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How to Publish in Biomedicine
500 TIPS FOR SUCCESS
THIRD EDITION
 How to Publish in Biomedicine
500 TIPS FOR SUCCESS
THIRD EDITION

John Dixon
Consultant in Healthcare Communications and Trainer in
Scientific Writing, United Kingdom
Louise Alder
Trainer and Medical Communications Consultant, able mc
Ltd., United Kingdom

Jane Fraser
Medical and Bioscience Communications Consultant and
Skills Trainer, United Kingdom
CRC Press
Taylor & Francis Group
6000 Broken Sound Parkway NW, Suite 300
Boca Raton, FL 33487-2742

© 2017 by John Dixon, Louise Alder and Jane Fraser

CRC Press is an imprint of Taylor & Francis Group, an Informa business

No claim to original U.S. Government works

Printed on acid-free paper

Version Date: 20160719

International Standard Book Number-13: 978-1-78523-010-3 (Paperback)

This book contains information obtained from authentic and highly regarded sources. While all
reasonable efforts have been made to publish reliable data and information, neither the author[s] nor
the publisher can accept any legal responsibility or liability for any errors or omissions that may be
made. The publishers wish to make clear that any views or opinions expressed in this book by
individual editors, authors or contributors are personal to them and do not necessarily reflect the
views/opinions of the publishers. The information or guidance contained in this book is intended for
use by medical, scientific or health-care professionals and is provided strictly as a supplement to the
medical or other professional’s own judgement, their knowledge of the patient’s medical history,
relevant manufacturer’s instructions and the appropriate best practice guidelines. Because of the rapid
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 Contents

Foreword to the first edition

About the authors
About this book
Acknowledgements

Part I The publishing process in science

1 What do you want to write?
2 Understanding the publishing process
3 Best practice, ethics and authorship
4 Original research: what can be published?
5 Selecting the right journal
6 Research papers and reviews: submitting your manuscript
7 Dealing with the editor’s and reviewers’ comments
8 Personal profile management

Part II Writing the core sections of a scientific

research paper
9 Research papers and reviews: titles
10 Research papers: abstracts
11 Conference abstracts
12 Research papers: introduction
13 Research papers: methods
14 Research papers: results
15 Research papers: figures
16 Research papers: tables
17 Research papers: photographs
18 Research papers: discussion and conclusions
19 References
20 Checking your manuscript

Part III Writing other scientific material

21 Review articles and book chapters
22 Theses and dissertations
23 How to write a book
24 Informal science writing

Part IV Fundamentals of scientific writing

25 Clear writing: sentences
26 Clear writing: words
27 Clear writing: paragraphs, headings and lists
28 Correct writing: common errors of grammar and idiom

Part V Practicalities of scientific writing

29 Planning your writing
30 Overcoming writer’s block
31 Managing your time for writing and revising
32 More effective word processing
33 Useful software for writers
34 E-resources for biomedical writers
35 Selected further reading
Appendix 1: Manuscript checklist
Appendix 2: Submission checklist
Index
 Foreword to the first edition

The Author’s Revenge

There was an old editor (your foe),
Who usually preferred to say no,
He ranted and railed,
’Till his heart nearly failed,
He died lonely and broken – ho, ho!

Anon, 1823

Such is the miserable life of a journal editor.

