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How to Write a Medical Research Paper

Last Updated: February 5, 2024 Approved

This article was co-authored by Chris M. Matsko, MD . Dr. Chris M. Matsko is a retired physician based in Pittsburgh, Pennsylvania. With over 25 years of medical research experience, Dr. Matsko was awarded the Pittsburgh Cornell University Leadership Award for Excellence. He holds a BS in Nutritional Science from Cornell University and an MD from the Temple University School of Medicine in 2007. Dr. Matsko earned a Research Writing Certification from the American Medical Writers Association (AMWA) in 2016 and a Medical Writing & Editing Certification from the University of Chicago in 2017. wikiHow marks an article as reader-approved once it receives enough positive feedback. In this case, 89% of readers who voted found the article helpful, earning it our reader-approved status. This article has been viewed 199,270 times.

Writing a medical research paper is similar to writing other research papers in that you want to use reliable sources, write in a clear and organized style, and offer a strong argument for all conclusions you present. In some cases the research you discuss will be data you have actually collected to answer your research questions. Understanding proper formatting, citations, and style will help you write and informative and respected paper.

Researching Your Paper

Step 1 Decide on a topic.

  • Pick something that really interests you to make the research more fun.
  • Choose a topic that has unanswered questions and propose solutions.

Step 2 Determine what kind of research paper you are going to write.

  • Quantitative studies consist of original research performed by the writer. These research papers will need to include sections like Hypothesis (or Research Question), Previous Findings, Method, Limitations, Results, Discussion, and Application.
  • Synthesis papers review the research already published and analyze it. They find weaknesses and strengths in the research, apply it to a specific situation, and then indicate a direction for future research.

Step 3 Research your topic thoroughly.

  • Keep track of your sources. Write down all publication information necessary for citation: author, title of article, title of book or journal, publisher, edition, date published, volume number, issue number, page number, and anything else pertaining to your source. A program like Endnote can help you keep track of your sources.
  • Take detailed notes as you read. Paraphrase information in your own words or if you copy directly from the article or book, indicate that these are direct quotes by using quotation marks to prevent plagiarism.
  • Be sure to keep all of your notes with the correct source.
  • Your professor and librarians can also help you find good resources.

Step 4 Organize your notes.

  • Keep all of your notes in a physical folder or in a digitized form on the computer.
  • Start to form the basic outline of your paper using the notes you have collected.

Writing Your Paper

Step 1 Outline your paper.

  • Start with bullet points and then add in notes you've taken from references that support your ideas. [1] X Trustworthy Source PubMed Central Journal archive from the U.S. National Institutes of Health Go to source
  • A common way to format research papers is to follow the IMRAD format. This dictates the structure of your paper in the following order: I ntroduction, M ethods, R esults, a nd D iscussion. [2] X Research source
  • The outline is just the basic structure of your paper. Don't worry if you have to rearrange a few times to get it right.
  • Ask others to look over your outline and get feedback on the organization.
  • Know the audience you are writing for and adjust your style accordingly. [3] X Research source

Step 2 Know the required format.

  • Use a standard font type and size, such as Times New Roman 12 point font.
  • Double-space your paper.
  • If necessary, create a cover page. Most schools require a cover page of some sort. Include your main title, running title (often a shortened version of your main title), author's name, course name, and semester.

Step 3 Compile your results.

  • Break up information into sections and subsections and address one main point per section.
  • Include any figures or data tables that support your main ideas.
  • For a quantitative study, state the methods used to obtain results.

Step 4 Write the conclusion and discussion.

  • Clearly state and summarize the main points of your research paper.
  • Discuss how this research contributes to the field and why it is important. [4] X Research source
  • Highlight potential applications of the theory if appropriate.
  • Propose future directions that build upon the research you have presented. [5] X Research source
  • Keep the introduction and discussion short, and spend more time explaining the methods and results.

Step 5 Write the introduction.

  • State why the problem is important to address.
  • Discuss what is currently known and what is lacking in the field.
  • State the objective of your paper.
  • Keep the introduction short.

Step 6 Write the abstract.

  • Highlight the purpose of the paper and the main conclusions.
  • State why your conclusions are important.
  • Be concise in your summary of the paper.
  • Show that you have a solid study design and a high-quality data set.
  • Abstracts are usually one paragraph and between 250 – 500 words.

Step 7 Cite while you write.

  • Unless otherwise directed, use the American Medical Association (AMA) style guide to properly format citations.
  • Add citations at end of a sentence to indicate that you are using someone else's idea. Use these throughout your research paper as needed. They include the author's last name, year of publication, and page number.
  • Compile your reference list and add it to the end of your paper.
  • Use a citation program if you have access to one to simplify the process.

Step 8 Edit your research paper.

  • Continually revise your paper to make sure it is structured in a logical way.
  • Proofread your paper for spelling and grammatical errors.
  • Make sure you are following the proper formatting guidelines provided for the paper.
  • Have others read your paper to proofread and check for clarity. Revise as needed.

Expert Q&A

Chris M. Matsko, MD

  • Ask your professor for help if you are stuck or confused about any part of your research paper. They are familiar with the style and structure of papers and can provide you with more resources. Thanks Helpful 0 Not Helpful 0
  • Refer to your professor's specific guidelines. Some instructors modify parts of a research paper to better fit their assignment. Others may request supplementary details, such as a synopsis for your research project . Thanks Helpful 0 Not Helpful 0
  • Set aside blocks of time specifically for writing each day. Thanks Helpful 0 Not Helpful 0

medical research article writing

  • Do not plagiarize. Plagiarism is using someone else's work, words, or ideas and presenting them as your own. It is important to cite all sources in your research paper, both through internal citations and on your reference page. Thanks Helpful 4 Not Helpful 2

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Use Internal Citations

  • ↑ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3178846/
  • ↑ http://owl.excelsior.edu/research-and-citations/outlining/outlining-imrad/
  • ↑ http://china.elsevier.com/ElsevierDNN/Portals/7/How%20to%20write%20a%20world-class%20paper.pdf
  • ↑ http://intqhc.oxfordjournals.org/content/16/3/191
  • ↑ http://www.ruf.rice.edu/~bioslabs/tools/report/reportform.html#form

About This Article

Chris M. Matsko, MD

To write a medical research paper, research your topic thoroughly and compile your data. Next, organize your notes and create a strong outline that breaks up the information into sections and subsections, addressing one main point per section. Write the results and discussion sections first to go over your findings, then write the introduction to state your objective and provide background information. Finally, write the abstract, which concisely summarizes the article by highlighting the main points. For tips on formatting and using citations, read on! Did this summary help you? Yes No

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Primacy of the research question, structure of the paper, writing a research article: advice to beginners.

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Thomas V. Perneger, Patricia M. Hudelson, Writing a research article: advice to beginners, International Journal for Quality in Health Care , Volume 16, Issue 3, June 2004, Pages 191–192, https://doi.org/10.1093/intqhc/mzh053

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Writing research papers does not come naturally to most of us. The typical research paper is a highly codified rhetorical form [ 1 , 2 ]. Knowledge of the rules—some explicit, others implied—goes a long way toward writing a paper that will get accepted in a peer-reviewed journal.

A good research paper addresses a specific research question. The research question—or study objective or main research hypothesis—is the central organizing principle of the paper. Whatever relates to the research question belongs in the paper; the rest doesn’t. This is perhaps obvious when the paper reports on a well planned research project. However, in applied domains such as quality improvement, some papers are written based on projects that were undertaken for operational reasons, and not with the primary aim of producing new knowledge. In such cases, authors should define the main research question a posteriori and design the paper around it.

Generally, only one main research question should be addressed in a paper (secondary but related questions are allowed). If a project allows you to explore several distinct research questions, write several papers. For instance, if you measured the impact of obtaining written consent on patient satisfaction at a specialized clinic using a newly developed questionnaire, you may want to write one paper on the questionnaire development and validation, and another on the impact of the intervention. The idea is not to split results into ‘least publishable units’, a practice that is rightly decried, but rather into ‘optimally publishable units’.

What is a good research question? The key attributes are: (i) specificity; (ii) originality or novelty; and (iii) general relevance to a broad scientific community. The research question should be precise and not merely identify a general area of inquiry. It can often (but not always) be expressed in terms of a possible association between X and Y in a population Z, for example ‘we examined whether providing patients about to be discharged from the hospital with written information about their medications would improve their compliance with the treatment 1 month later’. A study does not necessarily have to break completely new ground, but it should extend previous knowledge in a useful way, or alternatively refute existing knowledge. Finally, the question should be of interest to others who work in the same scientific area. The latter requirement is more challenging for those who work in applied science than for basic scientists. While it may safely be assumed that the human genome is the same worldwide, whether the results of a local quality improvement project have wider relevance requires careful consideration and argument.

Once the research question is clearly defined, writing the paper becomes considerably easier. The paper will ask the question, then answer it. The key to successful scientific writing is getting the structure of the paper right. The basic structure of a typical research paper is the sequence of Introduction, Methods, Results, and Discussion (sometimes abbreviated as IMRAD). Each section addresses a different objective. The authors state: (i) the problem they intend to address—in other terms, the research question—in the Introduction; (ii) what they did to answer the question in the Methods section; (iii) what they observed in the Results section; and (iv) what they think the results mean in the Discussion.

In turn, each basic section addresses several topics, and may be divided into subsections (Table 1 ). In the Introduction, the authors should explain the rationale and background to the study. What is the research question, and why is it important to ask it? While it is neither necessary nor desirable to provide a full-blown review of the literature as a prelude to the study, it is helpful to situate the study within some larger field of enquiry. The research question should always be spelled out, and not merely left for the reader to guess.

Typical structure of a research paper

The Methods section should provide the readers with sufficient detail about the study methods to be able to reproduce the study if so desired. Thus, this section should be specific, concrete, technical, and fairly detailed. The study setting, the sampling strategy used, instruments, data collection methods, and analysis strategies should be described. In the case of qualitative research studies, it is also useful to tell the reader which research tradition the study utilizes and to link the choice of methodological strategies with the research goals [ 3 ].

The Results section is typically fairly straightforward and factual. All results that relate to the research question should be given in detail, including simple counts and percentages. Resist the temptation to demonstrate analytic ability and the richness of the dataset by providing numerous tables of non-essential results.

The Discussion section allows the most freedom. This is why the Discussion is the most difficult to write, and is often the weakest part of a paper. Structured Discussion sections have been proposed by some journal editors [ 4 ]. While strict adherence to such rules may not be necessary, following a plan such as that proposed in Table 1 may help the novice writer stay on track.

References should be used wisely. Key assertions should be referenced, as well as the methods and instruments used. However, unless the paper is a comprehensive review of a topic, there is no need to be exhaustive. Also, references to unpublished work, to documents in the grey literature (technical reports), or to any source that the reader will have difficulty finding or understanding should be avoided.

Having the structure of the paper in place is a good start. However, there are many details that have to be attended to while writing. An obvious recommendation is to read, and follow, the instructions to authors published by the journal (typically found on the journal’s website). Another concerns non-native writers of English: do have a native speaker edit the manuscript. A paper usually goes through several drafts before it is submitted. When revising a paper, it is useful to keep an eye out for the most common mistakes (Table 2 ). If you avoid all those, your paper should be in good shape.

Common mistakes seen in manuscripts submitted to this journal

Huth EJ . How to Write and Publish Papers in the Medical Sciences , 2nd edition. Baltimore, MD: Williams & Wilkins, 1990 .

Browner WS . Publishing and Presenting Clinical Research . Baltimore, MD: Lippincott, Williams & Wilkins, 1999 .

Devers KJ , Frankel RM. Getting qualitative research published. Educ Health 2001 ; 14 : 109 –117.

Docherty M , Smith R. The case for structuring the discussion of scientific papers. Br Med J 1999 ; 318 : 1224 –1225.

