11

Effective Scientific Writing

Bandit Thinkhamrop, PhDDepartment of Biostatistics and Demography

Faculty of Public Health

Khon Kaen university

From Protocol to Publication

Many parts of slides are adopted from http://uwp.duke.edu/wstudio/resources/index.html

22

Getting started (1)Getting started (1)

Uniform Requirements for Manuscripts Submitted to Uniform Requirements for Manuscripts Submitted to Biomedical Journals Biomedical Journals – International Committee of Medical Journal EditorsInternational Committee of Medical Journal Editors– Web site: Web site: http://www.icmje.orghttp://www.icmje.org

The CONSORT StatementThe CONSORT Statement– Read CONSORT “Explanation and Elaboration” documentRead CONSORT “Explanation and Elaboration” document– Web site: Web site: http://www.consort-statement.orghttp://www.consort-statement.org

Web sites which provide instructions to authors for over Web sites which provide instructions to authors for over 5,000 journals in the health and life sciences at5,000 journals in the health and life sciences at http://mulford.meduohio.edu/instrhttp://mulford.meduohio.edu/instr

33

Getting startedGetting started (2)(2)

Ethical issuesEthical issues– USA: USA: http://www.hhs.gov/ohrp/policy/index.htmlhttp://www.hhs.gov/ohrp/policy/index.html

– Thai: FERCIT at Thai: FERCIT at http://www.fercit.org/newsletter.php http://www.fercit.org/newsletter.php

Plagiarism detection toolsPlagiarism detection tools– eTBLAST at http://invention.swmed.edu/etblast3 eTBLAST at http://invention.swmed.edu/etblast3 – Complete list of tools at Complete list of tools at

http://stang.sc.mahidol.ac.th/Plagiarism.htmhttp://stang.sc.mahidol.ac.th/Plagiarism.htm– Read plagiarism at Read plagiarism at http://www.fercit.org/Newsletter/eNews2_52.pdf http://www.fercit.org/Newsletter/eNews2_52.pdf

44

Getting startedGetting started (3)(3)

Reference management toolsReference management tools– Commercial: EndNote (http://www.endnote.com)– Free: Zotero [zoh-TAIR-oh], a free, easy-to-use Firefox e

xtension (http://www.zotero.org)

Advanced MS-Word Advanced MS-Word httphttp://://wwwwww..mdmd..gogo..thth//marine_knowledgemarine_knowledge//knowledgeknowledge//Word_AdvanceWord_Advance..pdfpdf

EndNoteEndNote– http://www.lib.su.ac.th/endnote/EndNoteX1.pdfhttp://www.lib.su.ac.th/endnote/EndNoteX1.pdf– http://www.car.chula.ac.th/gotoweb/endnotex49.pdfhttp://www.car.chula.ac.th/gotoweb/endnotex49.pdf

55

General PrincipleGeneral PrincipleBefore you write a scientific paper, read someBefore you write a scientific paper, read some

Follow a targeted or required format, if anyFollow a targeted or required format, if any

Follow a logical orderFollow a logical order

Be clear, concise, and completeBe clear, concise, and complete

Strive for accuracyStrive for accuracy

Get to the point quickly, and stick to itGet to the point quickly, and stick to it

Cite only references that are relevant and necessaryCite only references that are relevant and necessary

Use standard abbreviations for units, and be consistentUse standard abbreviations for units, and be consistent

Source: Source: http://www.srh.noaa.gov/ftproot/ssd/html/writetip.htmlhttp://www.srh.noaa.gov/ftproot/ssd/html/writetip.html

66

1. Writing a concept sheet2. Writing a protocol synopsis 3. Writing a full protocol

Draft 1: Outline sections and key sentencesDraft 2: Move sections around, avoid repetitionDraft 3: Add cites for statements in Draft 2Draft 4: Polish sentences, steps in Draft 2 Draft 3Leave it for 3-7 daysDraft 5: Act as a reviewer then polish sentencesGive it to friend for informal reviewDraft 6: revisions from friend’s reviewSubmit it for formal reviewRespond to comments from reviewers

Steps in Writing a Research Protocol

77

1.Main components:• Introduction: Why this study?• Methods: What was done?• Results: What was found?• Discussion: Answer

2.Transform the protocol to the report formatProtocol synopsis = AbstractKeep the Introduction as isModify Methods to standard format

2. Plan for Results section as mock (dummy) tables 3. Plan for data analysis as a batch file4. Write the reportFollowing slides provide comprehensive guides

Steps in Writing a Research Report

88

Manuscript preparationManuscript preparation

Choose a target journal for submission.Choose a target journal for submission.

