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International Biopharmaceutical Association Publication
Successful Medical Writing: Staff Training Aspects
By: Kalliopi Sofou, MD1
Contact information: ksofou@coronis.gr
I keep six honest serving-men
(They taught me all I knew);
Their names are What and Why and When,
And How and Where and Who.
--- Rudyard Kipling (The Second Jungle Book)
Abstract
Medical writing, once an underappreciated field, has witnessed a tremendous
expansion over the past few years, covering a broad spectrum of services, from
scientific writing of clinical research articles and evidence-based reviews to
regulatory and promotional material writing. Along with the exceeding growth of the
medical writing market came an increasing demand for professional writers. Driven
by this new challenge, the biopharmaceutical industry is engaged to train its staff on
effective medical writing, in order to secure long-term success in this constantly
evolving field. This paper is intended to introduce the reader to successful medical
writing from a training perspective.
Introduction
The medical and scientific ‘consensus’ is clear: “The research process is not complete
until the results are validated and transmitted to an appropriate target audience”. Only
through sound publication of results in established peer-reviewed journals or scientific
congresses can new ideas and research findings be disseminated and effectively
incorporated into clinical practice [1]. Successful medical writing serves as the
optimal pathway to advance medical knowledge, promote critical thinking and incite
scientific debate.
Medical writing is a highly specialized niche. It is quite varied as well, with its
activities ranging from regulatory writing as an integral part of the drug development
process to original research articles and abstract preparation. The constant expansion
of the medical writing market over the past decade has created an excessive demand
for well-written scientific articles [2]. The numbers speak for themselves. More than 6
million papers are estimated to be published every year in more than 70 thousand
scientific journals. Based on the market’s annual growth rate of 15% over the last
three years, job openings for medical writers and editors are expected to increase 21
to 35 percent through the year 2010 [2,3]. It is therefore essential for the
biopharmaceutical sector to train its personnel on successful medical writing
techniques, in order to keep pace with the rapidly growing market.
This paper aims to acquaint the reader with effective medical writing from a training
perspective. For the purposes of this paper, a core training course has been designed
to serve as a step-by-step guide to successful medical writing; an outline is presented
in Table 1. The course is organized into sixteen 90-minute sessions to be held over
four days. Each session is designed to focus on key issues involved in the medical
writing process and help knowledge be better integrated into the company’s strategy.
Table 1: Medical Writing Training Course
Day 1 Day 2 Day 3 Day 4
How to Write
Introduction to How to Write Choosing a
an Evidence-
Effective a Clinical Journal or
Session 1 Based Clinical
Medical Research Congress/
Review
Writing Article (Part 1) Cover Letter
Article (Part 1)
How to Write
How to Write
Types of an Evidence- The Peer
a Clinical
Session 2 Medical Based Clinical Review
Research
Writing Review Process
Article (Part 2)
Article (Part 2)
Responding to
The Medical How to Write Searching the
Session 3 Reviewers’
Writing Market an Editorial Literature
Comments
Authorship/ How to
Effective Time Ethical
Session 4 Contributorship Prepare an
Management Considerations
/ Ghostwriting Abstract
Types of Medical Writing
Once entering the medical writing field, one is confronted with numerous types of
writing, which could be broken down into the following four basic categories [2]:
Scientific writing which mainly refers to journal articles, white papers and
abstract preparation
Regulatory writing, including all types of regulatory submission documents,
from New Drug Application (NDA) reports to narrative summaries and
product labeling
Promotional writing that covers a broad spectrum of writing services within
the biopharmaceutical industry, such as patient brochures, sales detail aids,
posters and newsletters
Educational material writing, regarding the preparation of monographs,
continuing medical education (CME) material and sales training newsletters
As far as journal articles are concerned, following is an outline of the most frequently
encountered types in medical journals [4,5]:
a) Editorials: Short articles usually written by members of the Editorial Board or
by guest editors to highlight scientific issues within the journal’s scope
b) Clinical research articles: Reports of original research work that represent a
substantial advance in medical science or practice in terms of:
Originality
Importance to researchers or practitioners in the field
Interest for researchers or practitioners outside the field
Rigorous methodology with conclusions justified by the evidence
presented
Adherence to the highest ethical standards
c) Clinical reviews: Evidence-based updates that comprehensively examine the
medical literature in order to formulate the optimal approach to diagnosis
and/or treatment.
