1

Writing an Outstanding Scientific Paper for Journal of Clinical Oncology

Daniel G. Haller, MDEditor-in-Chief

Journal of Clinical Oncology

AttributionsDavid J Kerr

Editor-in-Chief, Annals of Oncology

Robert J MayerAssociate Editor Emeritus, NEJM

Joe Simone

George CanellosEditors Emeriti, JCO

Ed HuthEditor Emeritus,

Annals of Internal Medicine

Publications Represent:

• accomplishment in academic medicine• primary documentation of research data• evidence of expertise through writing an authoritative

review paper or book chapter• a major determinant in achieving academic promotion

and career development

4

Submission and Publishing Statistics

5

New Manuscripts Submitted, Pages Printed

All Material Submitted

OriginalReports Only

Pages Printed Year

2004 2,731 1,960 5,011

2005 3,716 2,455 9,466

2006 4,102 2,779 5,790

2007 4,371 2,834 5,845

6

140

160

180

200

220

240

260

280

300

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

New Original Report Submissions by Month

2007

2006

2005

7

New Manuscript Submissions by Manuscript Type

2005 2006 2007

Review Articles 153 186 174

Biology of Neoplasia 4 11 15

Total Reviews 157 197 189

Editorials 144 118 135

Correspondence 458 405 473

Art of Oncology 32 42 47

Diagnosis in Oncology

397 429 554

8

Total Submissions

2004 2005 2006 2007

USA 1,074 1,4231,681 1,750

Non-USA 1,359 2,095 2,338 2,295

Initial manuscript submissions based on corresponding author’s country of origin (if indicated).*

Submissions by CountrySubmissions by Country

* If no country indicated, then the manuscript was not counted

9

Final or current decisions rendered on Original Reports by year

2005

2006 2007

900 1051 1070

863 916 861

15 31 47

0 11 77

0 0 19

535 547 460

Manuscript DecisionsManuscript Decisions

Note: Assuming Minors and Majors will be accepted, the Acceptance Rate for Original Reports submitted in 2007 is 21%* Estimate for 2007

*

Priority Reject

Reject

Door Ajar

Major Rev

Minor Rev

Accept

10

Average Time for Manuscript Processing

2005 2006 2007

Submission to first decision 44 3.4(weeks)

Acceptance to print publication 13 13 13(weeks)

Submission to print publication 6 7 6(months)

Note: Only Original Reports submitted within that year are calculated

11

Publish Ahead of Print

Currently:

Accepted manuscripts are prioritized for publication at the time of acceptance, some papers are designated “fast track”, 1/3 are published online ahead of print

Now:

Eliminate fast track and prioritization designations

• All material will be published online ahead of print at weekly intervals

• Original papers with editorials will not be placed online before the accompanying editorial.

12

Impact Factor

• 2006 IF measures citations in 2006 of papers published in2004 and 2005

• Numerator: every detectable citation

• Denominator: only those designated as reviews or original reports

• IF is a mean, not a median

– Number may be skewed by one or two pivotal papers

– JCO: large number of citations, but very large denominator

In 2006, 85% of citations were from original reports, 10% from reviews, 4% from editorials.

See: Rossner M et al. J Cell Biol 179, number 6, December 17, 2007

13

Impact Factor Trends: Peer-Reviewed Oncology Journals

Journal 2005 2006 Change# 2006

Articles

Journal National Cancer Inst 15.171 15.271 0.100 156

Journal of Clinical Oncology 11.810 13.598 1.788 734

Blood 10.131 10.370 0.239 1189

Lancet Oncology 9.608 10.119 0.511 91

Cancer Research 7.616 7.656 0.040 1493

Clinical Cancer Research 5.715 6.177 0.462 946

Cancer 4.800 4.582 (0.218) 675

International Journal Cancer 4.660 4.693 0.033 837

Annals of Oncology 4.319 5.179 0.860 337

14

On-line Reader Tracking Information

JCO.org Usage Statistics

Home Page Visits 1,477,842 1,433,276 1,507,251

Abstracts Only Access 2,461,335 2,729,658 3,457,337

Full-Text HTML Access 3,954,530 3,122,233 3,673,330

PDF Access 2,361,666 2,216,629 2,539,979

Total Usage 10,255,373 9,501,796 11,177,897

2005 2006 2007

16

Top Ten Articles March ’07 – December ‘07

“American Society of Clinical Oncology Guideline for Antiemetics in Oncology: Update 2006”