Determine types of manuscripts the journal Determine types of manuscripts the journal will accept.will accept.

Familiarize yourself with the journal’s style Familiarize yourself with the journal’s style and format.and format.

Read the “Instructions to Authors.”Read the “Instructions to Authors.”

99

The Target JournalThe Target JournalReader interestReader interest

CirculationCirculation

Inclusion in Inclusion in Index MedicusIndex Medicus

Acceptance rateAcceptance rate

Publication lagPublication lag

Impact factorImpact factor

Byrne DW. Publishing Your Medical Research Paper. 1998.Byrne DW. Publishing Your Medical Research Paper. 1998.

1010

Manuscript Structure Manuscript Structure

Title pageTitle pageAbstractAbstractIntroduction or BackgroundIntroduction or BackgroundMaterials and MethodsMaterials and MethodsResultsResultsDiscussion and ConclusionsDiscussion and ConclusionsAcknowledgementsAcknowledgementsReferencesReferencesFigures and TablesFigures and Tables

1111

Writing the IntroductionWriting the IntroductionUse a funnel type of Use a funnel type of organization.organization.

Present what is the problem, Present what is the problem, what has been known and what has been known and unknown, leading to the unknown, leading to the question of the study:question of the study:– The nature and scope of the The nature and scope of the

problemproblem– Previous findingsPrevious findings– The gap of the knowledgeThe gap of the knowledge– The research question The research question

(hypothesis)(hypothesis) Source: Source: https://www.ctnbestpractices.org/edu/crwseries/https://www.ctnbestpractices.org/edu/crwseries/

1212

Tips for Writing IntroductionTips for Writing IntroductionDraw attention at the first paragraph:Draw attention at the first paragraph:– Dealing with an important problemsDealing with an important problems– Build on an existing important knowledgeBuild on an existing important knowledge

Best if it’s new, important, and interestingBest if it’s new, important, and interesting1 to 2 pages1 to 2 pagesArrange sections in logical sequenceArrange sections in logical sequenceEmphasize key terms from the titleEmphasize key terms from the titleBased on evidence, not opinionBased on evidence, not opinionSynthesize, not copy & paste -> PlagiarismSynthesize, not copy & paste -> PlagiarismMotivate to read in further sectionsMotivate to read in further sections

1313

Describe what was done to answer the Describe what was done to answer the research questionresearch questionDescribe how you obtained your resultsDescribe how you obtained your results– What is the type of the study?What is the type of the study?– Ethical considerations and ICH-GCPEthical considerations and ICH-GCP– How was the data collected?How was the data collected?

Outcome and outcome measurementsOutcome and outcome measurementsPotential biases and how to minimize themPotential biases and how to minimize them

– How was it analyzed?How was it analyzed?Sample size calculation and justificationsSample size calculation and justificationsStatistical analysisStatistical analysis

Writing Materials and Methods

1414

Writing Methodology EffectivelyWriting Methodology EffectivelyWrite methods in a logical order Write methods in a logical order (chronological or most to least important)(chronological or most to least important)Write in the past tenseWrite in the past tenseProvide signals of organization:Provide signals of organization:– Subtitles, new paragraphsSubtitles, new paragraphs– Topic sentences, transition phrasesTopic sentences, transition phrases

Each journal has different requirements, review the journal’s guidelines before beginning to write this sectionInclude appropriate figures and tables Include appropriate figures and tables (study design).(study design).Do not include results.Do not include results.

Source: Source: https://www.ctnbestpractices.org/edu/crwseries/https://www.ctnbestpractices.org/edu/crwseries/

1515

Describe what you did in accordant with the results Describe what you did in accordant with the results provided in the subsequent section.provided in the subsequent section.

Enable readers to evaluate the work performed

Provide enough detail to permit replication.Provide enough detail to permit replication.

Assume the reader is a trained investigator with Assume the reader is a trained investigator with considerable experience.considerable experience.

maintain a balance between :– Brevity (you cannot describe every technical issue)– Completeness (you need to give adequate detail so that readers

know what happened).