d) Case reports: Articles reporting clinical cases of educational interest
e) Meeting reports: Presentation of a recent conference from the author’s
viewpoint, mainly focused on the key developments discussed
f) Letters to the editor: A substantial re-analysis or response to a previously
published paper, aiming to encourage debate and promote clinical research
g) Commentaries: Short, opinionated, narrowly focused articles of contemporary
interest, whose authors are most often opinion leaders invited by the Editorial
Board
The Medical Writing Market
The medical writing market has witnessed a steady growth over the past decade,
reaching an average annual rate of approximately 15% during the last three years.
This exceedingly growing demand for medical writing services is also reflected on the
increasing rate of memberships in the American and European Medical Writers
Associations (AMWA and EMWA). Along with medical writing proliferation came a
significant expansion of its clientele, as shown in Figure 1. Based on a market
research study, 25% of AMWA members are currently employed in the
biopharmaceutical industry, while 50% work in journals, medical centers, public
relations agencies or advertising firms. The remaining 25% are freelance and contract
workers. Biopharmaceutical companies and Contract Research Organizations (CROs)
are still the leading clients for professional writers; CROs in particular have
developed advanced strategies in order to meet the increasing demands, by
incorporating medical writers in project teams from the beginning, thus ensuring
continuity in the drug development program and compliance with customer’s
timelines. However, the latest trends show a steady shift from full-time, in-house
employment toward freelance and contract medical writing, introducing a new era in
the previously underappreciated medical writing field [2].
Figure 1: The Medical Writing Market
Authorship/ Contributorship/ Ghostwriting
Authorship is an explicit way of assigning responsibility and attributing credit for
intellectual work and should be discussed between all parties concerned at an early
point of the writing process. The increasing concern of medical editors and writers
over perceived authorship improprieties such as honorary authorship (being named an
author though not meeting the corresponding criteria), graft authorship (using one’s
position in the byline to claim credit for work conducted by the other listed authors)
and ghostwriting (not named as author though having substantially contributed to the
research project) has given rise to various strategies for curtailing authorship abuses
and disputes [6,7,8,9].
Following are the authorship key criteria as proposed by the International Committee
of Medical Journal Editors (ICMJE) [8]:
1. Authorship credit should be reserved only for someone who has made
substantive intellectual contribution to the research, including a) conception
and design, or data acquisition, or data analysis and interpretation, b) article
drafting or revising, and c) final approval of the version to be published.
2. In case research is conducted by a scientific group, the group should identify
the individuals who fully meet the authorship criteria mentioned above and
should therefore accept direct responsibility for medical writing.
3. Authorship is not sufficiently justifiable where participation is solely through
acquisition of funding, collection of data, or general supervision of the
research group.
Persons designated as contributors are all those who make a significant contribution to
a paper, without fulfilling the criteria for authorship; they should preferably be listed
in an acknowledgment section, specifying their contributions [10]. Medical writers,
on the other hand, qualify for authorship mostly for review articles and less for
original research papers, unless they meet the authorship criteria of the target journal.
In any case, if professional writers are not listed among the authors or contributors,
reference to their work should be documented explicitly [9].
How to Write a Clinical Research Article
The basic structure of a clinical research article usually conforms to the following
format [11,12,13,14,15,16,17,18,19]:
I) Title
The title is intended to represent the content and breadth of the study reported and
should therefore be concise, descriptive and accurate. Including keywords is an
effective way to capture the reader’s attention. Abbreviations on the other hand are
preferably omitted. Medical writers should always bear in mind that the decision to
read an article often rests on the appeal of its title.
II) Authors
Authors’ designation, degree and affiliation should be clearly indicated, along with
contact information (e-mail address or telephone number) of the corresponding author.
