Writing an article
This chapter is not intended to be a ªGuide for Authorsº such as those thatyou can find in any journal. Our main advice is: do not write the paperfirst in your own language and then translate it into English; instead, do itin English directly.
When you have a subject that you want to report, first of all you needto look up references. You can refer to the Index Medicus (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed) to search for articles.
Once you have found them, read them thoroughly and underline those sen-tences or paragraphs that you think you might quote in your article.
Our advice is not to write the paper in your own language and then
translate it into English; instead, do write in English directly. In order todo so, pick up, either out of these references, or out of the journal in whichyou want your work to be published, the article that you find closest to thetype of study that you want to report.
Although you must follow the instructions of the journal to which you
want to send the paper, here we will use a standard form that may be ade-quate for most of them. In each section, we will give you a few examplesjust to show how you can get them from other articles.
The title of the article should be concise but informative. Put a lot ofthought into the title of your article.
An abstract of 150±250 words (it depends on the journal) must be sub-mitted with each manuscript. Remember that an abstract is a synopsis, notan introduction to the article.
The abstract should answer the question: ªWhat should readers know
Most journals require that the abstract is divided into four paragraphs
Objective: To state the purposes of the study or investigation; the hypoth-esis being tested or the procedure being evaluated.
Notice that very often you may construct the sentence beginning with
· To evaluate the utility of curved planar reformations compared with
standard transverse images in the assessment of pancreatic tumors.
· To present our experience of reconstruction of the chest wall after
· To study the diagnostic value of SPECT for multiple myeloma (MM).
· To assess . . .
· To compare . . .
· To determine . . .
· To perform . . .
· To develop . . .
· To demonstrate . . .
· To investigate . . .
· To ascertain . . .
· To design . . .
· To establish . . .
You can also begin with: ªThe aim/purpose of this study was to . . .º:
· The aim of this study was to adapt the Rheumatoid Arthritis Quality
of Life (RAQoL) questionnaire for use in Turkey and to test its reli-ability and validity.
· The purpose of this study was to determine, on the basis of published
reports, whether aspirin use during the first three months of pregnancyis associated with an increased risk of congenital malformations.
· The goals of this study were to define the natural history and growth
pattern of hemangioblastomas of the central nervous system (CNS)that are associated with von Hippel-Lindau (VHL) disease and tocorrelate features of hemangioblastomas that are associated with thedevelopment of symptoms and the need for treatment.
· The objective of this research was two-fold: . . .
You may give some background and then state what you have done.
· This study was designed to . . .
· We hypothesized that . . .
· We compared . . .
· We investigated . . .
· The relationship between liposarcoma and gene c-myc and p53 is not
clear. There are also different reports on p53 mutation in liposarcoma.
This study was designed to investigate the relationship between the ex-pression of c-myc and p53 genes and liposarcomas.
· Although several early trials indicate treatment of restenosis with ra-
diation therapy is safe and effective, the long-term impact of this newtechnology has been questioned. The objective of this report is todocument angiographic and clinical outcome 3 years after treatmentof restenotic stented coronary arteries with catheter-based 192Ir.
Materials and Methods: Briefly state what was done and what materials wereused, including the number of subjects. Also include the methods used toassess the data and to control bias.
· N patients with . . . were included.
· N patients known to have/suspected of having . . .
· . . . was performed in N patients with . . .
· N patients underwent . . .
· Quantitative/Qualitative analyses were performed by . . .
· Patients were followed clinically for . . . months/years.
· We examined the effects of alcohol on blood pressure, heart rate, and
forearm vascular resistance (FVR) during orthostatic stress achieved bystepwise increases in lower-body negative pressure (LBNP) in 14healthy young volunteers.
Results: Provide the findings of the study, including indicators of statisticalsignificance. Include actual numbers, as well as percentages.
· The clinical manifestations of the main kinds of intramedullary spinal
cord tumors were not significantly different, but there were certaincharacteristic features in their neuroimage. The tumors of the grade 0group (normal movement) were obviously smaller than those of othergrade groups. The pre- and post-operative grades of motor disturbanceshowed a better, positive linear correlation.
