How to Write a Rejection to Sponsorship Sample by ema17445

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									Publishing Academic Papers in the Medical Sciences:
         A Primer (and some rules of thumb)
                    Steve Miles, MD
                 University of Minnesota
      Caveats

  This talk is not about
      study design,
human subjects protections,
   statistical methods,
   conflicts of interest,
  getting promoted, etc.
I: Writing
A Basic Personal Library on Writing.




 Writing      Composition   Marketing


  BUT, Writing is not Publishing.
      Writing is not Publishing.
Writing               Publishing
  Self expression.      To change minds,
  Personal problem      policies.
  solving.              To build or sustain
  Maintain personal     professional
  relationships.        networks.
  Recreation.           To advance a career.
                        To earn money.
                    Academic Publishing
           Connecting your passion to an audience
                  to make things happen.



What are you                             Where is your
passionate about?                        audience?




                       What can you
                       make happen?
Getting Started: Find your passion.
 Why do I care?
 Why should someone else care?
 What am I trying to accomplish
 with this paper?
        Getting Started:
Find your audience (i.e., journal).
          Journals you admire/know.
          Writers you admire on same topic;
          Where are they publishing?
          Medline
            Search your topic for last 3-5
            years
            Sort by journal name.
            Voila!
      Who publishes on HIV Screening in Prisons?

#   Searches                           Results
1   HIV Infections                     193,706
2   Prisons                            6,630
3   Mass Screening                     83,260
4   1 and 2 and 3                      50
    limit 4 to (english language and
5                                      17
    yr="2005 - 2010")
               Partial output: Who publishes on HIV
                        Screening in Prisons?
1.     AIDS & Public Policy
      1.   HIV testing in correctional institutions: evaluating existing strategies, setting new standards.
           2005 Spring-Summer:
2.     AIDS Policy & Law
      1.   Testing. Delaware proposes to test all inmates for TB, hepatitis and HIV. 2006 May 5.
3.     American Journal of Public Health
      1.   HIV/AIDS and other infectious diseases among correctional inmates: transmission, burden,
           and an appropriate response. [Review] [73 refs] 2006 Jun.
4.     Clinical Infectious Diseases
      1.   Routine HIV testing in jails is critical for the early diagnosis of HIV infection in men. 2008 Nov
           15.
      2.   Opportunities to address the hepatitis C epidemic in the correctional setting. 2005 Apr 15
      3.   Is routine testing mandatory or voluntary?. 2005 Jan 15
5.     Sexually Transmitted Diseases.
      1.   Rapid HIV testing in rapidly released detainees: next steps. 2009 Feb
      2.   Sexually transmitted infections and HIV prevalence among incarcerated men who have sex
           with men, 2000-2005. 2009 Feb
      3.   Responding to the burden of STD, HIV, and viral hepatitis in correctional populations through
           program collaboration and integration. 2009 Feb


     Market in AIDS, STD, or Public Health Journals.
          Who publishes on DNR in Hospitals?

#   Searches                           Results
1   Do not resuscitate orders          415,197
2   Hospitals                          172,093
3   1 and 2                            4,488
    limit 3 to (english language and
4   yr="2005 - 2010")                  1,026

       Do you have anything new to say?
The Foundation: Your Literature Search.
 Your arguments about the
     newness of your findings and
     soundness of methodology rest on your lit search.

Search the topic very carefully with Medline,
web, news and citation tracking, etc.
Search reviews on your method: e.g., meta-
analysis, cost-effectiveness studies, qualitative
research.
Do not use proforma citations of classic works.
Reviewers can tell!!
    Getting Past Writer’s Block
                         Outlines.
                         Network of ideas mixing text and glyphs
                         (asemic writing).
                         Free writing.
                         Meditation (automatic) writing
                         Note cards.
                         Inspiration capture., e.g., text yourself,
                         notepad in pocket or next to your bed.


They all can produce a scientific paper.
Write from your passion—the scientific form comes during editing.
International Committee of Medical Journal Editors
 Uniform Requirements for Manuscripts Submitted to Biomedical Journals



  The Oracle.
  Seek.
  Bookmark.
  Obey.
  Violators will be punished.
  http://www.icmje.org/
Authorship
    Substantial Contribution to:
      Conception.
      Design.
      Drafting intellectual content.
      Complex data acquisition.
      Analysis.
      Final guarantee of claims.
         Acknowledgements
Contributors not meeting criteria for authorship
   Persons providing purely technical help, writing assistance
   Department chair who provided only general support.
   Persons who contributed materially to the project but not as
   authors, e.g., ―participating investigators‖ with descriptors of
   their function
   Financial and material support should also be acknowledged.
All persons must give written permission to be
acknowledged.
 Types of Papers
I: Quantitative Research
Quantitative Research: The Ideal

