Received: 6 April 2020 Revised: 29 April 2020 Accepted: 14 May 2020

DOI: 10.1002/jca.21797

CONCISE REVIEW

How to write a manuscript for peer review

Robert Weinstein

Department of Medicine, University of

Massachusetts Medical School, Worcester,
Massachusetts, USA
Correspondence
Robert Weinstein, Professor Emeritus,
Department of Medicine, University of
Massachusetts Medical School, 1020
Avery Meadows Way, DeLand, FL, USA.
Email: robert.weinstein@umassmed.edu
Abstract
Writing a manuscript for peer review is an art for which little formal prepara-
tion is provided during the education of physicians, scientists, and allied health
professionals. At the same time, publishing their work may be central to their
career ambitions. This article provides an explanation of the purpose and
expected content of the components of a peer review manuscript and advice
regarding how to go about writing one. It aims to somewhat demystify the pro-
cess of scientific writing and render it accessible to more members of the
American Society for Apheresis.

KEYWORDS
apheresis, plasmapheresis, publication, scholarly writing, scientific article

1 | INTRODU CTORY COMME NT S particularly helpful. The online “Author Guidelines” of

In 1999, the Journal of Clinical Apheresis published an
article that offered advice on how to write an abstract.1
The article stressed the importance of clear economical
writing, avoidance of redundancies, and a clear focus on
the take-home message meant to be conveyed. It also
offered tips on preparing and delivering a successful pre-
sentation of the abstract. The advice included tips on
how to format 35 mm presentation slides (it was 1999,
after all) how to use a laser pointer to maximum effect
and more. The contents of that article are, for the most
part, still relevant today and I recommend it to the
reader. But, those among us who have endeavored to
shinny up the greased pole of academic advancement
know that for over 300 years the generally accepted unit
of productivity is not the abstract, but rather is the peer
review manuscript.2,3
This article provides instruction and advice regarding
how to write a manuscript for submission to a peer
review journal following the IMRAD (Introduction,
Methods, Results, and Discussion) structure that has
been a standard in scientific and medical journals since
the middle of the last century.4 Given the paucity of for-
mal training they receive in this regard, junior faculty
and allied health professionals may find this information
the Journal of Clinical Apheresis will be used to provide
examples as needed.5 The opinions expressed will, natu-
rally, reflect the experience and biases of the author, but
there is an abundance of information, both online and in
print, to which the reader may refer.2-4,6-9
The information herein will be presented in three sec-
tions. First, will be a description of the various compo-
nents of an IMRAD manuscript, and the other
manuscript components that are typically required,5 with
comments regarding how to optimize their effectiveness.
This will be followed by suggestions regarding the order
in which a burgeoning young author may wish to write
the component parts of an IMRAD manuscript. The final
section will comprise the author's advice regarding how
to avoid common mistakes that may antagonize
reviewers and readers alike and are likely to imperil the
manuscript's acceptance for publication.
2 | THE G ROSS ANATOMY O F A
PEER REVIEW MANUSCRIPT
This description of the component parts of a manuscript
will follow the order in which they appear in the manu-
script.5 This is not meant to imply that they are actually

358 © 2020 Wiley Periodicals, Inc. wileyonlinelibrary.com/journal/jca J Clin Apher. 2020;35:358–366.

WEINSTEIN
written in the order in which they will eventually appear.
Comments on the order in which components of a manu-
script may be written are given in a subsequent section
below.
2.1 | Title page
The title page is akin to the face sheet of a hospital chart.
The identifiers, demographics, and other data contained
therein establish a unique record of your manuscript. As
with all elements of the manuscript, be sure to follow the
Guidelines or Instructions for Authors of the particular
peer review journal to which you intend to submit it. The
most important discretionary item on the title page is the
actual title of the manuscript. The old adage “You never
get a second chance to make a first impression” (attrib-
uted without evidence to both Oscar Wilde and Will Rog-
ers!) is completely germane here. The title you choose for
your manuscript will influence the reader's level of inter-
est in what you have written (the editor and reviewers
being the first readers).6 A succinct, informative title that
truly reflects the content of the manuscript is most likely
to make that good first impression, especially if it is
clearly written without relying on technical jargon and
abbreviations. The editor's or reviewers' specific areas of
specialty may not be the same as yours. Help them to
understand and appreciate what you are writing about.