· SPECT bone scan images of 44 patients were abnormal in the 46 pa-
tients with MM. The masculine rate was 95.6% . . .
Conclusion: Summarize in one or two sentences the conclusion(s) made onthe basis of the findings. It should emphasize new and important aspectsof the study or observations.
· Improvement in stress blood flow and CFR is delayed compared with
the lipid-lowering effect of fluvastatin, suggesting a slow recovery ofthe vasodilatory response to adenosine.
· MRI, particularly its enhancement, can differentiate an ependymoma
from astrocytoma and hemangioblastoma in most cases. A satisfactoryresult can be achieved to enable resection of the tumor immediately byusing minimally invasive, microsurgical techniques.
· Low p27(Kip1) expression is an independent adverse prognostic factor
in patients with MM. The proposed risk score might be useful for risk-adapted treatment in the future.
· In conjunction with antitumor therapy, zoledronic acid should be consid-
ered for routine use to reduce skeletal complications in patients with ad-vanced malignancies involving bone. In patients with hypercalcemia ofmalignancy, zoledronic acid is expected to become the treatment of choice.
Below the abstract you should provide, and identify as such, three to tenkeywords or short phrases that will assist indexers in cross-indexing thearticle and may be published with the abstract. The terms used shouldbe from the Medical Subject Headings list of the Index Medicus (http://www.nlm.nih.gov/mesh/meshhome.html).
The text of observational and experimental articles is usually (but not nec-essarily) divided into sections with the headings Introduction, Methods, Re-sults, and Discussion. Long articles may need subheadings within some sec-tions (especially the Results and Discussion sections) to clarify their con-tent. Other types of articles, such as Case Reports, Reviews, and Editorials,are likely to need other formats. You should consult individual journals forfurther guidance.
Avoid using abbreviations. When used, abbreviations should be spelled
out the first time a term is given in the text, for example magnetic reso-nance imaging (MRI).
The text should begin with an Introduction that conveys the nature andpurpose of the work, and quotes the relevant literature. Give only strictlypertinent background information necessary for understanding why thetopic is important and references that inform the reader as to why you un-dertook your study. Do not review the literature extensively. The final para-graph should clearly state the hypothesis or purpose of your study. Brevityand focus are important.
Details of clinical and technical procedures should follow the Introduction.
Describe your selection of the observational or experimental subjects
(patients or laboratory animals, including controls) clearly. Identify theage, sex, and other important characteristics of the subjects. Because therelevance of such variables as age, sex, and ethnicity to the object of re-search is not always clear, authors should explicitly justify them when theyare included in a study report. The guiding principle should be clarityabout how and why a study was done in a particular way. For example,authors should explain why only subjects of certain ages were included orwhy women were excluded. You should avoid terms such as ªraceº, whichlack precise biological meaning, and use alternative concepts such as ªeth-nicityº or ªethnic groupº instead. You should also specify carefully whatthe descriptors mean, and say exactly how the data were collected (for ex-ample, what terms were used in survey forms, whether the data were self-reported or assigned by others, etc.).
· Our study population was selected from . . .
· N patients underwent . . .
· N consecutive patients . . .
· N patients with proven . . .
· Patients were followed clinically . . .
· N patients with . . . were examined before and during . . .
· N patients with known or suspected . . . were prospectively enrolled in
· More than N patients presenting with . . . were examined with . . . over
· N patients were prospectively enrolled between . . . (date), and . . .
· N patients (N men, N women: age range, N±N years; mean, N Ô N
· In total, 141 children, aged 2 months to 4 years (mean 16 months), all
with AEDS fulfilling the Hanifin±Rajka criteria, were included in thestudy.
· Patients undergoing elective coronary arteriography for evaluation of
chest pain were considered eligible if angiography documented . . .
Identify the methods, instrumentation (trade names and manufacturer'sname and location in parentheses), and procedures in sufficient detail toallow other workers to reproduce your study. Identify precisely all drugsand chemicals used, including generic name(s), dose(s), and route(s) of ad-ministration.
· MR imaging was performed with a 1.5-T system (Vision; Siemens, Er-
· The US-guided biopsy procedures were performed by using model RT
3000 equipment (GE Medical Systems, Milwaukee, Wis.) with either a3.5- or a 5-MHz sector transducer combined with a needle guide or a5-MHz linear-array transducer with a free-hand technique.