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Writing a strong scientific paper in medicine and the biomedical sciences: a checklist and recommendations for early career researchers

  • Open access
  • Published: 28 July 2021
  • Volume 72 , pages 395–407, ( 2021 )

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  • Payam Behzadi 1 &
  • Márió Gajdács   ORCID: orcid.org/0000-0003-1270-0365 2 , 3  

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Scientific writing is an important skill in both academia and clinical practice. The skills for writing a strong scientific paper are necessary for researchers (comprising academic staff and health-care professionals). The process of a scientific research will be completed by reporting the obtained results in the form of a strong scholarly publication. Therefore, an insufficiency in scientific writing skills may lead to consequential rejections. This feature results in undesirable impact for their academic careers, promotions and credits. Although there are different types of papers, the original article is normally the outcome of experimental/epidemiological research. On the one hand, scientific writing is part of the curricula for many medical programs. On the other hand, not every physician may have adequate knowledge on formulating research results for publication adequately. Hence, the present review aimed to introduce the details of creating a strong original article for publication (especially for novice or early career researchers).

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Avoid common mistakes on your manuscript.

Introduction

The writing and editing of scientific papers should be done in parallel with the collection and analysis of epidemiological data or during the performance of laboratory experiments, as it is an integral step of practical research. Indeed, a scholar paper is the figurative product of scientific investigations (Behzadi and Behzadi 2011 ; Singh and Mayer 2014 ). Moreover, the publication of scholarly papers is important from the standpoint of providing relevant information—both locally and internationally—that may influence clinical practice, while in academia, national and international academic metrics (in which the number and quality of papers determine the score and rank of the scientists) are relevant to fulfill employment criteria and to apply for scientific grants (Grech and Cuschieri 2018 ; Singer and Hollander 2009 ). Thus, scientific writing and the publication of quality peer-reviewed papers in prestigious academic journals are an important challenge for medical professionals and biomedical scientists (Ahlstrom 2017 ). Writing a strong scholarly paper is a multi-procedure task, which may be achieved in a right manner by using a balanced and well-designed framework or blueprint (Gemayel 2016 ; Tóth et al. 2020 ). All in all, time needs to be spent of writing a well-designed and thoughtful scientific proposal to support the research, which will subsequently end in the publication of a paper in a prestigious, peer-reviewed, indexed and scholarly journal with an impact factor (IF). A well-designed scientific project encompasses well-supported and strong hypotheses and up-to-date methodology, which may lead to the collection of remarkable (and reproducible!) data. When a study is based on a strong hypothesis, suitable methodology and our studies result in usable data, the next step is the analysis and interpretation of the said data to present a valuable conclusion at the end of our studies. These criteria give you an influent confidence to prepare a robust and prestigious scholarly paper (Ahlstrom 2017 ; Behzadi 2021 ; Kallet 2004 ; Stenson et al. 2019 ). The aim of this review is to highlight all the necessary details for publication of a strong scientific writing of original article, which may especially be useful for novice or early career researchers.

Approaches for writing and formatting manuscripts before submission

In the presence of effective and appropriate items for writing a strong scientific paper, the author must know the key points and the main core of the study. Thus, preparing a blueprint for the paper will be much easier. The blueprint enables you to draft your work in a logical order (Gemayel 2016 ). In this regard, employment of a mass of charge, free or pay-per-use online and offline software tools can be particularly useful (Gemayel 2016 ; Behzadi and Gajdács 2020 ; Behzadi et al. 2021 ; Ebrahim 2018 ; Issakhanian and Behzadi 2019 ; O'Connor and Holmquist 2009 ; Petkau et al. 2012 ; Singh and Mayer 2014 ; Tomasello et al. 2020 ). Today, there are a wide range of diverse software tools which can be used for design and organization of different parts of your manuscript in the correct form and order. Although traditionally, many scientist do not use these softwares to help formulate their paper and deliver their message in the manuscript, they can indeed facilitate some stages of the manuscript preparation process. Some of these online and offline software facilities are shown in Table 1 .

The first step of writing any scientific manuscript is the writing of the first draft. When writing the first draft, the authors do not need to push themselves to write it in it’s determined order (Behzadi and Gajdács 2020 ; Gemayel 2016 ); however, the finalized manuscript should be organized and structured, according to the publisher’s expectations (Berman et al. 2000 ; Behzadi et al. 2016 ). Based on the contents of the manuscripts, there are different types of papers including original articles, review articles, systematic reviews, short communications, case reports, comments and letters to the editor (Behzadi and Gajdács 2020 ; Gemayel 2016 ), but the present paper will only focus on the original articles structured in the IMRAD (Introduction, Methods, Results and Discussion) structure. Materials and methods, results, discussion or introduction sections are all suitable target sections to begin writing the primary draft of the manuscript, although in most cases, the methods section is the one written first, as authors already have a clear sense and grasp on the methodologies utilized during their studies (Ebrahim 2018 ). The final sections of IMRAD papers which should be completed are the abstract (which is basically the mini-version of the paper) and conclusion (Liumbruno et al. 2013 ; Paróczai et al. 2021 ; Ranjbar et al. 2016 ). The authors should be aware that the final draft of the manuscript should clearly express: the reason of performing the study, the individuality (novelty and uniqueness) of the work, the methodology of the study, the specific outcomes examined in this work, the importance, meaning and worth of the study. The lack of any of the items in the manuscript will usually lead to the direct rejection of the manuscript from the journals. During the composition of the manuscript (which corresponds to any and all sections of the IMRAD), some basics of scientific writing should be taken into consideration: scientific language is characterized by short, crisp sentences, as the goal of the publication is to deliver the main message concisely and without confusion. It is a common misconception that scientific writing needs to be “colorful” and “artistic,” which may have the opposite effect on the clarity of the message. As the main goal of publishing is to deliver the message (i.e., the results) of our study, it is preferred that scientific or technical terms (once defined) are used uniformly, with avoiding synonyms. If young scientists have linguistic difficulties (i.e., English is not their first language), it is desirable to seek the help of professional proofreading services to ensure the correct grammar use and clarity. Traditionally, the passive voice was expected to be used in scientific communication, which was intended to strengthen the sense of generalization and universality of research; however, nowadays the active voice is preferred (symbolizing that authors take ownership and accountability of their work) and sentences in passive voice should take up < 10% of the paper (Berman et al. 2000 ; Behzadi et al. 2016 ).

Every scientist should be able to present and discuss their results in their own words, without copy–pasting sentences from other scientists or without referring to the work of others, if it was used in our paper. If an author copies or represents another authors’ intellectual property or words as their own (accidentally or more commonly on purpose) is called plagiarism. Scientific journals use plagiarism checker softwares to cross-check the level of similarity between the submitted works and scientific papers or other materials already published; over a certain threshold of similarity, journals take action to address this issue. Plagiarism is highly unethical and frowned upon in the scientific community, and it is strictly forbidden by all relevant scientific publishers, and if one is caught with plagiarism, the scientific paper is usually rejected immediately (if this occurs during the submission process) or is retracted. There are some freely available online software tools (e.g., iThenticate® ( http://www.ithenticate.com/ ) and SMALL SEO TOOLS ( https://smallseotoolz.net/plagiarism-checker ) for authors to screen their works for similarities with other sources; nevertheless, it is also unethical to use these tools to determine the “acceptable” level of similarity (i.e., cheating) before submitting a paper.

The structure of an IMRAD article includes the title, author’s(s’) name(s), author’s(s’) affiliation(s), author’s(s’) ORCID iD(s) ( https://orcid.org/ ), abstract, keywords, introduction, methods (or materials and methods), results, discussion, conclusion, acknowledgements, conflict of interest and references (Behzadi and Behzadi 2011 ; Singh and Mayer 2014 ). The acronym of ORCID (with a hard pronunciation of C ( https://orcid.org/blog/2013/01/07/how-should-orcid-be-pronounced )) (abbreviation of Open Researcher & Contributor ID) is considered as unique international identifier for researchers (Haak et al. 2012 ; Hoogenboom and Manske 2012 ). The ORCID iD is composed of 16 digits and introduced in the format of https URI ( https://support.orcid.org/hc/en-us/articles/360006897674 ). It is recommended for the authors to register their ORCID iD. The ORCID is important for manuscript submissions, manuscript citations, looking at the works of other researchers among other things (Haak et al. 2012 ; Hoogenboom and Manske 2012 ).

The contents of the IMRAD-structured manuscripts

Although the IMRAD format seems to be a cul-de-sac structure, it can be a suitable mold for both beginners and professional writers and authors. Each manuscript should contain a title page which includes the main and running (shortened) titles, authors’ names, authors’ affiliations (such as research place, e-mail, and academic degree), authors’ ORCID iDs, fund and financial supports (if any), conflicts of interest, corresponding author’s(s’) information, manuscript’s word count and number of figures, tables and graphs (Behzadi and Gajdács 2020 ).

As the title is the first section of your paper which is seen by the readers, it is important for the authors to take time on appropriately formulating it. The nature of title may attract or dismiss the readers (Tullu and Karande 2017 ). In this regard, a title should be the mirror of the paper’s content; hence, a proper title should be attractive, tempting, specific, relevant, simple, readable, clear, brief, concise and comprehensive. Avoid jargons, acronyms, opinions and the introduction of bias . Short and single-sentenced titles have a “magic power” on the readers. Additionally, the use of important and influent keywords could affect the readers and could be easy searchable by the search engines (Cuschieri et al. 2019 ). This can help to increase the citation of a paper. Due to this fact, it is recommended to consider a number of titles for your manuscript and finally select the most appropriate one, which reflects the contents of the paper the best. The number of titles’ and running titles’ characters is limited in a wide range of journals (Cuschieri et al. 2019 ).

The abstract is the vitrine of a manuscript, which should be sequential, arranged, structured and summarized with great effort and special care. This section is the second most important part of a manuscript after title (Behzadi and Gajdács 2020 ). The abstract should be written very carefully, deliberately and comprehensively in perfect English, because a well-written abstract invites the readers (the editors, reviewers, and readers who may cite the paper in the future) to read the paper entirely from A to Z and a rough one discourages readers (the editors and reviewers) from even handling the manuscript (Cuschieri et al. 2019 ). Whether we like it or not, the abstract is the only part of the manuscript that will be read for the most part; thus, the authors should make an effort to show the impressiveness and quality of the paper in this section.

The abstract as an independent structured section of a manuscript stands alone and is the appetizer of your work (Jirge 2017 ). So as mentioned, this part of paper should be written accurately, briefly, clearly, and to be facile and informative. For this section, the word count is often limited (150 to 250/300 words) and includes a format of introduction/background/, aim/goal/objective, methods, results and conclusions. The introduction or background refers to primary observations and the importance of the work, goal/aim/objective should represent the hypothesis of the study (i.e., why did you do what you did?), the methods should cover the experimental procedures (how did you do what you did?), the results should consider the significant and original findings, and finally, the clear message should be reported as the conclusion. It is recommended to use verbs in third person (unless specified by the Journal’s instructions). Moreover, the verbs depicting the facts which already have been recognized should be used in present tense while those verbs describing the outcomes gained by the current work should be used in past tense. For beginners in scientific publishing, it is a common mistake to start the writing of the manuscript with the abstract (which—in fact—should be the finalizing step, after the full text of the paper has already been finished and revised). In fact, abstract ideally is the copy-pasted version of the main messages of the manuscript, until the word limit (defined by the journal) has been reached. Another common mistake by inexperienced authors is forgetting to include/integrate changes in the abstract to reflect the amendments made in the bulk text of the paper. All in all, even a paper with very good contents and significant results may could be rejected because of a poor and weak abstract (Behzadi and Gajdács 2020 ).

Keywords are the key point words and terms of the manuscript which come right after abstract section. The keywords are used for searching papers in the related fields by internet search engines. It is recommended to employ 3 to 10 keywords in this section. The keywords should be selected from the MeSH (Medical Subject Headings) service, NCBI ( https://www.ncbi.nlm.nih.gov/mesh/ ). An appropriate title should involve the most number of keywords (Behzadi and Gajdács 2020 ; Jirge 2017 ).