Consider an example: Every spring you are called to
treat multiple patients with acute Guillain-Barré syn-
drome, for whom you employ the standard plasma
exchange regimen popularized by the North American
Guillain-Barré Study Group trial.10 You observe that a
standardized modification of that classic regimen results
in a superior outcome in the majority of your patients.
You submit your case series to the Journal of Clinical
Apheresis. A title that says:
“Plasma exchange in acute Guillain-Barré
syndrome: a case series”
is unlikely to generate any excitement. Any reader of the
ASFA Guidelines11 is already completely familiar with
the use of plasma exchange in this condition. On the
other hand, a title such as:
“An alternative schedule of plasma exchange
therapy results in improved outcomes in
patients who present with severe Guillain-
Barré syndrome”
alerts readers to the possibility of achieving superior out-
comes compared to what they usually expect, and offers
359
the dividend of a new way to schedule plasma exchange
in the disease. The title is succinct, informs the readers of
what is to be found in the manuscript, and offers claims
that are upheld by the data to be presented.
Other items on the title page include the names of the
authors, their departmental and institutional affiliations
and the institution where the work was done.5 Again,
consult the Author Guidelines regarding how this infor-
mation is to be presented on the title page (eg, given
names vs first initial, whether to include professional
and/or academic credentials, whether to list departments
as well as institutions). The title page will also include
the name and full contact information of the author to
whom correspondence regarding the manuscript is to be
addressed. Finally, the title page will include a short form
of the title of the manuscript, referred to as the “running
head” and consisting of 40 characters, including spaces,
for internal use by the publisher. For the manuscript
described in the example above, the running head might
be Treatment schedule for Guillian-Barré which consists
of 37 characters.
2.2 | Abstract
The purpose of the abstract is to concisely tell prospective
readers what you did and which of your findings were
important.6 The structure of an effective abstract, and an
effective approach to writing it, have been described else-
where.1 The Journal of Clinical Apheresis allows 150
words for a single paragraph, unstructured abstract or
250 words for a structured abstract (with its own Intro-
duction, Methods, Results, and Conclusion).5 The
abstract should be a focused, accurate and short descrip-
tion of your work. It should allow the reader to under-
stand what you did and found without reading the entire
manuscript. Give key results while minimizing experi-
mental details. Be sure to clearly present the “two
whats”: what has been done and what are the main find-
ings.6 An abstract that is clearly written, devoid of jargon
and uncommon abbreviations, interesting and easily
understood will pique the interest of reviewers and other
readers
2.3 | Key words
The major indexing services such as Medline, Google
Scholar, and so on, will use the words of your manu-
script's title (not the prepositions) for identifying the sub-
ject matter of your article in a search. Many journals ask
for an additional 3 to 6 key (indexing) words or phrases
that do not appear in the title. These may be listed on the
360
bottom of the abstract page. Some journals may ask for
them on the title page. For example, additional (beyond
those in the title) key words for the manuscript on treat-
ment of acute Guillain-Barré syndrome mentioned above
may include plasmapheresis, apheresis, and demyelinating
polyneuropathies, AIDP. Note that abbreviations are not
to be used as key words unless they are widely recognized
in the relevant field.
2.4 | The introduction
The actual text of a manuscript in the IMRAD format
begins with the introduction. The purpose of the intro-
duction is to orient the reader to the field in which your
work lies and, in particular, to the problem or knowledge
gap that your work addresses. It is also an opportunity to
engage the reader, and should provide sufficient informa-
tion such that an educated reader, but not a specialist in
your field, can understand and follow the logic of your
article.12 It is not meant to be a comprehensive review of
the field. This cannot be overstated: the introduction is
not meant to be a review article. An overly long introduc-
tion, that reviews extraneous information, citing too
many extraneous references will annoy the reader and
may frustrate a reviewer. An appropriately focused intro-
duction will usually consist of up to three paragraphs on
one page (what is the state of the field? What knowledge
gap will your study help to fill? What is the hypothesis to
be tested and what questions will your work answer?).3
The extent to which your introduction reviews a field
should be limited to what is necessary to explain where
your study fits in. Help the reader to be oriented to the
field in which you are working, to identify the problem
you are trying to fix, and to understand how your
methods and results purport to accomplish this. Please
note that in writing the text of an IMRAD manuscript
first person pronouns (eg, I, me, we, us, etc.) are gener-
ally to be avoided, although they may be used in the
Methods section.4
2.5 | The methods
The purpose of a properly documented methods section
is twofold. It provides sufficient details of your experi-
mental methods, and your statistical analyses (where rel-
evant) such that the reader can ascertain whether your
reported results and conclusions are supported by the
means employed to obtain them. Furthermore, the
methods section enables others to replicate your study
and, one hopes, to confirm your results. Thus, you must
make clear your study design, your means of data
WEINSTEIN
collection, the measurements used, and the principles
upon which you analyzed your data.3 If yours is a clinical
study involving patients or volunteers you must docu-
ment approval by your Institutional Review Board (or
Ethical Committee) and indicate whether informed con-
sent was obtained.13
Methods are generally described in the past tense. It
is best to use simple declarative sentences, rather than
complex compound sentences. New or unfamiliar
methods should be described in sufficient detail for a
reader to understand what was done, but established
methods can be mentioned and referenced. Similarly,
familiar reagents and materials (TRIS-buffered saline,
fresh frozen plasma) can be identified by their well-
known names without describing how they are made.