First things first. Read this book. It is all true. Beautifully written.
Brilliantly argued. You would be a fool to ignore the wise words it has to
offer.
If, however, you are pressed for time (and unless you are working at a
London teaching hospital, you will be), here is a summary. Structured, of
course. The three A’s to acceptance are:
Approach. The covering letter is vital. Editors are showered with
manuscripts daily (25 at The Lancet). We cannot possibly read through
every page of every paper. Nor would we want to. A brief, gently hyperbolic
account of what you have done and why it should be irresistible to the
editor is a sure way to get noticed. But …
Appeal. I am assuming rejection (which, be honest, is the likely
outcome). The editor’s decision is never final. Editors are jitteringly
insecure about their judgements. No one wants to pass up the scientific
equivalent of an actor’s role in Jurassic Park. If your paper has not been
peer-reviewed, claim tragic injustice and a terrible missed opportunity. If a
reviewer’s pen has led to editorial refusal, claim undisclosed bias and a
poverty of intellect on the part of the advisor. In other words, appeal to the
editor’s better nature – namely, greed for a higher impact factor.
Attitude. Be quick in your rebuttal of the editor’s decision. We have
short memories. No recollection of your paper means no chance. And, in all
your correspondence, be polite. I have a growing pile of incredibly irate
letters from well-known professors of medicine, all of whom are too used to
people saying yes to them. Here is the latest on my desk: ‘Although I have
not argued the toss with the last three rejections from The Lancet of papers
in which I have been involved, I think this decision is extremely unfair and
certainly I find it very difficult to accept based on the rather meagre contents
of your letter. I am becoming increasingly confused about your editorial
policy. I really cannot accept a rejection …’ (etc., etc.). You can imagine
that these sort of wails generate billowing gasps of laughter at The Lancet
and consign the feted professor’s paper to unrecoverable obscurity. Charm,
by contrast, works wonders.
Writing is hard, it is true. But when writing is done with others, it can be
rewarding – perhaps even pleasurable. Is this not a worthy end in itself,
irrespective of the capricious editor?
In all of this publishing palaver, authors should remind themselves that,
contrary to their expectations, editors like to be liked. We want to publish
your work. So, put your pen down, put your feet up, pour yourself a large
vodka, and read on. Even this Foreword was rejected first time around.

Richard Horton
July 1997
 About the authors

John Dixon MA FRCS MRCGP MBA

John qualified in medicine having studied at the University of Oxford and
Guy’s Hospital Medical School, London. Initially he trained as a surgeon,
gaining experience in accident and emergency medicine, orthopaedic,
thoracic, general and ENT surgery, and became a Fellow of the Royal
College of Surgeons of England (otolaryngology) and Edinburgh (general
surgery). He then became a GP and Member of the Royal College of
General Practitioners, having had experience in paediatrics, neonatology,
and obstetrics and gynaecology. Since 2003, John has completed an MBA at
Warwick University Business School whilst working as a Primary Care
Trust project manager. He then spent five years as Director of Medical
Communications in a UK medical communications agency, becoming a
freelance consultant in healthcare communications in 2013. Throughout his
career John has enjoyed teaching and being taught, and the peer-reviewed
academic literature has been central to his work. His consulting and training
interests include supporting scientific writers to ensure their
communications are accurate, understandable and use appropriate language.
He provides training in scientific writing and presentation skills for
academics from a diversity of scientific disciplines in universities and
research institutes across Europe

Louise Alder BSc (Hons) CMPP

Louise is Director and Trainer-in-Chief of JF Training, having taken over
ownership and management of the former Jane Fraser Associates in 2013.
Louise moved into scientific publishing through her work at the Royal
Pharmaceutical Society of Great Britain and as an editor at a leading
pharmaceutical journal. She has worked as a specialist writer in medical
communications for over 20 years, and held Scientific and Medical Director
roles at Ogilvy Healthworld and 7.4 Ltd before setting up her own
consultancy in 2007. An experienced trainer, Louise previously lectured in
medical communications (PGCert) at the University of Worcester (UK),
teaching writing and publications skills to postgraduate and doctoral
students. She holds the Certified Medical Publications Professional (CMPP)
qualification from the International Society for Medical Publication
Professionals (ISMPP) and has facilitated workshops on achieving
publications success. Louise runs training sessions on scientific publishing
and writing skills for healthcare professionals as well as pharmaceutical
companies, medical communications agencies and contract research
organisations.

Jane Fraser PhD

Jane started her career as a research scientist, but moved into publishing
when she realised that ‘I liked writing about the experiments more than I
liked doing them’. Her long career in biomedical publishing has given her
plenty of opportunities both to write herself and to edit the work of
scientists and clinicians. She has worked as editorial director of two
international medical communications companies and for many years as a
freelance medical writer. In 1991, Jane set up her own company teaching
writing, editing and presentation skills to scientists and clinicians in
universities, research institutes, pharmaceutical companies and medical
communications agencies. Jane is now semi-retired, leaving John and
Louise to carry on the work of the original company. However, she still
enjoys helping scientists and clinicians to write more effectively and get
their papers published.
 About this book