Kris et al (Jun 20, 2006: 2932-2947)

(Read 14460 times)

“2006 Update of Recommendations for the Use of White Blood Cell Growth Factors: An Evidence-Based Clinical Practice Guideline”

Smith et al (Jul 01, 2006; 24: 3187-3205) (Read 9434 times)

“American Society of Clinical Oncology/College of American Pathologists Guideline Recommendations for Human Epidermal Growth Factor Receptor 2 Testing in Breast Cancer”

Wolff et al (Jan 01, 2007: 118-145)

(Read 8381 times)

17

Top Ten Articles March ’07 – December ’07 (Continued)

“Initial Hormonal Management of Androgen-Sensitive Metastatic, Recurrent, or Progressive Prostate Cancer: 2007 Update of an American Society of Clinical Oncology Practice Guideline”

Loblaw et al (Apr 20, 2007; 25: 1596-1605)

(Read 8210 times)

“Erlotinib Plus Gemcitabine Compared With Gemcitabine Alone in Patients With Advanced Pancreatic Cancer: A Phase III Trial of the National Cancer Instituteof Canada Clinical Trials Group”

Smith et al (May 20, 2007; 25: 1960-1966) (Read 7761 times)

“American Society of Clinical Oncology Treatment of Unresectable Non–Small-Cell Lung Cancer Guideline: Update 2003”

Pfister et al (Jan 15, 2004; 22: 330-353)

(Read 7734 times)

18

Top Ten Articles March ’07 – December ’07 (Continued)“Sunitinib: From Rational Design to Clinical Efficacy”

Chow et al (Mar 01, 2007; 25: 884-896)(Read 7724 times)

“Clinical Cancer Advances 2006: Major Research Advances in Cancer Treatment, Prevention, and Screening -- A Report From the American Society of Clinical Oncology”

Ozols et al (Jan 01, 2007; 25: 146-162) (Read 7676 times)

“Phase II Study of Sorafenib in Patients With Advanced Hepatocellular Carcinoma”

Abou-Alfa et al (Sep 10, 2006; 24: 4293-4300)

(Read 7239 times)

“American Society of Clinical Oncology Guideline: Recommendations for Venous Thromboembolism Prophylaxis and Treatment in Patients With Cancer”

Lyman et al (Oct 29, 2007; doi: 10.1200/JCO.2007.14.1283.)

(Read 6987 times)

19

Editorial Roster

Daniel Haller Editor-in-Chief

Nora Disis Deputy Editor: Translational Research

David Khayat Deputy Editor: International Editions

20

Editorial Roster (Continued)

Associate Editors

Judith Abrams Biostatistics

George Bosl Genitourinary / Solid Tumors

Stephen Cannistra Gynecologic / Breast Cancer

Bruce Cheson Hematologic Malignancies

Arlene Forastiere Head and Neck / Solid Tumors

Patricia Ganz Breast Cancer / QOL / Supportive Care

Bruce Haffty Radiation

Stephanie Land Biostatistics

Mark Levine Breast Cancer / Cost Effectiveness / Epidemiology

Michael Link Pediatric

Eleftherios Mamounas Breast Cancer / Surgical Oncology

Nicholas Petrelli Surgical Oncology / GI

Joan Schiller Thoracic Oncology

Jaap Verweij Phase I & Clinical Pharmacology

21

Editorial Roster (Continued)

Consultant Editors

Marc Buyse Biostatistics

Daniel Normolle Biostatistics

Stephen Cannistra Biology of Neoplasia

Charles Loprinzi The Art of Oncology

Arthur Skarin Diagnosis in Oncology

22

International Editions

• JCO Chinese Edition Editor, Yan Sun, MD, Beijing

• JCO Greek Edition Editor, Nikolaos A. Malamos, MD, Athens

• JCO Hungarian Edition Editor, József Timár, MD, Budapest

• JCO Middle East Edition Editor, Nagi S. El Saghir, MD, Beirut

• JCO North African Edition Editor, Nagi S. El Saghir, MD, Beirut

• JCO Polish Edition Editor, Maciej Krzakowski, MD, Warsaw

• JCO Russian Edition Editor, Sergei A. Tjulandin, MD, Moscow

• JCO Spanish EditionEditor, Franco M. Muggia, MD, New YorkAssociate Editor, Roman Pérez-Soler,MD, Bronx