Reagents, instruments or specialized equipment should
be identified by name, vendor and the vendor's location
for example, “Plasma exchange procedures were per-
formed using a Spectra Optia Apheresis System (Terumo
BCT, Lakewood, Colorado). Colloid replacement con-
sisted of human serum albumin (5% solution, AlbuRx 5,
CSL Behring, Kankakee, Illinois).” If reporting a clinical
study, provide details of the study population (age, gen-
der, other relevant demographic information), the clini-
cal protocol, inclusion and exclusion criteria, and so on
in detail.14 The rationale or basis for the experimental
observations and procedures should be briefly stated. If
necessary they can be further illuminated in the discus-
sion section.
2.6 | The results
The results section is where your data are presented in a
straightforward manner, but it is not a place for com-
menting on your data or comparing them with data
reported by other authors. That would be done in the dis-
cussion section. There should be no need for citing refer-
ences in the results section. In many cases you would
have already formulated figures and tables for when you
presented your data in abstract form. The results section
text is not for the purpose of recapitulating what appears
in tables and figures, but for summarizing them and
describing how data variables relate to each other.15 For
example: “As shown in Table 1 the patient population
included equivalent numbers of men and women and
their age ranges were similar.” The actual data and, if
appropriate, a statistical test value (eg, P value) would be
provided in the table. Another example: “Patients in the
group receiving plasma exchange exhibited improved
functional scores within 48 hours of their first treatment,
while the group receiving best supportive care continued
to deteriorate for another 7-8 days (Figure 3).” When
WEINSTEIN
describing data in the results section it is acceptable to
summarize in terms of percent when n > 50 but not if
smaller numbers are being described (ie, it is acceptable
to say 60% of study subjects responded when 80 study
subjects were in the study, but it is most appropriate to
say 3 of 5 rather than 60% when describing small num-
bers).4 It is important to bear in mind that only data that
speak directly to the hypothesis you are testing or the
observations you are describing will appear in a table or
figure and be described in your results section. Secondary
data can be submitted as “supporting materials” that will
be made available online by the journal.
2.7 | The discussion
The discussion section is where you explain what the
results of your study mean.16 How do your results expand
knowledge in the field? What knowledge gap do they
help to fill? Can the data described in the results section
be explained in terms of cause and effect? The discussion
section will ordinarily begin with a simple qualitative
statement of the key findings described in the results sec-
tion and indicate whether and how they comport with
the issues raised in the introduction.4,6,16 It should not
begin with a repeat of the data presented in the results
section, but rather with explanatory summary state-
ments. In the example used above of a study of the sched-
uling of plasma exchange therapy in severe acute
Guillain-Barré syndrome, you would not begin the dis-
cussion with “In our study, 40% of the control group
required mechanical ventilation compared to 15% of the
experimental group, and the control group required, on
average, 19 more days of hospitalization than the experi-
mental group…” which is simply a repeat of the results.
