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Title: in the Medical Sciences Steve Miles, MD University of


1
Publishing Your First Three Academic Papers in
the Medical Sciences
  • Steve Miles, MD
  • University of Minnesota

2
Caveats
This talk is not about study design, human
subjects protections, statistical methods, etc.
3
I What is Academic Writing?
4
A Basic Personal Library on Writing.
Writing Composition
Marketing
BUT, Writing is not Publishing.
5
Get a Good Dictionary!
  • A dictionary is not just a spell-checker.
  • Effect v affect
  • Denote indicate
  • flashing yellow denotes caution
  • Connote imply
  • hospice should not connote giving up
  • Etymology a words origin adds resonance to
    your writing.
  • Palliate comes from pall, appall, pale.

6
Academic Writing is / is not
  • Academic Writing
  • Journal articles
  • Editorials
  • Letters to academic journals.
  • Peer reviews
  • Grant Applications
  • Personal Writing
  • Journaling
  • Poetry, Haikus, Limericks
  • Memos
  • Personal letters

7
Writing has different aims than Academic Writing.
  • Writing
  • Self expression.
  • Personal problem solving.
  • Maintain personal relationships.
  • Recreation.
  • Academic Writing is Published
  • To change minds, policies.
  • To build or sustain professional networks.
  • To advance a career.
  • To earn money.

8
Academic PublishingConnecting your passion to an
audience to make things happen.
What are you passionate about?
Who/Where is your audience?
What can you make happen?
9
Getting Started Find your passion.
  • Do I care?
  • Why do I care?
  • How can I get someone else to else care?
  • What do I want this paper to accomplish?

10
Getting Started Find your audience.
  • 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!

11
Partial output Who cares about HIV Screening in
Prisons?
  • AIDS Public Policy
  • HIV testing in correctional institutions
    evaluating existing strategies, setting new
    standards. 2005 Spring-Summer
  • AIDS Policy Law
  • Testing. Delaware proposes to test all inmates
    for TB, hepatitis and HIV. 2006 May 5.
  • American Journal of Public Health
  • HIV/AIDS and other infectious diseases among
    correctional inmates transmission, burden, and
    an appropriate response. Review 73 refs 2006
    Jun.
  • Clinical Infectious Diseases
  • Routine HIV testing in jails is critical for the
    early diagnosis of HIV infection in men. 2008
    Nov 15.
  • Opportunities to address the hepatitis C epidemic
    in the correctional setting. 2005 Apr 15
  • Is routine testing mandatory or voluntary?. 2005
    Jan 15
  • Sexually Transmitted Diseases.
  • Rapid HIV testing in rapidly released detainees
    next steps. 2009 Feb
  • Sexually transmitted infections and HIV
    prevalence among incarcerated men who have sex
    with men, 2000-2005. 2009 Feb
  • 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.
12
II The Literature Search
13
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!!

14
Static Search Who publishes on HIV Screening in
Prisons?
15
Search Key Words v Text Words
16
Static SearchWho publishes on DNR in Hospitals?
Do you have anything new to say?
17
Iterative Dynamic SearchUsing Complete
Reference to find search terms.
  • In the course of a search, look at the highly
    relevant articles
  • Complete Reference
  • Characteristics of cancer patients who refuse
    do-not-resuscitate orders.Cancer.
    116(12)3061-70, 2010.AdultAfrican
    AmericansCancer Care FacilitiesCase-Control
    StudiesFemaleHumansMaleMiddle AgedNausea /
    co ComplicationsNeoplasms / di
    DiagnosisNeoplasms / mo MortalityPain / co
    ComplicationsPalliative CarePatient
    Acceptance of Health CareResuscitation
    OrdersRetrospective StudiesSurvival Analysis

Do any of these search terms give you ideas? If
so, redesign and rerun your search.
18
Iterative Dynamic Search Citations Method II
  • Take a relevant article and note new articles
    that you missed in its citations
  • Add that article to your file.
  • Look it up on PubMed or Medline to see its
    Complete Reference
  • Take the new search terms and redesign your
    search.
  • Characteristics of cancer patients who refuse
    do-not-resuscitate orders.Cancer.
    116(12)3061-70, 2010.AdultAfrican
    AmericansCancer Care FacilitiesCase-Control
    StudiesFemaleHumansMaleMiddle AgedNausea /
    co ComplicationsNeoplasms / di
    DiagnosisNeoplasms / mo MortalityPain / co
    ComplicationsPalliative CarePatient
    Acceptance of Health CareResuscitation
    OrdersRetrospective StudiesSurvival Analysis

19
III What is Authorship?
20
Authorship Unitary Model
  • Substantial Contribution to
  • Conception.
  • Design.
  • Drafting intellectual content.
  • Complex data acquisition.
  • Analysis.
  • Final guarantee of claims.