III) Abstract and keywords
The abstract aims to effectively summarize the research work in a clear and concise
manner and should therefore state the objectives of the study, the methods used –
randomization procedures, interventions etc. –, the main results and a brief but precise
conclusion. Its usual length does not exceed 150-250 words. References are not to be
cited in the abstract. The keywords or short phrases used to index the article are
usually chosen from the Medical Subject Headings (MeSH) terms of Medline.
IV) Introduction
The introduction acquaints the reader with a sufficient –but not extensive- scientific
background to understand the scope of the problem under investigation. Four or five
pertinent publications related to the research problem should be presented and
critiqued. Any existing gaps in the knowledge or conflicting data are to be highlighted.
The introduction should end with a general overview of the study and the hypotheses
examined.
V) Materials and methods
This section is considered to be one of the most important parts of a scientific paper
and the fact that it is constantly neglected has rendered it the most common cause of
rejection. Its purpose is to describe how the study was designed and carried out and
how the data were analyzed. A logical sequence would be the following:
Study setting and design
“The study was conducted between January 2001 and December 2004 at 12
university clinics in Greece. Patients were randomly assigned to receive X or placebo
under double-blind conditions for a period of 12 months. The study was approved by
the IRB at each clinical site and the National Organization for Medicines. Signed
informed consent was obtained from all patients or their legal guardians. ”
Participants: inclusion and exclusion criteria
“Eligible patients were 18 to 65 years of age and had received a diagnosis of
schizophrenia, as determined on the basis of the Structured Clinical Interview for
DSM-IV. Patients were excluded if they had a history of serious adverse reactions to
the proposed treatment, etc.”
Interventions
“Identical-appearing capsules contained X (3.5mg) or placebo (3.5mg) and were
given on a twice daily-basis. Concomitant medications were permitted throughout the
trial, except for additional antipsychotic agents.”
Objectives and outcomes
“The primary objective of the trial was to assess the efficacy of X in patients with
chronic schizophrenia. The primary efficacy outcomes were the scores on PANSS,
CGI-S and CGI-I scales, evaluated at 1, 2, 3, 6 and 12 months of the treatment period.
Safety outcomes included the incidence of serious adverse events (SAE), the incidence
of adverse events (AE) during treatment, as well as changes in electrocardiographic
and laboratory findings.”
Statistical analysis, including sample size calculation
“The data from all randomized patients were analyzed on an intention-to-treat basis.
Statistical analyses were performed with the use of SAS software, version 9. The
differences between the treatment groups in the characteristics of the patients were
assessed by Fisher's exact test and the Mann–Whitney test with exact probabilities. All
tests were 2-sided and conducted at a 0.05 significance level.”
VI) Results
The results should be presented in a clear format, without any speculations or personal
opinions. A detailed characterization of the participants upon whom the analysis was
based helps assess how representative and/ or comparable the study groups were.
Results are not identical with data. Data are factual findings (mostly numbers) and
should preferably be summarized in tables, graphs, flow charts or figures; results, in
contrast, state the meaning of the data and should be emphasized within the text in
descending order of importance. Many readers tend to skip the text and focus on the
illustrations. It is therefore important for tables and figures to have strong visual
impact, self-explanatory design and informative legends and footnotes. Any negative
or unexpected findings (e.g. high incidence of SAE) should also be acknowledged.
VII) Discussion
The discussion aims to cover all the debatable and critical issues of the study, but
should not be misused as a platform to state subjective opinions. Relating and
comparing the observations with other relevant studies strengthens the paper and
allows new and important aspects of the study to be emphasized. Potential limitations,
such as lack of randomization procedures or small sample size, should also be
discussed.
VIII) Conclusions
Authors’ conclusions should commensurate with the design used and the results
drawn and state new hypothesis, where applicable. Vague or inconclusive conclusions
are not welcomed.