As an alternative, use an explicatory statement such as
“In our study, patients receiving a modified schedule of
plasma exchange required less frequent mechanical ven-
tilation, had shorter hospital stays, and more rapidly
improved on the modified Hughes scale than did the
group treated on a conventional schedule.” The latter is a
clear statement of the major findings of the study. The
discussion should state the major findings and explain
why they are important. It should relate them to the find-
ings of similar studies, whether they agree or disagree
with yours, thus indicating where your study fits into the
literature in the field. If there are discrepancies between
your study and those of others, try to explain why. It is
not necessary to provide an exhaustive commentary on
every study in the field. Better to focus on those that are
most pertinent to yours. The discussion section is not
meant to be a review of the literature. Perhaps there are
alternative explanations for your findings and you should
361
consider them as well as your preferred explanation. You
should make note of the limitations of your study and
briefly and fairly discuss them. This may lead you to sug-
gest further research.
It is very important to refrain from extrapolating your
results and their importance beyond what the actual data
support. Do not exaggerate the importance of your work.
Again, stay within the data. If the journal to which you
plan to submit your manuscript does not include a sepa-
rate conclusion section in the manuscript structure, you
can use a final short (1-3 sentences) paragraph of the dis-
cussion for the conclusion. Otherwise save it for the con-
clusion section.
2.8 | The conclusion
If so stipulated, the conclusion is a small, final para-
graph in which is presented a clear and concise take-
home message.3 It can consist of as little as one, but usu-
ally no more than three sentences. It does not repeat the
broader concepts of the discussion, but clearly states
what your data have taught. Going back to our example:
“A modified schedule of plasma exchange therapy
appears to improve the outcome of patients who present
with severe, acute Guillain-Barré syndrome. Further
studies regarding refinement of the schedule to reduce
the likelihood of relapse appear warranted.” Note the
contrition inherent in the wording of the conclusion. In
the absence of a high-quality randomized controlled
trial, observational studies, case series and the like can-
not provide proof of cause and effect. It is better to
exhibit a humble understanding of the impact of your
data than to present an over-inflated picture of it. Note
also that had this conclusion been written for a journal
that did not include a dedicated conclusion section, it
would have appeared as a final paragraph in the discus-
sion section and would have begun “In conclusion, a
modified schedule…”
2.9 | The references
The reference list begins on a separate page from the text
of the manuscript. If the text was double-spaced, main-
tain the same for the reference list. References are typi-
cally cited by number as they appear in the text of an
IMRAD manuscript, although some publications still
require the references to be listed alphabetically by the
last name of the first author and cited in the text as Name
(year of publication). The Journal of Clinical Apheresis
uses the former system. The format of the references
listed is as specified in the manual for authors, editors,
362
and publishers of the Council of Science Editors.17 The
Author Guidelines of most journals will give detailed
instructions for their preferred formatting of the list of
references. Authors may choose to manage their refer-
ences using reference management software packages,
many of which may be available for free.18 These provide
a convenient way to organize and update your reference
library and the references you are citing in a manuscript.
If you are affiliated with a university, school of medicine
or nursing, or large hospital such software may be made
available through your library.
2.10 | Legends to figures
Each figure in the manuscript must be accompanied by a
descriptive legend that explains the figure sufficiently to
be understood independent of the manuscript text. Pic-
ture a busy reader who is thumbing through your printed
article, reading the title, skimming the abstract, and then
focusing on the figures and their legends to understand
your points. The legends are submitted, double spaced if
so specified, beginning on a separate page following the
references.6 Take care in writing the figure legends to
clearly and accurately define all axes, symbols and lines,
and statistical tests used. Each legend may begin with a
phrase that provides an effective title for the figure. For
example, the legend for a line graph that depicts the
change in modified Hughes score over time of the
patients in our Guillain-Barré syndrome manuscript
might begin “Figure 1. Change in modified Hughes score
with plasma exchange using the standard or the modified
schedule.” On the other hand, to be a bit less boring the
legend could begin “Figure 1. Modified Hughes scores
improve faster in patients receiving plasma exchange
according to the modified schedule.” In either case, the
legend would go on to explain that modified Hughes
score is given on the y-axis and the day it was measured
denoted on the x-axis. Patients treated according to the
standard schedule of plasma exchange are represented by
filled circles and the solid line; patients treated on the
modified schedule are represented by open circles and
the dashed line, and so on.
