12 tips for sci paper
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International Journal of Angiology 11:53-55 (2002)DO1:10.1007/s00547-001-0054-8
T w e l v e T i p s o n W r i t i n g a G o o d S c i e n t i f i c P a p e r
J o h n A . E l e f t e r i a d e s , M.D., F.I.CoA.
Department of Cardiothoracic Surgery, Yale University School o f Medicine, New Haven, Connecticut
It is an indication of Dr. Chang's wisdom and experi-ence in academic matters that he should commission an
article on the technique o f writing a good scientific pa-
per. There are many pitfalls to which the new or occa-
sional writer is prone. Also, the manner of presentation
can make a great deal of difference as to how favorably
research information is received by editors and can im-
pact the usefulness of the paper to readers.
The compilation which follows incorporates sugges-
tions which the author hopes will be of use in writing
scientific papers. Much of this was taught to the author
by his mentors, and much was learned (the hard way) by
experience. This list is not meant to be exhaustive, but
rather to cover certain important general principles re-
garding how to present one's research data for scientificpublication.
Good Underlying Research Question
1. A good research paper needs to start with a good
research questio n--a question to which the reader wants
to know the answer. If the underlying question is not
pertinent or interesting or of clinical importance, no one
will want to know the answer, and no one will be in-
terested in accepting or reading the resulting paper. At
what size does an aneurysmal aorta rupture? How often
are infectious pathogens found in atheroma removed atsurgery? Does revascularization improve ventricular
function in patients with ischemic cardiomyopathy?
What is the influence of antecendent pulmonary hyper-
tension on mortality in heart transplantation? Can ar-
teriosclerosis occur in the absence of interferon-y? These
are all examples of research questions in angiology that
produced published papers which proved of interest
to readers. Good basic questions that stimulate
research--both in the laboratory and the clinic--arise
from the investigator's experience and creativity. With-
Correspondence to: John A. Elefteriades, M.D., Professor and Chief,Department o f Cardiothoracic Surgery, Yale University School ofMedicine, 333 Cedar Street, P.O. Box 208039, New Haven, CT 06520-8039
out such worthy underlying questions, the resultingmanuscript will not be of interest to editors, nor will the
paper capture readers' attention. Most often, for clinical
papers, a well-chosen question will impact substantially
on clinical management of real-world patients.
Brevity
2. The paper must be concise. This is often a hard
concept for scientific writers just s tarting out. The new
scientific writer is often not accustomed to the brevity of
scientific communicat ion , which is very different from
other forums. Excess length is not as much an issue for a
thesis or for general prose or fiction. But, the scientificreader is hard-pressed for time. For scientific journals,
space is at a premium. You must state your concept,
methods, results, conclusions, and discussion succinctly,
with as few words, Tables, Figures, and References as
possible. With experience, you will come to realize just
how much can be cut without adversely affecting con-
veyance of your message. I learned this concept from
Dr. Arthur Baue, my former Chairman, who cut a
chapter I had written on diaphragm pacing dramatically
without curtailing its message whatsoever. Dr. Baue,
editor of Glenn's Textbook of Thoracic and Cardio-
vascular Surgery, taught me just how much of what we
put on paper is repetitious or unnecessary to convey our
meaning. I learned this concept also from Dr. William
Roberts, editor of the American Journal of Cardiology.
Dr. Roberts has a reputation for cutting and cutting
without detracting in any way from the substance of a
report. This is a very important talent for the novice
scientific writer to learn.
Abstract Conveys All Critical Information
3. The abstract must convey all the cardinal findings
and messages. Please remember that even the an avid
reader of your work will read your abstract and at
most look at some of your figures, skim y~ur methodsand results, and glance at your discussion and con-
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54 J A. Elefteriades: Writi ng a Scientific Pap er
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Fig. 1. Examples o f cardinal visual images defining specific published pape rs.
clusions. Very few people--your editor, your reviewers,
and readers working in the exact same area as
you--will actually read the full content of your paper.
Be sure that everything you put in your abstract is
important and that nothing important is left out of
your abstract.
A void Excessive Li terature Review
4. Do not overdo y our review of the literature. Begin-
ning medical writers have a tendency to review past
studies on similar topics exhaustively. This is not nec-
essary and can be excessively cumbersome for editors
and readers. You must recognize prior work, but at the
same time be aware that the purpose of your paper is to
say what you studied and what were your findings.
Whole series of papers can often be summarized by one
or a few sentences describing the general thrust of prior
research. In your discussion, you will be able to address
significant similarities and contrasts vis-/t-vis prior workin a succinct fashion.