Publishing in scientific journals is the true end-product of scientific

research. Long after all the presentations are made, and all the details
debated, only the publication remains. Studies carried out, but not written
up, moulder away and are forgotten. Science only exists when it is
published in some permanent form, available to all who enquire. At present,
that form is usually the peer-reviewed scientific journal.
Today, the pressure on scientists to publish is stronger than ever before.
Despite the many complaints about the exploding number of journals and
papers, a long list of publications in prestigious journals is taken as a sign of
worth. The ability of scientists is judged not only on the quality of their
studies, but on the number and quality of their publications. There is a
whole science of scoring publications, with the aim of enabling objective
decisions about job appointments and grant applications.
Yet, despite the injunction to ‘publish and flourish’, most scientists have
little training in writing papers. A few of us are lucky enough to have a
mentor who knows not only how to write, but how to teach. The rest learn
to write papers by doing it, and by making mistakes. We waste valuable
time submitting papers, only to have them rejected.
Often, these rejections could have been avoided if we had been more
thoughtful about where we submitted the paper, or the format we chose.
Some rejections are a result of unclear or disorganised writing. While good
writing can never compensate for a badly designed study, bad writing can
actually obscure good science.
This book is designed to help you get your biomedical papers published.
It is based on many years of experience, not only of writing papers, but of
teaching scientists from a wide range of backgrounds and many different
countries. They have taught the authors what scientists really want to know
about writing and publishing papers.
 There are already plenty of comprehensive textbooks around on scientific
writing, but this book is different. It is intended to answer the commonest
questions about scientific writing, and to help you avoid the most frequent
problems and pitfalls. It is designed to be very practical, and to be used
when you are actually writing. You do not have to read it straight through
from beginning to end. Just dip into any chapter and you will find a range of
tips relevant to the section you are working on right now.
This book is also very realistic, in that it recognises that you may not
have very much time for writing. So it includes chapters on managing your
time for writing and revising, overcoming writer’s block and using
technology to make your writing more efficient.
This third edition has taken account of the considerable changes that have
taken place in the scientific publishing world since the second edition, in
process and technology. Publications such as the International Committee of
Medical Journal Editors (ICMJE) guidelines on authorship, best practice
and ethics have been widely accepted by journals. New models of peer
review are evolving. Open-access publishing is now the norm. Information
technology has leapt forwards, providing a greater variety of online
opportunities to communicate and share information, and giving us more
powerful software and tools for writing.
In this edition, we have presented the chapters in five parts to make
access to pertinent tips as easy as possible: (I) The publishing process in
science, (II) Writing the core sections of a scientific research paper, (III)
Writing other scientific material, (IV) Fundamentals of scientific writing
and (V) Practicalities of scientific writing. We hope that everyone who reads
this book will find useful hints that they can use again and again to help
ease the process of writing and publishing papers. There is no reason why
this process should always be long and painful. As with all other walks of
life, when you know what you are trying to achieve, you will be able to use
the skills you already have to maximise your potential. You might even have
time to do some research. Good luck!

John Dixon, Louise Alder and Jane Fraser

August 2016
 Acknowledgements

The book grew out of the questions and suggestions of participants in all the
courses we have taught on scientific writing and publishing. Special thanks
are therefore due to the Continuing Professional Development Centre and
Department of Medical Sciences at the University of Oxford for providing
the platform for many of these courses. We are also indebted to the Joint
Research Centres of the European Union, to the European Molecular
Biology Laboratory, to Gothenburg University and to the Flanders Institute
of Biotechnology. Thanks are also due to the many publishing and
pharmaceutical companies, universities, and their staff who have kindly
invited us to teach courses.
Sincere thanks also go to Liz Wager for her many helpful suggestions on
the manuscript of the first edition. Finally, we would also like to express our
gratitude to the countless friends and colleagues who have contributed over
the years to our store of tips. Without them, this book could not have been
written.
 PART I

The publishing process in science

 CHAPTER 1

What do you want to write?

If you want to publish something in a biomedical journal or magazine, you

will need to decide on the right format for what you have to say. This
section defines some of the commonest types of publication, to help you
decide into which category your publication fits.
Use these definitions in conjunction with the advice on choosing a
journal in Chapter 5. The important thing is to choose the right format for
the information you wish to convey, and to send your paper to a journal or
magazine that accepts that format.