Introduction section should be framed up to four paragraphs (up to 15% of the paper’s content). This section should be progressed gradually from general to specific information and gaps (in a funnel-formed fashion). In another words, the current condition of the problem and the previous studies should be briefly presented in the first paragraph. More explanation should be brought in discussion section, where the results of the paper should be discussed in light of the other findings in the literature (Ahlstrom 2017 ; Behzadi 2021 ). In this regard, the original articles and some key references should be cited to have a clarified description. The second paragraph should clarify the lack of knowledge regarding the problem at present, the current status of the scientific issue and explain shortly the necessity and the importance of the present investigation. Subsequently, the relevance of this work should be described to fill the current gaps relating to the problem. The questions (hypothesis/purpose) of the study comprising “Why did you do?/What did you do?/So What?” should be clarified as the main goal in the last paragraph (Ahlstrom 2017 ; Behzadi 2021 ; Burian et al. 2010 ; Lilleyman 1995 ; Tahaei et al. 2021 ). A concise and focused introduction lets the readers to have an influent understanding and evaluation for the performance of the study. The importance of the work presented should never be exaggerated, if the readers feel that they have been misled in some form that may damage the credibility of the authors’ reputation. It is recommended to use standard abbreviations in this section by writing the complete word, expression or phrase for the first time and mentioning the related abbreviation within parenthesis in this section. Obviously, the abbreviations will be used in the following sentences throughout the manuscript. The authors should also adhere to international conventions related to writing certain concepts, e.g., taxonomic names or chemical formulas. In brief, the introduction section contains four key points including: previous studies, importance of the subject, the presence of serious gap(s) in current knowledge regarding the subject, the hypothesis of the work (Ahlstrom 2017 ; Behzadi 2021 ; Lilleyman 1995 ; Tahaei et al. 2021 ). Previously, it was recommended by majority of journals to use verbs in past tense and their passive forms; however, this shows a changing trend, as more and more journals recommend the use of the active voice.

Materials and methods

As the materials and methods section constitutes the skeleton of a paper (being indicative of the quality of the data), this section is known as the keystone of the research. A poor, flawed or incorrect methodology may result in the direct rejection of manuscripts, especially in high IF journals, because it cannot link the introduction section into the results section (Haralambides 2018 ; Meo 2018 ). In other words, the methods are used to test the study’s hypothesis and the readers judge the validity of a research by the released information in this section. This part of manuscript belongs to specialists and researchers; thus, the application of subheadings in a determined and relevant manner will support the readers to follow information in a right order at the earliest. The presentation of the methodologies in a correct and logical order in this section clarifies the direction of the methods used, which can be useful for those who want to replicate these procedures (Haralambides 2018 ; Juhász et al. 2021 ; Meo 2018 ). An effective, accurate, comprehensive and sufficient description guarantees the clarity and transparency of the work and satisfies the skeptical reviewers and readers regarding the basis of the research. The following questions should be answered in this section: “What was done?” and “How was it done?” and “Why was it done?”

The cornerstones of the methods section including defining the type of study, materials (e.g., concentration, dose, generic and manufacturer names of chemicals, antibiotics), participants (e.g., humans, animals, microorganisms), demographic data (e.g., age, gender, race, time, duration, place), the need for and the existence of an ethical approval or waiver (in accordance with the Declaration of Helsinki and its revisions) for humans and animals, experimental designs (e.g., sampling methods, time and duration of the study, place), protocols, procedures, rationale, criteria, devices/tools/techniques (together with their manufacturers and country of origin), calibration plots, measurement parameters, calculations, statistical methods, tests and analyses, statistical software tools and version among many other things should be described here in methods section (Haralambides 2016 ; Stájer et al. 2020 ). If the details of protocols make this section extremely long, mention them in brief and cite the related papers (if they are already published). If the applied protocol was modified by the researcher, the protocol should be mentioned as modified protocol with the related address. Moreover, it is recommended to use flow charts (preferably standard flow charts) and tables to shorten this section, because “a picture paints a thousand words” (Ahlstrom 2017 ; Behzadi 2021 ; Lilleyman 1995 ; Tahaei et al. 2021 ).

The used online guidelines in accordance with the type of study should be mentioned in the methods section. In this regard, some of these online check lists, including the CONSORT (Consolidated Standards of Reporting Trials) statement ( http://www.consort-statement.org/ ) (to improve the reporting randomized trials), the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement ( http://www.prisma-statement.org/ ) (to improve the reporting of systematic reviews and meta-analyses), the STARD (Standards for Reporting Diagnostic accuracy studies) statement ( http://www.equator-network.org/wp-content/uploads/2015/03/STARD-2015-checklist.pdf ) (to improve the reporting of diagnostic accuracy studies), the STORBE (STrengthening the Reporting of OBservational studies in Epidemiology) statement ( https://www.strobe-statement.org/index.php?id=strobe-home ) (to improve the reporting of observational studies in Epidemiology), should be mentioned and highlighted in medical articles. Normally, the methods section begins with mentioning of exclusion (depicting safe selection) and inclusion (depicting no bias has happened) criteria (regarding the populations studied) and continues by the description of procedures and data collection. This section usually ends by the description of statistical data analyses. As mentioned in a previous section, older recommendations in “Instructions for authors” suggested the use of verbs in past tense, in 3rd person and passive forms, whereas novel guidelines suggest more text written in the active voice (Ahlstrom 2017 ; Behzadi 2021 ; Lilleyman 1995 ; Tahaei et al. 2021 ).

The results including negative and positive outcomes should be reported clearly in this section with no interpretation (Audisio et al. 2009 ; Behzadi et al. 2013 ). The most original information of an IMRAD paper originates from the results section. Indeed, the reported findings are the main core of the study which answers to the research question (hypothesis) “what was found?” The results section should answer all points brought up in the methods section. Categorization of findings by subheadings from the major to minor results, chronologically or by any logical order, facilitates readers to comprehend the results in an effective and influent manner (Ahlstrom 2017 ; Behzadi 2021 ; Lilleyman 1995 ; Tahaei et al. 2021 ).

Representing the motive of experiments, the related experimental setups, and the gained outcomes supports the quality and clarity of your results, because these components create logical and influent communications between obtained data, observations and measurements. The results section should represent all types of data (major to minor), variables (dependent and independent), variables effects and even accidental findings. The statistical analyses should be represented at the end of results section. The statistical significance should be represented by an exact amount of p value ( p  < 0.05 is usually recognized and set as the threshold for statistical significance, while p  > 0.05 depicts no statistical significance). Moreover, the mentioning of the 95% confidence intervals and related statistical parameters is also needed, especially in epidemiological studies (Mišak et al. 2005 ).

It is recommended to use tables, figures, graphs and charts in this section to give an influent representation of results to the readers. Using well-structured tables deeply impresses the readers. Usually the limitation of the number of figures, graphs, tables and charts is represented in the section of instructions for authors of the journal. Remember that well-designed tables and figures act as clean mirrors which transfer a clear and sharp illustration of your work and your efforts in preparing the manuscript. Thus, a well-designed graph, table, charts or figure should be understood easily; in other words, they should be represented as self-explanatory compartments. Avoid repeating the represented data in figures, tables, charts and graphs within the text. Citing figures, graphs, charts and tables in right positions within the text increases the impact and quality of your manuscript (Ahlstrom 2017 ; Behzadi 2021 ; Lilleyman 1995 ; Tahaei et al. 2021 ). Showing the highest and lowest amounts in tables by bolding or highlighting them is very effective. Normally, the legends are placed under graphs and figures and above the tables. It is recommended to begin the figure legends with conclusion and finish it by important technical key points.

Discussion and conclusion

This section represents the interpretations of results. In other words, discussion describes what these results do mean by the help of mechanistic interpretations of causes and effects. This argument should be achieved sharp and strong in a logical manner (Gajdács 2020 ; Rasko et al. 2016 ). The interpretations should be supported by relevant references and evidences. Usually, the first paragraph of discussion involves the key points of results. The represented data in results section should not be repeated within the discussion section. Magnification and exaggeration of data should never occur! “A good wine needs no bush.” Care about the quality of discussion section, because this part of the manuscript is determinative item for the acceptance of the paper (Ahlstrom 2017 ; Behzadi 2021 ).

Avoid representing new data in discussion, which were not mentioned in the results section. The following paragraphs should represent the novelty, differences and/or similarities of the obtained findings. Unusual and findings not predicted should be highlighted (Gajdács 2020 ; Rasko et al. 2016 ). It is important to interpret the obtained results by the strong references and evidences. Remember that citation of strong and relevant references enforces your evaluations and increases the quality of your points of view (Mack 2018 ; Shakeel et al. 2021 ). The probable weaknesses or strengths of the project should be discussed. This critical view of the results supports the discussion of the manuscript. The discussion section is finished by the final paragraph of conclusion. A critical paragraph in which the potential significance of obtained findings should be represented in brief (Ahlstrom 2017 ; Behzadi 2021 ). The bring/take-home message of the study in conclusion section should be highlighted. For writing a conclusion, it is recommended to use non-technical language in perfect English as it should be done in abstract section (Alexandrov 2004 ). It is suggested to use verbs in present tense and passive forms, if not otherwise mandated by the journal’s instructions. In accordance with policy of journals, the conclusion section could be the last part of discussion or presented within a separate section after discussion section (Ahlstrom 2017 ; Behzadi 2021 ).

Acknowledgements

This section is placed right after discussion and/or conclusion section. The unsaid contributors with pale activities who cannot be recognized as the manuscripts’ authors should be mentioned in acknowledgement section. Financial sponsors, coordinators, colleagues, laboratory staff and technical supporters, scientific writing proof readers, institutions and organizations should be appreciated in this section. The names listed in acknowledgements section will be indexed by some databases like US National Library Medicine (NLM) ( https://www.nlm.nih.gov/ ) (Ahlstrom 2017 ).

Conflict of interest

If the authors have any concerns regarding moral or financial interests, they should declare it unambiguously, because the related interests may lead to biases and suspicions of misconducts (Ahlstrom 2017 ; Behzadi 2021 ; Lilleyman 1995 ; Tahaei et al. 2021 ). This section usually comes right after acknowledgements and before references.

Application of relevant and pertinent references supports the manuscript’s scientific documentary. Moreover, utilization of related references with high citation helps the quality of the manuscript. For searching references, it is recommended to use search engines like Google Scholar ( https://scholar.google.com/ ), databases such as MEDLINE ( https://www.nlm.nih.gov/bsd/medline.html ) and NCBI ( https://www.ncbi.nlm.nih.gov/ ) and Web sites including SCOPUS ( https://www.scopus.com/ ), etc.; in this regard, the keywords are used for a successful and effective search. Each journal has its own bibliographic system; hence, it is recommended to use reference management software tools, e.g., EndNote®. The most common bibliographic styles are APA American Psychological Association, Harvard and Vancouver. Nevertheless, the authors should aware of retracted articles and making sure not to use them as references (Ahlstrom 2017 ; Behzadi 2021 ; Lilleyman 1995 ; Tahaei et al. 2021 ). Depending on the journal, there are different limitations for the number of references. It is recommended to read carefully the instructions for authors section of the journal.

Conclusions for future biology

From the societal standpoint, the publication of scientific results may lead to important advances in technology and innovation. In medicine, patient care—and the biomedical sciences in general—the publication of scientific research may also lead to substantial benefits to advancing the medical practice, as evidence-based medicine (EBM) is based on the available scientific data at the present time. Additionally, academic institutions and many academic centers require young medical professionals to be active in the scientific scene for promotions and many employment prospects. Although scientific writing is part of the curricula for many medical programs, not every physician may have adequate knowledge on formulating research results for publication adequately. The present review aimed to briefly and concisely summarize the details of creating a favorable original article to aid early career researchers in the submission to peer-reviewed journal and subsequent publication. Although not all concepts have been discussed in detail, the paper allows for current and future authors to grasp the basic ideas regarding scientific writing and the authors hope to encourage everyone to take the “leap of faith” into scientific research in medicine and to submit their first article to international journals.

Data accessibility

Not applicable.

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Payam Behzadi would like to thank the Islamic Azad University, Shahr-e-Qods Branch, Tehran, Iran, for approving the organization of the workshop on “How to write a scientific paper?” Márió Gajdács would also like to acknowledge the support of ESCMID’s “30 under 30” Award.

Open access funding provided by University of Szeged. Márió Gajdács was supported by the János Bolyai Research Scholarship (BO/00144/20/5) of the Hungarian Academy of Sciences and the New National Excellence Programme (ÚNKP-20-5-SZTE-330) of the Ministry of Human Resources.