State Hypothesis

                                                 Ethics needs more
           Develop Method to Test Hypothesis     quantitative research!
           (variables, controls, etc)


                            Collect Data


                                 Analyze Data and its
                                 limitations, and implications
Quantitative Ethics Research: Methods
  Monitors
    Audiotapes
                         Each form of data
    Videotapes
                         collection has special
    Observer
                         issues for
    Physiologic
                            Consent
    Record abstraction
                            Robustness of Findings
  Vignettes
  Mail outs
  Surveys
  Interviews
Quantitative Research: Types
Descriptive (Prospective or Retrospective)
  Cross Sectional
  Correlational
  Interventional-Prospective
     Randomized
     Controlled
     Single Blind
     Double Blind
     Univariate                   Warning: Not all
     Multivariate                 numbers should be
                                  taken as science.
      Quantitative Research: Perils
Bad Foundation   Too Many Variables      Underpowered




Bad Design       Bad Execution        Intellectual Dishonesty
 Types of Papers
II: Qualitative Research
General Forms of Qualitative Research
Describe phenomenological experiences
  (e.g., of praying)
Retrospectively discern subjective
influences
  (e.g., sexism in court rulings).
Prospectively measure subjective
population variables
  (e.g. religiosity, quality of life, caregiver burden)
      Qualitative Research: Methods
Historical Research.               Narration or storytelling
Ethical Inquiry: Analysis of       (eliciting the ―subjective reality‖
                                   from the study population)
ethical problems.
                                   Shadowing (non-participant,
Grounded Theory: inductive         passive observation).
research ―grounded‖ on             Participant Observation (―I got
observations.                      myself committed to an insane
Critical Research: analysis        asylum.‖)
using an apriori posited theory.   Focus groups
                                   Structured /unstructured
                                   interviews
                                   Analysis of documents and
                                   tapes, etc.
    Editorial or Analytic Papers
Reviews: Narrative             Editorials*
or Meta-analysis.              Essays (history,
Academia and Clinic            patient care, poems,
Clinical Guidelines            travel, bios
and Position Papers*           Case Reports
Health Policy                  Quality
                               Improvement
                               Letters
                               Book Reviews
    * Usually solicited or submitted by an institution.
            Graphics
        Charts and Tables


          The purpose of graphics is to
communicate a point, not to display data!
Graphs should tell an instant story: This one does.
   The US health care system is expensive.
         PER CAPITA SPENDING ON HEALTH CARE




$/yr
       OECD 2009: 2007
       The Organization for Economic Cooperation and Development was founded in 1961 to
       compile statistics and policy reports to promote economic growth.
Graphs should tell an instant story: This one doesn’t.
  Out Of Pocket drug costs:  compliance.




                                            Health Aff 2008;27:89-102
      Bubble Size = % non compliant with meds
                                Tables:
  Keep them simple with
  common terms and clear
  conclusions.
  If a reviewer can’t grasp it
  quickly, a reader won’t.
       A table like this can move
       your paper from a high
       circulation journal to a small
       circulation specialized
       journal.
  Complex data should go as
  online appendix
This necktie would
fit the mentor who
told me to submit this table!
Avoid Chart Junk
Avoid Chart Junk
Use Honest Charting
      Worse




       Better
     300,000 600,000 900,000




           600,000
300,000              900,000
  Graphics
Mixed Graphics
             The Greatest Chart Ever Made!




Temperature during retreat
Disparities in Pain Treatment
                          % Getting Pain Med in ER
                           for Long Bone Fracture




          Ann Emerg Med 2000;35:11–6. Retrospective cohort study of patients
          single ED in GA.
Avoid Multidimensional Distortion

                  Notice how
                  increasing size to
                  get to % changes
                  volume so that man
                  appears 4x as large
                  rather than 2x as
                  large.
Assembling the Whole Paper
               Step 1, 2, 3: Consult Oracle.
        The Whole Paper
Title            Methods
IDs              Results
Keywords         Discussion
Abstract         References