• JCO Turkish Edition Co-Editor, Erdem Göker, MD, Bornova Izmir Co-Editor, Erhan Gokmen, MD, Bornova Izmir

23

International Editions

• David Khayat: Deputy Editor

• Not only a business venture, but a palpable effort to deliver current oncology practice to the world, and increase access for patients

• Locally published and distributed

• All material solely chosen from JCO; no additional materials canbe added

• Editors given access to TOCs in advance to enhance timeliness

• Given varying frequency of publication, only a subset of JCO papers are selected for translation and reproduction

• Guidance and monitoring of selections of local editors byDeputy Editor

• German, French and Italian editions are in planning

24

Current TOC

• Celebrating JCO’s 25th Anniversary• Commentary • Editorials • Comments and Controversies • Original Reports

– Gastrointestinal Cancer – Phase I and Clinical Pharmacology– Hematologic Malignancies– Bone Marrow Transplantation– Genetic Testing for Cancer– Thoracic Oncology– Genitourinary Cancer– Breast Cancer– Neurooncology– Pediatric Oncology– Cost Effectiveness– Supportive Care and Quality Of Life

25

Current TOC (continued)

• Review Article • Biology of Neoplasia• ASCO Special Articles • Art of Oncology• Diagnosis in Oncology • Correspondence

Review SeriesReview Series

27

Upcoming Reviews Series

February 10, 2008 Breast Cancer

April 10, 2008 Stem-Cell Transplantation

June 10, 2008 Methods/Statistics

August 10, 2008 Improving the Quality of Supportive Cancer Care

October 10, 2008 Translational Oncology

December 10, 2008 Adolescent and Young Adult Oncology

The Editor

• “An editor is hired to define the journal’s terrain and direction, and set the tone. … More than anything an editor in biomedicine is there to attract, select, improve and publish the best manuscripts – to improve quality.”

• Rennie (Lancet, 1998)

The problem:

Pressures on a journal editor

Owners

Legal restraints

Governments/authorities

Readers

Reviewers

Authors

Technicaleditors

Distributors

Printers

Advertisers

Adapted from Albert T. Winning the publications game. 1997

Reporting clinical data collection

• WHO collected the data and from whom?• WHAT data were collected?• WHEN – frequency and intervals• WHERE – describe the setting • HOW – collection and analysis• WHY was this approach taken?

32

Before you write Register your clinical trial—Required by JCO

Remember at the initiation of the trial to consider any ongoing potential sponsor conflict of interest because JCO, like most journals, has policies concerning potential financial conflicts and authorship.

For Phase 3 clinical trials, follow CONSORT guidelines closely

CONSORT = CONsolidated Standards of Reporting Trialwww.consort-statement.org

CONSORT

• CONSORT = CONsolidated Standards of Reporting Trial• www.consort-statement.org

• A checklist and flow diagram to improve the quality of RCT reports

• A standard way for researchers to report trials• Checklist includes items, based on evidence, that need to be

addressed in the report• Flow diagram provides a clear picture of the progress of all

participants in the trial, from the time they are randomized until the end of their involvement

•

Why CONSORT?•

• RCTs can have great impact on patient care

• Poorly conducted RCTs can be biased and bias the evidence base

• Analysis of published RCTs had consistently shown wide variation in reporting quality

• RCT reports should give meaningful data about

– design

– conduct

– analysis

– generalizability

•

CONSORT

flow diagram,

2001

Reporting phase I trials

• There are no CONSORT-like reporting standards for Phase I trials

• Little published research on quality of Phase I reporting

• We might expect similar problems to those seen with other trial reports

Phase II trial reporting is still evolving

•• Reviewed 393 Phase II trials published in 1995 (n=185) and 2000 (n=208) • Neither sample size nor design parameters were specified in 157 (85%) and 113 (46%) papers in 1995 and 2000, respectively.•• Thezenas et al. (Eur J Cancer , 2004)