2.11 | Tables and figures
Tables should be presented, each on a separate manu-
script page, beginning after the Legends to Figures.5 They
should be self-explanatory, numbered with Roman
numerals in the order they will appear in the printed arti-
cle, and should have a title. Tables present data and
therefore their content should not be duplicated in the
WEINSTEIN
text (ie, results section). Figures are presented, each on a
separate manuscript page, following the tables. They
should be numbered according to the order of their
appearance in the printed article, but with Arabic rather
than Roman numerals. Axis labels, tick labels and other
lettering should be rendered using a 20 to 24-point sans-
serif font such as Arial, Arial Narrow, or Helvetica. In
general, tables are used to present data in an organized
way that facilitates the understanding of the data by the
reader. They should have very clearly marked columns
and rows, and, if needed, clearly labeled footnotes such
that the table is understandable independent of a reading
of the text of the manuscript. Figures are generally used
to compare data derived from different treatments or to
provide a visual representation of changes in values over
time. The actual design of tables and figures is beyond
the scope of this article. The reader is referred to refer-
ence #6.
3 | WRITING THE MANUSCRIPT:
OV E R C OM IN G W R I T ER 'S B L OC K
To experienced authors and novices alike, perhaps noth-
ing is more intimidating than the blank white screen and
blinking cursor that appear when creating a new docu-
ment in a word processing program. For some, that white
screen may as well be a brick wall. The most difficult part
of writing a manuscript is to begin, but knowledge of
how or where to begin is often elusive. Hence, it is best to
not begin at the beginning.6,16
What follows are recommendations for the actual
writing of the manuscript. The order in which the com-
ponents described above are written represents a strate-
gic approach to overcoming writer's block.15 In writing
a first draft of the various components it is acceptable to
be less concerned with grammar, spelling, and other
structural formalities than you will be in the finished
manuscript.3 The most important thing at this early
stage is to start expressing your ideas in writing, how-
ever informally. Capture in writing your thoughts
regarding the various manuscript components. You will
eventually transform your manuscript into a finished
product, but it is much easier to edit that which is
already written than to struggle to write it perfectly at
the first attempt.
Before we proceed, I offer a caveat: be certain that
you are familiar with the relevant literature. You cannot
know how your work addresses a gap in knowledge and
contributes to the field without knowing what the field
consists of. If your literature review is incomplete by the
time you sit down in front of that computer screen, stop
what you are doing and review the literature!
WEINSTEIN
3.1 | Start your manuscript with the
tables and figures
The most comfortable starting point is that with which
you are most familiar: your data. In fact, you may have
already presented your work as an abstract at the annual
meeting and have therefore already created tables and
figures that you can adapt for use in your manuscript. If
you have gathered additional data since your abstract
presentation, or have performed additional related stud-
ies or experiments, you may need to modify your figures
and tables accordingly or even create new ones. Just be
certain to determine whether or how the added data
require that you modify your conclusions regarding the
meaning of your work. The table titles and footnotes
should be written such that the tables are self-explana-
tory. You can then write the figure legends, with the first
sentence of each serving as a title to the figure (as
described above).
3.2 | Continue with the methods section
Having created the tables and figures that constitute your
data, return to the blank white screen and write the
methods section. Writing the methods requires persis-
tence and discipline but not much creativity or imagina-
tion. You can just plod through it. But be detailed and
thorough. Remember that standard, well-known methods
can be mentioned and referenced, but new or nonstan-
dard methods must be described in sufficient detail for
others to replicate them. Present your methods in the
order in which you intend to present your results. For a
clinical study you would ordinarily begin with a descrip-
tion of how study subjects were identified, inclusion and
exclusion criteria, whether Institutional Review Board
approval was required, and so on. Information about the
number of subjects screened, reasons for rejecting some,
and final number enrolled will be given in the results sec-
tion. Demographic and other basic information about the
study subjects will be given in Table 1, which will appear
in the results section.
3.3 | Move on to the results section
Having organized the data into tables and figures, and
having laid out your methods in a logical order, now
describe what you found in the course of your study. The
results should be reported in the order in which the
methods used to obtain them were reported. The order
should be logical with the most important and impactful
findings presented first, then follow with the supportive
363
findings. Remember that data of truly secondary impor-
tance that are not really required to make your point can
be submitted as supplementary material (example: a table
that summarizes the entire hospital course of each of
your study subjects need not be included in the results
section. It would be more appropriate to submit it as sup-
plementary material). Use subheadings in the results sec-
tion as needed to group similar types of results. This
makes them easier to read and understand, and the
reviewers will be appreciative. As rule of thumb, refer-
ences are not cited in the results section. You are pre-
senting your data here, not the results obtained in studies
performed by others. These citations would appear in the
discussion section.