Introduction
          Title and Keywords
      Titles                      Keywords
Avoid cute titles for         Don’t bury your work alive!
academic publications.          If keywords are
Avoid claims in your            requested, use Medline,
titles: ―A revolutionary        MeSH keywords.
advance in living wills.‖       Do not dream up your
Journal titles should avoid     own.
subtitles. Brain Death:
New Perspectives
Keep them short.
Introduction                        Methods
 Set the context.               Hypothesis
   Be succinct; this is not a   Sample selection
   review.                      Power calculation
   Defines the starting point   Variables and origins of
   for your work and why it     measurements and
   matters.                     instruments.
 State what you out to do       Statistical tests and where
 (or find).                     relevant software.
                                On line data appendices.
 State why it matters.
                    Results
     Content                     Etiquette
The sequential application   No analysis! (Save it for
of your method.              the discussion.)
Sample collection,           No reference to past
exclusions, final            studies (especially your
population.                  own).
Standardization.               Just the facts ma’am.
Comparisons
Graphics
                Discussion
     Content                  Etiquette
Discuss what you add to   Minimize self citation (It
the (previously stated)   even annoys reviewers).
context).
Discuss its utility,
importance, value.
State the limitations.
Discuss future research
that might confirm or
elaborate on this work.   Do not repeat data or
                          introduction.
         Write the Abstract Last!
Don’t take poison.                 Evolution of tropomyosin functional domains:
                                   differential splicing and genomic constraints.
  ―Unfortunately, many abstracts   We have cloned and determined the nucleotide sequence of a

  disagree with the text of the
                                   complementary DNA (cDNA) encoded by a newly isolated human
                                   tropomyosin gene and expressed in liver. Using the least-square
  article.‖                        method of Fitch and Margoliash, we investigated the nucleotide
                                   divergences of this sequence and those published in the literature,
                                   which allowed us to clarify the classification and evolution of the
                                   tropomyosin genes expressed in vertebrates. Tropomyosin undergoes
                                   alternative splicing on three of its nine exons. Analysis of the exons
                                   not involved in differential splicing showed that the four human
                                   tropomyosin genes resulted from a duplication that probably occurred
                                   early, at the time of the amphibian radiation. The study of the
                                   sequences obtained from rat and chicken allowed a classification of
                                   these genes as one of the types identified for humans. The divergence

Avoid non-therapeutic
                                   of exons 6 and 9 indicates that functional pressure was exerted on
                                   these sequences, probably by an interaction with proteins in skeletal

amputations.                       muscle and perhaps also in smooth muscle; such a constraint was not
                                   detected in the sequences obtained from nonmuscle cells. These results

  Abstracts are the online
                                   have led us to postulate the existence of a protein in smooth muscle
                                   that may be the counterpart of skeletal muscle troponin. We show that
  content of your article.         different kinds of functional pressure were exerted on a single gene,
                                   resulting in different evolutionary rates and different convergences in
  Follow length rules!             some regions of the same molecule. Codon usage analysis indicates
                                   that there is no strict relationship between tissue types (and hence the
                                   tRNA precursor pool) and codon usage. G + C content is characteristic
                                   of a gene and does not change significantly during evolution.
                                   (ABSTRACT TRUNCATED AT 250 WORDS)
              Polishing

Cannot be done enough.
Start at various points in the paper as
you write. Avoid a polished start and a
rough middle.
Read aloud.
A spell checker is not a magic detector.
Books and Theses


THE BIG MANUSCRIPT
Coherence, Balance, Organization
 Story Boards        Title     Topics      Words   Target
                     Intro     How I got to 1800   2000
 Outlines                      subj, Methods
 Dynamic Tables
 of Contents         Part I

   Subdocument for   Ch 1      Torture     3108    3000

   each page.        Ch 2      Med and     2967    3000
                               Torture
                     Part II
                                                   …
                     Totals                69745   75000
BACK UP
     Anthologizing and Spinoffs




Collect articles          Restructure and
by you or others
                          update chapters
for an anthology,
                          for publication
add commentary,
etc
Mark Twain Letter to D. W. Bowser, 3/20/1880
I notice that you use plain, simple language, short
words and brief sentences. That is the way to write
English - it is the modern way and the best way.
Stick to it; don't let fluff and flowers and verbosity
creep in.
When you catch an adjective, kill it. No, I don't mean
utterly, but kill most of them - then the rest will be
valuable. They weaken when they are close together.
They give strength when they are wide apart. An
adjective habit, or a wordy, diffuse, flowery habit,
once fastened upon a person, is as hard to get rid of
as any other vice.
      Murder your darlings.’
Style is not—can never be—extraneous
Ornament.
Whenever you feel an impulse to perpetrate a
piece of exceptionally fine writing, obey it—
whole-heartedly—and delete it before
sending your manuscript to press. Murder
your darlings.’
             Sir Arthur Quiller-Couch (1863–1944).
                        On the Art of Writing. 1916.
  A Grammar Checker won’t make you a great writer.
     (But it can stop you from being a turgid one.)