21
Authorship Contributor Model
Each Guantantor-Author takes overall
responsibility for the paper as a whole.
  • Each Contributor-Author has a disclosed
    substantial role
  • Conception.
  • Design.
  • Drafting intellectual content.
  • Complex data acquisition.
  • Analysis.

22
Honorary Authors
  • Acquisition of funding,
  • Collection of data,
  • General supervision of the research group alone

Does not constitute authorship.
23
Ghost Authors
  • People who write the paper behind the scenes
    without attribution
  • Drug or medical device companies or their PR
    departments.
  • Special academic assistants.

Undisclosed conflicts of interest. Plagiarism Puni
shed by editorial death!
24
Acknowledgements
  • Contributors not meeting authorship criteria.
  • 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.

25
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 authorshipghostwriting.
  • Seek the Oracle. http//www.icmje.org/
  • Disclose all.
  • Violators will be punished.

26
Cut Authorship Fights off at the Pass!
  • The lead author is project manager, director,
    screenplay writer, producer.
  • Author assignment, evaluation and ranking should
    be continuously updated in writing.
  • No paper should be submitted with an open
    authorship conflict.

27
IVA Quantitative Research
28
What is Scientific Research?
  • Scientific Research
  • Not Scientific Research
  • Fair
  • Transparent
  • Reproducible
  • Method of
  • Postulating,
  • Evaluating
  • Asserting inferences
  • That adds to generalizable knowledge
  • Concealed conflicts
  • Hidden
  • Incompletely described
  • Unmethodical
  • Imprecise premise
  • Non-valid testing
  • Non-sequitor conclusions
  • Relation of study popula-tion to general
    population is unclear.

29
What is Scientific Research?
  • Scientific Research
  • Not Scientific Research
  • Fair
  • Transparent
  • Reproducible
  • Method of
  • Postulating,
  • Evaluating
  • Asserting inferences
  • That adds to generalizable knowledge
  • Concealed conflicts
  • Hidden
  • Incompletely described
  • Unmethodical
  • Imprecise premise
  • Non-valid testing
  • Non-sequitor conclusions
  • Relation of study popula-tion to general
    population is unclear.

30
Quantitative Research The Ideal
State Hypothesis
Develop Method to Test Hypothesis (variables,
controls, etc)
Ethics needs more quantitative research!
Collect Data
Analyze Data and its limitations, and implications
31
Quantitative Research Types
  • Descriptive (Prospective or Retrospective)
  • Cross Sectional
  • Correlational
  • Interventional-Prospective
  • Randomized
  • Controlled
  • Single Blind
  • Double Blind
  • Univariate
  • Multivariate
  • Interventional-Retrospective

Warning Not all numbers should be taken as
science.
32
Quantitative Ethics Research Methods
  • Monitors
  • Audiotapes
  • Videotapes
  • Observer
  • Physiologic
  • Record abstraction
  • Vignettes
  • Mail outs
  • Surveys
  • Interviews
  • Each form of data collection has special issues
    for
  • Consent
  • Robustness of Findings

33
Quantitative Research Perils
Underpowered
Bad Foundation
Too Many Variables
Bad Design
Bad Execution
Intellectual Dishonesty
34
IVB Qualitative Research
35
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)

36
Qualitative Research Methods
  • Narration or storytelling (eliciting the
    subjective reality from the study population)
  • Shadowing (non-participant, passive observation).
  • Participant Observation (I got myself committed
    to an insane asylum.)
  • Focus groups
  • Structured /unstructured interviews
  • Analysis of documents and tapes, etc.
  • Historical Research.
  • Ethical Inquiry Analysis of ethical problems.
  • Grounded Theory inductive research grounded on
    observations.
  • Critical Research analysis using an apriori
    posited theory.