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Department of Microbiology, College of Basic Sciences, Shahr-e-Qods Branch, Islamic Azad University, Tehran, 37541-374, Iran

Payam Behzadi

Institute of Medical Microbiology, Faculty of Medicine, Semmelweis University, Budapest, Nagyvárad tér 4, 1089, Hungary

Márió Gajdács

Department of Pharmacodynamics and Biopharmacy, Faculty of Pharmacy, University of Szeged, Szeged, Eötvös utca 6., 6720, Hungary

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Correspondence to Márió Gajdács .

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Behzadi, P., Gajdács, M. Writing a strong scientific paper in medicine and the biomedical sciences: a checklist and recommendations for early career researchers. BIOLOGIA FUTURA 72 , 395–407 (2021). https://doi.org/10.1007/s42977-021-00095-z

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Received : 08 April 2021

Accepted : 16 July 2021

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DOI : https://doi.org/10.1007/s42977-021-00095-z

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medical research article writing

The Ultimate Guide for Medical Manuscript Writing

Medical Manuscript writing can be overwhelming, but there are some tried-and-true techniques and creative tips that can dramatically simplify the process.

We mined the literature for strategies plus revealed some tricks from our seasoned writers to help you get your manuscript written and published.

In this document, we focused our attention on manuscripts since they are one of the most common types of medical writing . However, these are techniques that can be useful for any medical writing project.

What is good medical manuscript writing?

When you’re writing for a scientific audience it’s important to write with three C’s in mind:

  • Clear: Don’t be ambiguous or leave anything to the imagination.
  • Concise: Use brief, simple language and avoid repetition/redundancy.
  • Correct: Be accurate, and don’t overstate the significance of your results.

Good medical writing is never more complicated than it needs to be.

Make it easy for your audience by keeping your language clear and simple.

medical manuscript writing

How is medical writing different?

Many people want to know how writing healthcare blog topics is different from other types of writing. The answer is simple: it isn’t.

Good writing has a goal and a target audience and they will influence how you write, regardless of what you’re writing. A good manuscript is rooted in a good story.

Even data-driven medical texts can be delivered in an engaging way. Most of us can think of examples of stand-out papers in our field of expertise.

At their best these papers are entertaining and thought-provoking even while they deliver complicated, data-heavy material.

Make an Outline for your Manuscript

Before you start writing you need to have a clear understanding of the type and scope of your writing.

For example, consider exactly what you are writing. Is it a case study, textbook chapter , or literature review? These distinctions have important implications for how you craft and present your material.

An outline should be an obvious place to start, but you’d be surprised at how often this step is skipped.

How to structure your medial manuscript outline

When possible, before you start your outline you should understand the formatting requirements for your targeted publisher.

Many publishers specify abstract headings and have specific requirements for what can (and can’t) be included in the body of your text.

Use the outline as a way to narrow down the research you’ll need to do as you write.

It is an unfortunate fact of life: the abstract is often the only portion of a paper that ever gets read. For this reason, your abstract needs to convey the most important points from your paper in 300 words or less. Note what these points are in your abstract.

Make sure you know what your publisher expects from your abstract. Some journals limit you to 150 words or require that you arrange your abstract using specific headers.

You may need to include an objective or a statement of impact as well.

Most publishers ask authors to provide some keywords. Think about the keywords you’d use to search for your paper and write them down.

Keywords that are more general will increase the number of search results your paper will appear in. For example, use “spinal cord stimulation” instead of “neuromodulation.”

Define your goal

Is your goal to present new research data or to provide a meta-analysis of existing data? By clarifying the goal of your manuscript you can streamline preparation and writing.

Defining the goal is one of the secrets of successful grants and manuscripts of top biomedical PIs . Having a well-defined goal will also help you find the most appropriate publisher.

Keep your target audience in mind as you define your goal.

Introduction/background

The outline for your intro should note the current state of the field and identify knowledge gaps.

A good way to understand how to arrange your intro is by looking at similar papers that have been published by your target journal.

A standard approach to an intro can be broken down as follows:

  • First paragraph: Current knowledge and foundational referencesYou’re paving the way for your readers to understand your objective
  • Second paragraph: Introduce your specific topic and identify knowledge gaps
  • Third paragraph: Clearly identify your aim

Key references and identifying your hypothesis and aim(s).

Methods Briefly list your methods and timeframe, but don’t get too detailed. This is just an outline.

Results The results section can be the most challenging to organize.

To simplify the writing process, state your overall question and create subsections for each dataset.

List the experiments you did and your results.

In your outline, identify data that should be presented in a figure or table. Save any subjective interpretations for the discussion section.

Discussion Your outline for the discussion should pick up where the introduction left off.

For example, if your intro ends with an aim, your discussion should start by restating your aim and reminding your readers of the knowledge gap(s) that you are addressing.

Your discussion needs to address each set of experiments and your interpretation, but don’t simply restate your results section.

Timeline Make a timeline for your manuscript and specify a submission date to help keep you on track.

Questions to consider when making your discussion outline include:

  • How do your data relate to your original question?
  • Do they support your hypothesis?
  • Are your results consistent with what other researchers have found?
  • If you had unexpected results, is there an explanation for them?
  • Consider your data from the perspective of a competitor. Can you punch holes in your argument?
  • Address potential concerns about your data head on. Don’t try to hide them or gloss over them.
  • If you weren’t able to fully address your question(s) or aim(s), what else do you need to do?
  • How do your data fit into the big picture?

Include a discussion subsection for each of your results subsections where you can subjectively interpret your data. Your outline should include the points you want to make in each subsection as well as your overall goal.

Conclude your discussion with a one sentence summary of your conclusion and its relevance to the field.

Again, don’t forget to write to your target audience!

Additional Resources for Medical Writing

Templates for Building a Perfect Writing Plan:

  • Scope of work guide
  • 30 Scope of work templates
  • Medical cover letter + Templates
  • Detailed guide of medical manuscript Scope of Work
  • Short guide of scope of work for a medical journal

Know the Literature Before You Write Anything

An effective medical or scientific manuscript provides compelling information that builds on the existing literature and advances what is currently known.

This means you need to have a thorough understanding of the relevant literature!

Your goal is to collect all relevant references into a structured document. Make note of the aim and conclusion of each reference. Use this as a foundation to refer back to when you’re writing your paper.

Organize your research into buckets.

medical research article writing

When you find a relevant source, ask yourself:

  • Are the data consistent with what’s already known?
  • If not: why are they different and how do they affect what’s known?
  • Do your data support or refute the data presented in the source?
  • You’ll need to explicitly address inconsistencies and identify potential resolutions.

Find Scholarly Sources

If you are writing an original research article , how do your data fit into the broader topic?

Google searches don’t usually produce scholarly resources unless you know where to look.

There are numerous FREE and Paid online resources available to find the right sources.

Top Scholarly Databases for journals, news, and articles

These tools can be used to find all the reputable sources needed to flesh out quality medical writing.

PubMed (MEDLINE):

medical research article writing

PUBMED is an extremely popular and free search engine hosted by the NIH (National institutes of Health and U.S. National Library of Medicine. It can be used to access a vast index of peer-reviewed biological and medical research.

medical research article writing

EMBASE is a database of literature intended to aid in organizational adherence to prescription drug regulations. Whereas it does contain some references that are not returned by PUBMED, there is a subscription fee associated with EMBASE.

Cochrane Library

medical research article writing

The Cochrane Library is a curated database of medical research reviews, protocols, and editorials. While a subscription is required, the Cochrane is a critical resource for evidence-based medicine.

Web of Science

medical research article writing

The Web of Science is another subscription service similar to those that have already been mentioned, albeit with an expanded range of academic disciplines including the arts, social sciences, and others.

Google Scholar

medical research article writing

Google Scholar leverages Google’s powerful search engine to retrieve published literature from the whole internet (rather than just biomedical journals). This means you’ll get textbooks, theses, conference proceedings, and other publications that won’t show up in PubMed or EMBASE searches. Google Scholar is a powerful tool but it lacks the curation of other search tools, so a careful vetting of any information from this source is important.

Other databases:

Faculty of 1000 (F1000) offers Faculty Opinions and F1000Research. Faculty Opinions are links to recommended life-science articles, while F1000Research is a database of open-source research papers and results.

EBSCO is an online library providing a wide range of services, including its research databases that allow powerful searches of journals in a variety of academic disciplines.

iSEEK Education:

iSeek Education is a search engine geared specifically for academics. The resources from iSeek are meant to be dependable and from reliable sources, such as government agencies and universities.

RefSeek is another popular option for academically oriented search engines. RefSeek is designed to pull results from a large number of sources but not commercial links. 

Virtual LRC:

The Virtual Learning Resources Center is a modified Google search of academic information websites. Its index of websites has been chosen by qualified curators.

More journal databases for medical research

  • 100+ journal databases
  • Top Academic Search Engines
  • 101 Free Journal and Research Databases
  • List of Global scholarly sources 

Organize Your References:

One other point on knowing the literature: find a strategy that helps you keep references organized. 

If you’ve ever written a paper and couldn’t remember where on earth you saw that one, perfect reference you know how important this is! 

Rather than putting things into a long word document start with a research template.

RESOURCE: Use our FREE research template to collect sources for your manuscript

You can also download free basic software to organize references.

5 Reference Organization Tools and Software

EndNote is the most popular reference organization tool for medical writers. 

A basic version of EndNote is available for free, but paid subscriptions offer more options.

medical research article writing

EndNote features include:

  • Import, annotate, and search PDFs
  • Ability to store reference libraries online, so you can access them from anywhere
  • Collaboration is easy with shared libraries
  • EndNote provides the most comprehensive citation style database, or you can create custom citation styles
  • Easy to import/export references from databases using RIS, BibTex, and many other standard data schemes 

One potential drawback of EndNote is that it’s not compatible with Linux.

Zotero Zotero is a free, open-source reference management and citation tool. 

Features of Zotero include:

  • Save screenshots and annotate them within your citation library
  • Import and export references in many formats, including RIS, BibTeX and BibLateX, EndNote, RefWorks, and more
  • Supports over 30 languages
  • Zotero’s online bibliography tool ZoteroBib lets you generate bibliographies without installing Zotero or creating an account
  • Drag-and-drop interface
  • Linux compatible

medical research article writing

Mendeley Mendeley is Elsevier’s “freemium” referencing software, meaning the basic package is available for free but more sophisticated versions require a paid subscription. 

Features of Mendeley include:

  • Extract metadata from PDFs
  • Create private, shareable libraries

medical research article writing

A free online reference tool, Citefast allows users to quickly generate a library in APA 6 or 7, MLA 7 or 8, or Chicago styles. 

Citefast doesn’t require you to make an account, but if you don’t create one your references will be lost after 4 days of inactivity.

Another free online resource, BibMe lets you import references and offers MLA, APA, Chicago, and Turabian formatting styles.

BibMe can also check your spelling and grammar, as well as look for plagiarism.

List of MORE Online Software Tools for Academic and Medical Research

30+ research tools to make your life easier

5 best tools for academic research

31 Best Online Tools for Research

10 great tools for online research

Know your audience

It’s important to know your audience before you start writing. This will help you define your goals and create an outline.  

For example, if you’re preparing a case study for specialists your manuscript will be different than one for a multidisciplinary audience. 

Ask yourself what your message is and find out how it aligns with the goals of your readers to maximize your paper’s impact.

Formatting requirements

Whenever possible, find out the formatting requirements you’ll need to follow before you start writing. They will explicitly state the layout, word limits, figure/table formatting, use of abbreviations, and which reference style to use.

If you’re writing for a journal their website will have a Guide for Authors that specifies formatting. If you’re not sure what the requirements are, you should contact the editor or publisher and ask them. 

Types of medical manuscripts

Knowing what kind of manuscript you’re writing will help you organize your material and identify which information you should present. In addition, many publishers have different formatting requirements for different types of articles.

Although each publisher has their own guidelines for authors, many journals encourage authors to follow reporting guidelines from the EQUATOR Network (Enhancing the QUAlity and Transparency Of health Research). 