Describe an experimental or observational study in

an original research paper …

Full-length original research papers are the main category of paper included
in any peer-reviewed journal. Think, however, about whether your paper
might have a better chance of publication as a shorter communication (see
below). Chapters 9–20 and 29 give more advice on how to prepare an
original research paper.

… Or consider shorter communication

opportunities in which to publish your research or
idea
Many journals publish shorter communications than full-length papers.
Some communications are specifically for comment on recent publications
in that journal, and some provide a route to publish new research. Journals
refer to these with various terminology such as: ‘letters to the editor’,
‘research letters’, ‘short communications’, ‘brief communications’,
‘comments’, ‘technical comments’, ‘correspondence’, ‘perspectives’,
‘analysis’ and ‘opinion’. These shorter communications vary in focus and
audience, and whether they are by invitation only or ‘open’ for submission
or proposal from prospective authors. If ‘open’ (and do check each journal’s
criteria), such articles provide alternative opportunities for publishing
original research or communicating ideas, albeit with a strict limit on the
number of words or pages allowed (Chapter 5).

Use a shorter communication such as a letter to the

editor to give a brief description of a study …

When describing original research in a shorter communication, you will be

restricted in the number of references and graphics you can include. In a
‘letter to the editor’ you can usually include a couple of references, but no
figures or tables. Note that if you publish results of your own research in
something such as a letter to the editor, you will not be able to publish the
same study again as a full paper. Bear in mind also that relatively few letters
to the editor are indexed in PubMed (the database of biomedical research at
the US National Library of Medicine), so although your publication will be
citable as a research publication, it will be less likely to be identified and
read than a full paper.

… Or to comment on other studies the journal has

recently published

You may wish to comment on a study recently published in the journal, and
amplify the comment with a few lines reporting your own findings, e.g. ‘In
their recent paper (Elderly Issues. 2016;36:2–7), Smith and Brown reported
that gerontazole is an effective treatment for Portillo’s disease in elderly
patients. In our own pilot study in six women aged 95 years or older, we
found that …’

… Or state your point of view on a topical issue

Shorter communications can simply convey your opinion or state some

relevant facts on any topical issue. For a young scientist, having such a
publication in a top journal can be a useful career boost. The chief criterion
for acceptance of this kind of communication is that it should be of interest
to the journal’s readers. Make sure that, in commenting on someone else’s
research or practice, you do not inadvertently say anything that could be
construed as libellous – keep it as impersonal as possible. Make it clear in
your communication that you give your permission to publish (some letters
sent to the editor are written for the eyes of the editor only).

Describe an unusual case in a case report

Only some journals accept case reports – descriptions of one or more

patients or a family that illustrate some novel clinical problem or its
solution. Be sure that your case history is really as interesting as you think it
is – it will have to tell a story that has not been told before. Case reports are
most likely to be published if they describe:

• a previously unknown disease or syndrome (it still happens occasionally)

• a diagnostic challenge or problematic differential diagnosis and how the
problem was solved
• a previously unsuspected causal association between two diseases
• a new and unexpected variation in the usual pattern of a disease
• a hitherto unreported adverse drug reaction or interaction.
 Write a ‘methods’ paper if your research focused on
developing a new method

Frequently, considerable time is spent developing, optimising and validating

a new method while undertaking research, for instance during a PhD
programme. Often, such research remains unpublished because no ‘results’
or new discoveries materialise. However, there are increasing numbers of
‘methods’ journals in which such research is ideally suited for publication:
another publishing opportunity.

Write a review article to summarise the literature or

a series of studies

Only some journals accept review articles. They are often commissioned by
the editor, so a review article submitted with no prior notice may be
courting rejection. However, editors of journals that publish review articles
are always open to new ideas, so contact them first to see if your suggested
topic is welcome. For more about review articles, see Chapter 21.

