how to publish research paper in pubmed

How to Submit Your Paper in PubMed

PubMed Central ( PMC ) is a free resource that provides access to millions of peer-reviewed articles in the biomedical and life sciences field, mainly from the MEDLINE database. The archive is maintained by the US National Library of Medicine at the National Institutes of Health (NIH) and allows authors and publishers to store and cross-reference information from several sources using a common format within a single platform.

Four Methods

Accepted papers can get to PMC in different ways : Published articles may be deposited to the repository by the publishers, but final peer-reviewed manuscripts can also be submitted to PMC directly by the authors through the NIH Manuscript Submission (NIHMS) system . There are four methods to ensure that all submitted papers comply with the NIH Public Access Policy:

• Method A : In this case, participating journals deposit final published articles directly in PMC without any author involvement.
• Method B : Some journals only submit selected articles to PMC. So, in this case, authors may need to ask the publishers to deposit the paper for them.
• Method C : Authors (or their delegates) upload final peer-reviewed manuscripts to the repository via the NIHMS system.
• Method D : Authors complete the submission of final peer-reviewed manuscripts started by a publisher through the NIHMS system.

All articles submitted to PMC receive a unique identifier —the PMCID — which can be used to cite them after acceptance. During the first three months, the PMC Journal- In Process (for methods A and B) or the NIHMSID (for methods C and D) identifiers can be used instead.

Submitting Papers to PMC

NIH-funded articles should be submitted to PMC immediately after being accepted by a journal; the manuscripts are made publicly available within 12 months of publication. The submission process is quite easy and fast:

For methods A and B:

• The publisher sends the article —including all tables, figures, and supporting information— to PMC in a specific format (XML). It is a good idea to check the copyright form when submitting a paper to a journal to verify that the publisher will be responsible for submitting the files to PMC. In some cases, the authors will have to ask the publisher to do so.
• The deposited files are then checked by the PMC staff.
• Finally, the paper is added to PMC.

For methods C and D:

• The author, a designee, or the publisher submits the manuscript file (in Word, PDF, or another format) together with all tables, figures, and supporting materials to the NIHMS system.
• The author then provides funding information, associates it with the manuscript, and finally approves the files for processing.
• NIHMS converts the submitted files to a PMC format.
• The author must then approve the converted version.
• After all the previous steps have been completed, the manuscript is added to PMC.

Many journals have agreements to deposit articles in PMC, some of them with full participation, others offering selective deposit, and others with an NIH portfolio agreement, which means that they only deposit NIH-funded articles. To help authors find out which method is supported by a particular journal, the NIH has published several lists on their homepage as well as additional information on how to submit a manuscript to PMC.

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How to Write and Publish a Research Paper for a Peer-Reviewed Journal

• Open access
• Published: 30 April 2020
• Volume 36 , pages 909–913, ( 2021 )

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• Clara Busse   ORCID: orcid.org/0000-0002-0178-1000 1 &
• Ella August   ORCID: orcid.org/0000-0001-5151-1036 1 , 2  

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Communicating research findings is an essential step in the research process. Often, peer-reviewed journals are the forum for such communication, yet many researchers are never taught how to write a publishable scientific paper. In this article, we explain the basic structure of a scientific paper and describe the information that should be included in each section. We also identify common pitfalls for each section and recommend strategies to avoid them. Further, we give advice about target journal selection and authorship. In the online resource 1 , we provide an example of a high-quality scientific paper, with annotations identifying the elements we describe in this article.

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Avoid common mistakes on your manuscript.

Introduction

Writing a scientific paper is an important component of the research process, yet researchers often receive little formal training in scientific writing. This is especially true in low-resource settings. In this article, we explain why choosing a target journal is important, give advice about authorship, provide a basic structure for writing each section of a scientific paper, and describe common pitfalls and recommendations for each section. In the online resource 1 , we also include an annotated journal article that identifies the key elements and writing approaches that we detail here. Before you begin your research, make sure you have ethical clearance from all relevant ethical review boards.

Select a Target Journal Early in the Writing Process

We recommend that you select a “target journal” early in the writing process; a “target journal” is the journal to which you plan to submit your paper. Each journal has a set of core readers and you should tailor your writing to this readership. For example, if you plan to submit a manuscript about vaping during pregnancy to a pregnancy-focused journal, you will need to explain what vaping is because readers of this journal may not have a background in this topic. However, if you were to submit that same article to a tobacco journal, you would not need to provide as much background information about vaping.

Information about a journal’s core readership can be found on its website, usually in a section called “About this journal” or something similar. For example, the Journal of Cancer Education presents such information on the “Aims and Scope” page of its website, which can be found here: https://www.springer.com/journal/13187/aims-and-scope .

Peer reviewer guidelines from your target journal are an additional resource that can help you tailor your writing to the journal and provide additional advice about crafting an effective article [ 1 ]. These are not always available, but it is worth a quick web search to find out.

Identify Author Roles Early in the Process

Early in the writing process, identify authors, determine the order of authors, and discuss the responsibilities of each author. Standard author responsibilities have been identified by The International Committee of Medical Journal Editors (ICMJE) [ 2 ]. To set clear expectations about each team member’s responsibilities and prevent errors in communication, we also suggest outlining more detailed roles, such as who will draft each section of the manuscript, write the abstract, submit the paper electronically, serve as corresponding author, and write the cover letter. It is best to formalize this agreement in writing after discussing it, circulating the document to the author team for approval. We suggest creating a title page on which all authors are listed in the agreed-upon order. It may be necessary to adjust authorship roles and order during the development of the paper. If a new author order is agreed upon, be sure to update the title page in the manuscript draft.

In the case where multiple papers will result from a single study, authors should discuss who will author each paper. Additionally, authors should agree on a deadline for each paper and the lead author should take responsibility for producing an initial draft by this deadline.

Structure of the Introduction Section

The introduction section should be approximately three to five paragraphs in length. Look at examples from your target journal to decide the appropriate length. This section should include the elements shown in Fig.  1 . Begin with a general context, narrowing to the specific focus of the paper. Include five main elements: why your research is important, what is already known about the topic, the “gap” or what is not yet known about the topic, why it is important to learn the new information that your research adds, and the specific research aim(s) that your paper addresses. Your research aim should address the gap you identified. Be sure to add enough background information to enable readers to understand your study. Table 1 provides common introduction section pitfalls and recommendations for addressing them.

The main elements of the introduction section of an original research article. Often, the elements overlap

Methods Section

The purpose of the methods section is twofold: to explain how the study was done in enough detail to enable its replication and to provide enough contextual detail to enable readers to understand and interpret the results. In general, the essential elements of a methods section are the following: a description of the setting and participants, the study design and timing, the recruitment and sampling, the data collection process, the dataset, the dependent and independent variables, the covariates, the analytic approach for each research objective, and the ethical approval. The hallmark of an exemplary methods section is the justification of why each method was used. Table 2 provides common methods section pitfalls and recommendations for addressing them.

Results Section

The focus of the results section should be associations, or lack thereof, rather than statistical tests. Two considerations should guide your writing here. First, the results should present answers to each part of the research aim. Second, return to the methods section to ensure that the analysis and variables for each result have been explained.

Begin the results section by describing the number of participants in the final sample and details such as the number who were approached to participate, the proportion who were eligible and who enrolled, and the number of participants who dropped out. The next part of the results should describe the participant characteristics. After that, you may organize your results by the aim or by putting the most exciting results first. Do not forget to report your non-significant associations. These are still findings.

Tables and figures capture the reader’s attention and efficiently communicate your main findings [ 3 ]. Each table and figure should have a clear message and should complement, rather than repeat, the text. Tables and figures should communicate all salient details necessary for a reader to understand the findings without consulting the text. Include information on comparisons and tests, as well as information about the sample and timing of the study in the title, legend, or in a footnote. Note that figures are often more visually interesting than tables, so if it is feasible to make a figure, make a figure. To avoid confusing the reader, either avoid abbreviations in tables and figures, or define them in a footnote. Note that there should not be citations in the results section and you should not interpret results here. Table 3 provides common results section pitfalls and recommendations for addressing them.