Passive sentences
    Keep less than 20%
    Active is shorter and more fun
    to read.
Flesch Reading Ease:
    should be over 60 (easily read
    by 13 year olds)
F-K Grade Level : 13 or less.
Gettysburg Address is 69 and 9.1
Law school tenure policy 23, 16.6
II: Submitting your Paper
       Honor Thy Cover Letter
The cover letter is a      Etiquette
                        One page.
job application for
                        2-3 sentence synopsis,
your paper.
                        50 words tops.
                        ―This submission is
                           Perfect for your
                           readers
                           Compatible with your
                           mission.‖
                        Mandatory content from
                        the Oracle.
 Never Make an Editor Mad at You!
Thou shalt not
  Simultaneously submit the same
  piece to two journals.
  Publish the same piece twice (no
  matter what media).
  Violate embargo dates.
Editors never forget.
        Conflicts of Interest
Financial: ―I have a financial interest in
this paper being published.‖
Intellectual: ―I cannot be intellectually
fair to this topic.‖
Control of authorship—ghostwriting.
Seek the Oracle. http://www.icmje.org/
Disclose all.
Violators will be punished.
    Suggesting Reviewers
Quality of peer review is comparably high.
Acceptance recommendations are higher.
Avoid conflicts of interest.
  Not your institution, teacher, etc.
                                        J Peds 2007;151:202-5.
                                         JAMA 2006;295:314-7.
III: Dealing with Rejection
         Far East Economic Review
"We have read your manuscript with boundless delight. If we
publish your paper, it would be impossible for us to publish any
work of lower standard. And as it is unthinkable that in the
next thousand years we shall see its equal, we are, to our
regret, compelled to return your divine composition and to beg
you a thousand times to overlook our short sightedness and
timidity."



       Don’t take it personally.
 Why do papers get rejected?
   Paper factors                Journal factors
Out of date.                  So many submissions
   Don’t procrastinate.            -- so little space.
Flawed lit search.            Just published on this.
Flawed methods.               Not our audience/issue.
Flawed writing.               Bad luck with
   Grumpy reviewers are       reviewer/editor.
   not friendly.
No passion.
   Nor are bored reviewers.
Dealing with Rejection
 Is it really a rejection? (Some are, ―We can’t take
 this paper but revise and we may take another look.‖)
 What can you learn from the reviews?
 Are the criticisms about
    the paper or
    about its fit with the journal’s audience?
 Papers in minor journals can have MAJOR
 influence.
    Dealing with Rejection
Read the paper aloud.
Does it flow as well as I thought it did?
How many grammar mistakes were
there, really?
Does it convey my passion?
Did I speak to the journal’s audience?
         Dealing with Rejection.
Have your next journal in mind
when you submit a paper.
Re-edit to reviewers’ comments.
Update literature search!
Resubmit ASAP (you have put a lot
of work into this).
My personal record is 17 rejections for one paper not counting
the dead papers lying on my hard drive.
IV: Acceptance (is not the final stage.)
Acceptance is an Emergency!
Answer queries and complete various
forms on same day if possible.
Your paper may be timely—e.g., delay
can harm its inclusion in a special issue.
Then relax!
          After the Publication:
     Connecting your passion to an audience
            to make things happen.
Scientific
                                    Legislative
Meetings                            testimony
Academic
                                    Community
Lectures
                                    Education
Follow-up
                                    Op-ed pieces
confirmatory
or outcome                          Legal work
papers.
Build Your Brand (& Career)

 Your Name            Your
Same name &         Expertise
initials on all    Publish at
work.              least three
Allow editors      times on any
to print your      topic.
email address      Present at
(get asked out).   public
Allow editors      meetings.
to use you as      Peer Review—
a reviewer.        openly.
                      Readings
International Council of Medical Journal Editors http://www.icmje.org/
Holmes DR Jr, et al. Manuscript preparation and publication.
Circulation. 2009;120(10):906-13.
Turka LA. J. After Further Review. J Clin. Invest. 2009;119:1057.
Ushma N. How to write an effective referee report.
J. Clin. Invest. 1195 http//www.jci.org/articles/view/39424/pdf
Skandalakis JE. Mirilas P. Plagiarism. Archives of Surgery. 2004;
139(9):1022-4.
Anonymous. Self-plagiarism: unintentional, harmless, or fraud? Lancet
2009; 374(9691):664.
Irwin RS. The role of conflict of interest in reporting of scientific
information. Chest 2009 136(1):253-9.
Davidoff F, et al Sponsorship, authorship, and accountability. JAMA
2001;286:1232-4.
Angell M, Relman AS. Redundant publication. New Engl J Med
1989;320:1212-4.
Slides available on request.
               Steven H. Miles, MD
            University of Minnesota
               miles001@umn.edu

								
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