Original research

The goal of an original research article is to convey your research findings to an audience. These articles typically follow the same structure:

  • Introduction 

Methods & Materials

Examples of great original medical research manuscripts:

  • Nowacki J, Wingenfeld K, Kaczmarczyk M, et al. Steroid hormone secretion after stimulation of mineralocorticoid and NMDA receptors and cardiovascular risk in patients with depression . Transl Psychiatry . 2020 Apr 20;10(1):109.
  • Pfitzer A, Maly C, Tappis H, et al. Characteristics of successful integrated family planning and maternal and child health services: Findings from a mixed-method, descriptive evaluation . F1000Res . 2019 Feb 28;8:229. 
  • Yi X, Liu M, Luo Q, et al. Toxic effects of dimethyl sulfoxide on red blood cells, platelets, and vascular endothelial cells in vitro . FEBS Open Bio . 2017 Feb 20;7(4):485-494. 
  • Karsan N, Goadsby PJ. Imaging the Premonitory Phase of Migraine . Front Neurol . 2020 Mar 25;11:140. 
  • Chan SS, Chappel AR, Maddox KEJ, et al. Pre-exposure prophylaxis for preventing acquisition of HIV: A cross-sectional study of patients, prescribers, uptake, and spending in the United States, 2015-2016 . PLoS Med . 2020 Apr 10;17(4):e1003072.

Examples of great medical journal publications from The Med Writers :

medical research article writing

Rapid communications

Rapid (or brief) communications are aimed at publishing highly impactful preliminary findings. 

They are shorter than original research articles and focus on one specific result. 

Many journals prioritize rapid communications, since they can provide paradigm-shifts in how we understand a particular topic.

5 Examples of Rapid Communications

  • Rose D, Ashwood P. Plasma Interleukin-35 in Children with Autism . Brain Sci . 2019 Jun 27;9(7).
  • Nash K, Johansson A, Yogeeswaran K. Social Media Approval Reduces Emotional Arousal for People High in Narcissism: Electrophysiological Evidence . Front Hum Neurosci . 2019 Sep 20;13:292.
  • Su Q, Bouteau A, Cardenas J, et al. Long-term absence of Langerhans cells alters the gene expression profile of keratinocytes and dendritic epidermal T cells . PLoS One . 2020 Jan 10;15(1):e0223397.
  • Nilsson I, Palmer J, Apostolou E, et al. Metabolic Dysfunction in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Not Due to Anti-mitochondrial Antibodies . Front Med . 2020 Mar 31;7:108.
  • Rabiei S, Sedaghat F, Rastmanesh R. Is the hedonic hunger score associated with obesity in women? A brief communication . BMC Res Notes. 2019 Jun 10;12(1):330. 

Case reports

Case reports detail interesting clinical cases that provide new insight into an area of research. 

These are brief reports that chronicle a case, from initial presentation to prognosis (if known). 

Importantly, when writing a case report, you need to clearly identify what makes your case unique and why it’s important. 5 Examples of Great Case Studies

  • Scoles D, Ammar MJ, Carroll SE, et al. Cytomegalovirus retinitis in an immunocompetent host after complicated cataract surgery . Am J Ophthalmol Case Rep . 2020 Apr 6;18:100702.
  • Yanagimoto Y, Ishizaki Y, Kaneko K. Iron deficiency anemia, stunted growth, and developmental delay due to avoidant/restrictive food intake disorder by restricted eating in autism spectrum disorder . Biopsychosoc Med . 2020 Apr 10;14:8.
  • Pringle S, van der Vegt B, Wang X, et al. Lack of Conventional Acinar Cells in Parotid Salivary Gland of Patient Taking an Anti-PD-L1 Immune Checkpoint Inhibitor . Front Oncol . 2020 Apr 2;10:420.
  • Crivelli P, Ledda RE, Carboni M, et al. Erdheim-Chester disease presenting with cough, abdominal pain, and headache . Radiol Case Rep . 2020 Apr 10;15(6):745-748.
  • Tsai AL, Agustines D. The Coexistence of Oculocutaneous Albinism with Schizophrenia . Cureus . 2020 Jan 9;12(1):e6617.

Literature review

A good literature review provides a comprehensive overview of current literature in a new way. There are four basic types of literature review:

Traditional: Also known as narrative reviews, these reviews deliver a thorough synopsis of a body of literature. They may be used to highlight unanswered questions or knowledge gaps.

Li X, Geng M, Peng Y, Meng L, Lu S. Molecular immune pathogenesis and diagnosis of COVID-19 . J Pharm Anal . 2020 Mar 5. 

Wardhan R, Kantamneni S. The Challenges of Ultrasound-guided Thoracic Paravertebral Blocks in Rib Fracture Patients . Cureus . 2020 Apr 10;12(4):e7626.

Lakhan, S.E., Vieira, K.F. Nutritional therapies for mental disorders . Nutr J 7, 2 (2008). https://doi.org/10.1186/1475-2891-7-2

A minireview is similar to a review, but confines itself to a specific subtopic:

Marra A, Viale G, Curigliano G. Recent advances in triple negative breast cancer: the immunotherapy era . BMC Med . 2019 May 9;17(1):90.

  Systematic : These are rigorous, highly structured reviews that are often used to shed light on a specific research question. They are often combined with a meta-analysis or meta-synthesis. 

Asadi-Pooya AA, Simani L. Central nervous system manifestations of COVID-19: A systematic review . J Neurol Sci . 2020 Apr 11;413:116832.

Katsanos K, Spiliopoulos S, Kitrou P, Krokidis M, Karnabatidis D. Risk of Death Following Application of Paclitaxel-Coated Balloons and Stents in the Femoropopliteal Artery of the Leg: A Systematic Review and Meta-Analysis of Randomized Controlled Trials . J Am Heart Assoc . 2018 Dec 18;7(24):e011245.

Meta-analysis: A meta-analysis analyzes data from multiple published studies using a standardized statistical approach. These reviews can help identify trends, patterns, and new conclusions.

Zhang J, Zhang X, Meng Y, Chen Y. Contrast-enhanced ultrasound for the differential diagnosis of thyroid nodules: An updated meta-analysis with comprehensive heterogeneity analysis . PLoS One . 2020 Apr 20;15(4):e0231775.  

  Meta-synthesis: A meta-synthesis is a qualitative (non-statistical) way to evaluate and analyze findings from several published studies.

Stuart R, Akther SF, Machin K, et al. Carers’ experiences of involuntary admission under mental health legislation: systematic review and qualitative meta-synthesis . BJPsych Open . 2020 Feb 11;6(2):e19. 

At this point you’ve established three things for your manuscript:

  • Your goal : Is your goal to convey the latest research? You should find a way to describe what you want to accomplish with this article. 
  • Your target audience : The most effective medical writing is done with a specific audience in mind. 
  • Type of manuscript : The type of article you’re writing will influence the format of the document you are writing.

You probably have a target journal or publisher in mind and you should have checked out their formatting requirements. Now it’s time to start writing!

Notably, many seasoned authors don’t write their articles from beginning to end. For example, if you’re preparing an original research manuscript they suggest writing the methods section first, followed by the results, discussion, introduction, and, lastly, the abstract. This will help you stay within the scope of the article.

Generally, the title for a medical document should be as succinct as possible while conveying the purpose of the article. 

If you’re writing an original research article your title should convey your main finding as simply as possible. 

Avoid using unnecessary jargon and ambiguity.

Some authors recommend including keywords that will help people find your writing in the title.

Your publisher may have a specific abstract format for you to follow. There are three general types of abstract:

  • Indicative (descriptive) abstracts provide a clear overview of the topics covered. They are common in review articles and conference reports.
  • Informative abstracts summarize the article based on structure (e.g. problem, methods, case studies/results, conclusions) but without headings.
  • Structured abstracts use headings as specified by the publisher.

Good abstracts are clear, honest, brief, and specific. They also need to hook readers or your article will never be read (no pressure!).

Many publishers will ask you to come up with some keywords for your article. Make sure they’re specific and clearly represent the topic of your article. 

If you’re not sure about your keywords the National Library of Medicine’s Medical Subject Headings ( MeSH ) website can help. Just type in a term and it will bring up associated subject headings and definitions.

Introduction

The goal of the introduction is to briefly provide context for your work and convince readers that it’s important. It is not a history lesson or a place to wax poetic about your love of medicine (unless you’re writing about history or your love of medicine). Everything in your introduction needs to be directly relevant to the overall goal of your manuscript.

Introductions vary in length and style between the different types of manuscript. The best way to understand what your publisher is looking for in an introduction is to read several examples from articles that are stylistically similar to yours.

Broadly speaking, an introduction needs to clearly identify the topic and the scope of the article. For an original research article this means you explicitly state the question you’re addressing and your proposed solution. For a literature review, the topic and its parameters should be stated.

Importantly, don’t mix the introduction with other sections. Methods and results don’t belong in the introduction.

Abbreviations

If you use terms that are abbreviated, some journals will ask you to include a section after the introduction where you define them. Consult the authors guide to learn how you should handle abbreviations. Also check to see if they have standard abbreviations that you don’t need to define in your manuscript.

A couple of tips for abbreviations:

·        Terms that are only used once or twice should be spelled out, not abbreviated

·        Don’t capitalize each word in an acronym unless it’s a proper noun (e.g. ubiquitin proteasome system (UPS), not Ubiquitin Proteasome System (UPS))

A good methods section will contain enough information that another researcher could reproduce the work. Clearly state your experimental design, what you did in chronological order, including equipment model numbers and specific settings you used. Make sure to include all equipment, materials, and products you used as they could account for future variability. Describe any statistical analyses.

The methods section should describe the following:

·        Population and sampling methods

·        Equipment and materials

·        Procedures

·        Time frame (if relevant)

·        Analysis plan

·        Approaches to ensure reliability/validity

·        Any assumptions you used

·        Scope and limitations

If you are using methods that have been described before you can refer to that publication or include them in your supplementary material, rather than re-writing them in the body of your text.

The results section is where your findings are objectively presented (save your interpretation of the results for the discussion section). Figure out which data are important for your story before you write the results section. For each important data set provide the results (preferably in a table or graph) and include a sentence or two that summarizes the results.

It’s easy to lose sight of the goal of the paper when you’re relaying numbers through the lens of statistics. Make sure to tie your results back to the biological aspects of your paper.

The discussion section is where you sell your interpretation of the data. Your discussion section needs to tie your introduction and your results sections together. A common strategy for the discussion section is to reiterate your main findings in light of the knowledge gaps you outlined in your introduction. How do your findings move the field forward?

Consider each of your results with respect to your original question and hypothesis. If there are multiple ways to interpret your data, discuss each of them. If your findings were not in line with your hypothesis, state this and provide possible explanations.

If your data are inconsistent with other published literature it’s important to consider technical and experimental differences before concluding that you’ve stumbled onto a groundbreaking medical discovery. Discuss all potential reasons for the divergent data.

Key points to include in your discussion section:

·        What your results mean

·        Whether your methods were successful

·        How findings relate to other studies

·        Limitations of your study

·        How your work advances the field

·        Applications

·        Future directions

Don’t draw grand conclusions that aren’t supported by your data; some speculating is okay but don’t exaggerate the importance of your findings.

It’s important to remind your reader of your overall question and hypothesis throughout the discussion section, while you are providing your interpretation of the results. This will ensure that you stay on track while you’re writing and that your readers will understand exactly how your findings are relevant.

This is your final chance to convince your readers that your work is important. 

Start your conclusion by restating your question and identify whether your findings support (or fail to support) your hypothesis. 

Summarize your findings and discuss whether they agree with those of other researchers. 

Finally, identify how your data advances the field and propose new or expanded ways of thinking about the question.

It’s important to avoid making unsupported claims or over-emphasize the impact of your findings. Even if you think your findings will revolutionize medicine as we know it, refrain from making that claim until you have the evidence to back it up.

Figures/Tables

Many readers will get the bulk of their information from your figures so make sure they are clear and informative. Your readers should be able to identify your key findings from figures alone.

Tips for figures and tables:

·        Don’t repeat data in tables, figures and in the text

·        Captions should sufficiently describe the figure so the reader could understand it even if the figure was absent

·        Keep graphs simple! If a basic table will work there’s no need for a multi-colored graph

Acknowledgements

Use the acknowledgments section to identify people who made your manuscript possible. Include advisors, proofreaders, and financial backers. In addition, identify funding sources including grant or reference numbers.

Make sure to use the reference style specified by your target journal or publisher. Avoid too many references, redundant references, excessive self-referencing, and referencing for the sake of referencing. Personal communications, unpublished observations, and submitted, unaccepted manuscripts should generally be avoided.