IX) Acknowledgements
See section “Authorship/ Contributorship/ Ghostwriting”
X) References
Inaccuracies in the references or excessive self-citation may condemn an otherwise
good scientific paper. Two main reference systems exist: a) the Vancouver system
which uses superscript numerals in the text and the references are in the order which
they appear in the text and, b) the Harvard system which uses the name of the first
author and the date of the paper and the references are then in alphabetical order.
How to write an editorial
Editorials in medical journals may address a broad spectrum of scientific topics, from
the social and economical impact of a medical advancement to a commentary on a
clinical research paper hosted in the same issue. In essence, an editorial is an
opinionated piece and for this reason, it is the only section in a scientific journal that
allows for author bias. An emerging problem that ‘plagues the craft’ is exposition;
writing in a clear, concise and thought-provoking manner helps build on the
editorial’s argument and automatically place it on a well-grounded basis [20].
In order to write a well-structured editorial, the medical writer is invited to follow a
step-by-step approach:
a) Introduce the reader to the scientific topic under discussion by using a lead-in
statement
b) Provide brief but sufficient background information or other contextualizing
material regarding the topic
c) Include a timely news angle, if applicable
d) Refer to the opposing viewpoints in an objective manner, bearing in mind that
no profit is achieved by refuting a weak opposition
e) Develop his own argument through critical examination of all supporting
evidence, facts and quotations
f) Provide a solid and consistent conclusion that powerfully summarizes his
point of view
The emphasis lately on editorial comment is a sincere effort of the medical journal
editors to promote critical thinking, advance scientific knowledge and support clinical
research. Medical writers are expected to contribute greatly to this promising effort.
Effective Time Management
Effective time management is one of the mostly appreciated skills of a medical writer,
considering the heavy workload he has to endure, in order to adhere to the strict
deadlines imposed by the sponsor. Planning and prioritization are thought to be the
fundamental principles of time management [21]. In order to implement these guiding
principles, the writer is encouraged to:
1. Translate priorities into concrete goals, break each goal into component
activities and estimate the time each activity will require
2. Categorize each activity in order of importance
3. Identify the activities demanding co-operation or assistance of other people
and schedule the necessary meetings at an early stage
4. Overestimate the workload to ensure on-time delivery, even in the face of
unforeseen delays
5. Keep track of all activities, timelines and appointments with the use of a daily/
weekly planner; technology has greatly contributed to this area, by developing
software programs, such as personal information managers (PIMs) and
portable devices, such as Personal Digital Assistants (PDAs), and tablet PCs
6. Pinpoint the hours of peak performance and schedule the work accordingly
7. Overcome procrastination by listing all the long-overdue activities, prioritizing
them and setting new, manageable deadlines
How to Write an Evidence-Based Clinical Review Article
Systematic review is defined as an efficient scientific technique that uses systematic
and explicit methods to identify, select and critically appraise relevant research, as
well as to collect and analyze data from the studies included in the review. Statistical
methods (meta-analysis) may or may not be used to analyze and summarize the
results of these studies. Evidence-based reviews, also known as updates, are usually
based on systematic reviews, but differ from them in the way that they selectively
review the medical literature and incorporate all relevant research findings regarding a
given disorder. Such evidence-based updates serve as excellent educational tools,
providing readers with sound clinical guidance [18,22,23].
In order to conduct an evidence-based clinical review, the medical writer is invited to
browse through the following step-by-step guide:
1. Select a topic/ disease of common interest, for which there is new information
regarding diagnosis or treatment options. Rare diseases or cases of curiosity
value only should preferably be avoided.
2. Search the literature, seeking for pertinent guidelines on the management
(diagnosis, treatment, prevention) of the topic under discussion. See section
“Searching the Literature”.
3. Evaluate the strength and validity of the literature used to support the
discussion. High-quality evidence is usually derived from meta-analyses or
reports of randomized controlled trials (RCTs). However, well-designed,
nonrandomized clinical trials, clinical cohort studies or case-controlled studies
with consistent findings may also be appropriate.
4. Write the article using the following format:
Introduction: Define the topic and purpose of the review, focusing at
the same time on what this evidence-based review has to offer to Continuing
Medical Education (CME). A separate table summarizing the CME objectives
may be included.