Write an editorial to put forward a new or

controversial point of view

Look closely, and you will see that ‘editorials’ and similar articles are not
always written by the editor of the journal, but also by invited contributors,
well-known and well-respected in their field. You are unlikely to get an
editorial accepted if it is submitted speculatively. However, if you have
something really important to say, it is worth approaching the editor to see
if they would consider inviting you to write an editorial.
 Write an informal article to reach a wider audience,
to describe recent events or to tell a personal story

You may find that not everything you want to say fits into the categories
described above. A few journals include informal articles alongside peer-
reviewed research papers. These ‘news and views’ articles do not carry the
academic kudos of a peer-reviewed paper, but they can still help attract
attention to you and your institution. They can also be fun to write. For
example, you might want to write about something ‘newsy’ like ‘How our
geriatric unit cut antibiotic costs’ or ‘The Global Congress of
Gastroenterology 2016: a surgeon’s view’. You might also want to write
something more personal, or even humorous – ‘Medicine at 30 000 feet’.
Opportunities for informal writing may also be available in magazines
and newsletters for your fellow professionals or the general public. For
example, you might have a suitable idea for the New Scientist, Scientific
American or Trends in Pharmaceutical Sciences. If you are unsure whether
the article you have in mind would be appropriate, you can contact the
editor for advice. Advice on writing informal scientific and medical articles
is given in Chapter 24.
 CHAPTER 2

Understanding the publishing process

If you do any kind of biomedical research, you are going to become very
familiar with the process of publishing scientific papers. For better or worse,
the success of your research career will depend on your ability to get your
research published in peer-reviewed journals. So, it pays to be familiar with
the process and the people involved.

Familiarise yourself with the publishing process

Figure 2.1 outlines the typical progress of a paper from submission to

publication. You submit your paper to the editor. Often, the editor and/or
editorial colleagues will perform a preliminary (‘in-house’) review on all
papers that are submitted to the journal, before sending ‘possibles’ out for
peer review. On the advice of the reviewers (referees), the editor then makes
the decision to accept or reject your paper. Usually, you will have to make
some amendments, taking into consideration the reviewers’ comments.
Once your paper is accepted, it will be edited to conform to journal style,
and proofs returned to you for correction. Only then will it finally be ready
for publication.

Understand the roles of the people involved

At different stages of the publication process, you may find yourself dealing
with:
• the editor
• reviewers (also known as referees)
• the managing editor
• copy-editors (also known as sub-editors or desk editors).

Each has a specific role to play in publishing the journal. Let’s look at their
roles one by one.

FIGURE 2.1 The publishing process – a simplified view.

The editor decides whether to accept or reject

papers
The editor of a peer-reviewed journal is always an eminent scientist with
many years of experience. The biggest and most prestigious journals often
have full-time editors – for example, the editors of The Lancet, New
England Journal of Medicine and Nature are paid professionals, with a
distinguished academic career behind them. However, the editors of smaller,
specialised journals are almost always part-time and unpaid, fitting in their
editorial role alongside the demands of research, teaching and clinical
responsibilities. The editor is usually advised by an editorial board of other
eminent scientists or clinicians, who may sometimes also act as reviewers
(see below).

The reviewers advise the editor

Reviewers may be members of the editorial board, personal contacts of the

editor, or simply chosen from a database of suitably qualified people.
Editors are constantly adding to the pool of reviewers. Sometimes, they will
remove from the pool those who do not provide reviews on time, or do not
meet the journal’s standards for scientific stringency and attention to detail.
The details of the peer-review process vary slightly between journals, but
the general principle remains the same. Typically, the editor will send out
copies of the paper to two reviewers simultaneously. Others may use a
single reviewer to screen the paper, followed by a second reviewer if the
paper is deemed worthy of further consideration. A third reviewer may be
called in if the first two disagree, as sometimes happens. Many journals also
send papers out for a separate statistical review – in fact, statistical
inadequacy is one of the commonest reasons for rejection. The reviewers do
not actually make the decision to accept or reject the paper. For clinical
papers they generally advise the editor, who then makes the final decision.

The managing editor oversees the day-to-day

running of the journal
Most larger journals employ a managing editor to oversee the day-to-day
running of the journal and supervise the work of the copy-editors (see
below). The managing editor is often the easiest person to contact if you
have questions about non-scientific matters (for example, clarification of
Instructions to Authors, or a query about when your paper is to be
published). However, queries regarding the scientific content of your paper
must always be addressed to the editor.

Copy-editors (also known as sub-editors or desk

editors) edit your paper to journal style

Once a paper has been accepted for publication it will usually go through a
process known as copy-editing. Most well-known journals employ copy-
editors. The copy-editor will make small changes to the paper so that it
conforms exactly to the journal’s ‘house style’. The house style lays down
rules on everything from the size of headings to the abbreviations allowed
to the formatting of references. The copy-editor will also correct
grammatical and spelling errors, improve poorly constructed sentences and
paragraphs and generally polish the manuscript to publication standard.