It should go without saying that you need to be ethical when preparing medical manuscripts. Fabricating or falsifying data is never acceptable, and you put your career at risk. It’s not worth it.

Plagiarism is not a viable strategy for getting works published. Any indication that you’ve plagiarized will be investigated, and if you’re found to have plagiarized your career and scientific reputation are at stake. Any time you refer to published work you need to reference it, even if it was your own publication. Be very careful about self-plagiarizing!

To learn more about ethical writing take a look at the U.S. Department of Health and Human Services guide: Avoiding Plagiarism, Self-plagiarism, and Other Questionable Writing Practices: A Guide to Ethical Writing , by Dr. Miguel Roig.

Ethics standards require that you submit your manuscript to only one publisher at a time. If you’re caught submitting to multiple editors none of them will publish your work.

Traps to avoid

Seasoned writers told us some of the pitfalls they’ve learned how to watch out for:

Writing versus editing

Writing and editing are not the same. Get comfortable writing , that is, pouring out all of your ideas without editing yourself. Then go back and edit.

Lack of editing

One of the toughest parts of writing is opening yourself up to critique. As hard as it can be, the best way to get a polished and meaningful manuscript is to have other people read it. As writers we can get attached to particular phrases or styles that may not read as well to other people.

Scientific manuscript editing is the toughest of any manuscript editing but if you keep patience and edit honestly it will get easier over time. Imagine that you’re editing someone else’s document to help give you fresh eyes. If possible give yourself a couple of days without looking at the manuscript, then go back and read it.

Being unfamiliar with the literature

It’s important to be familiar with the current literature on the topic you’re writing about. A fatal flaw of any research manuscript is proposing a hypothesis that has already been tested or posing questions that have already been answered.

Not formatting properly

If your manuscript is not formatted properly, it is less likely to be accepted. Make sure your font and line spacing are correct, that you’ve adhered to word and figure limits, and that your references are in the correct style.

Useful tips

Here are some helpful tips that you can use to improve your writing:

Framing your manuscript

A common trope in outlining manuscripts is the inverted triangle approach, which starts generally and ends specifically. A more useful method is to consider an hourglass-shaped outline, which starts generally, specifically addresses your contribution to the field, then ties your contribution back to current knowledge and unanswered questions.

Passive and active voice

Medical writing has long used passive voice to communicate and, while this is still the status quo for many journals, don’t be afraid to get out of that mire. As journals begin to recognize that active voice is not only more economical but can also be more readable they are becoming more comfortable publishing articles that include active voice.

Don’t edit while you write

Get a first draft onto paper as quickly as possible and then edit. Don’t waste time trying to get a paragraph perfect the first time you write it.

Ask someone else to edit

Medical writing does have some unique challenges associated with it. Your audience may not be experts on the material you are delivering, so an ability to communicate complicated information in an accessible manner is very helpful. Improve on your skills by asking people outside of your field to provide constructive criticism on writing samples.

It can be a very useful practice to edit some manuscripts that other people have written. This will help you understand what editors are paying attention to.

Keep track of references

Make sure to keep detailed notes of where you got your references so that you can easily and accurately cite the literature you used. There’s nothing more frustrating than not being able to remember where you saw a really great reference.

Before you submit your manuscript

Ideally, you’ve left yourself plenty of time to proofread and have other people edit your document. At the very least make sure you budget some hours to carefully proofread. Triple check that your paper adheres to formatting requirements. You can learn how to proofread scientific manuscripts before submitting them for publication.

Cover letters

If you’re submitting an article for consideration you’ll need to write a cover letter. Take the time to find out who the editor is and address your letter to him or her. This is your chance to communicate with the editor! A generic “To whom it may concern” won’t impress anyone.

Your cover letter should be brief, but it needs to convey the value of your paper to the journal. Describe your main findings and their significance and why they’re a great fit for your publication of interest. 

If you have conflicts of interest, disclose them in your cover letter. Also, if your paper has already been rejected, let them know. Include the reason (if known) and reviewer comments, as well as discussing changes you’ve made to improve the paper.

You can also suggest peer-reviewers or people who shouldn’t review your paper. Be cautious when suggesting reviewers! Some of the most critical reviews come from suggested reviewers.

Your cover letter is an excellent opportunity to prove that you know what the goals of the journal are and that your article furthers them. Don’t waste it!

Reviewer comments/Revisions

If the publisher asks you to address reviewer comments, take the time to do this seriously and thoughtfully. Understand reviewer comments and address them objectively and scientifically (be polite!). If you disagree with a comment, state why and include supporting references. When more experiments or computations are requested, do them. It will make your paper stronger.

When you resubmit your manuscript make sure to identify page/line numbers where changes were made.

What if you’re rejected?

Don’t despair! Rejection happens to every writer. Try to understand why your manuscript was rejected. Evaluate your manuscript honestly and take the opportunity to learn from your mistakes.

A rejected paper isn’t a dead paper. You’ll need to make some substantial revisions and may need to change your formatting before resubmitting to a new journal or publisher. In the cover letter to the new editor you’ll need to state that your manuscript was rejected. Include any information you got about why your manuscript was rejected and all reviewer comments. Identify changes you made to the paper and explain why you chose to submit to the new journal.

Medical writing can be very rewarding but it’s important that writers have a clear understanding of what publishers are looking for. High-quality, original works that advance the medical field are much more likely to be published than papers that are not original or that have little medical or scientific interest.

Quality medical writing should have clarity, economy of language, and a consistent theme. It’s important to always state the question or topic you’re addressing early and refer to it often. This will help you stay focused and within the scope of your article during the writing process and it will help your readers understand your intentions. Using an outline is a very helpful way to make sure your article is consistently on-topic.

Following the tips and techniques provided here will definitely improve your writing skills, but the most effective way to get better at medical writing is to do it. There is no single best way to prepare a medical manuscript and even professional writers are continuously tweaking their writing strategies.

Hopefully these tips have helped you create a great manuscript. If you’re feeling overwhelmed and want some help with your medical writing or editing, we at The Med Writers can help. Contact us to learn more about our writing and editing services. 

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New Medical Writer Toolkit

Ultimate Guide to Becoming a Medical Writer

Medical writing is an esteemed profession. Every day, medical writers are detailing, documenting, and sharing news and research that is improving health outcomes and saving lives. Their roles and opportunities are always evolving, whether they’re crafting peer-reviewed articles reporting on clinical trials, marketing cutting-edge devices, educating health care professionals or even the general public about new treatments, or writing grant proposals to fund innovative research.

This guide provides information and resources on what medical writers do, the companies they work for, and what you need to know to embark on this growing, rewarding—and lucrative—career.

What Is Medical Writing?

Medical writing involves the development and production of print or digital documents that deal specifically with medicine or health care. The profession of medical writing calls for knowledge in both writing and science, combining a writer’s creative talent with the rigor and detail of research and the scientific process. 

With the constant advancement and innovation in medicine and health care, the need to communicate about research findings, products, devices, and services is growing. Medical writers are increasingly in demand to convey new information to health care professionals as well as the general public.

Ultimate-Guide-To-Becoming-A-Medical-Writer-3

Depending on their position and the scope of their duties, medical writers are involved in communicating scientific and clinical data to many audiences, from doctors and nurses to insurance adjusters and patients. They work in a variety of formats, including traditional print publications to electronic publications, multimedia presentations, videos, podcasts, website content, and social media sites.

Medical writers often work with doctors, scientists, and other subject matter experts (SMEs) to create documents that describe research results, product use, and other medical information. They also ensure that documents comply with regulatory, publication, or other guidelines in terms of content, format, and structure. 

Medical writers are also key players in developing applications for mobile devices that are used in multiple ways, such as

  • Disease management
  • Continuing education and training
  • Medical reference and information-gathering
  • Practice management and monitoring

Ultimate-Guide-3h-1

Medical communicators may be writers, editors , health care journalists, supervisors, project managers, media relations specialists, educators, and more. At their core, they are exceptionally skilled at gathering, organizing, interpreting, evaluating, and presenting often complex information to health care professionals, a public audience, or industry professionals such as hospital purchasers, manufacturers and users of medical devices, pharmaceutical sales representatives, members of the insurance industry, and public policy officials. For each of these audiences, the language, documents, and deliverables are distinct.  

What Are Examples of Medical Communication Jobs?

Medical communication positions in writing and editing vary greatly across industries, companies, organizations, and other entities. 

In addition to the title of medical writer, medical communicators may be known as scientific writers, technical writers, regulatory writers , promotional writers, health care marketers, health care journalists, or communication specialists. Both medical writers and medical editors may work for pharmaceutical and biotechnology companies, medical communication agencies, medical education companies, health care professionals associations, academic institutions, medical and health care book publishers, trade publications, and more. 

What Do Medical Writers Write?

The expertise and contributions of medical writers and editors can be found throughout the medical community. Examples of their work include

  • Abstracts for medical journals and medical conferences
  • Advertisements for pharmaceuticals, devices, and other products
  • Advisory board summaries
  • Continuing medical education materials
  • Decision aids for patients
  • Grant proposals
  • Health care policy documents
  • Health education materials
  • Magazine and newspaper articles
  • Medical and health care books
  • Medical and scientific journal articles
  • Marketing materials
  • Poster presentations for medical conferences
  • Regulatory documents, including FDA submissions
  • Sales training
  • Slide presentations for medical conferences
  • White papers

Who Hires Medical Writers?

Right now, there is tremendous growth in the medical industry. Pharmaceutical companies are developing drugs more quickly, and new medical devices and diagnostic tools are being released every day. With this comes the increased need to meet regulatory and insurance requirements and to relay medical and consumer information. All of this results in greater opportunities for medical writers and communicators. 

Medical writers can find positions with a variety of employers, reaching a multitude of audiences with different communication needs and styles. These may include

  • Associations and professional health care societies
  • Authors or investigators
  • Biotechnology companies
  • Clinical or contract research organizations   (CROs)
  • Communications, marketing, or advertising agencies
  • Government agencies
  • Health care organizations or providers
  • Medical book publishers
  • Medical device companies
  • Medical education companies
  • Medical schools or universities
  • News outlets   for health/medical news
  • Peer-reviewed medical journals
  • Pharmaceutical companies
  • Trade journals   for health care professionals

AMWA members can access a current list of available openings on   AMWA Jobs Online . (Not a member?   Join here. )

How Much Do Medical Writers Make?

Medical writer salaries vary from city to city and region to region. Compensation also depends on the writer’s experience, the type of employer, and the type of work.

Sites such as Salary.com , PayScale.com , and Glassdoor.com indicate that a salary range for a junior-level or beginning medical writer is $52,000 to $80,000 annually and a salary range for a junior-level or beginning medical editor as $57,000 to $75,000 annually.

The AMWA Medical Communication Compensation Report provides an in-depth analysis of medical communication salary data by experience level, degree, industry categories, and much more.

Ultimate-Guide-To-Becoming-A-Medical-Writer-5

Join our professional community of skilled medical communicators.

Join AMWA

What Does It Take to Be a Medical Writer?

While medical writers come from all educational and professional backgrounds, they do share some traits.  Medical writers have an interest and flair for both science and writing. They also have a clear understanding of medical concepts and ideas and are able to present data and its interpretation in a way the target audience will understand.

Although it’s not required, many medical communicators hold an advanced degree. Some have a medical or science degree (eg, PhD, PharmD, MD) or experience in academic settings or as bench scientists, pharmacists, physicians, or other health care professionals. Others have an MFA or a PhD in communications or English.

Certificates and certifications are additional credentials that demonstrate your knowledge and proficiency in the medical communication field. Many are described in this guide.

How Do I Become a Medical Writer?

Medical communication can be a flexible, rewarding, and well-paying career in a growing field of both full-time and freelance opportunities. To get started, follow these steps. 

1. Determine a focus

Based on the wide range of companies and organizations that employ medical communicators, the field is generally divided into different writing settings and specializations, each requiring specific technical writing skills or knowledge of medical terminology and practices. In this step, it’s important to focus on an area you’re most interested in and that best matches your skill set.