37
Editorial or Analytic Papers
  • Editorials
  • Essays (history, patient care, poems, travel,
    bios
  • Case Reports
  • Quality Improvement
  • Letters
  • Book Reviews
  • Reviews Narrative or Meta-analysis.
  • Academia and Clinic
  • Clinical Guidelines and Position Papers
  • Health Policy

Usually solicited or submitted by an
institution.
38
V Assembling the Whole Paper
Step 1, 2, 3 Consult Oracle.
39
VI The Whole Paper
  • Title
  • IDs
  • Keywords
  • Abstract
  • Introduction
  • Methods
  • Results
  • Discussion
  • References

40
International Committee of Medical Journal
EditorsUniform Requirements for Manuscripts
Submitted to Biomedical Journals
  • This is The Oracle.
  • Seek. http//www.icmje.org/
  • Bookmark.
  • Obey.
  • Violators will be punished.

Each Journals Instructions for Authors must also
be read carefully.
41
Getting Past Writers 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 passionthe scientific form comes
    during editing.

42
Title and Search Terms
  • Titles
  • Search Terms
  • Avoid cute titles for academic publications.
  • Avoid claims in your titles A revolutionary
    advance in living wills.
  • Keep them short.
  • Journal titles should avoid subtitles. Brain
    Death New Perspectives
  • Dont bury your work alive!
  • If keywords are requested, use Medline, MeSH
    keywords.
  • Do not dream up your own.
  • It is always OK to suggest search terms to the
    editor with the MSS.

43
Methods
Introduction
  • Hypothesis
  • Sample selection
  • Power calculation
  • Variables, measurement tools, and instruments.
  • Statistical tests and/ relevant software.
  • On line data appendices.
  • In short, everything someone would need to
    duplicate your work.
  • Set the context.
  • Be succinct not a review.
  • Define the starting point for your work.
  • State what you are out to do (or find).
  • State why it matters.

44
Results
Content
  • Etiquette
  • The sequential application of your method.
  • Sample collection, exclusions, final population.
  • Standardization.
  • Comparisons
  • Graphics
  • No analysis! (Save it for the discussion.)
  • No reference to past studies (especially your
    own).

45
Vb Graphics
  • Charts and Tables

The purpose of graphics is to communicate a
point, not to display data!
46
The US health care system is expensive.
Graphs should tell an instant story This one
does.
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.
47
Graphs should tell an instant story This one
doesnt.
? Out Of Pocket drug costs ? compliance.
Health Aff 20082789-102
Bubble Size non compliant with meds
48
Tables
  • Keep them simple with common terms and clear
    conclusions.
  • If a reviewer cant grasp it quickly, a reader
    wont.
  • 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
try to publish this table!
49
Avoid Chart Junk
50
Avoid Chart Junk
51
Use Honest Charting
Worse
Better
Months
Months
Actual chart from a drug company study showing
how a drug improved dementia scores.
52
300,000
600,000
900,000
600,000
300,000
900,000
53
Mixed Graphics
54
The Greatest Chart Ever Made!
Temperature during retreat
55
Disparities in Pain Treatment
Getting Pain Med in ER for Long Bone Fracture
Ann Emerg Med 200035116. Retrospective cohort
study of patients single ED in GA.
56
Avoid Multidimensional Distortion
  • Notice how increasing size to get to changes
    volume so that man appears 4x as large rather
    than 2x as large.

57
Discussion
  • Etiquette
  • Content
  • Minimize self citation (It even annoys
    reviewers).
  • Do not repeat data or introduction.
  • Discuss what you add to the (previously stated)
    context).
  • State the limitations.
  • Discuss its utility, importance, value.
  • Discuss future research that might confirm or
    elaborate on this work.