Discussion Section

Opposite the introduction section, the discussion should take the form of a right-side-up triangle beginning with interpretation of your results and moving to general implications (Fig.  2 ). This section typically begins with a restatement of the main findings, which can usually be accomplished with a few carefully-crafted sentences.

Major elements of the discussion section of an original research article. Often, the elements overlap

Next, interpret the meaning or explain the significance of your results, lifting the reader’s gaze from the study’s specific findings to more general applications. Then, compare these study findings with other research. Are these findings in agreement or disagreement with those from other studies? Does this study impart additional nuance to well-accepted theories? Situate your findings within the broader context of scientific literature, then explain the pathways or mechanisms that might give rise to, or explain, the results.

Journals vary in their approach to strengths and limitations sections: some are embedded paragraphs within the discussion section, while some mandate separate section headings. Keep in mind that every study has strengths and limitations. Candidly reporting yours helps readers to correctly interpret your research findings.

The next element of the discussion is a summary of the potential impacts and applications of the research. Should these results be used to optimally design an intervention? Does the work have implications for clinical protocols or public policy? These considerations will help the reader to further grasp the possible impacts of the presented work.

Finally, the discussion should conclude with specific suggestions for future work. Here, you have an opportunity to illuminate specific gaps in the literature that compel further study. Avoid the phrase “future research is necessary” because the recommendation is too general to be helpful to readers. Instead, provide substantive and specific recommendations for future studies. Table 4 provides common discussion section pitfalls and recommendations for addressing them.

Follow the Journal’s Author Guidelines

After you select a target journal, identify the journal’s author guidelines to guide the formatting of your manuscript and references. Author guidelines will often (but not always) include instructions for titles, cover letters, and other components of a manuscript submission. Read the guidelines carefully. If you do not follow the guidelines, your article will be sent back to you.

Finally, do not submit your paper to more than one journal at a time. Even if this is not explicitly stated in the author guidelines of your target journal, it is considered inappropriate and unprofessional.

Your title should invite readers to continue reading beyond the first page [ 4 , 5 ]. It should be informative and interesting. Consider describing the independent and dependent variables, the population and setting, the study design, the timing, and even the main result in your title. Because the focus of the paper can change as you write and revise, we recommend you wait until you have finished writing your paper before composing the title.

Be sure that the title is useful for potential readers searching for your topic. The keywords you select should complement those in your title to maximize the likelihood that a researcher will find your paper through a database search. Avoid using abbreviations in your title unless they are very well known, such as SNP, because it is more likely that someone will use a complete word rather than an abbreviation as a search term to help readers find your paper.

After you have written a complete draft, use the checklist (Fig. 3 ) below to guide your revisions and editing. Additional resources are available on writing the abstract and citing references [ 5 ]. When you feel that your work is ready, ask a trusted colleague or two to read the work and provide informal feedback. The box below provides a checklist that summarizes the key points offered in this article.

Checklist for manuscript quality

Data Availability

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Brett M, Kording K (2017) Ten simple rules for structuring papers. PLoS ComputBiol. https://doi.org/10.1371/journal.pcbi.1005619

Lang TA (2017) Writing a better research article. J Public Health Emerg. https://doi.org/10.21037/jphe.2017.11.06

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Acknowledgments

Ella August is grateful to the Sustainable Sciences Institute for mentoring her in training researchers on writing and publishing their research.

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Department of Maternal and Child Health, University of North Carolina Gillings School of Global Public Health, 135 Dauer Dr, 27599, Chapel Hill, NC, USA

Clara Busse & Ella August

Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA

Ella August

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Correspondence to Ella August .

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Busse, C., August, E. How to Write and Publish a Research Paper for a Peer-Reviewed Journal. J Canc Educ 36 , 909–913 (2021). https://doi.org/10.1007/s13187-020-01751-z

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DOI : https://doi.org/10.1007/s13187-020-01751-z

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How to add academic journal articles to PubMed: An overview for publishers

If you work with journals in the biomedical or life sciences, getting the articles you publish added to PubMed to make them more discoverable is likely one of your top goals. But, you may be wondering how to go about it.

We caught up with PubMed Central (PMC) Program Manager Kathryn Funk to get answers to some of the most common questions that we hear from journal publishers about PubMed and the related literature databases at the National Library of Medicine (NLM), MEDLINE and PMC. Read on to learn more about how the PubMed database works and how to apply to have a journal indexed in MEDLINE or PMC in order to make its articles searchable via PubMed.

PubMed, PubMed Central, and MEDLINE—understanding the differences

Before digging into NLM’s different journal selection criteria, it’s important for publishers to understand the differences between PubMed, PMC, and MEDLINE and how the systems influence each other. Funk said she often hears publishers talk about being indexed in PubMed, when what they really mean is being added to either MEDLINE or PMC.

“PubMed is a kind of superset for content archived and indexed by NLM. It pulls in articles from both the MEDLINE index and PMC full-text archive. PubMed is the public facing search for those two resources,” Funk explained. “So you don’t apply for or get selected to be in PubMed. You apply for and get selected to be in either MEDLINE or PMC and as a result your records are searchable in PubMed.”

How to decide whether to apply for MEDLINE, PubMed Central, or both

For a publisher trying to decide whether to apply to have their journal indexed in PMC, MEDLINE, or both, Funk said it depends on a few factors, including the journal’s publishing model, the language the journal publishes in, and the number of peer-reviewed articles that the journal has published.

“The decision for many publishers may depend on the journal’s business model, but NLM recommends all journals consider making their full-text articles accessible in PMC. Journals who choose not to do so may choose to only apply to MEDLINE,” said Funk. She added that journal publication language is also a key factor because only MEDLINE has the resources to review applications for foreign language journals at this time.

From there, Funk said the decision of where to apply often comes down to the number of articles a journal has published and how quickly the publisher wants to have its articles made discoverable in PubMed. “For journals that want to get into PubMed as quickly as possible, PMC has a lower minimum article requirement. Journals can apply to PMC when they have 25 peer-reviewed articles available, whereas for MEDLINE journals should wait until they have published 40 peer-reviewed articles. PMC also has a rolling application and review process, so a decision on an application will be made usually within 12 weeks of applying. Whereas, the Literature Selection Technical Review Committee (LSTRC) that recommends journals for MEDLINE meets to review journals three times a year.”

Funk added that MEDLINE has traditionally been the more selective option. “The mission of PMC is to support open science and long-term archiving of full-text articles, so that selection process is a little broader,” Funk explained.

If you want to index a journal in both MEDLINE and PMC, Funk said the two application processes do inform each other both in terms of acceptances and rejections. “If a journal applies to MEDLINE first and is selected, we generally consider them eligible for inclusion in PMC, and we don’t reassess them. On the flip side, if a journal applies to PMC first and is not accepted, it will not be eligible to apply for MEDLINE for at least two years. That is so that we can make sure we’re using our reviewer resources as efficiently as possible. And because if reviewers identify deficiencies, it gives the journals time to address them and demonstrate the change.”

PubMed Central and MEDLINE application requirements

Funk said there are some basic pre-application requirements for both MEDLINE and PMC that journal publishers should be aware of before applying to be indexed in either. “First of all, it’s important to bear in mind that the scope of what NLM collects is biomedical and life science content. I always recommend that journals familiarize themselves with the scope of the library’s collection before applying for either MEDLINE or PMC because we do see a lot of submissions that are outside of the scope for the databases,” said Funk. “We also look at the types of articles being published. We focus on journals that publish original research including clinical research and clinical observations, analysis of various philosophical or social aspects of health professions, critical reviews, statistical compilations, and case reports.”

In addition to content scope, Funk said both MEDLINE and PMC consider journals’ scientific and editorial quality, and even their production quality. “We do consider layout, graphics, tables, and illustrations to make sure that the journal is high-quality not just from a scientific and editorial perspective but also from a production perspective,” said Funk. “In terms of content and editorial quality, some things NLM focuses on are whether study aims are clearly stated, whether the justifications of studies are clearly supported, and whether study methods are described in specific detail. NIH and NLM are both very invested in supporting the reproducibility of science and so we encourage journals to be as thorough as possible in providing research methods. We also want to see references that are appropriate in number and up-to-date.”