  • Continuing education for healthcare professionals
  • Health communication
  • Marketing/Advertising/PR
  • Patient education
  • Publications for professional audiences (non-peer reviewed)
  • Regulatory writing
  • Sales training (biotech or pharma industry)
  • Scientific publications (peer-reviewed journals)

2. Assess your knowledge and skills

Medical communicators come to the field from a variety of different disciplines. Those with a medical or science background commonly need refreshers in writing and editing mechanics, whereas medical terminology and statistics are typically more difficult for those with a writing or communications background. No matter what your training has been, you should take an inventory of your essential skills .

Basic Grammar and Usage

  • Parts of speech and grammatical principles form the foundation of writing in every discipline. Can you identify a dangling modifier or notice the lack of a pronoun referent?

Sentence Structure

  • Even if you know grammar, you may need a refresher on achieving emphasis and organizing your sentences for clarity. Do you know the difference between an independent and a dependent clause? Do you understand parallel structure?

Punctuation

  • A single misplaced comma can create a very different meaning, which can have serious implications in medical writing. Are all your commas in the right places? What about your semicolons?

Medical Terminology

  • It’s not enough to know medical terms. You gain more insight into medical vocabulary by learning about the prefixes, combining forms, and suffixes that make up all your favorite medical words. Do you know the rules for eponyms? Do you know the difference between an acronym and an initialism?

Professional Ethics

  • Every profession has a code of ethics, and medical communication is no different. Make sure you know the steps to ethical decision-making and the ethical principles to uphold.
  • If you’re working with medical research, it’s essential to have a basic understanding of statistics. Can you describe the difference between mean, median, and mode? Can you define a hazard ratio?

Tables and Graphs

  • Tables and graphs are essential tools for communicating complex information. Do you know what kind of graph to use for continuous data? Are your table column headings doing their job?

If you need to fill gaps in your knowledge, AMWA offers a variety of educational activities , including the AMWA Essential Skills Certificate Program , which addresses all of these topics.

3. Explore resources

As you explore the medical writing profession, the next step is to become aware of the resources available to you. AMWA offers many opportunities to support new medical communicators and a wealth of professional development resources to help throughout an evolving career. The following are some examples.

  • AMWA Online Learning activity: A Career in Medical Communication: Steps to Success
  • AMWA Career Services : Jobs Online ,  Freelance Directory
  • Live   webinars
  • AMWA Essential Skills Certificate Program
  • Comprehensive Guide to Medical Editing
  • Medical Editing Checklist
  • How to Identify Predatory Publishers eBook

Other resources include a number of recommended books on medical writing , listed in the "Medical Writer Resources" section below.

Ultimate-Guide-To-Becoming-A-Medical_Writer-6

Although there are plenty of opportunities in medical communication, it is important to recognize that it can be a difficult field to break into.   Networking   is a crucial part of gaining success as a medical writer.

Throughout your career, but especially at the start, it’s important to connect with other medical communicators in your local area as well as   across the country .

Networking   is an excellent way to connect with other medical communicators. Not only does it provide informal learning opportunities, but some experts say that 70% to 80% of people found their current position through networking.   Others say it’s closer to 85%. Whether you are using LinkedIn ,   Facebook ,   Twitter , community boards, or conference attendance , it is important to seek out ways to stay connected.

Take the leap!

Medical writer resources, books about medical writing.

  • The Accidental Medical Writer . Brian G. Bass and Cynthia L. Kryder. Booklocker.com, Inc, 2008.
  • Essentials of Writing Biomedical Research Papers . 2nd ed. Mimi Zeiger. McGraw-Hill, 2000.
  • Health Literacy from A to Z: Practical Ways to Communicate Your Health Message . Helen Osborne. Jones and Bartlett Publishers, 2005.
  • How to Write and Publish a Scientific Paper, 8th ed .   Barbara Gastel and Robert A. Day. Greenwood, 2016.
  • Targeted Regulatory Writing Techniques: Clinical Documents for Drugs and Biologics . Linda Fossati Wood and MaryAnn Foote, eds. Birkhauser, 2009.

Style Guides

  • AMA Manual of Style
  • Associated Press Stylebook 
  • Chicago Manual of Style
  • American Psychological Association Style
  • Scientific Style and Format: The CSE Manual for Authors, Editors, and Publishers

Publication Ethics

  • Code of Conduct and Best Practice Guidelines for Journal Editors   (Committee on Publication Ethics)
  • White Paper on Publication Ethics  (Council of Science Editors)
  • Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals   (International Committee of Medical Journal Editors)
  • Good Publication Practice Guidelines - GPP3   (International Society for Medical Publication Professionals)

Professional Associations & Societies

  • American Medical Writers Association
  • Association of Health Care Journalists
  • Board of Editors in the Life Sciences
  • Council of Science Editors
  • Drug Information Association
  • Editorial Freelancers Association
  • International Society for Medical Publication Professionals
  • National Association of Science Writers
  • Regulatory Affairs Professionals Society
  • Society for Health Communication
  • Society for Technical Communication

Medical Communication Programs – Universities, Colleges, Associations

This list is not comprehensive and was last updated on 11/23/2022.

Graduate Programs in Medical/Health Communication/Writing/Journalism

  • Master of Science in Health Communication (Online)
  • Master of Science: Science & Medical Journalism
  • Carnegie Mellon University  - Master of Arts: Professional Writing
  • Johns Hopkins University  - Master of Arts: Science-Medical Writing
  • New York University  - Master of Arts / Master of Science: Health and Environmental Reporting
  • Texas A&M University  - Master of Science: Science and Technology Journalism
  • Towson University  - Master of Science: Professional Writing
  • University of Houston-Downtown  - Master of Science: Technical Communication
  • University of Illinois  - Master of Science: Health Communication
  • University of Minnesota  - Professional Master of Arts: Health Communication
  • University of North Carolina  - Master of Arts: Medical Science & Journalism

Undergraduate Programs in Medical/Health Communication/Writing/Journalism

  • Juniata College  - Degree in Health Communication
  • Missouri State University  - Bachelor of Arts / Bachelor of Science: Science/Professional Writing
  • University of Minnesota   - Bachelor of Arts: Technical Writing and Communication 

Tracks or Minors in Medical Communication

  • Ferris State University  - Bachelor of Science: Journalism and Technical Communication
  • University of Tennessee at Knoxville  - Science Communication Program  

Degree Programs in Regulatory Affairs

  • George Washington University -  Dual Degree: BSHS/MSHS in Clinical Operations & Healthcare Management
  • University of Washington School of Pharmacy -  Master of Science in Biomedical Regulatory Affair s  

University Certificate Programs

  • Purdue University - Medical and Healthcare Writing Graduate Certificate
  • UC San Diego Extension - Medical Writing Certificate
  • University of Chicago Graham School of General Studies -  Medical Writing and Editing Certificate

AMWA acknowledges the contributions of Lori Alexander, MPTW, ELS, MWC, Lori De Milto, MJ, and Cyndy Kryder, MS, MWC in the development of this AMWA resource. 

WANT A PORTABLE VERSION OF THIS ARTICLE?  DOWNLOAD IT HERE.

Ultimate-Guide-To-Becoming-a-Medical-Writer-cover

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How to Write a Medical Abstract for Publication

medical research article writing

Preparing Your Study, Review, or Article for Publication in Medical Journals

The majority of social, behavioral, biological, and clinical journals follow the conventional structured abstract form with the following four major headings (or variations of these headings):

OBJECTIVE   (Purpose; Aim; Goal) : Tells reader the purpose of your research and the questions it intends to answer

METHODS   (Setting; Study Design; Participants) : Explains the methods and process so that other researchers can assess, review, and replicate your study.

RESULTS (Findings; Outcomes) : Summarizes the most important findings of your study

CONCLUSIONS   (Discussion; Implications; Further Recommendations) : Summarizes the interpretation and implications of these results and presents recommendations for further research

Sample Health/Medical Abstract

medical research article writing

Structured Abstracts Guidelines *

  • Total Word Count: ~200-300 words (depending on the journal)
  • Content: The abstract should reflect only the contents of the original paper (no cited work)

*   Always follow the formatting guidelines of the journal to which you are submitting your paper.

Useful Terms and Phrases by Abstract Section

Objective:  state your precise research purpose or question (1-2 sentences).

  • Begin with “To”: “We aimed to…” or “The objective of this study was to…” using a verb that accurately captures the action of your study.
  • Connect the verb to an object phrase to capture the central elements and purpose of the study, hypothesis , or research problem . Include details about the setting, demographics, and the problem or intervention you are investigating.

METHODS : Explain the tools and steps of your research (1-3 sentences)

  • Use the past tense if the study has been conducted; use the present tense if the study is in progress.
  • Include details about the study design, sample groups and sizes, variables, procedures, outcome measures, controls, and methods of analysis.

  RESULTS : Summarize the data you obtained (3-6 sentences)

  • Use the past tense when describing the actions or outcomes of the research.
  • Include results that answer the research question and that were derived from the stated methods; examine data by qualitative or quantitative means.
  • State whether the research question or hypothesis was proven or disproven.

CONCLUSIONS : Describe the key findings (2-5 sentences)

  • Use the present tense to discuss the findings and implications of the study results.
  • Explain the implications of these results for medicine, science, or society.
  • Discuss any major limitations of the study and suggest further actions or research that should be undertaken.

Before submitting your abstract to medical journals, be sure to receive proofreading services from Wordvice, including journal manuscript editing and paper proofreading , to enhance your writing impact and fix any remaining errors.

Related Resources

  • 40 Useful Words and Phrases for Top-Notch Essays  (Oxford Royale Academy)
  • 100+ Strong Verbs That Will Make Your Research Writing Amazing  (Wordvice)
  • Essential Academic Writing Words and Phrases  (My English Teacher.eu)
  • Academic Vocabulary, Useful Phrases for Academic Writing and Research Paper Writing  (Research Gate)
  • How to Compose a Journal Submission Cover Letter  (Wordvice/YouTube)
  • How to Write the Best Journal Submission Cover Letter  (Wordvice)

The Sheridan Libraries

  • Science and Medical Writing
  • Sheridan Libraries
  • Books/E-Books/Encyclopedias
  • News and Newspapers
  • Data and Statistics
  • Writing and Editing Guides & Resources
  • Books On Scientific Writing
  • Citing Sources
  • Other Research Guides of Interest
  • Evaluating Information This link opens in a new window

When You Need Articles

  • Key Databases for Articles
  • Need Scholarly Articles?
  • Need A Specific Article?
  • PubMed PubMed lists journal articles back to 1947. It indexes about 5,400 journals and covers the areas of medicine, nursing, dentistry, veterinary medicine, health care systems, preclinical sciences, and related areas.
  • Scopus Scopus is a comprehensive scientific, medical, technical and social science database. Scopus also allows for citation searching back to 1996.
  • Web of Science Web of Science actually lets you search science, engineering, medicine, social sciences, arts, and humanities journals for articles on a topic. You can also do citation searching back to 1900.
  • Science Database ProQuest Science Database is a definitive resource for students studying both the applied and general sciences. Whether you’re researching the effects of global warming or interested in the latest scandal surrounding genetically modified food, ProQuest Science Journals™ will guide you directly to the information you need.
  • JSTOR JSTOR is an archive of important scholarly journals, spanning many disciplines. The most recent 3-5 years are not included.
  • History of Science and Technology
  • Nexis Uni Contains the full text of hundreds of publications, including law journals, wire services, country economic reports, government publications, magazines, newspapers, news digests, and industry-specific newsletters and periodicals.
  • PsycINFO This database contains more than one million citations and summaries of journal articles, book chapters, books, dissertations and technical reports, all in the field of psychology. It also includes information about the psychological aspects of related disciplines such as medicine, psychiatry, nursing, sociology, education, pharmacology, physiology, linguistics, anthropology, business and law. Journal coverage, which spans from 1887 to present, includes international material selected from more than 1,700 periodicals in over 35 languages.
  • Academic Search Ultimate Academic Search Ultimate is a scholarly, full text database designed for academic institutions. The database includes full text as well as images, for nearly every academic field of study.

When searching in a database, look for a way to limit to Scholarly journals.

In many databases, look for a filter that will limit your search results to scholarly or peer-reviewed articles

medical research article writing

If you need to confirm that a journal is scholarly, use Ulrich's to look up the name of the journal and confirm if it is scholarly or referred/peer reviewed.  The video shows how Ulrich's works.