Journal % Reporting statistical design

1995 2000

Am J Clin Oncol 12.5 36.0

Br J Cancer 29.4 28.6

Cancer 15.1 56.1

Eur J Cancer 8.3 33.3

JCO 20.0 59.3

Ann Oncol 6.9 39.3

Clinical Trials Registration1. Unique Trial number2. Trial Registration Date3. Secondary IDs4. Funding Source(s)5. Primary Sponsor6. Secondary Sponsor(s)7. Responsible Contact Person8. Research contact person9. Title of the Study10. Official Scientific Title 11. Research Ethics Review approval 12. Condition13. Interventions(s).14. Key Inclusion and Exclusion Criteria15. Study Type/ Database16. Anticipated Trial Start Date17. Target Sample Size.18. Recruitment Status19. Primary Outcome.20. Key Secondary Outcomes

Clinical Trials Databases

• Clinical Trials Databases Currently Meeting Requirements of Registration

• www.actr.org.au• www.clinicaltrials.gov• www.ISRCTN.org• www.umin.ac.jp/ctr/index/htm• www.trialregister.nl

Clinical Trials Registration and the JCO

• The registration policy is all about public trust in clinical research. The JCO will apply the registration policy to trials whose patient enrollment begins on or after November 1, 2006. Authors will have six months from the start of patient enrollment to register the trial, but registration prior to patient enrollment is recommended. The editors will use the ICMJE definition of a clinical trial as follows: “Any research project that prospectively assigns human subjects to intervention and comparison groups to study the cause-and-effect relationship between a medical intervention and a health outcome. By ‘medical intervention’ we mean any intervention used to modify a health outcome. This definition includes drugs, surgical procedures, devices, behavioral treatments, process-of-care changes, and the like…a trial must have at least one prospectively assigned concurrent control or comparison group in order to trigger the requirement for registration.”.

41

Before you write Consider what you have to say: Is the paper worth writing?

Apply the Editor’s questions:- “So what?”- “Who cares?”

Search the literature—are your findings new?

Be wary of multiple papers from same research- Avoid “salami science”—slicing data too thin- Republish only if there is substantial new data- Don’t plagiarize yourself or violate previous copyright- When in doubt, consult ICMJE and WAME guidelines

42

Before you write

Know the target audience: will your message or findings be new and relevant to JCO readers?

Is the topic within the scope of the journal?

Is the topic represented in the journal frequently, or only rarely?

Check out the formats (categories of papers) accepted by the journal

One of the most frequent reasons for rejection is the priority of the journal for the work that is being considered.

How to Start

• Know what type of paper you are writing

• research report (“original article”)

• review paper

• special article

• editorial

• case report• letter to the editor

How to Start

• What Is the Right Format?– The research paper

• the most articulate paper cannot overcome the deficiencies of an ill-conceived or poorly-executed trial

• requires a detailed report format, to allow the reader to assess the details of the study design and the results

• In general, choose the shortest format for what you have to say

How to StartHow to Start• What Is the Right Journal?

– Colleagues– Quality

• Impact factor

– Prestige journal vs. rapid publication

Writing the PaperWriting the Paper• Authorship: responsibility and content

– Should have generated at least part of the intellectual content of the paper.

– Collected and interpreted reported data– Should have taken part in writing and revising the

intellectual content– Should be able to defend publicly in the scientific

community the intellectual content of the paper for which responsibility is taken

– NEVER submit a paper without all authors taking responsibility

– If a communications firm or company writes your draft (ghostwrites), NEVER have them communicate with the journal directly, and always use their words as a draft…

47

Writing the PaperWriting the Paper Writer’s block: the first draft is not the final draft—

don’t obsess

Start with the Materials/Methods and Results sections—don’t try to write in sequence, from Abstract to Conclusion

48

Writing the PaperWriting the Paper

Finish a first draft—it won’t be pretty, but it’s a working document

Undoubtedly, it will be too long, redundant, and insufficiently focused

Deliver the document to your senior mentor and other authors …expect it to be read and returned within 10-14 days

Use professional editing services if needed to perfect writing (this is not the same as ghostwriting) Content is most important, but appearance also matters.