A void Excessive Use o f Figures
5. Remember that the Figures appropriate for a publi-
cation are very different from those for a lecture pre-
sentation. For a presentation, you want to illustrate
every point for ease of assimilation. Yo u will want ma ny
slides. By contrast, for a publication, yo u need to min-
imize the illustrations. The reader can assimilate simple
numerical data from the body of the text. Only complex
compilations of data require a Figure or Table. Chose
your figures for publication critically and sparingly.
One Cardinal Visual Image
6. You should have one single, cardinal visual image
which the reader will recall long-term that conveys the
crux of your paper. This is what I call the Wacker's rule
(after Frans Wackers, our distinguished chief of Nuclear
Cardiology at Yale). We all know that visual material is
readily assimilated and visual images easily recalled.Your cardinal figure may convey a change in a certain
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J.A. Elefteriades: Writing a Scientific Paper 55
paramet er before or after tr eatment. The figure may show
a germinal histologic finding. The figure may illustrate
the steps of a new technique. Nonetheless, you should
have such a central figure, and it must be an exceptional
one. You should ask yourself, if a colleague were to cite
my work in a lecture, wha t one slide would I want him toshow. This will be your cardinal figure. (Some illustra-
tions of "cardinal figures" from publications by our
group are included in the accompanying Figure.)
series" or "shows the lowest mortality," or other such
superlative self-assessments. Very often, som eone from
somewhere will disprove your claim-perhaps from an
article published in an obscure journal from another
country. Your work and your data will speak for
themselves. I learned this from the very wise Dr. WilliamW. L. Glenn, the great cardiac surgical pioneer from
Yale University.
C a r e f u l F i n a l R e - R e a d i n g
7. Read and re-read until you know that everything in
your paper is accurate. Make sure not only that all your
data is well-substantiated and scientifically accurate, but
also that all the numbers "add up." Usually it is best to
have at least one of your co-authors read the paper
extremely critically, word by word in the text, and line
by line in the Tables and captions, to check for errors.
Oftentimes, it is good also to have a trusted colleague
not directly involved in the work read your paper for
accuracy. The author who actually composes the paper
may not be able to spot his own errors or omissions. In
my experience, the paper with no inconsistencies or in-
accuracies in totals or other figures is a rarity.
I n c l u d e S e c ti o n o n W e a k n e s s e s o f Y o u r S t u d y
8. Be sure to include a section on weaknesses of the
current study. No study is immune from weaknesses, not
even the largest, best-planned, double-blind, random-ized, prospective multi-institutional trials. Most ordi-
nary laboratory or clinical papers have major
weaknesses. Patient number may be smaller than one
would want. Relevance may hindered by pre-selection
bias before a certain population reaches a tertiary cen-
ter. Follow-up may not be as long as one would wish.
The editors an d reviewers will respect your work mo re if
you show an awareness of the weaknesses of your study
and enumerate these for your readership. Also, such
frankness is an ethical responsibility, as readers may
alter their care of patients based on your recommenda-
tions. Being aware of the limitations of your work will
help the reader to determine if he feels your conclusions
are firmly enough established to warrant a change in his
clinical practice.
A v o i d S u p e r l a t iv e s i n D e s c r i b i n g y o u r W o r k
9. What I mean by this is that you should not succumb
to saying that your work is "the first" or the "biggest
T h e E d i t o r is' A l w a y s R i g h t
10. By and large, accept what your editor says and
wants. He was chosen for his experience and insight. He
is completely objective. He has enlisted expert opinions
regarding your work rendered by recognized authorities.
He directly controls whether or not your manuscript will
become a published paper. Do what he wants in modi-
fying your manuscript. Also--and this is very impor-tant-provide the editor a clear, concise tabulation of
the changes you have rendered in you r paper in response
to his and the reviewer's comments.
S t a t i s t i c a l C o n s u h a t i o n
11. Enlist statistical assistance liberally. Today's stan-
dards in terms of statistical analysis for leading jour-nals are very high. If major data analysis is inherent in
your research paper, it is often advisable to enlist the
support and advice of a trained statistician in analyzing
and interpreting your data. This can prevent later
problems in the review process and also enable you to
respond more meaningfully to any statistical issues that
are raised.
D o n o t b e d i s c o u r a g e d i f y o u r p a p e r i s r e j e c t e d
o n o n e o r m o r e s u b m i s s i o n s . fo r r e v i e w
12. Some o f the very best papers, which eventu ally come
to be respected and frequently quoted, are not accepted
on initial submission. You can learn from the reviewer's
comments and submit your work to another journal.
Anyone with significant experience in academic medi-
cine has learned to become inured to the rejection pro-cess. This does not necessarily mean that your work is
unworthy. You must persevere without getting dis-
couraged.The author hopes that these observations will be of
some use to the novice or occasional medical essayist
and may help in achieving acceptance of your manu-
scripts for publication.