Generally speaking, the publisher of a journal applying for inclusion in MEDLINE or PMC should have at least a two-year history of publishing. NLM also expects journals to maintain established publishing schedules to demonstrate sustainability.

Additionally, Funk said NLM looks to see if journals are following standard publishing and editorial policies including recommendations provided by the International Committee of Medical Journal Editors and the Committee on Publication Ethics .

As noted, both PMC and MEDLINE have their own particular application requirements, in addition to the language specifications and peer-reviewed article counts explained above:

MEDLINE requirements: For more detailed information on MEDLINE Indexing requirements publishers can visit the Journal Selection Fact Sheet . Those looking to index an online-only journal should also review MEDLINE’s Policy on indexing electronic journals .

PMC requirements: For more detailed information on PMC selection criteria, visit the Journal Selection for PMC page and the “ How to Include a Journal in PMC “ overview.

Article submission format requirements for PubMed Central and MEDLINE

Both MEDLINE and PMC also require that records from accepted journals be submitted in specific formats. Like most major academic archives and indexes, the systems require machine-readable article files in standard XML markup language.

“For MEDLINE, journals are required to send article citation and abstract data in XML format. For PMC, journals must supply the full text of all articles in XML and include all figures, tables, and supplementary materials for archiving. Unsurprisingly, we prefer JATS XML, but we can work with other XML formats and other DTDs as needed.”

For more details on NLM XML requirements check out the XML Help for PubMed Data Providers page and the PMC File Submission Specifications page .

If you use Scholastica for open access publishing, you’re a few steps ahead in terms of meeting these technical requirements. Scholastica provides front-matter JATS XML files formatted with all the necessary data for MEDLINE indexing to journals that use our Open Access Publishing Platform and full-text JATS XML files ready to be submitted to PMC for all journals that use our digital-first Production Service . You can instantly download these files from your article pages and submit them via PubMed’s FTP server.

Putting it all together

There is a lot more to getting journal articles added to PubMed than what meets the eye! By taking a methodical approach to reviewing NLM’s indexing and archiving policies and requirements publishers can determine where their journals stand and take the necessary steps to be added to either system.

“Publishers should start with the basics— making sure they’re producing quality content that follows editorial and ethical best practices and that, of course, fits within the scope of PubMed and then drill down to the specifics from there,” said Funk. From making journal articles more discoverable, to enhancing journal reputation, the benefits of being included in PubMed are many making the application process well worth the effort!

For more detailed information on helping a journal apply to PMC when you’ve never done it before, check out this blog post .

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Writing and Publishing

Do i have to fill in the citation information on request forms manually is there somewhere i can enter a pmid number.

The NIH Library offers a method to pre-populate the document delivery order from with citation information. To use this feature to start your search in PubMed @ NIH . Look for the NIH Library Fulltext Plus button. This service will populate the request form from the PubMed citation. The same service is available in Web of Science, Embase, Scopus and Google Scholar.

Do I have to submit my manuscript to PubMed Central?

As noted on the NIH public access website , your peer-reviewed papers should be submitted to PubMed Central (PMC) immediately upon acceptance for publication by a journal. PMC will make these papers publicly available within 12 months of publication. The Policy applies to all peer-reviewed papers that you author or co-author as part of your NIH or NIH-funded duties, even if the corresponding author or other authors are not supported by NIH.

There are four methods to ensure that an applicable paper is submitted to PubMed Central (PMC) in compliance with the NIH Public Access Policy. Authors may use whichever method is most appropriate for them and consistent with their publishing agreement. Click on the method in the table below for details.

EndNote Output Styles

The EndNote styles collection contains more than 4,500 bibliographic styles for a variety of disciplines. If you do not see the style you need, check the EndNote website .

If you find the journal style you need, download the file and save to the desktop.

• For windows: left click on the Start menu, click Explore , go to Program Files , click on EndNote , click on the Styles folder.
• Drag and drop the output style file from your desktop to the folder.

If you cannot find the output style you need from the EndNote website, you can alter an existing style to conform to your needs.

• From the Edit menu, choose Output Styles and select Open Style Manager .
• In the Style Manager, change the setting in the information panel (on the right- hand side) from Style Info to Style Preview. The preview of the selected style should now be displayed.
• Scroll through the list of available styles to see if you can find one that is similar to what you need.
• Once you have found a similar style, select it, and click the Edit button. The Style window opens.
• Choose Save As from the File menu, give this copy of the style a new name that corresponds to the name of the journal you want to use it for, and click Save. This will also keep the original style unchanged, in the event that you need to use it later.
• The new Style window remains open for you to edit as you need.
• There are many elements of the style that may be edited. For detailed information on specifics of editing styles refer to the EndNote Manual (via the Help button). As an example, you can edit the citations in the text from superscript numbers "1" to "author-year type". Click on Templates under the Citation heading to see the Citation panel. This template tells EndNote how to format the in-text citations. (The bibliography number corresponds to a numbered reference in a bibliography.) An author-year type of style would display as “(Author, Year)” in the citation template. You may change the template by deleting unwanted field names or punctuation, retyping the punctuation you want, and inserting new fields with the Insert Field button.

What does it cost to have someone edit my manuscript?

The  NIH Library Editing Service provides, as a free service, light and medium editing for NIH- and HHS-related work. The service is intended to help you get your draft ready for peer review. As the writer, you have the option to accept or reject the editing suggestions. In order to serve all eligible staff who request editing assistance, we leave it to you to perform in-depth editing and to make all revisions.

Where can I find help on searching PubMed?

NLM has comprehensive online help available at http://www.ncbi.nlm.nih.gov/books/NBK3830/?depth=2

There is an online tutorial at https://www.nlm.nih.gov/bsd/disted/pubmedtutorial/cover.html

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How to Write and Publish Your Research in a Journal

Last Updated: May 26, 2024 Fact Checked

Choosing a Journal

Writing the research paper, editing & revising your paper, submitting your paper, navigating the peer review process, research paper help.

This article was co-authored by Matthew Snipp, PhD and by wikiHow staff writer, Cheyenne Main . C. Matthew Snipp is the Burnet C. and Mildred Finley Wohlford Professor of Humanities and Sciences in the Department of Sociology at Stanford University. He is also the Director for the Institute for Research in the Social Science’s Secure Data Center. He has been a Research Fellow at the U.S. Bureau of the Census and a Fellow at the Center for Advanced Study in the Behavioral Sciences. He has published 3 books and over 70 articles and book chapters on demography, economic development, poverty and unemployment. He is also currently serving on the National Institute of Child Health and Development’s Population Science Subcommittee. He holds a Ph.D. in Sociology from the University of Wisconsin—Madison. There are 13 references cited in this article, which can be found at the bottom of the page. This article has been fact-checked, ensuring the accuracy of any cited facts and confirming the authority of its sources. This article has been viewed 700,704 times.

Publishing a research paper in a peer-reviewed journal allows you to network with other scholars, get your name and work into circulation, and further refine your ideas and research. Before submitting your paper, make sure it reflects all the work you’ve done and have several people read over it and make comments. Keep reading to learn how you can choose a journal, prepare your work for publication, submit it, and revise it after you get a response back.

Things You Should Know

• Create a list of journals you’d like to publish your work in and choose one that best aligns with your topic and your desired audience.
• Prepare your manuscript using the journal’s requirements and ask at least 2 professors or supervisors to review your paper.
• Write a cover letter that “sells” your manuscript, says how your research adds to your field and explains why you chose the specific journal you’re submitting to.

• Ask your professors or supervisors for well-respected journals that they’ve had good experiences publishing with and that they read regularly.
• Many journals also only accept specific formats, so by choosing a journal before you start, you can write your article to their specifications and increase your chances of being accepted.
• If you’ve already written a paper you’d like to publish, consider whether your research directly relates to a hot topic or area of research in the journals you’re looking into.