49

Original Research PapersOriginal Research Papers

Used for research papers

State the problem or pose the question

Present the evidence

Show validity of the evidence

Discuss implications: initial conclusion

Present additional supporting evidence

Assess conflicting evidence

Present final conclusion

50

Research Paper ElementsResearch Paper Elements

The Introduction

Tell the reader why the research was started

Do not re-explain what is in any textbook in the field

Make clear what question the research was designed to answer

Keep it short!

51

Research Paper ElementsResearch Paper Elements

Materials and Methods—the credibility of the evidence

How was the study design selected?

Definition of the subjects

Interventions

Specified measurements and methods

Statistical procedures for assessment of the data

CONSORT (Phase III)

52

Research Paper ElementsResearch Paper Elements

Results: The initial evidencePresent efficiently

- Graphs and tables…don’t repeat the text

Did the study design accomplish what was expected of it?

Order the results from the most known to the unknown (standard to experimental)

Include unequivocal statements of statistical significance; do not inflate statistically insignificant differences (“trends”)

Be sure to present results with both absolute differences and relative differences as well as confidence intervals.

53

The review articleThe review article

Structured differently from research papers or case reports

May be invited or submitted without invitation

Must be clinically oriented

What is the question that the review intends to answer?

Will it be structured and exhaustive?

Will it be a critical review?

Are you an expert in the field?

Can you find it in a standard text? Not a shopping list…. The meta-analysis

- Compilation of published reports

- Individual patient data»Piedbois and Buyse, JCO 2004

54

Consensus/Guidelines statements

The editors feel that a good consensus statement should:

• Describe a topic that has recently changed (being sure not to rehash material not dramatically new)

• Come from an established, high profile cancergroup made up of recognized experts on a topic

• Include a high level of evidence

• Be consistent with the current standard of care

Additionally, if the statement was created in responseto a meeting, then the meeting has to be an openscientific meeting.

Letter to the EditorWhat a Letter to the Editor is:

• A comment or question about an article that appears in (this) Journal, to which the author can respond

• Occasionally, an interesting observation from a study or patient that does not qualify as an original report that might stimulate further research

What it is not:

• A CV stuffer

• A place to report small, non peer-reviewed clinical trial

• Cliff’s notes: a summary of an article, and review of the literature

Remember: All LTEs do not have to start with “We read with great interest…”

55

56

Edit to communicate clearly

The ABC’s of good prose

– Accuracy

– Brevity

– Clarity

How to write a boring article….

1. Avoid focus. Introduce so many questions, ideas, and possible relationships that you kill any hope of a clear hypothesis2. Avoid originality and personality 3. Make the article really, really long4. Remove any suggestion of the work's potential implications5. Leave out illustrations, particularly good ones

Chemical & Engineering NewsSeptember 10, 2007Volume 85, Number 37p. 56

6. Omit necessary steps of reasoning7. Use as many abbreviations and technical terms as possible8. Don't even think about being funny or using flowery language. 9. Focus only on statistics10. Support every statement with a reference

How to write a boring article….

Orwell’s rules1. Never use a metaphor, simile, or other figure of speech which

you are used to seeing in print2. Never use a long word where a short one will do.3. If it is possible to cut a word out, always cut it out.4. Never use the passive where you can use the active.5. Never use a foreign phrase, a scientific word or a jargon word if

you can think of an everyday English equivalent.6. Break any of these rules sooner than say anything outright

barbarous

George Orwell, Politics and the English Language

60

Submitting the Paper

The cover letter: Your opening argument

State the title of the paper

Describe the paper

Name which manuscript category it best fits

Divulge any (apparent) overlap or prior publication (provide reprints as needed)

State conditions of publication (eg, embargo until after a meeting)

Suggest reviewers

It’s Time to Submit

• Original Reports are the primary presentation mode of scientific communication in the Journal. The Editor-in-Chief and an Associate Editor generally review Original Reports. Selected manuscripts are also reviewed by at least two external peer reviewers, and, when required, a biostatistician. Comments offered by external reviewers are returned to the author(s) for consideration.