3.4 | Now you are ready for the
discussion section
If you have done a proper job with the tables and figures,
methods, and results, you are now able to explain the
meaning and importance of your work and compare it to
the work of others. The work on your manuscript that
you have done by this point will likely have shattered the
writer's block that had been standing in your way. It
should be possible for you to write the discussion section
beginning with a statement of what your work has dem-
onstrated (remember, this is not meant as a repeat of data
in the results section but rather is a statement summariz-
ing what those results mean). Discuss your results and
compare them to the published work of others. See “The
discussion” above. Either end the discussion with a very
short paragraph that states your take-home message as a
conclusion, or package the take-home message in a sepa-
rate conclusion section that follows the discussion section
(see above).
3.5 | At this point write an engaging
introduction
Having come this far you should be able to present your
project as a means to fill a gap in knowledge or as a way to
answer a question. Remember to make clear the hypothesis
tested and the objectives pursued. When you have written
all the IMRAD components you can carefully go through
the manuscript to put in the reference citations.
3.6 | Finally, write the abstract and title
You may already have the text of an abstract from a pre-
sentation at the annual meeting. Will it suffice or does it
364
require editing to conform with the Guidelines for
Authors of the journal or to account for new data? By
writing the title last, you can profit from having a
coherent manuscript, which you are now in a position
to describe in a title of 1 to 2 sentences.
4 | A V O ID I N G C O M M O N
MIS TAKES
4.1 | Do not ignore the Author Guidelines
Having your manuscript rejected outright because it vio-
lates the Author Guidelines is frustrating and shameful
but also completely preventable. Take the Author Guide-
lines seriously. The editors and publishers do. Pay careful
attention to instructions regarding formatting, word
count or pages allowed, reference citations, article type,
etc. In particular, if your manuscript had previously been
rejected from a different journal, take special care to
assure it now comports with the Author Guidelines for
the journal to which you are now submitting it.
4.2 | Watch your language
The era of text messaging and social media has exposed
the abysmal education in written English received by
American schoolchildren. You're vs your; there vs their
vs they're; “me and him” vs “he and I" and others are
traps into which even ostensibly educated people fall
when attempting to express themselves in writing. While
forgivable in social communications, poor spelling or
grammar make a terrible impression in professional writ-
ten communication. Fluid writing that is correct in spell-
ing and grammar will favorably impress reviewers, help
reviewers to understand the points you are trying to
make, and improve the likelihood of your manuscript
being accepted for publication. A review that begins with
an observation that your manuscript is well-written will
probably end with a recommendation to accept it for
publication (with revision in most cases). Have your
coauthors carefully read your manuscript prior to submit-
ting it. They should all understand each part of it to mean
the same thing. If English is not your first language con-
sider seeking help from a professional editor (best option)
or from a trusted colleague or two who are fluent in
English (or from your cousin who is an undergraduate
English major at university). Get into the habit of regu-
larly reading periodicals that are noteworthy for their
excellent written English. Two that come to mind are the
editorial page of the Wall Street Journal, a daily morning
newspaper that is nationally distributed, and the articles
WEINSTEIN
and columns in The Economist, an English weekly news
magazine that is published as a US edition. The Wall
Street Journal leans center-right and The Economist
leans center-left. You may or may not agree with their
respective points of view, but their written English is
magnificent. They provide wonderful examples of how to
write clearly, correctly, and effectively.
4.3 | Choose the correct typeface
The Author Guidelines for the Journal of Clinical Aphere-
sis state “Your manuscript should be double-spaced and
formatted in 12-point Times New Roman.” A serif typeface
is preferable for text because the serifs guide the eye across
the page and help the reader to stay on the same line of
text. Sans serif fonts, such as Arial or Helvetica are crisp
and easy to read but are preferable for titles or labels (such
as the labels on a graph). Picture a commuter on the New
York City subway, standing in an overcrowded car, very
much like the Statue of Liberty with one hand raised to
hold the overhead handle and the other hand holding a
tightly folded morning newspaper. While the subway car
lurches back and forth, side to side, the commuter is able
to calmly read the microscopic print, column by column,
with perfect comprehension. The serif fonts used by The
Wall Street Journal and The New York Times enable the
reader to do this. The crisp, clean look of a sans serif font
certainly has its own appeal, but it can be somewhat tiring
to read pages of text when a sans serif font is used. The
reviewer may not consciously thank you for using a serif
font, but the easier it is for the reviewer to read through
your manuscript the easier it will be for the reviewer to
understand the points you are making.