· Automatic high-speed core biopsy equipment (Biopty instrument and
Biopty-Cut needles; Bard Urological, Covington, Ga.) was used.
· After baseline PET investigation, 40 mg of fluvastatin (Cranoc, Astra
· Dynamic PET measurements were performed with a whole-body scan-
ner (CTI/ECAT 951R/31; Siemens/CTI). After a transmission scan forattenuation correction, 20 mCi of 13N-labeled ammonia was adminis-tered as a bolus over 30 seconds by an infusion pump. The dynamicPET data acquisition consisted of varying frame durations (12 ´ 10 sec-onds, 6 ´ 30 seconds, and 3 ´ 300 seconds). For the stress study, adeno-sine was infused at a dose of 0.14 mg ´ kg--1 ´ min--1 over 5 minutes. 13N-labeled ammonia was administered in a similar fashion as in the base-line study during the third minute of the adenosine infusion.
It is essential that you state the manner by which studies were evaluated:independent readings, consensus readings, blinded or unblinded to otherinformation, time sequencing between readings of several studies of thesame patient or animal to eliminate recall bias, random ordering of studies.
It should be clear as to the retrospective or prospective nature of yourstudy.
· Entry/inclusion criteria included . . .
· These criteria had to be met: . . .
· Patients with . . . were not included.
· Further investigations, including . . . and . . . , were also performed.
· We prospectively studied N patients with . . .
· The reviews were not blinded to the presence of . . .
· The following patient inclusion criteria were used: age between 16 and
50 years and closed epiphyses, ACL injury of one knee that requiredsurgical replacement with a bone-to-patellar tendon-to-bone auto-graft, and signed informed consent with agreement to attend follow-up visits. The following exclusion criteria were used: additional liga-ment laxities with a grade higher than 2 (according to the Europeanclassification of frontal laxity) in the affected knee, . . .
· Two skeletal radiologists (O. J., C.V.) in consensus studied the follow-
ing parameters on successive MR images . . .
· Both the interventional cardiologists and echocardiographers who
performed the study and evaluated the results were blinded to drugadministration.
· Histologic samples were evaluated in a blinded manner by one of the
authors and an outside expert in rodent liver pathology.
Give references to established methods, including statistical methods thathave been published but are not well known; describe new or substantiallymodified methods and give reasons for using these techniques, and evalu-ate their limitations. Identify precisely all drugs and chemicals used, in-cluding generic name(s), dose(s), and route(s) of administration. Do nouse a drug's trade name unless it is directly relevant.
· The imaging protocol included . . .
· To assess objectively the severity of atopic dermatitis, all children were
scored at each visit using the SCORAD method (10).
· The stereotactic device used for biopsy has been described elsewhere
· Gut permeability was measured in isolated intestinal segments as de-
Describe statistical methods with enough detail to enable a knowledgeablereader with access to the original data to verify the reported results. Put ageneral description of methods in the Methods section. When data aresummarized in the Results section, specify the statistical methods used toanalyze them:
· A statistically significant difference was calculated with the Fisher ex-
· The probability of . . . was calculated by using the Kaplan-Meier meth-
· To test for statistical significance, . . .
· Statistical analyses were performed with . . . and . . . tests.
· The levels of significance are indicated by P values.
· Interobserver agreement was quantified by using k statistics.
· All P values of less than 0.05 were considered to indicate statistical sig-
· Univariate and multivariate Cox proportional hazards regression mod-
· The v -test was used for group comparison. Descriptive values of vari-
ables are expressed as means and percentages.
· We adjusted RRs for age (5-year categories) and used the Mantel exten-
sion test to test for linear trends. To adjust for other risk factors, weused multiple logistic regression.
· They were selected consecutively by one physician between February
· This study was conducted prospectively during a period of 30 months
from March 1998 to August 2000. We enrolled 29 consecutive patientswho had . . .
Specify any general-use computer programs used:
· All statistical analyses were performed with SAS software (SAS Insti-
· The statistical analyses were performed by using a software package
(SPSS for Windows, release 8.0; SPSS, Chicago, Ill.).
