Best practices for developing Medical manuscripts

Medical research comprises a significant subset of scientific literature. Although there are many shared elements between the preparation of medical articles and those from other scientific fields, certain nuances apply for medical papers. Perhaps surprisingly, a great deal of work needs to take place before the research itself begins. This article offers several best practice ideas to help you develop and ultimately submit the best medical article possible.

1. Determine your hypothesis and goal/purpose

The best place to start developing your paper is to identify, then very carefully and succinctly, articulate your hypothesis.

What question do you want to address with your research paper?

What is your narrow, intermediate and contextual focus for the study?

Based upon your knowledge of the field, is your hypothesis novel and important?

Tip: Obtain input and refinement from your co-authors for this crucial first step.

2. Contextualise your study with a literature review

Next you will need to develop a solid base of understanding and context for your hypothesis. 

What is the body of literature that forms a foundation for your premise?

How does your study build upon earlier work and move it forward?

Performing a thorough literature review will enable you to intelligently situate your paper within the overall milieu of the topic and will provide clarity regarding the overall novelty and degree of importance of your work.

3. Familiarise yourself with the articles in your target journal(s)

Not only should you be familiar with the broader literature, but also with the articles in the specific journal where you plan to submit. If you’ve recently seen multiple articles on the same topic, you may want to consider submitting to an alternative publication. Even though journal editors may favourably evaluate your submission, they may reject it if they feel their journal is saturated with the topic.

4. Develop a clear study design

Developing a clear and appropriate study design, and then superbly executing that design are the next major components to developing your medical paper.

What data do you currently have to shed light on your hypothesis?

Can you identify gaps in your data that will need to be filled in order to be able to answer your questions?

If there are data gaps, what additional experimental or clinical data do you need to collect and in what quantities?

What statistical tests and measures will be best suited to answer your questions? 

Tip: At this stage, collaboration with a competent biostatistician who is fluent in study design and statistical analysis is crucial. You may consider seeking the help of co-authors who can potentially augment your data with their own.

Important note: The study design phase, complete with a sufficiently large patient population, proper design methodology, sufficiently long follow-up and proper controls, is perhaps where most otherwise good papers come up short.

Our advice: If you take the time to very carefully think through what you need to prove (or disprove) your hypothesis, you will do yourself a huge favour. Such advance preparation will also enable you to execute prospective, randomised, double-blinded studies instead of prospective, non-randomised, unblinded studies.

Once this crucial step is complete, gathering data, evaluating it and writing the paper will effectively take care of themselves because you have a clear scientific roadmap to guide you. 

5. Obtain the necessary approvals 

With your hypothesis, literature review and careful study design in hand, you’re ready to apply for your institution’s ethical review/Institutional Review Board (IRB) approval.

Important to-dos:

• Be sure you obtain IRB approval for your study before embarking on gathering clinical data. 
• Similarly, prior to beginning your clinical study, be sure to enrol it in an appropriate national or international clinical trial registry database. Nearly every type of clinical study should be registered with trial registries such as ISRCTN or ClinicalTrials.gov.
• Once you receive IRB approval and have registered your trial, be sure to include that information in your manuscript, typically in the first few pages of the document.

6. Include quality figures, illustrations and photos

High-quality figures, illustrations and photos significantly bolster not only the presentation of data but also the overall aesthetic and visual appeal of an article. Between two equally good manuscripts, the one with high quality images will always be selected over the one without such images. Consult with your target journal’s Information for Authors (IFA), as well as sample published articles, to gain insight on their desired visual aesthetic.

7. Be aware of journal guidelines and conflicts of interest

After completing your thoughtful preparation, collecting your data and interpreting the results, you are ready to write the manuscript itself. However, before and while commencing your writing, there are some other actions to implement.

Important to-dos:

• Be sure to read and follow the IFA from the target journal.
• Don’t forget to include financial disclosures for you and your co-authors to avoid conflicts of interest (COIs).

Summary

If you follow these best practices, you will be well on your way to designing, writing and ultimately publishing high quality articles for medical journals.

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