Tips for Writing MethodologyTips for Writing Methodology

1616

Writing Results SectionsOutline Sections: Study algorithm Characteristics of the study sample Results of an exploratory analysis to support ways

to answer the RQ Results to answer the RQ Results of an exploratory analysis to know more

about the answer of the RQFollow formats required by the research sponsor or the target journalBest done with SAP – Statistical Analysis Plan Narrated tables or figures with key messages and avoid repetitionsDo not include explanations in Results section

1717

Report results with purposeReport results with purpose

Refer to the corresponding table or figures early at the beginning of the descriptions

Report sufficient data to allow evaluation of the calculation while Report sufficient data to allow evaluation of the calculation while avoid redundancyavoid redundancy

Document steps of data analysis from which the results were Document steps of data analysis from which the results were transcribedtranscribed

Provide statistical inference for the main findings that are the basis Provide statistical inference for the main findings that are the basis for the conclusionsfor the conclusions

Always report the confidence intervals, p-value can be an optional Always report the confidence intervals, p-value can be an optional – not the main target– not the main target

Tips for Writing Results SectionTips for Writing Results Section

1818

Writing Discussion Sections

Explain the results Explain the results Summary the main findingsSummary the main findingsRelate to previous researchRelate to previous research

Did the study confirm/deny the hypothesis?Did the study confirm/deny the hypothesis?If not, did the results provide an alternative hypothesis? What interpretation can If not, did the results provide an alternative hypothesis? What interpretation can be made?be made?Do results agree with other research? Sources of error/anomalous data?Do results agree with other research? Sources of error/anomalous data?

Implications of studyImplications of study

Strength of the studyStrength of the studyLimitation of the studyLimitation of the studyReport results of sensitivity analysis, if limitations could effect the Report results of sensitivity analysis, if limitations could effect the conclusionsconclusionsRecommendations:Recommendations:– For participant of the studyFor participant of the study– For policy makers or researchersFor policy makers or researchers– For improvement and future researchFor improvement and future research

1919

Tips of writing DiscussionTips of writing DiscussionBegin with the same key terms that were in the Begin with the same key terms that were in the statement at the end of the introductionstatement at the end of the introductionAt the middle, At the middle, – Interpret the resultsInterpret the results– Compare your work with others’ workCompare your work with others’ work– Describe limitations of your studyDescribe limitations of your study

At the end,At the end,– Explain unexpected findings.Explain unexpected findings.– Include speculation if it is appropriate.Include speculation if it is appropriate.– Be certain there is a basis for your speculation in the results you Be certain there is a basis for your speculation in the results you

presented.presented.– Write a strong conclusion.Write a strong conclusion.– Mention need for future work, if necessary.Mention need for future work, if necessary.

Recommended length: Recommended length: 2 pages2 pagesDon’t repeat the results; Don’t repeat the results; assess them and present their import.assess them and present their import.

2020

Common Mistakes in Writing Discussion Sections

New literature review presented Repetitions New results presented Broad statements No discussion at all Incorrectly discussing inconclusive results Provide recommendations that are:

- based on opinion, not the research findings- general, not specific- misleading

2121

BackgroundBackground - Concisely states goals and - Concisely states goals and rationale for study (10%)rationale for study (10%)MMaterials/Methodsaterials/Methods - Clinical data; techniques - Clinical data; techniques employed; drug names, strengths, regimens; employed; drug names, strengths, regimens; number, types of subjects; length of treatment number, types of subjects; length of treatment plan; experiments; statistical methods (30–35%)plan; experiments; statistical methods (30–35%)RResultsesults - Important findings; safety and efficacy; - Important findings; safety and efficacy; adverse effects; statistical patterns and adverse effects; statistical patterns and significance; follow-up (35–40%) significance; follow-up (35–40%) aandndCConclusionsonclusions - Most important things learned; - Most important things learned; recommendations (25%)recommendations (25%)