Methods: Describe in a concise manner the criteria used for study
selection and determination of independent findings, as well as the search
strategy followed for the identification of relevant studies. The quality of the
reviewed research should also be evaluated.
Discussion: A detailed presentation of the collected data should be
accompanied by an emphasis on recent developments in the field. Potential
controversies, unresolved issues or introduction of bias that might have
influenced the strength of the evidence presented, should also be
acknowledged.
Conclusion: Resist the temptation of writing clichés, such as that more
research is needed. Gathering all new information in cleverly stated “take
home messages” is a far more interesting way to end the paper.
Searching the Literature
Effective literature search is one of the most time-consuming aspects of medical
writing and thus requires a well-designed, methodical approach and an advanced
planning. The advent of electronic bibliographic databases of medical and scientific
literature over the past few years has significantly facilitated the process. The two
most widely recognized are Medline and EMBASE. Access to Medline is provided by
Pubmed, an internet getaway maintained by the United States National Library of
Medicine. OVID is another widely used search interface, offering access to a wide
range of bibliographic databases, including Medline and EMBASE [Appendix I]
[22,23,24].
A sequential, step-wise approach to systematic literature search is presented below:
1. Define and structure the query appropriately, based on a preliminary
assessment of potentially relevant literature and its corresponding size. Taking
a look into the number of studies retrieved from other relevant, published
papers may also indicate the size and composition of the existing literature.
Moreover, restriction of search results with respect to publication date,
geographic boundaries or language must be decided in advance.
2. Identify the indexes/ libraries to be used, based on the type of search
[Appendix I].
3. Prepare search filters, meaning combination of search terms, carefully adapted
to the question/ proposal at hand. Alternative terms should always be kept in
mind. For example, when searching for a neonatal disorder, the alternative
terms used to describe the population are: neonate(s), newborn(s), infant(s),
etc.
4. Broaden or limit the search using the Boolean methodology. For instance, if
the previous example refers to a literature search focused on trials evaluating
phototherapy for neonatal jaundice, then the search strategy might be
summarized as follows:
neonate(s) OR newborn(s) OR infant(s)
AND
jaundice OR hyperbilirubinemia OR hyperbilirubinaemia OR kernicterus
AND
phototherapy
5. Evaluate the retrieved results and revise the search strategy accordingly
How to Prepare an Abstract
Preparing an abstract for a scientific meeting is one of the most common activities
assigned to medical writers, especially those employed in the biopharmaceutical
industry. A proposed format would be the following [18,19]:
Title
The title is a concise summary of the abstract and must demonstrate that the research
under discussion is well-conducted, important and innovative.
Authors
See section “How to write a clinical research article”.
Background
Summarize previously published relevant work, especially focusing on controversial
issues that this abstract sheds light into.
Objectives
Describe briefly but accurately the primary aims of the research presented.
Methods
A concise description of the eligibility criteria, the techniques employed and the
statistical methods performed should be included.
Results
The key results are usually summarized in four or five sentences, including data on
the studied population and reference to new research findings.
Discussion/ Conclusion
The discussion should reveal the significance and potential generalization of the
results and conclude with a statement showing what this research has to add to the
scientific research landscape.
Choosing a Journal or Congress/ Cover Letter
There are a number of elements medical writers consider when choosing a journal to
submit their paper to; one of the most frequent is the impact factor. Top-tier journals,
with rejection rates as high as 70 percent, tend to publish only original research work
of great importance to the field. Second and third-tier journals are not as tightly edited,
with the latter rarely rejecting a paper, unless the entire study is flawed or the data are
improperly interpreted [25]. Other factors to be considered are the journal’s focus,
circulation, submission cost –where applicable-, timelines of review and publication,
as well as launch of special issues –supplements- [26,27]. Choosing a congress, on the
other hand, is a more restrictive procedure, since it is closely linked to the date and
place the congress will be held, the topics authors are invited to cover, subscription
costs and whether the congress is international or not.