4.4 | Get to the point
This cannot be overemphasized. A gratuitously lengthy
introduction or discussion section will distract the reader
from your core message and may irritate reviewers. You
are not writing a review article. Rather you are adding new
knowledge to your field and explaining its significance.
You are trying to make a point. Be mindful of your point
as you write your manuscript and have every aspect of it
be in service to making that point. There is no inherent vir-
tue in lengthiness. Ask yourself “who will want to read all
this twaddle?” A recounting of numerous studies, and cita-
tion of numerous references, that do not relate directly and
importantly to the point of your manuscript will not make
you seem erudite or conversant with the literature. Rather,
it will portray you as insufficiently familiar with the litera-
ture to know what is germane and what is not. A
WEINSTEIN
manuscript written with concision is more likely to make
clear its meaning to reviewers and hence more likely to be
accepted for publication. As Polonius said (Hamlet, Act 2,
Scene 2) “…brevity is the soul of wit…” Polonius was not
true to his words of wisdom, but you should be.
4.5 | Stay within the data
Your job is to explain where your work has added knowl-
edge and why it is important. Do not make claims
beyond what your data really show. Do not engage in
rank speculation about the significance of your data. Do
not extrapolate your data beyond the specific conditions
or patient population to which your study applies.
Reviewers will easily spot puffery and will react nega-
tively to it. It is better to exhibit humility. Your work is
meant to fill a gap in knowledge in your field. Point out
how it does that; do not claim more than you are due.
4.6 | The reviewer is not your enemy
Peer review manuscripts are almost never accepted for
publication without a request for revision. Do not expect
yours to be. Inexperienced authors may react to reviewers'
comments with disappointment or resentment and may
even scoff at them. This is self-defeating. Experienced
authors advise you to skim the reviews and then put them
in a drawer (or a metaphorical drawer) for 2 to 3 days.
Then, when passion has cooled, read the reviews
again.19,20 They will not look as bad. And bear in mind
that even if major revision is requested, your manuscript
has not been rejected. The reviewer's role is twofold: one is
to assess your manuscript for accuracy and clarity, to
assess whether the studies performed and data collected
justify the claims that are made, and to judge the impact
of the work on the field in general. The other is to help the
author strengthen the manuscript so that it is likely to be
accepted in revised form. Think of the reviewer as a con-
sultant and take recommendations seriously, even if you
do not agree with them.19 If the reviewer seems to have
misunderstood aspects of your manuscript it could be that
your writing was unclear. Be conciliatory in your approach
to the reviewer. You cannot go to war with the reviewer
and expect to win. Remember that a reviewer who asks for
major revision would like to see your work accepted.
5 | C O N C L U D IN G C O M M E N T S
Abstracts submitted for presentation at professional or
scientific meetings will be subject to a relatively cursory
365
review by an abstract selection committee and published
as conference proceedings.1,21 But over half of all such
abstracts, and nearly a third of abstracts describing ran-
domized clinical trials, will not be published as full man-
uscripts within 10 years of presentation.21 Among
apheresis-related abstracts presented at the annual meet-
ing of the American Society for Apheresis or AABB
between 2005 and 2012 only 17% eventually emerged as
PubMed-indexed publications by 2016.22,23 Among those
full-length publications almost one in five reported
results inconsistent with the original abstract.24
These facts underscore the ephemeral value of publi-
shed abstracts. The publication of full-length manu-
scripts, in which hypotheses, methods, and results are
reported in much greater detail, and which are subject to
much more stringent review than are submitted
abstracts, is required for claims of new knowledge to be
accepted by our colleagues. And this sharing of knowl-
edge is the higher purpose of the peer-review manuscript.
The information and advice presented herein are meant
to provide tools that junior colleagues can use in the shar-
ing of knowledge and to make them aware that the process
of doing so is accessible to them. There is a great deal of
room in the apheresis literature for their contributions.
ACKNOWLEDGMENT
Dr. Weinstein was Editor-in-Chief of the Journal of Clini-
cal Apheresis from 2004 to 2016.
ORCID
Robert Weinstein https://orcid.org/0000-0003-3895-8401
RE FER EN CES
1. Weinstein R. How to write an abstract and present it at the
annual meeting. J Clin Apher. 1999;14:195-199.
