will be taken into account in the review process.

42. Haskal, Ziv J., Rees, Chet R., Ring, Ernest J., Saxon, Richard, Sacks, DavidReporting Standards for Transjugular Intrahepatic Portosystemic Shunts J Vasc Interv Radiol 2003 14: 419S-426

44. How To Get Your Paper Published Tip 3 • Make the manuscript as “readable” as possible

45. How To Get Your Paper Published Make the Manuscript Readable • Reviewers are only human, and errors in grammar, syntax, and spelling are at the very least frustrating and distracting to the reviewer. • In extreme cases, such errors can confuse the message of even the most scientifically sound study. • Also, reviewers may assume (rightly or wrongly) that such errors are reflective not only of the writing of the manuscript, but the way the study itself was performed. • Abbreviations should be explained at first “callout” in text • Avoid unconventional abbreviations (abbreviations place the burden of remembering what they stand for on the reader, and can be extremely irritating to the reader) • Note: as a reviewer, your choice to point these out, but if there are many, many such errors simply state--multiple errors of grammar and syntax

46. How To Get Your Paper Published Make the Manuscript Readable • The problem of readability is particularly relevant for authors for whom (at least for JVIR) English is not their native tongue. • While this problem is completely understandable, a good suggestion is to have a colleague fluent in English manuscript preparation review the manuscript prior to submission

47. How To Get Your Paper Published Tip 4 • Accept Suggestions By Reviewers as Ways to Improve the Manuscript

48. How To Get Your Paper Published Accept Suggestions By Reviewers • Too often, authors respond to reviewers in an argumentative fashion, as if the reviewer were personally attacking them. “What in the world does this reviewer want???” • Be respectful of the reviewers: while they may be mistaken in some of their suggestions, most are trying very hard to help authors recognize weaknesses in the study and its presentation. Try to respond in a calm, thoughtful fashion even if you disagree with a suggestion.

49. How To Get Your Paper Published Tip 5 • Be Succinct!

50. How To Get Your Paper Published Be Succinct • Short, concise articles that “stick to the point” are far easier to read and review than rambling tomes that stray far from the heart of the study. • It is reasonably easy to add material if an editor or reviewer believes more detail is necessary. • Delete material extremely familiar to journal readers (e.g. explanation of Seldinger technique)