After the paper has been written and the journal has been selected, the author is called
to overcome another serious obstacle: how to write a good cover letter that will entice
the editor to read the whole manuscript. Simplicity and courtesy are the virtues mostly
appreciated. The contact information (contact and e-mail address, telephone/ fax
number) of the corresponding author should always be included. The main body of a
cover letter should address the following three basic issues:
Why the authors have written this paper –importance of research findings, new
developments in the field etc.-
Why they have chosen this particular journal – high-prestige, wide circulation etc.-
Why the editor should consider this paper for publication – notice of a gap concerning
recent publications of this journal on the topic under discussion etc.-
The Peer Review Process
Getting acquainted with the peer review process enables the medical writer to decide
whether his paper is ready for submission or requires further modifications. There are
a number of different peer review systems, but the basic screening procedure remains
the same: as soon as the paper arrives at the editorial office, the editor assesses
whether it reaches the minimum publication standards of the journal, in terms of
quality, integrity, ethics and scientific interest, and subsequently allocates the
manuscript to two reviewers [4,28,29]. The consecutive review process focuses on the
following aspects:
Scientific reliability
Originality
Interest to researchers within or outside the field
Rigorous methodology with substantial evidence for its conclusions
Credibility of results
Soundness and relevance of discussion
Clarity of figures and tables, avoidance of duplication
References relevant and up-to-date
Adequacy of abstract and key words
Compliance with the highest ethical standards
Overall presentation according to the journal’s guidelines for authors
Summarizing, we might say that a manuscript worthy of publication is the one that
successfully answers the editor/ reviewers’ three baseline questions:
Do I understand it?
Do I believe it?
Do I care?
Responding to reviewers’ comments
The editorial decision, once reached, may accept the manuscript ‘as is’, accept it with
suggestions for minor revisions, provisionally reject it with the opportunity to make
major revisions or state an outright rejection. Responding to reviewers’ comments
may be quite burdensome, especially in the event of provisional rejection; it is,
however, the route to get one’s work improved and successfully published. Instead of
consigning worthy manuscripts to desk drawers to be dealt with ‘later’, authors should
develop a high-yield strategy in order to respond to each and every reviewer remark in
a thorough and timely manner. Authors should bear in mind that the final decision for
acceptance/rejection rests with the editor and that editors appreciate a well-organized
revision [30,31,32].
As soon as the comments arrive, the author should:
Read each reviewer’s criticism in a broad perspective, figuring out why he
was led to the particular comment
Create a checklist for his revision and corresponding timelines, keeping in
mind that prolonged delays at this point might jeopardize publication
In case of conflicting advice from reviewers, decide which suggestion seems
more valid and state it in the cover letter or request the editor’s assistance
Enable the reviewers to instantly recognize the respective revisions by
tracking changes
Finally, the revised manuscript should be sent to the editor along with a detailed cover
letter providing each reviewer’s comment, the respective response and its location in
the revised document.
Ethical Considerations
Scientists engaged in clinical research and medical writing should be fully informed
of the ethical framework in which they are expected to operate. Driven by the
imperative need to define best practice in the ethics of research and publication and
prevent misconduct, the Committee on Publication Ethics (COPE) has recently
developed Guidelines on Good Publication Practice (GPP) [33]. Some of the key
issues being addressed by the GPP guidelines include the following:
1. Laboratory and clinical research should be conducted according to a well
justified and appropriately designed protocol, in full compliance with the ICH-
GCP guidelines
2. All methods of data analysis should be fully disclosed and any issues of bias
should be mentioned and explained in the discussion section of the paper;
fabrication or falsification of data do constitute misconduct
3. Authorship guidelines should be followed, as already discussed
4. Conflicts of interest, or competing interests between authors, researchers and
reviewers must be declared to editors and disclosed to readers
5. Peer review should be carried out by committees of experts, under proper and
clearly-articulated procedures that ensure confidentiality, integrity and data
protection
6. Publication breaches, such as redundant publication (two or more papers that
share the same hypothesis, data, discussion points or conclusions, without full
cross-reference) and plagiarism (unreferenced use of other’s published or
unpublished ideas), should be avoided
7. Editors are expected to consider and balance the interests of many constituents,
including readers, authors, editorial staff, reviewers and media; good editorial
decision making and compliance with the ethical aspects involved are the
basic principles that all editors should abide by. Furthermore, editorial
decisions should not be influenced by advertising revenue or reprint potential
8. Medical research findings are of great interest to the media and authors are
therefore encouraged to promote their work accordingly.