• Review the journal’s peer review policies and submission process to see if you’re comfortable creating or adjusting your work according to their standards.
• Open-access journals can increase your readership because anyone can access them.

• Scientific research papers: Instead of a “thesis,” you might write a “research objective” instead. This is where you state the purpose of your research.
• “This paper explores how George Washington’s experiences as a young officer may have shaped his views during difficult circumstances as a commanding officer.”
• “This paper contends that George Washington’s experiences as a young officer on the 1750s Pennsylvania frontier directly impacted his relationship with his Continental Army troops during the harsh winter at Valley Forge.”

• Scientific research papers: Include a “materials and methods” section with the step-by-step process you followed and the materials you used. [5] X Research source
• Read other research papers in your field to see how they’re written. Their format, writing style, subject matter, and vocabulary can help guide your own paper. [6] X Research source

• If you’re writing about George Washington’s experiences as a young officer, you might emphasize how this research changes our perspective of the first president of the U.S.
• Link this section to your thesis or research objective.
• If you’re writing a paper about ADHD, you might discuss other applications for your research.

• Scientific research papers: You might include your research and/or analytical methods, your main findings or results, and the significance or implications of your research.
• Try to get as many people as you can to read over your abstract and provide feedback before you submit your paper to a journal.

• They might also provide templates to help you structure your manuscript according to their specific guidelines. [11] X Research source

• Not all journal reviewers will be experts on your specific topic, so a non-expert “outsider’s perspective” can be valuable.

• If you have a paper on the purification of wastewater with fungi, you might use both the words “fungi” and “mushrooms.”
• Use software like iThenticate, Turnitin, or PlagScan to check for similarities between the submitted article and published material available online. [15] X Research source

• Header: Address the editor who will be reviewing your manuscript by their name, include the date of submission, and the journal you are submitting to.
• First paragraph: Include the title of your manuscript, the type of paper it is (like review, research, or case study), and the research question you wanted to answer and why.
• Second paragraph: Explain what was done in your research, your main findings, and why they are significant to your field.
• Third paragraph: Explain why the journal’s readers would be interested in your work and why your results are important to your field.
• Conclusion: State the author(s) and any journal requirements that your work complies with (like ethical standards”).
• “We confirm that this manuscript has not been published elsewhere and is not under consideration by another journal.”
• “All authors have approved the manuscript and agree with its submission to [insert the name of the target journal].”

• Submit your article to only one journal at a time.
• When submitting online, use your university email account. This connects you with a scholarly institution, which can add credibility to your work.

• Accept: Only minor adjustments are needed, based on the provided feedback by the reviewers. A first submission will rarely be accepted without any changes needed.
• Revise and Resubmit: Changes are needed before publication can be considered, but the journal is still very interested in your work.
• Reject and Resubmit: Extensive revisions are needed. Your work may not be acceptable for this journal, but they might also accept it if significant changes are made.
• Reject: The paper isn’t and won’t be suitable for this publication, but that doesn’t mean it might not work for another journal.

• Try organizing the reviewer comments by how easy it is to address them. That way, you can break your revisions down into more manageable parts.
• If you disagree with a comment made by a reviewer, try to provide an evidence-based explanation when you resubmit your paper.

• If you’re resubmitting your paper to the same journal, include a point-by-point response paper that talks about how you addressed all of the reviewers’ comments in your revision. [22] X Research source
• If you’re not sure which journal to submit to next, you might be able to ask the journal editor which publications they recommend.

Expert Q&A

You might also like.

• If reviewers suspect that your submitted manuscript plagiarizes another work, they may refer to a Committee on Publication Ethics (COPE) flowchart to see how to move forward. [23] X Research source Thanks Helpful 0 Not Helpful 0

• ↑ https://www.wiley.com/en-us/network/publishing/research-publishing/choosing-a-journal/6-steps-to-choosing-the-right-journal-for-your-research-infographic
• ↑ https://link.springer.com/article/10.1007/s13187-020-01751-z
• ↑ https://libguides.unomaha.edu/c.php?g=100510&p=651627
• ↑ https://www.canberra.edu.au/library/start-your-research/research_help/publishing-research
• ↑ https://writingcenter.fas.harvard.edu/conclusions
• ↑ https://writing.wisc.edu/handbook/assignments/writing-an-abstract-for-your-research-paper/
• ↑ https://www.springer.com/gp/authors-editors/book-authors-editors/your-publication-journey/manuscript-preparation
• ↑ https://apus.libanswers.com/writing/faq/2391
• ↑ https://academicguides.waldenu.edu/library/keyword/search-strategy
• ↑ https://ifis.libguides.com/journal-publishing-guide/submitting-your-paper
• ↑ https://www.springer.com/kr/authors-editors/authorandreviewertutorials/submitting-to-a-journal-and-peer-review/cover-letters/10285574
• ↑ https://www.apa.org/monitor/sep02/publish.aspx
• ↑ Matthew Snipp, PhD. Research Fellow, U.S. Bureau of the Census. Expert Interview. 26 March 2020.

About This Article

To publish a research paper, ask a colleague or professor to review your paper and give you feedback. Once you've revised your work, familiarize yourself with different academic journals so that you can choose the publication that best suits your paper. Make sure to look at the "Author's Guide" so you can format your paper according to the guidelines for that publication. Then, submit your paper and don't get discouraged if it is not accepted right away. You may need to revise your paper and try again. To learn about the different responses you might get from journals, see our reviewer's explanation below. Did this summary help you? Yes No

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• Review Article
• Open access
• Published: 25 May 2024

Relationship between obstructive sleep apnoea syndrome and gastrointestinal diseases: a systematic review and Meta-analysis

• Liubin Cao 1   na1 ,
• Chengpei Zhou 2   na1 ,
• Rupei Zhang 1 ,
• Shan Zhou 1 ,
• Xiaolei Sun 2 &
• Jun Yan 1  

npj Primary Care Respiratory Medicine volume  34 , Article number:  12 ( 2024 ) Cite this article

128 Accesses

Metrics details

• Outcomes research
• Respiratory distress syndrome

Studies exploring the association between obstructive sleep apnoea syndrome (OSA) and gastrointestinal diseases (GID) are important for enhancing clinical outcomes. This study aimed to systematically assess the association between these two diseases. Adhering to PRISMA guidelines, a comprehensive literature search was conducted across databases including PubMed, Web of Science, Willey Library, Cochrane Library and Scopus. This search focused on English literature published up to January 2024. Literature screening, quality assessment (using the NOS scale) and data extraction were performed by two independent researchers. Statistical analyses were performed using the meta-package of the R.4.2.2 software. An initial screening of 2178 papers was conducted and 11 studies were included. Meta-analysis results showed a significant association between OSA and GID ( p  < 0.01). Subgroup analyses further indicated a stronger association between OSA and GID in Asian populations compared to Europe and the United States. In addition, both benign and malignant GID were significantly associated with OSA, with a pronounced association for malignant GID than for benign GID. The results of publication bias analysis revealed no significant bias (Begg’s test p  = 0.45, Egger’s test p  = 0.60). This study uncovers a notable association between OSA and GID, especially in Asian populations, suggesting that clinicians should consider the potential connection between these two diseases during diagnosis and treatment. However, due to the heterogeneity and limitations of the study, these conclusions need to be further validated through more comprehensive research.

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Introduction.

Obstructive sleep apnoea syndrome (OSA) is a prevalent sleep breathing disorder characterised by recurrent partial or complete obstruction of the upper airway during sleep, leading to apnoea or hypopnoea 1 , 2 . OSA not only diminishes sleep quality, but is also associated with a wide range of health problems such as cardiovascular disease, metabolic disorders, and neurocognitive dysfunction 3 , 4 , 5 , thereby emerging as an important public health concern.