Writing an Abstract

2222

Good Conclusion WritingGood Conclusion WritingOBJECTIVE: To describe the incidence and epidemiological characteristics of hip fracture (HF) in OBJECTIVE: To describe the incidence and epidemiological characteristics of hip fracture (HF) in patients aged 65 years or over in the various autonomous regions (AR) of Spain from the year patients aged 65 years or over in the various autonomous regions (AR) of Spain from the year 2000 to 2002 and to determine which factors affect in-hospital mortality. METHODS: 2000 to 2002 and to determine which factors affect in-hospital mortality. METHODS: Retrospective, observational study including all patients aged >65 years with acute hip fracture in Retrospective, observational study including all patients aged >65 years with acute hip fracture in the 19 AR of Spain from 2000 to 2002. Data were obtained from the National Record of the the 19 AR of Spain from 2000 to 2002. Data were obtained from the National Record of the Minimum Basic Data Set of the Ministry of Health. We analyzed the following: incidence rates Minimum Basic Data Set of the Ministry of Health. We analyzed the following: incidence rates (crude and age- and gender-adjusted rates) and incidence of hospital admission by season, (crude and age- and gender-adjusted rates) and incidence of hospital admission by season, length of hospital stay and in-hospital mortality. We used regression analysis to identify the length of hospital stay and in-hospital mortality. We used regression analysis to identify the factors that influenced in-hospital mortality. RESULTS: There were 107,718 cases of HF in factors that influenced in-hospital mortality. RESULTS: There were 107,718 cases of HF in patients aged >65 years; of these, 74% were women, with a mean age of 79 years (SD 14). The patients aged >65 years; of these, 74% were women, with a mean age of 79 years (SD 14). The crude incidence rate for HF was 511 cases per 100,000 >65-year-old patients per year (265 crude incidence rate for HF was 511 cases per 100,000 >65-year-old patients per year (265 cases per 100,000 men and 688 per 100,000 women and year). Incidence adjusted for age and cases per 100,000 men and 688 per 100,000 women and year). Incidence adjusted for age and gender was 503 cases per 100,000 inhabitants per year. Catalonia had the highest age-adjusted gender was 503 cases per 100,000 inhabitants per year. Catalonia had the highest age-adjusted incidence and Galicia the lowest (623 and 317 cases per 100,000 inhabitants per year, incidence and Galicia the lowest (623 and 317 cases per 100,000 inhabitants per year, respectively). Incidence rates increased from spring (24.1%) to winter (25.8%). The mean length respectively). Incidence rates increased from spring (24.1%) to winter (25.8%). The mean length of hospital stay was 15 days (SD 13). Seasonal influence and length of stay varied greatly of hospital stay was 15 days (SD 13). Seasonal influence and length of stay varied greatly between autonomous regions. While the overall in-hospital mortality rate was 5.3%, the rate for between autonomous regions. While the overall in-hospital mortality rate was 5.3%, the rate for males was double that of females (8.9% and 4.8%, respectively), and in-hospital mortality males was double that of females (8.9% and 4.8%, respectively), and in-hospital mortality increased with comorbidity (each point on the Charlson index increased mortality by 34.5%) was increased with comorbidity (each point on the Charlson index increased mortality by 34.5%) was higher in winter (11% more risk compared to warmer seasons) and in cold climate regions (15% higher in winter (11% more risk compared to warmer seasons) and in cold climate regions (15% more risk compared to regions with a warm climate, i.e.: Catalonia, Valencia, Murcia, Andalusia, more risk compared to regions with a warm climate, i.e.: Catalonia, Valencia, Murcia, Andalusia, Balearic Islands and Canary Islands). CONCLUSIONS: Hip fracture mainly affects elderly women Balearic Islands and Canary Islands). CONCLUSIONS: Hip fracture mainly affects elderly women and presents great variability in incidence, seasonality, length of hospital stay and mortality and presents great variability in incidence, seasonality, length of hospital stay and mortality between the different autonomous regions in Spain. Elderly male patients with severe comorbid between the different autonomous regions in Spain. Elderly male patients with severe comorbid conditions, who are admitted in winter and in cold climate regions are more at risk of in-hospital conditions, who are admitted in winter and in cold climate regions are more at risk of in-hospital mortality.1 mortality.1

2323

Tips of Writing an AbstractsTips of Writing an Abstracts

No abbreviations or symbols other than standardNo abbreviations or symbols other than standard

No citations of references (or references No citations of references (or references themselves)themselves)

No tables or figuresNo tables or figures

No information not contained in the textNo information not contained in the text

No jargon (short-cut terms or phrases)No jargon (short-cut terms or phrases)

No words “coined” by authorsNo words “coined” by authors

2424

Title PageTitle Page

TitleTitle

Authors: full names and degreesAuthors: full names and degrees– Institutional affiliations for all authorsInstitutional affiliations for all authors

Funding: all sources of support for the Funding: all sources of support for the research, including grant numbersresearch, including grant numbers

Address for correspondence and reprints, Address for correspondence and reprints, including telephone and fax #s, e-mailincluding telephone and fax #s, e-mail

2525

Ethical ConsiderationsEthical ConsiderationsAuthorship criteriaAuthorship criteria

FraudFraud

Plagiarism, copyright infringementPlagiarism, copyright infringement

Duplicate publicationDuplicate publication

Financial conflict of interestFinancial conflict of interest

Privacy and confidentialityPrivacy and confidentiality

Protection of human subjects and animals in Protection of human subjects and animals in research research – See informed consent tips at See informed consent tips at

http://www.hhs.gov/ohrp/policy/index.htmlhttp://www.hhs.gov/ohrp/policy/index.html– FERCIT at FERCIT at http://www.fercit.orghttp://www.fercit.org