58
Write the Abstract Last!
Evolution of tropomyosin functional domains
differential splicing and genomic constraints. We
have cloned and determined the nucleotide
sequence of a complementary DNA (cDNA) encoded by
a newly isolated human tropomyosin gene and
expressed in liver. Using the least-square 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 of exons 6
and 9 indicates that functional pressure was
exerted on these sequences, probably by an
interaction with proteins in skeletal muscle and
perhaps also in smooth muscle such a constraint
was not detected in the sequences obtained from
nonmuscle cells. These results 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 different kinds of
functional pressure were exerted on a single
gene, resulting in different evolutionary rates
and different convergences in 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)
  • Dont take poison.
  • Unfortunately, many abstracts disagree with the
    text of the article.
  • Avoid non-therapeutic amputations.
  • Abstracts are the online content of your article.
  • Follow length rules!

59
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.

60
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.

61
Murder your darlings. 
  • Style is notcan never beextraneous Ornament.
  • Whenever you feel an impulse to perpetrate a
    piece of exceptionally fine writing, obey
    itwhole-heartedlyand delete it before sending
    your manuscript to press. Murder your darlings.
  • Sir Arthur Quiller-Couch  
  • On the Art of Writing. 1916.

62
A Grammar Checker wont 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

63
Read Your Paper Aloud
64
Writing Tips
  • Average sentence lt 15 - 20 words.
  • Paragraph
  • 40 - 70 words
  • 3 - 7 sentences

65
Pick a topic
  • New technologies have transformed the body from
    primarily a source of labor to a seemingly
    endless source of scientific data. Researchers
    desire access to tissue samples and DNA from
    many people. This change in the utilization
    use of tissue samples has been prompted by gene
    patenting and the commercial development of
    genetic screening tests. These activities have
    given rise to concerns about control and
    ownership of genetic information. Genetic
    research can lead to important personalized
    information regarding targeted diagnoses and
    treatments, reduced variability in outcomes,
    maximized efficacy and minimized adverse effects.
    Individuals should have the right to access all
    information that is generated from the use of
    their tissue samples for research.

66
 Do not create unfulfilled expectations. Cover
each point in your list.
  • The use of unmanned aerial drones by the US
    military and CIA to execute alleged enemies of
    the US is unethical, unconstitutional, and
    undermines its credibility as a source of global
    leadership, justice, and integrity.
  • Myriads DNA-sequencing techniques tied to the
    BRCA gene patents are outdated, slow, and costly.
  • Mandated insurance coverage for services related
    to Autism Spectrum Disorder (ASD) is the duty of
    any society that values the lives of children.  

67
One idea per paragraph
  • Health information exchange can succeed without
    resorting to a single medical identifier.
    Alternative approaches put patients in control of
    their own medical records. Patients own their
    healthcare data and are at the center of requests
    to link or release it. This requires patients to
    be actively engaged. Just as use of a patients
    healthcare data without their permission is
    unacceptable, so too is patient apathy toward how
    their healthcare data is used. We put our trust
    in our medical professionals. We do not turn over
    control of our rights or responsibilities when we
    engage the healthcare system. Unique medical ids
    make it easier for healthcare organizations,
    insurance and government agencies to forget that
    an individual person is behind every piece of
    medical information. Certainly many will permit
    the use of their data for research, or prefer,
    for example, that any provider can access their
    records in an emergency. In all cases, patients
    should set the rules about what information
    should be shared and under what circumstances.
    Proponents correctly claim that a UPI would make
    data exchange easier. A patients right to
    privacy is more important than the convenience of
    the healthcare industry.

68
Add specificity
  • The result is that one in three people killed by
    a U.S. drone in Pakistan has been a civilian,
    with at least 1700 dead (a conservative
    estimate).
  • According to the Defense Department, 17,000
    civilians have died in U.S. drone attacks in
    Pakistan conservatively a third of drone
    casualities.

69
Give context to your issue without opening an
entire field.
  • Patent law defines that products of nature are
    beyond the scope of a patentable subject matter.
    Court decisions to allow patents for individual
    genes primarily cite the technique by which genes
    are discovered. Those who favor gene patents
    insist that by purifying translational exons by
    cdna, this alters the naturally occurring gene
    enough to give companies the right to profit from
    a commercial sequencing test. This reasoning is
    flawed in that the screening test that results by
    this method not detect purified genes in
    patients. It detects naturally occurring
    mutations. The natural mutation invalidates the
    patent.

