Vol. 124 No.
1 July 2017
EDITORIAL
So you want to be published? Pearls for journal publishing
Your engagement in advancing the scientific evidence
base for our dental specialties through scholarship and
publication is essential to effect improvements and in-
novations in our practices in the twenty-first century.
The process of writing for publication can be new and
challenging for many young scholars. With the concept
of “publish or perish” being an increasingly important
aspect for career progress of dental academics, scientific
writing is a critical skill that can and must be developed.
I am fortunate to be on the faculty of a school of
dentistry that has an active faculty development men-
toring program for junior members, and through this
experience, I have become more aware of the lack of
mentorship for scientific writing in many of our graduate
specialty programs. This creates a handicap for junior
faculty members, who are expected to come prepared to
be productive in publication. I do not want to imply that
publishing is only for academics, as some of our most
impactful writers who present scientific analyses with the
intention of making the science useful for practicing
clinicians are private practitioners.
In the tradition of our distinguished former Oral
Medicine section editor, Dr. Craig S. Miller, who
shared his insights to assist authors in the development
of their manuscripts,1 I would like to add some of my
thoughts on how youdour readers and potential
contributing writersdcan improve your chances of
success in publishing, from the stages of planning and
writing through submission and publication.
PLANNING
The purpose of your study and your goal of commu-
nication of your observational findings will help you
decide what type of article you will write. Keep in mind
the hierarchy of publication types that comprises the
evidence pyramid. The foundation or base of the pyr-
amid contains editorials (like this one), expert opinions,
and commentaries. As you move up the pyramid, you
will find observational studies, experimental studies,
critical appraisals, and systematic reviews, with meta-
analyses at the top of the pyramid (Figure 1).
Dr. Stephen R. Covey offered a philosophic approach
to goal setting in Habit 2 of The 7 Habits of Highly
Effective People2: “Begin with the end in mind.” Having a
clear vision of your end product allows you to better plan
and execute the task of writing and communicating with
your audience. When embarking on a research project, I
find that drafting or outlining the future publication’s
Results tables right at the beginning, in the design
phase, often ensures that data points that will be needed
for the ultimate publication are not omitted. When
designing the study, the methods that will be used
should be well thought out and described, and the
necessary standardization, description, calibration (if
multiple examiners are involved), and an appropriate
statistical analysis plan should be created. For clinical
studies, this detailed description of the study methods
can be formulated with publication in mind, in concert
with the description required for the institutional review
board application or for the review process of the
human subjects committee.
First, ask yourself: Is my work publishable? What do
my research findings add to the literature? What is
novel about my study? What expands the science?
What can improve clinical practice? What is the pur-
pose of my study? With the answers to these questions
in mind, plan a single article so that you can focus on
the outcome of the study. Remember, you are trying to
tell a story that will interest and educate others.
If you are a novice at publishing, you may want to
begin working in a team or with an interesting, well-
illustrated, and well-documented case report that in-
cludes a long-term treatment outcome. Be sure there is
something “unique” about the case being reported so
that the reader will learn from your experience. This
will require you to have a good understanding of past
publications on the topic.
Several nonprofit organizations that aim to improve
research study reporting also provide checklists and
flowcharts to help create some transparency and stan-
dardization in reporting. Use the checklist and flowchart
that are relevant to your research design. If you are
reporting on the outcome of a clinical trial, use the 25-
item checklist and flowchart of the Consolidated Stan-
dards of Reporting Trials (CONSORT) 2010 statement.3
Do not forget to register your U.S.-based clinical trial on
clinicaltrials.gov. If you are reporting the outcome of a
systematic review or meta-analysis, use the checklist
and flowchart provided in the Preferred Reporting Items
for Systematic Reviews and Meta-Analyses (PRISMA)
statement.4 If you are reporting on an observational
study, the Strengthening The Reporting of
Observational Studies in Epidemiology (STROBE)
statement will help you to ensure that you have
included all of the necessary elements to best describe
your study.5 Reporting of diagnostic accuracy studies
1
EDITORIAL
2 Patton
Fig. 1. Hierarchy of publications in the evidence pyramid.
should follow the Standards for Reporting Diagnostic
Accuracy (STARD) 2015 statement and use its
checklist and flowchart.6
Systematic reviews should be designed to answer a
health care research question or to help resolve a con-
troversy. These reviews commonly use the PICO
format; that is, they address a Patient Problem/Popula-
tion with an Intervention/Indicator and Comparison/
Control to determine an Outcome. For example,
“Among adults with total joint prostheses undergoing
dental procedures, does use of prophylactic antibiotics
compared with not using prophylactic antibiotics
reduce the incidence of total joint infection?” The Pa-
tient Problem/Population here would refer to adults
with total joint prostheses undergoing dental proced-
ures; Intervention/Indicator is the use of prophylactic
antibiotics; Comparison/Control would refer to not
using prophylactic antibiotics; and Outcome is the
incidence of total joint infection.