Conclusion
Successful medical writing has come to expand Simon’s philosophy “Publishing is
the currency in which researchers deal”, to include the entire pharmaceutical and
biotechnology industry a well.
Acknowledgments
With special thanks for their support, I would like to acknowledge Scientific &
Medical Affairs Director Mrs. Katerina Papataxiarchou and Biostatistician Mrs. Olga
Kerasidou for reviewing and commenting on earlier drafts of this paper and Graphic
& Creative Designer Mrs. Sofia Darviri for designing the illustrations.
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http://www.publicationethics.org.uk/guidelines
Appendix I: Electronic Databases
ELECTRONIC DATABASES LINKS
Agency for Healthcare Research and http://www.ahrq.gov/clinic
Quality (AHRQ), formerly known as the
Agency for Health Care Policy and
Research (AHCPR): Clinical Guidelines
and Evidence Reports*
Allied and Complementary Medicine http://www.bl.uk/collections/health/amed.
Database (AMED) html
American College of Physicians Journal http://www.acponline.org/journals/acpjc/j
Club (ACPJC) cmenu.htm
Bandolier* http://www.jr2.ox.ac.uk/bandolier/
Centre for Evidence Based Medicine http://www.cebm.net/
(CEBM)
Clinical Evidence, BMJ Publishing http://www.clinicalevidence.org/ceweb/c
Group onditions/index.jsp
Clinical Trials http://clinicaltrials.gov/
Cochrane Database of Systematic http://www.cochrane.org/
Reviews
Cumulative Index to Nursing and Allied http://www.cinahl.com/
Health Literature (Cinahl)
Database of Abstracts of Reviews of http://www.york.ac.uk/inst/crd/darehp.ht
Effectiveness (DARE) m
Effective Health Care http://www.york.ac.uk/inst/crd/ehcb.htm
EMBASE http://www.embase.com/
Evidence-Based Medicine http://www.evidence-basedmedicine.com
Evidence-Based Practice Newsletter http://www.ebponline.net
(including JFP Patient-Oriented
Evidence that Matters [POEM])
Health Technology Assessment (HTA) http://www.york.ac.uk/inst/crd/crddataba
Database ses.htm
InfoPOEMs http://www.infopoems.com
Institute for Clinical Systems http://www.ICSI.org
Improvement (ICSI)
MEDLINE http://medline.cos.com/
National Guideline Clearinghouse http://www.guideline.gov/
(NGC)
National Health Service (NHS) Centre http://www.york.ac.uk/inst/crd/
for Reviews and Dissemination (CRD)
National Library of Medicine's Health http://www.ncbi.nlm.nih.gov/books/bv.fc
Services/Technology Assessment Text gi?rid=hstat
(HSTAT)
National Research Register http://www.update-
software.com/National/
PEDro The Physiotherapy Evidence http://www.pedro.fhs.usyd.edu.au/index.
Database html
Primary Care Clinical Practice http://medicine.ucsf.edu/resources/guide
Guidelines lines
Pubmed Medline http://www.ncbi.nlm.nih.gov/entrez/query
.fcgi?DB=pubmed
SUMSearch http://www.rehabtrials.org/
Turning Research Into Practice (TRIP) http://www.tripdatabase.com/index.html
Database
U.S. Preventive Services Task Force http://www.ahrq.gov/clinic/uspstfix.htm
(USPSTF)
(1) Kalliopi Sofou, MD
Medical Advisor
CORONIS Research SA
2 Nikitara str, Chalandri, 15232, Greece
Tel: +302108778000, Fax: +302108778200
Mobile: +306979009482