70
Fact check every assertion.
  • Private payer or well-insured patients have
    access to a coveted awareness of gene mutations
    to guide early intervention. The class of
    patients tied to state coverage or without
    insurance altogether is deprived of this
    potentially life-saving knowledge.

71
Do not build an argument of rhetorical questions.
  • Is it fair that one physician is paid differently
    for the same work because of where he chooses to
    practice? Wouldnt it be more just to pay the
    Mexican physician who earns 50,000 annually the
    same as the US physician who earns 250,000? Is
    it fair that a physician is compensated for a
    presentation based on what they earn for treating
    patients? Wouldnt there be greater confidence
    and trust if patients knew that physicians were
    earning less for collaborating with industry than
    in practice? Wouldnt this be proof of the
    physicians belief in the quality of the product?

72
Ungrounded moral exhortation is not an argument.
  • x is the duty of any society that values the
    lives of children.
  • overlooks the moral imperatives of society to
    care for the needs of citizens.
  • a denial of basic human rights to a population
    incapable of safeguarding those rights for
    itself .  

73
Hot rhetoric weakens a paper.
  • The current protection of intellectual property
    has manifested a monster which is impossible to
    overcome without radical changes in the current
    patenting system.
  • I am appalled. I am beyond appalled.  

74
Hot rhetoric weakens a paper.
  • fertile females are pumped full of extra
    hormones over the course of a month to develop
    and mature an unnatural number of eggs for
    harvesting. The eggs are then removed during an
    outpatient procedure and the donor is sent on
    their merry way to heal and recover from the
    physically traumatic process. Donors include
    young college girls who typically are strapped
    for cash and are easily influenced by the
    disguise of a good deed. Unbeknownst to most of
    them, however, they are being used and
    manipulated by desperate and rich infertile,
    wannabe parents. Young girls are being enticed by
    thousands of dollars to volunteer their bodies to
    unnaturally cultivate mature eggs for the benefit
    of the payer. This for-profit business operates
    under the mask of helping others start families
    and is highly devious.

75
Reduce wordiness.
  • Patent law defines that products of nature are
    beyond the scope of a patentable subject matter.
  • Court decisions to allow patents for individual
    genes primarily cite the technique by which genes
    are discovered.
  • Products of nature are not patentable.
  • Genetic patents primarily protect the technique
    by which genes are identified.

76
Reduce wordiness
  • Also, while it is true
  • It is a fact that
  • To me,
  • It is my opinion that
  • Modern science shows

77
Use pronouns to shorten text.
  • It is quite possible the patient or research
    participant will disregard all or a portion of
    the presented information, which is often
    technical and complicated.
  • They might disregard some or all of the presented
    technical and complicated information.

But keep track of them.
  • Unique medical IDs make it easier for healthcare
    organizations, insurance and government agencies
    to forget that an individual person is behind
    every piece of medical information. Certainly
    many will permit the use of their data for
    research, or prefer, for example, that any
    provider can access their records in an
    emergency.

78
BACK UP
79
The BIG Manuscript
  • Books and Theses

80
Coherence, Balance, Organization
  • Story Boards
  • Outlines
  • Dynamic Tables of Contents
  • Subdocument for each page.

81
Anthologizing and Spinoffs
Collect articles by you or others for an
anthology, add commentary, etc
Restructure and update chapters for publication
82
VII Submitting your Paper
83
The Cover Letter is a Job Application for Your
Paper!
  • One page TOPS.
  • 2-3 sentence synopsis, 50 words TOPS (not the
    abstract).
  • This submission is
  • Perfect for your readers.
  • Perfect for your brand.
  • Mandatory content from the Oracle (ICJME).

84
Thy Chatty and Friendly Cover Letter!
Promises
  • This is not being considered by any other
    journal.
  • This paper has not been previously submitted to
    your journal (or if it has why you have the gall
    to resubmit).
  • No conflicts of interest or they are disclosed
    per your policy.
  • The cover letter should be friendly and
    colleagial, not stuffy and pretentious. Business
    casual.
  • It should pique interest, show professionalism
    and invite a conversation.

85
Suggesting Reviewers
  • Quality of peer review is comparably high.
  • Acceptance recommendations are higher.
  • Avoid conflicts of interest.
  • Not your institution, teacher, etc.
  • J Peds 2007151202-5.
  • JAMA 2006295314-7.

