Manuscript Writing for epidemiological studies

1. Manuscript Writingfor epidemiological studies

2. Useful resources • For style and grammar • Elements of style, by Strunk W. and White E.B., 1979 • http://owl.english.purdue.edu/handouts/grammar/g_dangmod.html (for dangling modifiers) • Bedford Handbook for Writers, Hacker • Writing Research Papers: An Easy Guide for non-Native-English Speakers, by Stapleton’s, 1987 • Books on Scientific writing • How to write and publish a scientific paper, Day, R. 1995 • Essentials of Writing Biomedical Research papers, Zeiger M, 1991 • From Research to Manuscript, A Guide to Scientific Writing, Katz MJ, 2009, (available online at UCLA: http://www.springerlink.com/content/p31tn6/)

3. Manuscript Sections • Title • Author affiliations • Abstract • Introduction • (Materials and) Methods • Results • Discussion • Acknowledgements/Funding • References • Tables

4. Order in which you write • Methods • Results • Introduction • Discussion • Abstract

5. Strengthening the reporting of observational studies in epidemiology (STROBE) • Is a checklist of items that should be addressed in articles reporting on 3 main study designs of analytical epidemiology. • www.strobe-statement.org

6. Title and title page • Needs to be attention grabbing • Few words that can adequately describe the contents of the paper • Often times in epidemiological studies, we indicate the study’s design or the name of the study • Title page includes: • Author affiliations • Corresponding author • Running title • Keywords • List of abbreviations

7. Example of a title page (prior to publication) Title Authors Affiliations

8. Example of a title page, con’t.

9. Abstract • A summary of the manuscript, giving the reader a "preview" of what's to come. • Allows readers to quickly scan the large scientific literature, and decide which articles they want to read in depth. The abstract should be a little less technical than the article itself. • Often 200-300 words, dependent on the journal

10. An Abstract should… • Not have additional information beyond what is in the manuscript. • State the principal objectives and scope of the investigation • Describe methods employed • Summarize the results • State principal conclusions • Provide a balanced summary of what was done and found. • Common Mistakes • Too much background or methods information • Figures or images • References to other literature, figures or images • Abbreviations or acronyms

11. Structured vs. unstructured abstract

12. Introduction • The introduction summarizes the relevant literature so the reader will understand why you are interested in the question you asked. • Introduction should always • Provide the background/rationale and objectives • Review pertinent literature • Briefly state the method of the investigation

13. Material and Methods • Study Design • Cross-section, case-control, cohort • Setting • Location(s), relevant dates: period of recruitment, exposure, follow-up, and data collection. • Participants • Eligibility criteria • Methods of selection • For case-control study: case ascertainment, control selection, rational for case and control choice • For cohort study: methods of follow-up • Participation rates

14. Material and Methods • Variables • Define outcome, exposure, potential confounders, and effect modifiers • Datasource/ measurement, data collection, laboratory methods • Provide details regarding source of data and methods of assessment. • Bias • Describe any efforts to address potential sources of bias • Study size

15. Example of materials and methods section Study size Recruitment rates Data collection IRB info

16. Statistical methods • Explain how variables were handled in the analysis, i.e. continuous, categorical, if so what were the categories. • Describe all statistical methods • How one controlled for confounding • Methods for stratified analyses or interactions • How missing data was addressed • Sensitivity analyses • Study specific: • Cross-sectional study: analytical methods to account for sampling strategy • Case-control study: how cases and controls were matched (if applicable) • Cohort study: how loss to follow-up was addressed.

17. Statistical model Adjustment variables

18. Results • In paragraph format, a summary of your main findings presented tables and figures. • Results not presented in tables or figures can also be mentioned in this section. • If this is the first time presenting information regarding the study, one may want to present numbers of individuals at each stage of the study. • Section should include: • Characteristics of study participants (usually Table 1) • Number of missing • Main results (Usually table 2) • Additional analyses, such as stratified analyses, effect modification, interactions, sensitivity analyses (additional tables)

24. Tables and Figures • Should be after the Discussion or Reference section • Tables and figures should stand alone. • About 6 tables max, sometimes this depends on the journal. • Use a consistent footnoting style (footnotes may be specific to journals) • Define abbreviations, even if they have been defined in the manuscript.

25. Discussion • This is your moment to shine and show your knowledge of the prior literature. • Summarize key results in reference to study objectives • Usually numbers from results should not be in the discussion section • Do not restate the results • Interpretation • Give a cautious overall interpretation of results considering the objectives, limitations, results from similar studies, and other relevant evidence. • Mention the significance of the paper.

26. Discussion, con’t. • Limitations of the study and study findings • Potential bias • Potential imprecision • Whenever discussing your limitations try to put a positive spin on what you have to say. • For instance, “Measures of height and weight were self-report, likely resulting in nondifferential misclassification. Nonetheless, such misclassification was not an important cause of concern as some found self-reported height and weight to be reasonably accurate (CITATION)” • Study strengths • Conclusions • Of the study • Future directions • Potential public health implications.

27. Acknowledgements/Funding • List funding sources for the study and authors • Thank the participants of the study for their time, commitment, and participation.

28. Reference section • Use products like Procite, Reference Manager, or Endnote for citations. • Reference style is dependent on the journal. • Order of references can be presented in alphabetical order or by order of presentation. • Formatting for a specific journal can be done using one of these programs. Many programs have the journal styles pre-set. • However, ALWAYS check to make sure the formatting is done correctly, sometimes the journal info may have been imported incorrectly or the journal format style may be different than the one in the program.

29. General rules • Spell-check, try to avoid typos and errors. • Use correct and standard nomenclature • When using abbreviations always define the abbreviations the first time they are used. • For example, upper aerodigestive tract (UADT) • Consistency • Number your pages

30. Final advice • Rewrite, rewrite, rewrite • Proofread, proofread, proofread • Check all your numbers for accuracy and consistency