• Original Reports are limited to 3,000 words of body text, excluding the abstract, references, figures, and tables. Original Reports are limited to six total figures and tables, not counting panels within figures. Additional figures or tables (eg, the required CONSORT diagram) can be submitted as supplemental information. Reports may be appropriately brief.

62

Information for Contributors

Revisions to be in line with ICMJE/WAME

Proposal:All clinical trials will be submitted with the originalprotocol document as a supplemental file, forboth reviewers and readers when published (online access)

• Eligibility criteria

• Dose modifications

• Stats section/endpoints

It’s Time to SubmitReview Articles Review Articles are usually solicited by the Editor-in-Chief. However, unsolicited

Reviews are considered. Authors should contact the Editor-in-Chief in advance to determine the appropriateness of their Review for publication in the Journal Manuscript Preparation Guidelines, and will be reviewed in the same manner as Reports. The text should be limited to 4,500 words, excluding the abstract, references, figures, and tables. The editors also suggest a limit of 150 references.

Editorials and Comments and ControversiesEditorials are usually solicited by the Editor-in-Chief to accompany a published article

or an accepted manuscript. Editorials offering an opinion on a topic not related to a specific article are published in the Comments and Controversies section. Avoid “cute” titles

Special Articles

Special Articles are manuscripts whose content and style do not fall under the category of Reports or Review Articles. These may include, but are not limited to, guidelines, summaries of consensus meetings, and other scholarly communications. The Editors decide on which articles are “special”;

DISCLOSURES OFPOTENTIAL CONFLICTS OF INTEREST

• Relationships with pharmaceutical companies or biomedical device manufacturers or other corporations whose products or services are related to the subject matter of the submission

• Financial interests or relationships• Disclosures of financial interests or relationships involving the authors

must be addressed on the Author Disclosure Declaration. Each author must complete a declaration form online with every manuscript submission. The corresponding author may complete the form online on behalf of other authors; or authors may also complete their own forms and forward them to the corresponding author. This information will be entered as part of the online submission process, and hard copies of these forms should not be sent to the Editorial Office. Statements regarding financial support for the research must be made on the manuscript title page, and disclosed under question #6 (Research Funding) on the form. This form is available in every issue of the Journal, online, or upon request from the Editorial Office. We recommend that authors complete the Author Disclosure Declaration before starting the formal, online submission. All disclosures will be included in published articles.

DISCLOSURES OFPOTENTIAL CONFLICTS OF INTEREST

• The intent of this policy is not to prevent authors with these relationships from publishing their work. It is merely intended that any relationships be identified openly so the Editors and peer reviewers may make informed decisions about submitted manuscripts, and so the readers may form their own judgments about the publication with the full disclosure of the facts. It remains for readers to determine whether the authors’ outside interests reflect a possible bias in the conclusions presented.

AUTHORSHIP CONTRIBUTIONS

• Contributions must be substantive in order to justify authorship. Each author should have participated sufficiently in the work to take public responsibility for the content. All other contributors, who do not meet sufficient criteria for authorship, should instead be noted in the Acknowledgments section. Corresponding authors are responsible for ensuring that all authors have seen and approved the final manuscript prior to submission.

• Every submission must include the Author Contribution Form. Author Contribution Forms must be filled out and submitted as part of the online submission process. These forms are available for reference in the print Journal, but do not need to be sent to the Editorial Office. This form is available in every issue of the Journal, online, or upon request from the Editorial Office. As part of the online submission process, the corresponding author must submit this form on behalf of every author. We recommend, therefore, that each author complete this form and forward it to the corresponding author before the formal, online submission

STATISTICAL GUIDELINES

• All results from clinical studies should be supported by a clear description of the study design, conduct, and analysis methods used to obtain the results. The description should include the originally planned sample size and the power considerations that led to that choice of sample size.

• In the case of randomized clinical trials, authors should follow the guidelines of the CONSORT statement available online at www.consort-statement.org. For randomized clinical trials, two-sided P values should be reported. If the trial design was Bayesian, used one-sided P values, or was not based on a standard two-sided test, the primary result and conclusion may be described in terms of the original design, but the two-sided P value of a standard test must also be included. Differences may be reported in terms of odds ratios or hazard ratios, but there should also be a comparison of an absolute difference of the primary measure such as difference in survival at 5 years or difference in proportions of successes.