86
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.

87
  • To Journal of Family Practice
  • Re Torture Survivors Screening, Assessing,
    Referring
  • Steven H. Miles MD (corresponding author)
  • Dear Dr. Sussman,  
  • The enclosed article is the only article that I
    am aware of that comprehensively discusses the
    role of the primary care physician in identifying
    and referring torture survivors. There are about
    as many torture survivors in the United States as
    persons with Parkinsons disease. Accordingly,
    even physicians who do not undertake the
    treatment of such persons should be familiar with
    case finding and referral.
  • The enclosed work is a collaboration. I am a
    practicing general internist with extensive
    academic experience with the issue of global
    torture, have worked in high torture prevalence
    field assignments and serve as an unpaid board
    member of the Center for Victims of Torture, a
    501c3 organization based in Minneapolis. My
    coauthor (RG-P), who fully meets ICJME criteria
    for coauthorship (substantial contribution to
    conception , content, and design, and analysis
    revising critically for important intellectual
    content and approving the submitted version) is
    a licensed PhD psychologist with extensive
    experience treating torture survivors. This
    academic and clinical collaboration particularly
    suits a topic like torture where the studies are
    internationally scattered and clinical practice
    guidelines remain ill-defined.
  • There are no financial conflicts of interest
    bearing on this paper. The paper was
    independently written and was not subject to
    oversight or approval of anybody or any
    institution. There are no ghost authors.
  • This paper has not been published in any venue
    and is not under consideration by any other
    journal. It has been presented as a Medical Grand
    Rounds at the University of Minnesota.
  • Should you wish, I do have a PowerPoint slide set
    of this material and can offer a stable link to
    this slide set at my faculty page at the
    University of Minnesota.
  • Sincerely,  Steven H. Miles, MD

88
Assignment II Write A Cover Letter
  • Address it to a particular named professional
    publication.
  • It should conform to that journals Instructions
    to Authors.
  • Dream up the content of the article that you are
    submitting with it.
  • It should conform to all of the instructions in
    this section of the course.

89
VIII Dealing with Rejection
90
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."
Dont take it personally.
91
Why do papers get rejected?
  • Paper factors
  • Out of date.
  • Dont procrastinate.
  • Flawed lit search.
  • Flawed methods.
  • Flawed writing.
  • Grumpy reviewers are not friendly.
  • No passion.
  • Nor are bored reviewers.
  • Journal factors
  • So many submissions
  • -- so little space.
  • Just published on this.
  • Not our audience/issue.
  • Bad luck with reviewer/editor.

92
Dealing with Rejection
  • Is it really a rejection? (Some are, We cant
    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 journals audience?
  • Papers in minor journals can have MAJOR influence.

93
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 journals audience?

94
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.

95
IX Acceptance (is not the final stage.)
96
Acceptance is an Emergency!
  • Answer queries and complete various forms on same
    day if possible.
  • Your paper may be timelye.g., delay can harm its
    inclusion in a special issue.
  • Then relax!

97
After the Publication Connecting your passion
to an audience to make things happen.
  • Scientific Meetings
  • Academic Lectures
  • Follow-up confirmatory or outcome papers.
  • Legislative testimony
  • Community Education
  • Op-ed pieces
  • Legal work

98
IX Building a Career with your Academic Papers
99
Build Your Brand ( Career)
Your Expertise Publish at least three times on
any topic. Present at public meetings. Peer
Reviewopenly.
Your Name Use the same name initials on all
work. Allow editors to print your email address
(get asked out). Allow editors to use you as a
reviewer.
100
Readings
  • International Council of Medical Journal Editors
    http//www.icmje.org/
  • Holmes DR Jr, et al. Manuscript preparation and
    publication. Circulation. 2009120(10)906-13.
  • Turka LA. J. After Further Review. J Clin.
    Invest. 20091191057.
  • 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 20012861232-4.
  • Angell M, Relman AS. Redundant publication. New
    Engl J Med 19893201212-4.

101
Slides available on request.
  • Steven H. Miles, MD
  • University of Minnesota
  • miles001_at_umn.edu
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