WRITING
Follow the standard structure of a biomedical research
article. The International Committee of Medical Journal
Editors (ICMEJ) has tips for manuscript preparation,
providing excellent guidance to novice and expert
writers alike.7 The typical recommended organization
of a research article is as follows:
1. Title, Authors, Sources of Support: Be sure that the
title is descriptive.
2. Structured Abstract: Provide a short synopsis of your
article.
3. Introduction: Include a clear statement of the
purpose or hypothesis of your study at the end of the
Introduction section.
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July 2017
4. Methods: Be thorough in the description of the
methods employed in your study (standard, refer-
enced), keeping in mind that the article may be later
abstracted for someone else’s systematic review.
This section should contain:
i. Selection and description of participants
ii. Technical information
iii. Statistical tests
5. Results: Do not repeat in the text the information
provided in tables and figures.
6. Discussion: Include your study’s limitations within
the Discussion section (all studies have limitations).
7. Conclusions: This section must directly relate to the
Results section.
8. References: Follow the standard format of the
journal in which the article is intended to be
published.
9. Tables/Figures/Clinical images: Do not clutter these
with too much data or split these into too many parts
unnecessarily.
When you sit down to put fingers to keyboard, the
following order is suggested to approach your writing:
Methods, Results, Introduction (you should know the
background information for your study), Discussion/
Conclusion, and finally, Abstract. Above all, keep the
article concise.
Figures and tables are critical and should be
self-explanatory. Many readers read only the abstract
and look at the figures and tables. All abbreviations
should be defined in the figure/table legends and follow
standard abbreviation nomenclature. For figures, ensure
that all graph axes are labeled, and include standard
error bars. Clinical images should be of high quality.
For tables, include statistical results if you are
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Volume 124, Number 1
presenting analytical data, and ensure that all columns
and rows have the proper headings.
Be knowledgeable about and use PubMed, a free
service of the U.S. National Library of Medicine, which
allows access to MEDLINE through any Internet-
connected device worldwide. If you cannot access
original articles, do not cite them as references. If your
library does not carry the journal, try using
ResearchGate.net to ask for a PDF reprint of the article
directly from the author if the article has not already
been posted by the author on this research social media
website.
Do not plagiarize. This is an illegal act that includes
copying published material verbatim or with minor
alterations, with or without reference to the original
source. Many journals run submitted articles through
electronic cross-reference programs, such as Cross-
Check by Ithenticate, used by Elsevier. A high simi-
larity index score indicating similarities to other
publications, especially a large percentage of word
matches with a particular article, even if it is your own
prior work, raises a red flag and may lead to rejection of
your submitted article on that basis alone.
Acknowledge grants and other funding support. If
your project described in the article has been supported
by the U.S. National Institutes of Health (NIH) or other
federal government agencies, ensure that there is
registration of the article with PubMed Central in
compliance with the NIH Public Access Policy.
Elsevier directly sends articles accepted for our journal
to PubMed Central to maintain author compliance with
this policy. Carefully select the keywords for your
article by using MeSH words for indexing so that your
publication will be accessed when the next researcher in
your field conducts a systematic review on the topic of
your publication.
FROM SUBMISSION TO PUBLICATION
Know the journal’s mission and the audience you are
trying to reach. Each journal has an established mission
and indicates what type articles the journal is seeking to
meet the needs of its readership. As your target jour-
nals, consider those that have published the articles you
have cited in your report. If you are still uncertain
regarding to which journals you want to send your
article, try the website Jane.biosemantics.org. This
website provides a novel journal/author name estimator
that will reveal where similarly titled articles have been
published in the past.
Consider whether it is important to you to have your
article published in print format or if an electronic
publication is adequate for communication to other
scientists and clinicians in your article’s area of study.
In this era of online self-publishing, thousands of new
journals are in existence with the sole aim of profiting
EDITORIAL
Patton 3
from charging the author for the privilege of publishing.
If the journal is not indexed in MEDLINE, the U.S.
National Library of Medicine journal citation database,
then it will have limited visibility, and authors will not
be able to easily access the content from the PubMed
search engine.
The 2 main ranking systems or metrics to assess the
quality of journals and journal articles, the Journal
Impact Factor and the Eigenfactor, have been discussed
in our journal previously by Dr. Craig S. Miller.8 Both
indices, produced by the Journal Citation Reports of
Thomson Reuters ISI, are quantitative evaluation
tools. The Journal Impact Factor assesses journals and
determines how prestigious it would be to have an
article published in a particular journal. This is a
measure of the frequency with which the “average
article” in a given journal has been cited in a
particular year. For example, the impact factor in
2016 for a journal is X/Y, where X ¼ number of
times articles published in that journal in 2014-2015
were cited in indexed journals in 2016 and
Y ¼ number of articles, reviews, and proceedings
published by that journal in 2014-2015. This metric
favors journals that publish few articles per year that
are frequently cited in the next 2 years. Among all
health journals in 2016, the highest Journal Impact
Factor was 131.723 for CA-A Cancer Journal for
Clinicians.9 In contrast, the Eigenfactor score
measures the total number of article citations over
5 years since publication in a given journal and
determines the value of having this journal in your
library. In times of limited resources for funding of
print and e-journal subscriptions for libraries, this
score is valuable in a library administrator’s decisions
regarding retention of journal subscriptions. The
Eigenfactor rewards journals that publish numerous
articles each year on a variety of topics, such as Oral
Surg Oral Med Oral Pathol Oral Radiol. The
Eigenfactor score reflects a journal’s importance to
and influence on the scientific community.