2626

Common problems in writingCommon problems in writing

Keep doing everything except writingKeep doing everything except writing

Ineffective or excessive review and revisionIneffective or excessive review and revision

Fragmented paragraphingFragmented paragraphing

Inconsistency, illogicalInconsistency, illogical

Poor version controlPoor version control

Integrating inputs from other contributorsIntegrating inputs from other contributors

Poor coordinationPoor coordination

Fishing expeditionsFishing expeditions

2727

Keys to success in writingKeys to success in writingWrite,Write,Write, andWrite, andWrite.Write.Many eyes make accurate work: review both Many eyes make accurate work: review both among and outside of the team can make the among and outside of the team can make the difference.difference.Establish a process for deciding on accepting Establish a process for deciding on accepting or rejecting critiques or suggestions.or rejecting critiques or suggestions.Keep detailed minutes/records of all meetings Keep detailed minutes/records of all meetings or project discussions; mandate or project discussions; mandate acknowledgment of receipt of important acknowledgment of receipt of important communicationscommunicationsKeep the protocol leanKeep the protocol lean

2828

Double check all citationsDouble check all citations

– ““Bibliographic inaccuracies harm the citing Bibliographic inaccuracies harm the citing author and may cast doubt on the quality of author and may cast doubt on the quality of the research being reported…”the research being reported…”

Wyles DF, Behavioral and Social Sciences Librarian, 2004Wyles DF, Behavioral and Social Sciences Librarian, 2004

– “…“…[A]uthors should verify references against [A]uthors should verify references against the original document.”the original document.”

Uniform Requirements for Manuscripts Submitted to Uniform Requirements for Manuscripts Submitted to Biomedical Biomedical Journals, ICMJE, 2005 (http://www.icmje.org/)Journals, ICMJE, 2005 (http://www.icmje.org/)

2929

Tools for Better Writing: Tools for Better Writing: ProofreadingProofreading

Make time for proofreadingMake time for proofreading– Don’t make last-minute changes and submit a Don’t make last-minute changes and submit a

document for review or approval without document for review or approval without subjecting it to a formal proofreading.subjecting it to a formal proofreading.

Once is not enoughOnce is not enough– Remember: protocols are lengthy, complex Remember: protocols are lengthy, complex

documents. You will need more than single documents. You will need more than single review to catch all mistakes.review to catch all mistakes.

3030

Tools for Better Writing: Tools for Better Writing: ProofreadingProofreading

Fresh eyesFresh eyes– Working too long on a protocol may habituate Working too long on a protocol may habituate

eyes and brains to mistakes, simply because eyes and brains to mistakes, simply because they’ve been there all along. Get an “outside” they’ve been there all along. Get an “outside” reviewer!reviewer!

Spell-checkers, etc.Spell-checkers, etc.– A document that has been “checked” by A document that has been “checked” by

automatic software has NOT been proofread.automatic software has NOT been proofread.

3131

Tools for Better Writing: Tools for Better Writing: ProofreadingProofreading

Seize the opportunity to review the entire protocol; Seize the opportunity to review the entire protocol; this “continuing review” may uncover errors or this “continuing review” may uncover errors or omissions that passed through earlier reviews.omissions that passed through earlier reviews.

Don’t just make a “point” change to a protocol; Don’t just make a “point” change to a protocol; check the entire document for ramifications.check the entire document for ramifications.

Remember: maintain version control!Remember: maintain version control!

Archive EVERYTHING!Archive EVERYTHING!

Control access to materials:Control access to materials:– Have a defined procedure for creating or modifying filesHave a defined procedure for creating or modifying files– Limit write-access to files, where appropriateLimit write-access to files, where appropriate

3232

Effective Paragraphing (1)Effective Paragraphing (1)

Keep one thought to a sentence.Keep one thought to a sentence.

Keep one idea to a paragraph.Keep one idea to a paragraph.

Length of paragraph should be 50–100 words.Length of paragraph should be 50–100 words.

Ideas in a paragraph must be organized.Ideas in a paragraph must be organized.

The relationship between ideas must be clear.The relationship between ideas must be clear.

Important ideas should be emphasized.Important ideas should be emphasized.

3333

Effective Paragraphing (2)Effective Paragraphing (2)

Write a topic sentence Write a topic sentence

Write details to support the topic Write details to support the topic sentence in the remaining sentences of sentence in the remaining sentences of the paragraph. the paragraph.

Organize these sentences in a logical Organize these sentences in a logical way.way.

3434