Remember that credibility depends on peer review

In peer-reviewed journals, original research papers or review articles are

only published if they meet the standards set by one or more independent
expert reviewers. Publication in peer-reviewed journals means that your
work has been given a ‘seal of approval’ by the scientific community.

Peer review acts as ‘quality control’ for the scientific

content of papers

Readers will assume that peer-reviewed papers have been checked for:
• a logical starting hypothesis, in the light of existing knowledge
• appropriate experimental design and statistical analysis
• complete and precise description according to a standard scientific format
• reasonable conclusions supported by your own experiments and those of
others.

Peer review has its limitations

Of course, publication in a peer-reviewed journal is no guarantee that the

conclusions drawn in a paper are the ultimate answer to any particular
scientific question. Biomedical research is not like that – it deals in
probabilities rather than absolute proofs. Even papers by the most respected
scientists are regularly revealed to have been ‘wrong’ in the light of further
research. What’s more, the peer-review process is undoubtedly imperfect –
it can be cumbersome, time-consuming and open to bias. However, it is the
best method so far devised for ‘quality control’ in science.

Remember that reviewers are very busy people

Reviewers give many hours of service to scientific journals – usually

completely free of charge. Without their goodwill the whole system would
collapse. Most scientists feel it to be their duty to their fellow researchers to
take part in the peer-review process. Most say that they find it interesting
and educational. However, because the best reviewers are constantly in
demand, the time they can devote to reading and commenting on each paper
is limited. So, it pays to make sure that your paper is written clearly and
concisely, so that the reviewer can make a swift evaluation of the scientific
content without having to struggle with impenetrable writing.

‘Blinding’ review policy varies between journals but

is usually ‘single blind’
Many journals adopt a ‘single blind’ peer-review process in which the peer
reviewers remain anonymous but the author names and affiliations remain
visible to reviewers. (Despite this, authors may know the identity of one of
the reviewers if they actually suggested them to the editor.) Supporters of
this method argue that this allows reviewers to provide the most objective
and uninhibited critique of new research. However, a downside is the
potential for reviewer bias either for or against authors or institutions.
Arguably, ‘double blind’ review is the fairest process, in which any
evidence of author identity and affiliation are removed from the manuscript.
Unfortunately, such blinding can never be controlled completely.
Considerable effort is required to completely ‘anonymise’ a manuscript and
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It was some moments before Polly could speak, then the words came in
gasps.

"She's gone with him," she panted.

"What?"

"She's gone right—away—with him—to Heaven." She could scarcely speak.

"Do you mean she is dead?" cried Gwen.

"Yes; yes, she's dead; and the moon is shining on 'em both."

Gwen appalled at the news, opened the door and looked in. But what she saw
was so wonderful and beautiful that all horror subsided. Rachel was kneeling
by the bed on which Luke lay, her cheek resting on his dead hand and a smile
of rapture on her face. The moonlight was streaming into the room from the
open window on to the faces of husband and wife. Once more they were
together in its pathway as they had been on that evening on the sea at
Southwold, but now they were unconscious of it, as they were together in the
city that has no need of the sun neither the moon to shine in it, for the glory of
God did lighten it and the Lamb is the Light thereof.

When the villagers heard that Rachel had died of heart failure on the same
day as her husband they mourned and wept. So young, they said, to die! Two
valuable lives given for the sake of a poor sick baby of a drunken woman!
What a waste of life!

But the Bishop, who came to preach the funeral sermon, said, "It was one of
the most beautiful things of which he had ever heard, and he felt that instead
of mourning and weeping, there should be flowers and singing. Two happy
saints treading together the streets of gold! No long parting! No farewells! The
Rector," he told the people, "could hardly have had time to reach the gates of
Heaven before he was joined by his wife. What could be more joyful for them!"

"But," he added, and with evident emotion, "when we look at it from our own
point of view, we cannot help tears. Did not our blessed Lord weep at the
tomb of Lazarus? It is not wrong to weep; but in thinking of our loss, we must
not forget their gain; for they were lovely and pleasant in their lives and in their
death they were not divided!"
THE END.
 *** END OF THE PROJECT GUTENBERG EBOOK LUKE'S WIFE
***

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