• Reports of phase II studies should include a clear definition of the primary end point (from the protocol) and a discussion of possible weaknesses, such as comparison to historical controls.

STATISTICAL GUIDELINES• Reports focused on prognostic markers (eg, those based on clinical factors,

etiologic factors, genetic factors), will receive highest priority when an algorithm obtained in a training set is applied exactly the same way in the validation set as in the training set (i.e., the factors included and the cutoffs must be determined in the training and applied to each patient in the validation set). Further fine tuning should clearly be identified as exploratory. Prognostic studies that report the results of an algorithm from the same data that were used to fit the algorithm will have lower priority, but will be enhanced by the inclusion of cross-validation analyses and a clear statement of the limitations of the study.

• Reports describing data from multiple studies will be considered to be a meta-analysis only if individual patient data are used for analyses and an attempt is made to include data from unpublished studies. Systematic reviews that use summary data should also include unpublished data and a discussion of the limitations of such studies. Systematic reviews will have a lower priority than meta-analyses. Reports of studies of multiple or secondary end points should address the multiple comparison issues and describe the exploratory nature of the studies

69

A letter (email) from JCO arrives!

Outright acceptance (rare)

Minor revisions requested

Major revision

Rejection (may occur without external peer review)

Remember: Every paper will get published somewhere!

“There seems to be no study too fragmented, no hypothesis too trivial, no literature citation too biased or egotistical, no design too warped, no methodology too bungled, no presentation of results too inaccurate, too obscure, and too contradictory, no analysis too self-serving, no argument too circular, no conclusions too trifling or too unjustified, and no grammar and syntax too offensive for a paper to end up in print.”

Rennie (JAMA, 1986)

Peer Review: Benefits, Perceptions and AlternativesWare M. www.publishingresearch.net

• Peer review is an essential component of scholarly communication. It is the mechanism that facilitates the publication of primary research in respected scientific journals. In recent years there has been a good deal of debate about the effectiveness of peer review. There is, however, little reliable data to inform these discussions. 

• 93% of academics believe peer review is necessary• 90% believed that peer review improved quality of papers• Majority of academics believe that current peer review is satisfactory;

criticisms include speed of review and overloading of reviewers• Majority agreed with double-blind review (anonymous)• Most important to reviewers: methodology, relevance,

importance/originality, data• About 2/3 felt that reviewers should have access to authors’ data (protocol

submission)

What we want from referees:

• Promptness • Politeness• Honesty• An assessment of the quality and importance

• There are no absolute rules in refereeing: medical publishing thrives on variety.

73

Reviewers may have differing opinions

Possible reasons:

Complexity of manuscript assessment

Divergent interests of reviewers

Valid differences in the expertise of reviewers

74

Criteria for acceptance

Relevance to the journal’s scope and audience

Importance to most of the journal’s audience

Newness of the message

Scientific validity of the evidence supporting the conclusions

Usefulness to the journal in maintaining a balance of topics (“priority”)

75

Reasons for rejection

Unimportant issue studied

Unoriginal work

Research poorly done

Analysis poorly done

Conclusions not supported by results

Data set too small

Poorly written/presented

Submission does not comply with Information for Contributors

Priority of the journal

76

Responding to a rejection of your paper

Don’t take it personally

Did you shoot too high?

Is the paper more appropriate elsewhere?

Carefully read the comments; don’t be defensive!!

Blatant protest to the editor is rarely successful

On the other hand, even editors and reviewers are not perfect…

77

Responding to a rejection of your paper

Appealing a decision

- Contact the editor to see whether the paper is salvageable

- Plead your case, but don’t whine or get angry

Consider whether the paper would better be submitted to another journal

- Revise using external reviewers comments (the same reviewers may see the paper again)

Don’t let journal #2 know that it was an also-ran….

78

Responding to a major revision request

Respond to the comments

Provide more data (often updated)

Condense—brevity is ideal

Fix the figures

“Never miss a good chance to shut up.”

Will Rogers