Once you have identified your target journal, be sure
to follow that journal’s instructions to authors. If you
are reprinting material from other journals, you will
need to obtain the appropriate permissions from those
source journals. If you are publishing an identifiable
image of a patient, you will need to get that patient’s
written consent for use of the image in your print and
electronic publications.
It is often helpful to set aside your article for a week
or two and come back to review it one last time before
submitting it; this will help you take a fresh look at it
and correct ambiguities and mistakes. Have a colleague
read your article to evaluate ease of understanding and
to help identify typographical or grammatical errors
before submission for publication. If English is not your
EDITORIAL
4 Patton
first language or if you lack fluency, have a native
English speaker review your article to ensure that it
makes sense. Verify that the components of your listed
references, such as spelling and order of author names,
article titles, abbreviated journal name, year, volume,
and article pages, are accurate and in the format
required by the target journal. This can be done by
taking the first 3 to 4 author names from each reference
in your list and placing the author names individually
and sequentially in a PubMed search.
The letter of submission should describe why you
believe the article is important to the field and to the
journal’s readership. The letter should contain any
required statements about prior presentation of the
material and confirmation that the article is original, not
previously published, and not under consideration by
any other journal.
Editorial decisions vary from journal to journal, but
typically, journal editors may accept the article, ask for
minor or major revisions, reject the article, or provide a
referral to another, more appropriate journal of that
publisher. Journal editors seek the assistance of peer
reviewers who are content experts in the area of your
work. If you are asked to suggest peer reviewers who
are in the same field and may provide a useful critique,
do so; however, be sure to provide the full name of the
reviewer, the address of his or her institution, and the
academic e-mail address to assist the journal editor in
verifying the reviewer’s credentials. Peer reviewers for
journals volunteer their time for the review process and
aim to help you make your research study as useful as
possible to the readers and future clinicians/scientists.
Make it easy for the busy peer reviewer, who will be an
example of your target audience, and the journal editor
to understand and to appreciate your work.
Expect to do at least one revision, but aim for
immediate acceptance for publication at your initial
submission by making the best possible “first impres-
sion” of your manuscript. Be respectful of the peer
reviewer, and respond to the peer critique with line-by-
line responses to suggestions and questions. Use the
critique as a guide for modifications, if possible and
reasonable. If it is not possible or feasible to revise
particular elements of your article, explain your ratio-
nale in the “response to critique” included as part of
your submission of the revised manuscript.
All journals aim for as short a review period as
possible, but publishers have different electronic
manuscript review systems that set specific timelines
and prompt or remove reviewers at different time in-
tervals when they are unresponsive or late in their
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July 2017
response or submission of their critiques. Typically, a
quick response time from the publisher may indicate a
rejection. If you receive a rejection, rethink your
submission strategy, and consider changes needed for
publication or perhaps submission to another journal
that may be a better fit for your article. If your article is
submitted to the peer review process, it may be weeks
to months before an initial decision is rendered and the
peer review critiques are sent to you.
Once your article is accepted, you will likely be
asked to submit the copyright release for the work while
the article is sent to the copy editor for editing of lan-
guage and form and for “typesetting.” The “page
proofs” will be sent to you with any queries with a
request of a 24- to 48-hour turnaround time. It is
important to give your full attention to this part of the
process, as this is the last chance you will have to
correct any minor errors before the article is electroni-
cally published. Happy writing!
Lauren L. Patton, DDS
Section Editor, Oral Medicine
Department of Dental Ecology
School of Dentistry
University of North Carolina at Chapel Hill
CB 7450, Chapel Hill, NC 27599-7450
Lauren_patton@unc.edu
http://dx.doi.org/10.1016/j.oooo.2017.04.001
REFERENCES
1. Miller C. A good manuscriptdan excellent journal. Oral Surg
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2. Covey SR. Habit 2. Begin with the end in mind. The principles of
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3. CONSORT statement. Available at: http://www.consort-statement.
org. Accessed March 24, 2017.
4. PRISMA statement. Available at http://www.prisma-statement.org/
Default.aspx. Accessed March 24, 2017.
5. STROBE statement. Available at: http://strobe-statement.org/
index.php?id¼strobe-home. Accessed March 24, 2017.
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updated list of essential items for reporting diagnostic accuracy
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statement.org/. Accessed March 24, 2017.
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recommendations.pdf. Accessed March 24, 2017.
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Oral Med Oral Pathol Oral Radiol. 2012;113:145-146.
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