2. Singer AJ, Hollander JE. How to write a manuscript. J Emerg
Med. 2009;36:89-93.
3. Liumbruno GM, Velati C, Pasqualetti P, Franchini M. How to
write a scientific manuscript for publication. Blood Transfus.
2013;11:217-226.
4. Cooper ID. How to write a original research paper (and get it
published). J Med Lib Assoc. 2015;103:67-68.
5. Author Guidelines. J Clin Apheresis. https://onlinelibrary.
wiley.com/page/journal/10981101/homepage/forauthors.html.
Accessed March 28, 2020.
6. Borja A. 11 steps to structuring a science paper editors will take
seriously. https://www.elsevier.com/connect/11-steps-to-
structuring-a-science-paper-editors-will-take-seriously. Accessed
March 28, 2020.
7. Hsieh M. A brief guide to writing your first scientific manuscript.
https://blogs.plos.org/scicomm/2018/03/07/a-brief-guide-to-writing-
your-first-scientific-manuscript/. Accessed March 28, 2020.
8. How to write a successful scientific manuscript. https://www.
enago.com/academy/how-to-write-a-successful-scientific-
manuscript/. Accessed March 28, 2020.
366
9. Gewin V. The write stuff. How to produce a first-class paper tht
will get published, stand out from the crowd and pnull in
plenty of readers. Nature. 2018;555:129-130.
10. The Guillain-Barré syndrome Study Group. Plasmapheresis
and acute Guillain-Barré syndrome. Neurology. 1985;35:1096-
1104.
11. Padmanabhan A, Connelly-Smith L, Aqui N, et al. Guidelines
on the use of therapeutic apheresis in clinical practice—evi-
dence-based approach from the writing committee of the
American Society for Apheresis: the eighth special issue. J Clin
Apher. 2019;34:171-354.
12. Foote M. How to make a good first impression. A proper intro-
duction. Chest. 2006;130:1935-1937.
13. Barron JP. The uniform requirements for manuscripts submit-
ted to biomedical journals recommended by the International
Committee of Medical Journal Editors. Chest. 2006;129:1098-
1099.
14. Kallet RH. How to write the methods section of a research
paper. Respir Care. 2004;49:1229-1232.
15. O'Connor TR, Holmquist GP. Algorithm for writing a scientific
manuscript. Biochem Mol Biol Educ. 2009;37:344-348.
16. Hess DR. How to write an effective discussion. Respir Care.
2004;49:1238-1241.
17. Scientific style and format. The Council of Scientific Editors
Manual for Authors, Editors and Publishers. 8th ed. Chicago,
IL: University of Chicago Press; 2014.
18. Ivey C, Crum J. Choosing the right citation management tool:
EndNote, Mendeley, Refworks, or Zotero. J Med Lib Assoc.
2018;106:399-403.
WEINSTEIN
19. Provenzale JM. Revising a manuscript: ten principles to guide
success for publication. Am J Roentgenol. 2010;195:W382-
W387.
20. Happell B. Responding to reviewers' comments as part of writ-
ing for publication. Nurse Res. 2011;18:23-27.
21. Scherer RW, Meerpohl JJ, Pfeifer N, Schmucker C,
Schwarzer G, von Elm E. Full publication of results initially
presented in abstracts (review). Cochrane Database Syst Rev.
2007;18:MR000005. https://doi.org/10.1002/14651858.MR000
005.pub4.
22. Pham HP, Jiang N, Pan Z, Williams LA III, Marques MB.
Apheresis research- more abstracts should be published as full
manuscripts to provide more evidence for clinical practice
guidelines. J Clin Apher. 2016;31:353-358.
23. Feldman AZ, Staley EM, Siniard RC, Williams LA III,
Pham HP. More apheresis medicine abstracts should be publi-
shed into manuscripts for clinical use. J Clin Apher. 2017;32:
203-204.
24. Simmons SC, Bui CM, Kim CH, Feldman AZ, Staley EM,
Pham HP. Frequency of alterations in apheresis-related
abstracts prior to publications as peer-reviewed articles. Ther
Apher Dial. 2020;24:215-220.
How to cite this article: Weinstein R. How to
write a manuscript for peer review. J Clin Apher.
2020;35:358–366. https://doi.org/10.1002/jca.21797