Recently, the potential link between OSA and gastrointestinal diseases (GID) has garnered increasing attention from the medical community 6 , 7 , 8 , 9 , 10 . GID, including gastroesophageal reflux disease (GERD) and inflammatory bowel disease (IBD), commonly affects the health of the global population. It has been suggested that symptoms of GERD are more prevalent in patients with OSA, and these gastrointestinal symptoms may in turn exacerbate the manifestations of OSA. GID affects not only the digestive system but may also cause a range of systemic health problems.

In their Meta-analysis, Nabil El Hage Chehade and other researchers 7 suggested an association between OSA and GERD, independent of screening or diagnostic methods. They noted that GERD’s presence does not directly affect the severity of OSA. This finding implies a more complex interaction mechanism between OSA and GID, possibly involving a variety of physiological and pathological processes including intermittent hypoxaemia 10 , 11 , nocturnal respiratory abnormalities 8 , and comorbid obesity and metabolic syndrome 12 .

Despite studies that have been conducted to explore the potential association between OSA and GID, the results of these studies have been inconsistent 6 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 . Therefore, this study aims to comprehensively evaluate the association between OSA and various types of GID to provide stronger evidence support for clinical diagnosis and treatment, thereby improving the diagnostic and treatment protocols and quality of life for patients.

Results of literature screening

The literature screening process for this study was meticulously executed in strict adherence to the pre-established inclusion and exclusion criteria. The initial search yielded a total of 2,178 pieces of literature, with 2,173 obtained through electronic database searches, and 5 obtained through manual searches from references. After removing 483 duplicates, 1408 pieces of literature were excluded due to titles and abstracts not aligning with the study’s focus and 5 pieces of literature were not accessible in full text. Subsequently, the remaining 282 literatures were then reviewed in full text, leading to the exclusion of an additional 271 papers, primarily due to non-compliance with the study design, or incomplete or substandard data quality. Ultimately, a total of 11 pieces of literature were eventually included in the final analysis, as seen in Fig. 1 . Details of the included literature are given in Table 1 .

Schematic diagram of the literature screening process.

Literature quality evaluation results

The quality of the literature included in this study was evaluated using the NOS scale. The evaluation revealed that seven literatures scored more than 7, which showed high research quality, and four literatures scored 6, which was medium quality and met the quality requirements of this paper, as shown in Table 2 .

Association between OSA and GID

The meta-analysis incorporated eleven studies with a total of 2729 patients to assess the association between OSA and GID. Heterogeneity analysis found substantial variability I 2  = 88%. By using a random-effects model, the Meta-analysis showed a statistically significant correlation between the two diseases (OR = 1.37, 95% CI [1.13, 1.66], p  < 0.01) (Fig. 2 ). For subgroup analysis, GID was categorized into benign and malignant conditions, observing a significant difference ( p  < 0.01) between benign (OR = 1.25, 95% CI [0.88, 1.79]) and malignant GID (OR = 1.42, 95% CI [1.16, 1.75]). When analysed using a fixed-effects model, a notably stronger association was observed in malignant GID (Fig. 3 ). Subgroup analyses based on regional classification revealed that the correlation between OSA and GID was significantly different between geographic regions using fixed-effect model analysis ( P  < 0.01) (Fig. 4 ), with the correlation between OSA and GID being stronger in Asia (OR = 1.57, 95% CI [1.14, 2.15]) than Europe and the United States (OR = 1.24, 95% CI [1.13, 1.66]) was stronger (Fig. 4 ).

OR odds ratio, SE standard error, CI confidence interval, OSA obstructive sleep apnoea syndrome, GID gastrointestinal diseases.

Factors influencing the correlation between OSA and GID

In analysing the factors influencing the OSA-GID correlation, both age and gender demonstrated a high degree of heterogeneity for both the age and gender factors ( I 2  = 97% and I 2  = 99%), both analysed using a random-effects model. The findings suggested that neither age (OR = 1.20, 95% CI [0.99, 1.46], P  = 0.07) nor gender (OR = 1.33, 95% CI [0.95, 1.86], P  = 0.10) were not key factors influencing the correlation between OSA and GID, as seen in Figs. 5 , 6 .

Publication bias analysis

To assess the possible presence of publication bias in this Meta-analysis, several statistical methods were employed. Visual inspection of funnel plots indicated good symmetry, despite some studies falling outside the funnel. Additionally, the outcomes of Begg’s test ( z  = 0.76, p  = 0.45) and Egger’s test ( t  = −0.54, p  = 0.60) showed that the included literature was free of publication bias, as seen in Fig. 7 .

OSA obstructive sleep apnoea syndrome, GID gastrointestinal diseases.

Sensitivity analysis

The results of the sensitivity analyses showed that neither the combined effect sizes nor the heterogeneity indicators of the Meta-analyses changed significantly after the exclusion of any single study, suggesting that the results of our Meta-analyses were highly robust and that no single study had an excessive effect on the overall results.

The results of this systematic evaluation and Meta-analysis suggest that there is a strong interconnection between OSA and GID, especially for malignant GID. This finding provides new insights into the mechanisms of OSA and GID interactions and suggests the need for optimisation in clinical practice.

Numerous studies have been conducted in recent years to investigate the mechanisms linking OSA and GID and to establish a causal relationship between 2 , 3 , 23 . Recent studies have revealed that OSA-induced physiological changes, such as intermittent hypoxaemia and sleep disruption, may increase the risk of GID, including gastroesophageal reflux disease, gastric ulcers, and another digestive disorders 20 , 21 , 22 . The increased stress on the body’s internal environment caused by OSA may precipitate gastrointestinal dysfunction 18 , 19 . Furthermore, the high prevalence of obesity and metabolic syndrome among OSA patients may also further exacerbate the risk of GID 24 . However, some studies have yielded inconsistent results 6 , 17 , 18 , 19 . Therefore, our systematic evaluation and meta-analysis aimed to provide more comprehensive and precise evidence by synthesising data from a large number of studies to address the existing controversies regarding the association of OSA with GID. We focused on parsing differences across regions, ethnicities, and lifestyle contexts, and on exploring potential biological mechanisms, aiming to offer deeper insights into the field. Our study not only focuses on the aggregation of existing evidence but also endeavours to identify potential biases in research and suggest future research directions to provide more instructive information for clinical practice and patient management.

From a pathophysiological perspective, the correlation between OSA and GID may involve a series of complex biological pathways. Intermittent hypoxaemia, which often occurs at night in patients with OSA, may trigger a systemic inflammatory response. This inflammatory response is particularly closely related to benign GID, which implies that OSA may cause damage to the gastrointestinal mucosal barrier and increase the probability of GERD and other benign GID 4 , 25 . In addition, OSA-induced changes in intrathoracic and intra-abdominal pressure may disrupt the lower oesophageal sphincter’s function, promoting gastric acid reflux 26 . These changes can directly impair gastrointestinal health and may also indirectly affect the digestive system through neuroreflex mechanisms. The prevalence of obesity in patients with OSA is also an important factor exacerbating the risk of GID. Obesity may exacerbate the symptoms of GID by increasing the intra-abdominal pressure and causing metabolic disturbances 27 . In addition, obesity may also affect the rate of gastric emptying and the balance of intestinal flora, which may further exacerbate gastrointestinal problems 28 .

In exploring the geographic distribution of the OSA-GID relationship, our study found a particularly significant association in Asian populations 13 , 15 , 19 . This pattern may be due to the unique genetic background, dietary habits, and lifestyle of the Asian region. The high content of salt and fat in the Asian diet may significantly influence the pathogenesis of GID, such as GERD 18 , promoting increased gastric acid secretion and exacerbating GERD symptoms, which may trigger or worsen GID in patients with OSA. In addition, the high carbohydrate intake in Asian populations may be associated with an increased prevalence of GID, especially among patients with diabetes mellitus 29 . Genetic factors There may be specific genetic variants or genetic predispositions in the development of OSA and GID that make Asian populations more susceptible to both diseases. For example, genetic variants associated with obesity, diabetes, and other metabolic diseases may increase the risk of both OSA and GID 30 . Nevertheless, research in this domain is nascent, and more comprehensive genetic epidemiological studies are needed to uncover specific molecular mechanisms and genetic predispositions.