Present your results in logical sequence in the text, along with tables, andillustrations. Do not repeat in the text all the data in the tables or illustra-tions; emphasize or summarize only important observations. Avoid non-technical uses of technical terms in statistics, such as ªrandomº (which im-plies a randomizing device), ªnormalº, ªsignificantº, ªcorrelationsº, andªsampleº. Define statistical terms, abbreviations, and most symbols:
· Statistically significant differences were shown for both X and X.
· Significant correlation was found between X and X.
· Results are expressed as means Ô SD.
· All the abnormalities in our patient population were identified on the
prospective clinical interpretation.
· The abnormalities were correctly characterized in 14 patients and in-
· The preoperative and operative characteristics of these patients are
· The results of the US-guided core-needle pleural biopsies are shown in
· The clinical findings are summarized in Table 1.
· Two minor complications were encountered. After the second procedure,
one patient had a slight hemoptysis that did not require treatment,and one patient had local chest pain for about 1 hour after a puncturein the supraclavicular region. Pneumothorax was never encountered.
· Among the 11,101 patients, there were 373 in-hospital deaths (3.4%),
204 intraoperative/postoperative CVAs (1.8%), 353 patients with post-operative bleeding events (3.2%), and 142 patients with sternal woundinfections (1.3%).
Give numbers of observations. Report losses to observation (such as drop-outs from a clinical trial):
· The final study cohort consisted of . . .
· Of the 961 patients included in this study, 69 patients were reported to
have died (including 3 deaths identified through the NDI), and 789 pa-tients were interviewed (Figure 1). For 81 surviving patients, informa-tion was obtained from another source. Twenty-two patients (2.3%)could not be contacted and were not included in the analyses becauseinformation on nonfatal events was not available.
Within this section, use ample subheadings. Emphasize the new and im-portant aspects of the study and the conclusions that follow from them. Donot repeat in detail data or other material given in the Introduction or theResults sections. Include in the Discussion section the implications of thefindings and their limitations, including implications for future research.
Relate the observations to other relevant studies.
Link the conclusions with the goals of the study, but avoid unqualified
statements and conclusions not completely supported by the data. In par-
ticular, avoid making statements on economic benefits and costs unless thereport includes economic data and analyses. Avoid claiming priority andalluding to work that has not been completed. State new hypotheses whenwarranted, but clearly label them as such. Recommendations, when appro-priate, may be included.
· In conclusion, . . .
· In summary, . . .
· This study demonstrates that . . .
· This study found that . . .
· This study highlights . . .
· Another finding of our study is . . .
· One limitation of our study was . . .
· Other methodological limitations of this study . . .
· Our results support . . .
· Further research is needed to understand . . .
· However, the limited case number warrants a more comprehensive
study to confirm these findings and to assess the comparative predic-tive value of relative lung volume versus LHR.
· Some follow-up is probably appropriate for these patients.
· Further research is needed when endoluminal surface coil technology is
List all contributors who do not meet the criteria for authorship, such as aperson who provided purely technical help, writing assistance, or a depart-ment chair who provided only general support. Financial and material sup-port should also be acknowledged.
People who have contributed materially to the paper but whose contri-
butions do not justify authorship may be listed under a heading such asªclinical investigatorsº or ªparticipating investigators,º and their functionor contribution should be described: for example, ªserved as scientific ad-visors,º ªcritically reviewed the study proposal,º ªcollected data,º or ªpro-vided and cared for study patients.º
Because readers may infer their endorsement of the data and conclusions,
everybody must have given written permission to be acknowledged.
· The authors express their gratitude to . . . for their excellent technical
· The authors thank Wei J. Chen, MD, ScD, Institute of Epidemiology,
College of Public Health, National Taiwan University, Taipei, for theanalysis of the statistics and his help in the evaluation of the data.
The authors also thank Pan C. Yang, MD, PhD, Department of InternalMedicine, and Keh S. Tsai, MD, PhD, Department of Laboratory Medi-cine, National Taiwan University, Medical College and Hospital, Taipei,for the inspiration and discussion of the research idea of this study. Wealso thank Ling C. Shen for her assistance in preparing the manuscript.