These findings highlight the importance of identifying and managing patients with both OSA and GID in daily clinical practice. Primary care physicians should consider the interrelationship between OSA and GID, particularly in Asian, and conduct a comprehensive evaluation of the medical history including pay attention to the patient’s dietary habits, lifestyle, and genetic background. It is recommended that during the diagnosis, a comprehensive evaluation should be performed for GID patients with OSA symptoms. Multi-disciplinary treatment should be considered for these patients, including Department of Gastroenterology and Department of Respiration.

This study analyzed the association between OSA and GID, and explored the association between OSA and malignant or benign GID through subgroup analysis, as well as subgroup analysis of the population, to obtain more comprehensive analysis results. Although there are some limitations. Most included studies were observational, causality could not be established. In addition, the high heterogeneity of the included studies may affect the robustness and generalisability of the results, and future studies should adopt a more rigorous study design and uniform diagnostic criteria to further validate our findings.

In conclusion, this study not only highlights the importance of considering patients’ gastrointestinal conditions in the diagnosis and treatment of OSA, but also sheds light on biological mechanisms that need to be investigated in greater depth. Future studies should aim to clarify the causal relationship between OSA and GID, analyse regional and racial differences, and delve deeper into the underlying molecular and cellular mechanisms, so as to provide more comprehensive treatment strategies for the clinic.

As this study involves the summary and analysis of other studies, it does not involve medical ethics approval or patient-informed consent.

Search strategy

This study was conducted in accordance with the PRISMA guidelines 23 , and to systematically assess the relationship between OSA and GID, the study was searched in several databases, including PubMed, Web of science, Willey Library, Cochrane Library, and Scopus. The search strategy included keywords and medical subject terms related to OSA and various GID. The search language was English, and the search period was from the establishment of each database to January 2024.

The search terms included “Obstructive Sleep Apnea”, “OSA”, “Gastrointestinal Diseases”, “Gastroesophageal Reflux Disease (GERD)”, “Irritable Bowel Syndrome (IBS)”. “Inflammatory Bowel Disease (IBD)”, “Crohn’s Disease”, “Ulcerative Colitis “, “Gastritis”, “Peptic Ulcer Disease”, “Gastroenteritis “, “Colorectal Cancer”. The search was performed using a combination of subject terms and free words with matching truncation, using PubMed as an example: (“Obstructive Sleep Apnea” [MeSH Terms] OR “OSA” [Title/Abstract]) AND (“Gastrointestinal Diseases” [MeSH Terms] OR “Gastroesophageal Reflux Disease (GERD)”[Title/Abstract] OR “Irritable Bowel Syndrome (IBS)”[Title/Abstract] OR “Inflammatory Bowel Disease (IBD)”[Title/Abstract] OR “Crohn’s Disease”[Title/Abstract] OR “Ulcerative Colitis”[Title/Abstract] OR “Gastritis”[Title/Abstract] OR “Peptic Ulcer Disease”[Title/Abstract] OR “Gastroenteritis”[Title/Abstract] OR “Colorectal Cancer”[Title/Abstract]).

Literature inclusion and exclusion criteria

Inclusion criteria included (1) studies with a clear diagnosis of OSA, and the basis for the diagnosis should include standard sleep monitoring data or recognised clinical diagnostic guidelines; (2) studies assessed the association between OSA and GID (such as GERD, IBS, IBD, Crohn’s Disease, Ulcerative Colitis); (3) studies provided quantitative data, such as risk ratios (RR), odds ratios (OR), or correlation data; (4) the publication was a peer-reviewed full-text article; and (5) the article was written in English.

Exclusion criteria included: (1) interventional studies, case reports, commentaries, expert opinions, conference abstracts, review articles, or non-peer-reviewed publications; (2) studies that did not provide sufficient data to estimate risk ratios or odds ratios; (3) studies in which the diagnostic criteria for OSA or GID were unclear or did not meet widely accepted clinical guidelines; (4) studies that were repetitively published or had duplicated data; (5) studies that were not original, such as secondary data based on published data.

Literature screening

The literature screening process for this study followed a rigorous process, wherein the titles and abstracts of retrieved literature were initially examined by two intended researchers. The preliminary screening aimed to exclude irrelevant studies, specifically those not addressing OSA or a specific GID. Subsequently, a detailed full-text review was undertaken for literature that seems to the inclusion criteria, to determine whether the inclusion criteria were fully met. Discrepancies in opinion were resolved through discussion or, if necessary, by consulting third-party experts.

Literature quality assessment

The Newcastle-Ottawa Scale (NOS), a standardised tool for appraising the quality of observational studies, particularly cohort and case-control studies, was used in this study for literature quality evaluation. The NOS encompasses three main domains: selectivity (choice of the study population), comparability (comparisons between study groups), and outcome (assessment of the study’s results.) The NOS scale reflects the methodological quality of each study by providing it with an overall score of up to 9 points. In this study, each study meeting the inclusion criteria was independently assessed by two researchers using the NOS scale. Disagreements during the scoring process were addressed through discussion, and third-party experts were consulted as needed.

Data extraction

In this study, the data extraction process was carried out independently by two researchers to ensure the accuracy and completeness of the data. A comprehensive data extraction form was designed to gather key information from each study, including (1) basic information about the study, such as authors, year of publication, and type of study design; (2) characteristics of the study population, including sample size, age range, and gender ratio; (3) primary and secondary outcome indicators, including all relevant clinical outcomes and measurements; (4) study results, such as the odds ratio (OR), correlation coefficient, and so on, as well as their confidence intervals and statistical significance levels. Upon completion of each data extraction, investigators cross-verified the data to eliminate potential errors or biases. Any disagreements identified during the data extraction process were resolved through discussion, and third-party expert consultation was sought as necessary.

Statistical methods

The Meta-analysis was conducted using the meta-package in R software (R 4.2.2). Firstly, we will extract the corrected Odds Ratio (OR) of the outcome metrics and their 95% Confidence Interval (CI) from each included study. Subsequently, these ORs and 95% CIs were converted to logORs and their standard errors (Standard Error, SE) for meta-analysis. For the heterogeneity test, I ² statistic was used to assess the heterogeneity between studies, when I ² ≤ 50%, indicating small heterogeneity, a fixed-effect model (FEM) was employed for meta-analysis. If I ² > 50%, indicating a high degree of heterogeneity, in which case a random-effects model was used to analyse the data. To assess the quality of the studies, the Newcastle-Ottawa Scale (NOS) was used for cohort studies. In addition, for studies numbering 10 or more, funnel plots, Begg’s test, and Egger’s test were utilized to assess possible publication bias. A statistically significant difference of P  < 0.05 was used as the criterion for all tests.

Data availability

The data used to support the findings of this study are included within the article.

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Acknowledgements

We are grateful for the support of the National Natural Science Foundation of China (No.: 81300346).

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These authors contributed equally: Liubin Cao, Chengpei Zhou.

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Department of Forensic Medicine, Nantong University Medical College, Nantong, China

Liubin Cao, Rupei Zhang, Shan Zhou & Jun Yan

Department of Pathogenic Biology, Nantong University Medical College, Nantong, China

Chengpei Zhou & Xiaolei Sun

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Conception and design: Liubin Cao and Chengpei Zhou. Administrative support: Rupei Zhang. Collection and assembly of data: Shan Zhou. Data analysis and interpretation: Xiaolei Sun. Drafting the work: Jun Yan. Revising the work: Jun Yan. Final approval of manuscript: All authors. Liubin Cao and Chengpei Zhou contributed equally to this paper.

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Cao, L., Zhou, C., Zhang, R. et al. Relationship between obstructive sleep apnoea syndrome and gastrointestinal diseases: a systematic review and Meta-analysis. npj Prim. Care Respir. Med. 34 , 12 (2024). https://doi.org/10.1038/s41533-024-00373-y

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How to Write Articles that Get Published

Kirti nath jha.

1 Professor, Department of Ophthalmology, Mahatma Gandhi Medical College & Research Institute, Pondy-Cuddalore Main Road, Pillaiyarkuppam, Pondicherry, India.

Publications are essential for sharing knowledge, and career advancement. Writing a research paper is a challenge. Most graduate programmes in medicine do not offer hands-on training in writing and publishing in scientific journals. Beginners find the art and science of scientific writing a daunting task. ‘How to write a scientific paper?, Is there a sure way to successful publication ?’ are the frequently asked questions. This paper aims to answer these questions and guide a beginner through the process of planning, writing, and correction of manuscripts that attract the readers and satisfies the peer reviewers. A well-structured paper in lucid and correct language that is easy to read and edit, and strictly follows the instruction to the authors from the editors finds favour from the readers and avoids outright rejection. Making right choice of journal is a decision critical to acceptance. Perseverance through the peer review process is the road to successful publication.

Introduction

Writing and publishing scientific papers is the core business of every researcher [ 1 ]. The scientific output medical researchers generate is not only important for society to improve health through advancement of knowledge but also for the individual researcher’s career [ 2 ]. Effective scientific writing, however, is not easy [ 1 ] .

Scientific paper has a required structure and style. However, a research article is not only a technically rigid document, but also a subjective intellectual product. Therefore, it requires good skills in both structuring and phrasing. These skills are acquired through experience, and can also be taught [ 3 ]. ‘Uniform Requirements for Manuscripts Submitted to Biomedical Journals: Writing and Editing for Biomedical Publication’ gives the required technical and structural details of scientific papers [ 4 ]. Also, there is no dearth of literature on scientific writing and publishing. Ironically, most graduate programmes in medicine do not offer hands-on training in writing and publishing in scientific journals. Therefore, most authors learn the art and science of scientific writing the hard way; though there are papers that provide step-by-step guide to writing [ 5 ].

What constitute a good paper- worthy of publication? There are no straight answers. Some define a good paper as a clear, coherent, focussed, well-argued document that uses unambiguous language[ 3 ]. Editors and reviewers appreciate manuscripts that are easy to read and edit [ 4 ]. However, no foolproof rules exist for success in publishing a manuscript. Good scientific content of a paper alone does not guarantee its publication in a good journal [ 5 ].

This article presents a review of the selected articles on writing and publishing in biomedical journals and aims to provide beginners the basics of effective scientific writing, and tips on successful publishing.

Writing a Scientific Paper: Getting started.

When planning a scientific paper, Berk’s memo to the authors in the American Journal of Roentgenology is worth following [ 6 ]. He felt that getting the things right the first time improved the chances of acceptance and avoided revisions. He set out 5 guiding principles for the inexperienced authors : They are : 1. Determine the specific focus of your article, 2. Select the right journal, 3. Decide the type of article, 4. Follow the guidelines for authors published in the selected journal, 5. Revise, revise, and revise. Remember, ‘the most of the important work of composing a manuscript occurs during the study design that is critical for determining the resultant manuscript’s publication [ 7 ]. Therefore, study design and methodology requires careful planning; they form the touchstone on which results and conclusions are tested.

Preparing a Manuscript

The scope of work determines the type of article. The choice of journal depends upon the field a journal covers, area of research, time frame for publication, and the journal’s impact factor- a proxy for relative importance of the journal within its field. ‘Uniform requirements for manuscripts submitted to biomedical journals: writing and editing for biomedical publication’ provides the guidelines for preparing manuscripts for any journal [ 4 ]. The text of observational and experimental articles is usually divided into sections with the headings, introduction, methods, results, and discussion, the so-called “IMRAD” structure. Other types of articles have different structure. Therefore, it is necessary to familiarize with and strictly follow the instructions to the authors of the target journal.

To begin with read a paper written in the format you plan to write. Prepare a skeleton of your paper [ 8 ]. Note down the key points in each section. It is neither desirable nor practical to actually write the article sections in sequential order. Introduction and the discussion may wait till at the end. Abstract may be written the last.

Keep the language simple, concise and easy to understand. Follow UK or US English as desired by the journal. Remove all unnecessary words. Use active voice rather than passive. The sentences should begin with the operative word and end with the message. Expand the abbreviations when used for the first time. Check the grammar and spelling. A word processing tool may be helpful. However, many biomedical words do not exist in the vocabulary of the word processing tools. Here, the textbooks or a medical dictionary may be helpful.

Following text sequentially discusses the elements of the individual sections of a scientific paper. Peer-review and reasons for rejection are discussed subsequently.

Title: A good title should attract and inform the readers and be accurate [ 9 ]. It should make it stand out from other literature in the field [ 10 ]. Titles may be phrased in a variety ways. Some examples of descriptive and informative titles are given below:

- Correlation of Tear Fluorescein Clearance and Schirmer test scores with Ocular irritation symptoms (a descriptive title)

- What Are the Biomarkers for Glaucoma?

- Dry eyes: are new ideas drying up?

- Angiopoetin-2 levels are elevated in exudative pleural effusions (informative title)

As a rule, the title should contain all the words that the readers use for searching relevant literature. The authors may, to begin with, consider a number of titles and finally choose the most appropriate. Co-authors and peers may provide useful suggestions. Some journals also ask for short running titles in limited characters to be used at the top or bottom of the journal page. Provide a short running title whenever asked.

Abstract: The abstract reflects the main story of the scientific paper. While reading articles most readers go no beyond the abstracts. Therefore, the abstract should attract the readers to go further. Abstract may be structured or unstructured. Most journals ask for a structured abstracts within given word limit. Structured abstract is divided into:

1. Background: What is known and why is this study needed?

2. Methods: What did you do ?

3. Results: What did you find ?

4. Conclusion: What does it mean ?

Write the abstract in past perfect tense, active voice, and with no citations.

Provide word count, if asked, and key words for indexing, preferably confirming to medical subject heading (MeSH) vocabulary. MeSH vocabulary is available on www.PubMed.com .

Introduction: A crisp introduction is an essential ingredient of a good paper. A good introduction will ‘‘sell’’ the study to editors, reviewers, readers, and sometimes even the media [ 11 ]. It should tell what is known, what is unknown , and also the rationale behind the study. The introduction should start with the background of previous research, and state the aim, the research question, and the study design. Give in the introduction only the strictly pertinent references and do not include the data or conclusions from the work being reported.

Methods: The methods tell how the study was conducted and how the conclusions were arrived at. Methods of an original study have four basic elements; study design, setting and subjects, data collection, statistical methods, and ethical approval. Describe the type of study (prospective/ retrospective/ experimental/observational), the subjects or the study population (human/animal), the sample size and sample size calculation, recruitment of study population, methods of randomization, blinding, inclusion and exclusion criteria, measurement tools, outcome measures, and statistical analysis. The methods provides the readers insight into correctness or otherwise of design. Also, details of methods allow the readers to replicate the intervention or experiment so that they can try and test for themselves the efficacy of an intervention and the validity of conclusions. While describing new surgery or experiment provide sufficient details. When you followed a standard procedures described elsewhere, provide the relevant references.

Results: Results answers the research question without interpretation. Structure the results like the material and methods [ 12 ]. Be objective and use past tense. Remove all the superfluous details that does not form the part of study question, outcome measure or a factor affecting it. Start the results with recruitment process, and a description of demographic characteristic of the population. For controlled trials first describe the experimental group followed by the control group. Give both the percentage and the actual numerical values with decimals e.g. 90%(54/60). Wherever applicable present the values with mean, standard deviation (SD) and 95 % confidence interval. Describe the primary and secondary outcome, and also the unexpected findings. Give p-values with 95 % confidence interval to state the beneficial / adverse effects established by a test of statistical significance. Also provide effect sizes e.g. odds ratio or relative risk with 95 % confidence interval.

Do not over interpret the results. Over interpretetation of result may weaken the impact of conclusion and result in rejection of your paper.

Tables, charts, graphs and figures reduce the text and makes visual impact for easy reading. Number the figures, tables, charts, graphs and the photographs serially. Mention them in the text at appropriate places. Prepare the clinical photographs and diagrams on separate pages in desired format (e.g. JPEG, TIFF, or PNG of desired file size and resolution). Provide as a separate file for the legends for figures, charts, and the clinical photographs. Place the legends after the references. Additional media, like video, in desired file format of given file size, may be submitted for online journals.