References should be numbered consecutively in the order in which theyare first mentioned in the text. Identify references in text, tables, and leg-ends by Arabic numerals in parentheses (some journals require superscriptArabic numbers). References cited only in tables or figure legends shouldbe numbered in accordance with the sequence established by the first cita-tion in the text of the particular table or figure.
· Clinically, resting thallium 201 (201Tl) single photon emission computed
tomography (SPECT) has been widely used to evaluate myocardial via-bility in patients with chronic coronary arterial disease and acute myo-cardial infarction (8±16).
· In addition, we have documented a number of other parameters pre-
viously shown to exhibit diurnal variation, including an assessment ofsympathetic activity, as well as inflammatory markers recently shownto relate to endothelial function. 14
Use the style of the examples below, which are based on the formats usedby the NLM in Index Medicus. The titles of journals should be abbreviatedaccording to the style used in Index Medicus. Consult the List of JournalsIndexed in Index Medicus, published annually as a separate publication bythe library and as a list in the January issue of Index Medicus. The list canalso be obtained through the library's website (http://www.nlm.nih.gov).
Avoid using abstracts as references. References to papers accepted but
not yet published should be designated as ªin pressº or ªforthcomingº;authors should obtain written permission to cite such papers as well as ver-ification that they have been accepted for publication. Information frommanuscripts submitted but not accepted should be cited in the text as ªun-published observationsº with written permission from the source.
Avoid citing a ªpersonal communicationº unless it provides essential in-
formation not available from a public source, in which case the name ofthe person and date of communication should be cited in parentheses inthe text. For scientific articles, authors should obtain written permissionand confirmation of accuracy from the source of a personal communica-tion.
The references must be verified by the author(s) against the original
The Uniform Requirements style (the Vancouver style) is based largely on
an ANSI standard style adapted by the NLM for its databases. Notes havebeen added where Vancouver style differs from the style now used by NLM.
Standard Journal ArticleList the first six authors followed by et al. (Note: NLM now lists up through25 authors; if there are more than 25 authors, NLM lists the first 24, thenthe last author, then et al.).
Vega KJ, Pina I, Krevsky B. Heart transplantation is associated with anincreased risk for pancreatobiliary disease. Ann Intern Med 1996 Jun 1;124 (11):980±3.
As an option, if a journal carries continuous pagination throughout a vol-ume (as many medical journals do) the month and issue number may beomitted. (Note: For consistency, the option is used throughout the exam-ples in Uniform Requirements. NLM does not use the option.)
Vega KJ, Pina I, Krevsky B. Heart transplantation is associated with anincreased risk for pancreatobiliary disease. Ann Intern Med 1996;124:980±3.
The Cardiac Society of Australia and New Zealand. Clinical exercisestress testing. Safety and performance guidelines. Med J Aust 1996; 164:282±4.
Cancer in South Africa [editorial]. S Afr Med J 1994; 84:15.
Article Not In English(Note: NLM translates the title to English, encloses the translation insquare brackets, and adds an abbreviated language designator.)
Galandi D, Allgaier HP. [Diet therapy in chronic inflammatory bowel dis-ease: results from meta-analysis and randomized controlled trials] SchweizRundsch Med Prax. 2002 Nov 20; 91(47):2041±9. Review. German.
Joint analysis of two Phase II studies with Desmoteplase presented at the European Stroke Conference Confirmatory study DIAS-2 started to confirm 3-9 hour treatment time window Aachen, Bologna, 30 May 2005 – The joint analysis of DIAS and DEDAS, two Phase II studies sponsored by PAION that examined the investigational novel plasminogen activator Desmoteplase in the treatment of acute isc
Current Resources for Evidence-Based Practice,January/February 2009Published simultaneously in Journal of Obstetric, Gynecologic &able without charge from Childbirth Connection’s website). (Disclosure: thisauthor is an employee of Childbirth Connection). MILBANK REPORT PROPOSES FRAMEWORK FOR EVIDENCE-BASED MATERNITY CARE AND POLICY RECOMMENDATIONSFOR IMPROVEMENTA new Milbank Report focus