Discussion: Discussion interprets the results. Keep it concise. Begin the discussion with brief recapitulation of the main findings (the answer to the research question) without repeating the results. Repeating results in the discussion is a common mistake. Refrain from bringing in new findings. Compare your results with the findings of similar studies by other authors and explain the reasons of variation. Emphasise the new findings. Interpret the unexpected. Underline the implications of your findings. Also, describe the strengths and weaknesses of your study. Finally provide a conclusion - the take home message.

References: References authenticate the scientific facts and statements. Include only the essential references. Cite most accessible reference, and the primary source rather than reviews. Eliminate archaic and irrelevant references, and references for established facts. Check the references for accuracy. Follow the referencing style suggested by the target journal. Most biomedical journals today follow Vancouver style or APA (American Psychological Association) style. There may be a limit for the number of references for a given type of article. Some journal offer online software for checking accuracy of the listed references. Limited number of references can be arranged manually. Especially designed referencing software is useful for maintaining and managing large volume of references. Annotation of references - sentence case or superscript- also varies. Follow the individual journal’s guidelines.

Submission: Revise your paper thoroughly before submission. Read it critically as you would another author’s paper. Ensure you have strictly followed the instruction to authors. Failure to adhere to the instructions may result in summary rejection of your paper. Check and recheck the language and grammar for errors. Create separate files for the cover letter, the abstract, the blinded article file (without author details); figures, charts, tables, and images, legends, and permission from copyright holder for use of published materials, etc. Provide in the cover letter the title, main findings, and their relevance. Ensure correctness of author details (name, surname, degree, etc.), authorship (first author, co-author, guarantor, corresponding author), and their mailing address and the institutional affiliation. Provide all the information desired by the editor including contribution of individual authors. Some journal require details of contributions of each author e.g., conception and design, data collection, statistical analysis, manuscript preparation and revision. Declare the conflict of interest, if any. Online submission shall remain incomplete unless you sequentially upload all the required sections, and the copyright transfer form signed by each author. The copyright transfer form should mention the corresponding author. Preserve the raw data and the final submission for future reference.

Reasons for Rejection: Rejection is an unpleasant situation, but common in scientific publishing. Initial rejection occurs at the editorial level. During the peer review, reviewers assess the quality of paper according to 2 main criteria: contribution to the field and the adequacy of research design [ 13 ]. Deficiency in the study design was the most commonly cited reason for outright manuscript rejection according to a study that queried the editors and reviewers [ 14 ]. A study that studied peer review evaluations of a large number of papers concluded that ‘the main determinant of the recommendation for acceptance or rejection of a given manuscript was the relationship between the experimental design, the results, and the conclusion. Inappropriate experimental design was again strongly associated with rejection [ 15 ].

Failure to adhere to the ‘instruction to the authors’ is another important reason for rejection. Plagiarism in any form is another reason for summary rejection. Available software readily check the submission for plagiarism. Also articles found unsuitable for the journal on account of their content, language, grammar, and format are summarily rejected. There are excellent works that have identified the’ principles to improve the likelihood of publication of a scientific manuscript’ and the reasons why manuscripts are not accepted for publication’ [ 6 , 13 , 16 ]. Lack of what improves the likelihood of acceptance, is the cause of rejection. Common reasons for rejection other than those mentioned above include: poor study design, insufficient problem statement, incomplete, inaccurate, or outdated review of literature, suboptimal reporting of results, getting carried away in the discussion, and poor writing [ 17 ]. Language poses a problem for researches from non-English-speaking countries. Some publishers provide paid language-services for manuscripts.

Peer review, Responding to Reviewers and Resubmission: Peer review is considered the virtue of science communication [ 18 ]. Peer review is an essential tool the journals apply to maintain high quality and standard of the articles published in their journals. The process starts after your paper is past the editorial scrutiny. It supplements the authors work in making it more acceptable to the wider readership. Some journals ask suggestions for potential reviewers, and also those reviewers you will wish not to review your paper. Reviewers may accept, reject or suggest minor/ major revisions. Provide point-wise response to the reviewer’s comments and in time resubmit the revised manuscript incorporating the suggestions for change. Highlight the changes in the revised manuscript. Remember, revision gives no guarantee for acceptance. But failure to respond and resubmit closes the door.

Writing and publishing is integral to research. Scientific manuscript has a required structure and style; the available literature provides adequate guidelines. Online abstracts and full text references, language services, and referencing software have made preparation of manuscript easier. Read the instructions carefully and adhere to them strictly. A beginner has to travel the learning curve of the writing, peer review, and publishing. Originality of content, valid study design, good manuscript- conforming to language, style, and format- are prerequisite for successful publication. Attention to details at every stage and perseverance through the arduous process of research, manuscript preparation, peer review and publication is essential for success.

Literature Search

A PubMed search of the database (1990 to 2004) was conducted. Following key words were used: writing, publishing, biomedical journals, and peer review. Additional sources included publications cited in other articles. Relevant articles were reviewed and included.

Financial or Other Competing Interests

Where to publish

• PMID: 26264081
• PMCID: PMC5096572
• DOI: 10.1308/rcsann.2015.0003

“If you want to make an impact among your colleagues, look especially at the journals that they’re reading and publishing in”

Dr H Goldman, Chief Editor of Polar Research

Writing medical articles is highly competitive. Many hours are expended conducting research, and even more hours writing and rewriting the manuscript. Furthermore, countless hours are spent chasing references and performing complex statistics. However, when it comes to understanding the target audience, are authors guilty of not investing as much effort to get maximum impact from the fruits of their labour?

The issue of where to send your manuscript has never been more critical. Most clinicians receive daily invitations via email to submit work to journals that sound legitimate and valid. But are they? Although many journals are reputable, many others are not. This stems partly from the sharp decline in paper journals and the parallel exponential rise in digital journals. With intense pressure to publish, it is hard not to be seduced by online journal marketing ploys. For instance, one researcher used www.randomtextgenerator.com to make up an article and submitted it to 37 open access journals over a period of 2 weeks. At least 17 accepted his work and agreed to publish his article once a $500 ‘processing fee’ had been paid.

Investing time and effort in ‘where to publish’ is time well spent. It is an exercise in understanding the target audience that will benefit most from the publication. Doing this at an early stage in the publishing process saves valuable time and resources. More importantly, this increases the chances of acceptance.

Check the journal website and look through a recent issue.

Is the journal indexed? Check journal databases like PubMed Central® or the Web of Science®. Is there a link on the journal web pages to the spoof www.medline.com ?

Check the name of the editor-in-chief and associated board members.

Check the registered address on Google Maps®.

Have your colleagues and friends read, reviewed or published in the journal?

Is the journal identified in Jeffrey Beall’s list of potential predatory journals?

Finally, a word about blogs and social media. As the internet revolutionises the whole business of publishing and makes information easy to access, are blogs and self-publishing a way forward for scholarly publications? Such open narratives encourage comments and dialogue with readers, leading to an open and transparent form of peer review. This process itself leads to change, revision and expansion. Is this the future?

In this article, Anna Sharman, who launched Cofactor in 2014, provides readers with some useful insights into where to publish. Anna did a PhD degree in biology and then entered the world of journal publishing. She worked for publishers such as BMJ, Public Library of Science, BioMed Central and Nature Publishing Group. Her latest venture, Cofactor, is a company that offers editing advice and training for scientific researchers to help them publish their work more effectively.

Commissioning Editor

Why a fake article titled ‘Cuckoo for cocoa puffs?’ was accepted by 17 medical journals. Fast Company. http://www.fastcompany.com/3041493/body-week/why-a-fake-article-cuckoo-for-cocoa-puffs-was-accepted-by-17-medical-journals (cited May 2015).

List of Standalone Journals. Scholarly Open Access. http://scholarlyoa.com/individual-journals/ (cited May 2015).

• Peer Review*
• Periodicals as Topic*
• Publishing*