When you know what article you are seeking, try one of these approaches to see if we have an electronic version of the article.

  • Use Google Scholar from the the library's homepage to paste in the title of the article. When you get results, use FINDIT to get the full text.
  • Use our Article Lookup tool when you have a proper citation

                                                               

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  • Next: Books/E-Books/Encyclopedias >>
  • Last Updated: Sep 6, 2023 11:46 AM
  • URL: https://guides.library.jhu.edu/science-medical-writing

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Pharma Focus Asia

Accelerating the Medical Writing Process with Automation From research to publication

Nirupama parate, senior associate, medicinal products division, freyr solutions.

Regulatory medical writing is a highly complex task and requires expertise. There are various challenges that medical writers face every day while creating documents required for submissions to competent Health Authorities (HAs). One of the major challenges here is the time required for the entire medical writing process, from the first draft to the final submissions-ready draft. If some of the steps in this process are automated, it will save medical writers a lot of time and reduce the turnaround time. Medical Writing Automation (MWA) will help ease the task of medical writers. However, the lack of awareness of how automation and medical writers’ expertise go hand in hand to make medical writing tasks more productive is a huge challenge that must be overcome. This article decodes how automation is a boon for the medical writing industry and how various companies are proactively trying to adopt automation in medical writing.

The Pharmaceutical and Life Sciences industry has seen a constant growth in the need for medical writing. The global medical writing market was valued at US$3.6 billion in 2021 and is expected to reach US$8.4 billion in 2030, growing at a Compound Annual Growth Rate (CAGR) of 10.41 per cent. Patents have been expiring, Regulatory standards have been rapidly changing, and Research and Development (R&D) expenditure has been steadily rising. Because of this, the necessity to continuously adapt, produce, maintain, and update medical materials has evolved.

Medical writing is a highly specialised field that involves the art and science of content creation and clinical research. It entails creating well-structured scientific resources, such as clinical research papers, web content for the Healthcare industry, periodicals, journals, etc. With the increasing need for medical writing, writers are under constant pressure to deliver high-quality content within limited timeframes. It would be easy for medical writers if some steps of the process were cut down with automation tools.

The Medical Writing industry has been trying to stay at par with the revolution in the industry and the shift towards automation by adopting innovative and intelligent solutions that will ease the process of Regulatory writing, thereby ensuring a quick turnaround time.

Complexities and Challenges in Medical Writing

Medical writing is a highly technical and operationally difficult process involving a broad range of stakeholders and deep subject-matter expertise. The creation of several crucial papers, such as clinical trial protocols, investigators’ brochures, clinical and non-clinical study reports, summary documents, and labeling documents, is a crucial component of medical writing during clinical or R&D phases. The following are some of the challenges that medical writing professionals face:

  • Depending on the nature of the papers, there are numerous ways to represent data-heavy documents, and no standardised format exists.
  • Knowing what to focus on while completing quality checks in a limited amount of time is difficult.
  • It is necessary to have in place error-free processes due to the emergence of strict data redaction and anonymisation guidelines in various countries, for instance, the European Medicines Agency (EMA)’s Policy 70.
  • Because the requirements are different for each document, consistency and time allocation are difficult, which can be a problem, especially when they must be delivered as soon as possible.
  • The quality control process must be documented, and findings must be addressed and justified, which can be daunting.
  • Due to redundant content and the efforts required, information stored in different silos, and persistent reliance on human knowledge throughout the entire process, the efficiency and productivity of the medical writing process are negatively impacted, which increases the Time to Market (TTM).

Medical Writing Automation (MWA)

MWA is a framework that generates content using Natural Language Processing (NLP) and Natural Language Generation (NLG) techniques and algorithms. Artificial Intelligence (AI) has made significant advances in text generation, processing, and data mining. AI-powered engines used in these services may comprehend the context and recommend the relevant terminology. The technology is also useful when developing user-friendly content. A computer, when correctly programmed, shows no bias. It makes forecasts and suggestions based on its training. Medical writers can benefit from computer innovation and the advent of AI in the domains of NLP and NLG when creating medical documentation.

The MWA Process

NLP is a five (05)-step process that begins with identifying and analysing the structure of words, checking the grammar, arranging words meaningfully, drawing the exact dictionary meaning of words, comparing the meaning of a sentence to the sentence preceding it, and finally, reinterpreting the actual meaning of a sentence. NLG produces meaningful phrases and sentences in natural language from some internal interactions between human language and computers. It involves text planning, sentence planning, and text realisation.

AI, combined with NLP and NLG, automatically extracts information from a wide range of data sets, whether structured or unstructured. The extracted data is subsequently analysed to interpret and categorise the substance and context of the information, and the content and context data are stored in a dynamic semantic model. The diagram below (Figure 1) depicts how NLP and NLG aid the medical writing process, making it more efficient.

Figure 1: NLP and NLG Assisting in the Medical Writing Process

medical research article writing

Source:  Created by Author

The process described above modifies the information and context of the material when it needs to be reused or repurposed to suit the needs of diverse stakeholders in the life sciences ecosystem. The solution maintains a data set that is easily searchable using Natural Language queries. Additionally, impact analysis is performed to improve change management whenever any new or updated content is made public.

MWA is especially useful for repetitive activities with a high level of redundancy. Most of the time and effort devoted to developing these documents is spent acquiring data from pre-existing sources (such as study procedures, figures, tables, and statistical analyses) and organising them under appropriate section headings. The figure below (Figure 2) explains how the AI/NLP solution can reduce 50–80 per cent of the time, as compared to the traditional approach.

Figure 2: The Traditional Approach of Medical Writing Vs. Adopting the AI/NLP Solution for Medical Writing

medical research article writing

Source: Created by Author

After the automated process, as described above, is done, the medical writer’s input would now be valuable in refining the finished article and putting forward an expert scientific interpretation. It can also expedite submissions and marketing authorisations by producing complex documents in a fraction of the time the process usually takes days rather than weeks, which saves costs. The capabilities of MWA are growing every day, and it may now be used to create documents that require a higher level of editorial expertise, such as peer-reviewed articles, abstracts, and posters.

Adoption of Automation in Medical Writing

Well, this topic is up for debate between medical writing service providers, on the one hand, and medical writers, on the other. Some companies have started pilot studies on the use of automation in medical writing. The results of the studies carried out by various companies mention that automation is going to be beneficial for medical writers; it will save up to 80 per cent of their time and can process and manipulate a large quantity of data in only a few minutes. When it comes to automation, businesses are adopting a two (02)-pronged strategy. They are either building internal automation capabilities for quality control, data structure, analysis, and document generation, among other things, or liaising with organisations that offer automation tools and platforms, either by acquiring these companies or by using the tool or platform developed by the companies. In the figure below (Figure 3), some steps are mentioned, which should be followed while selecting a medical writing tool for your company:

Figure 3: Steps for Selecting a Medical Writing Tool for Your Company

medical research article writing

However, medical writers are skeptical about adopting these technologies; they have heard that AI can produce reports from scratch in only a few minutes, which sounds like a job-elimination program to some! The truth is that the output from AI will be a first copy that pulls together content from source papers and source data. It will put all the components in place, leading up to the truly intellectually stimulating portion of medical writing, which is working with the authoring team to design the storyline and polish the messaging. It is precisely this intellectual input that no AI tool can provide, which indicates that competent medical writers will continue to be in demand even with the full-stream adoption of AI in the medical writing field.

The adoption of MWA remains a question mark. Companies are eagerly exploring how they can adopt this technology, which can help them save a lot of time and enable medical writers to complete their work faster. Therefore, for a smoother adoption of MWA by organisations, it is crucial to create awareness among medical writers about the beneficial role of AI and how it complements their work, making them more productive.

The Future of MWA

With all the buzz that is going around on AI and Machine Learning (ML) and a major shift from traditional approaches toward using tools and technologies to make lives easier, the transition to automation will occur very soon. Medical writers will soon align with the importance of using automation, which will not only ease the process and cut down some of the steps involved in the traditional medical writing method but will also ensure that the writers are not completely replaced. Moreover, companies are proactively trying to find ways to adopt automation, be it internally by developing tools or bots or externally by liaising with some other company that has a similar tool or platform. Hence, the only way forward is to accept the fact that automation is the need of the hour and to get aligned with it as soon as possible.

Nirupama Parate

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[Writing and publication of a medical article]

Affiliation.

  • 1 Institut de santé publique, d'épidémiologie et de développement, université Victor Segalen Bordeaux 2, France.
  • PMID: 10609412

To advance in their strategies to manage patients, clinicians need new research results. To be accessible, medical research must be published. Writing and publishing medical articles should respect principles that are described in this article. Good writing is based on a logical organization and the application of scientific style. Organization according to the IMRD structure (Introduction, Methods, Results, Discussion) allows one to present the reasons for and objectives of the study (Introduction), details on whatever has been done to answer the question (Methods), data on the actual study population and answers to the main question (Results), and a critical appraisal of these results, given the limits of the study and current knowledge (Discussion). The main elements of scientific style are precision, clarity, fluidity and concision. Finally, submitting a paper to a scientific journal implies presenting the work in a covering letter and respecting rules for formatting a manuscript (order of presentation, typography, etc.).

Publication types

  • English Abstract
  • Guidelines as Topic
  • Periodicals as Topic*
  • Planning Techniques
  • Publishing / standards*
  • Research Design / standards*
  • Science / methods
  • Open access
  • Published: 14 February 2024

Quality improvement project to reduce medicare 1-day write-offs due to inappropriate admission orders

  • Olufolarin Oke 1 ,
  • K. Michaela Sullivan 2 ,
  • Jason Hom 3 ,
  • David Svec 3 ,
  • Yingjie Weng 4 &
  • Lisa Shieh 3  

BMC Health Services Research volume  24 , Article number:  204 ( 2024 ) Cite this article

153 Accesses

Metrics details

We identified that Stanford Health Care had a significant number of patients who after discharge are found by the utilization review committee not to meet Center for Mediare and Medicaid Services (CMS) 2-midnight benchmark for inpatient status. Some of the charges incurred during the care of these patients are written-off and known as Medicare 1-day write-offs. This study which aims to evaluate the use of a Best Practice Alert (BPA) feature on the electronic medical record, EPIC, to ensure appropriate designation of a patient’s hospitalization status as either inpatient or outpatient in accordance with Center for Medicare and Medicaid services (CMS) 2 midnight length of stay benchmark thereby reducing the number of associated write-offs.

We incorporated a best practice alert (BPA) into the Epic Electronic Medical Record (EMR) that would prompt the discharging provider and the case manager to review the patients’ inpatient designation prior to discharge and change the patient’s designation to observation when deemed appropriate. Patients who met the inclusion criteria (Patients must have Medicare fee-for-service insurance, inpatient length of stay (LOS) less than 2 midnights, inpatient designation as hospitalization status at time of discharge, was hospitalized to an acute level of care and belonged to one of 37 listed hospital services at the time of signing of the discharge order) were randomized to have the BPA either silent or active over a three-month period from July 18, 2019, to October 18, 2019.

A total of 88 patients were included in this study: 40 in the control arm and 48 in the intervention arm. In the intervention arm, 8 (8/48, 16.7%) had an inpatient status designation despite potentially meeting Medicare guidelines for an observation stay, comparing to 23 patients (23/40, 57.5%) patients in the control group ( p  = 0.001). The estimated number of write-offs in the control arm was 17 (73.9%, out of 23 inpatient patients) while in the intervention arm was 1 (12.5%, out of 8 inpatient patient) after accounting for patients who may have met inpatient criteria for other reasons based on case manager note review.

This is the first time to our knowledge that a BPA has been used in this manner to reduce the number of Medicare 1-day write-offs.

Peer Review reports

Designation of a patient’s hospital encounter at time of discharge as either outpatient or inpatient, also known as status determination, is important for all parts of the health system including hospitals, insurer, and patients. Outpatient is defined by CMS as a person who has not been admitted as an inpatient but who is registered on the hospital or critical access hospital (CAH) records as an outpatient and receives services (rather than supplies alone) directly from the hospital or CAH [ 1 ]. Another designation that is used for patients hospitalized for acute care is called observation. Observation care is care that is provided when additional time for patient testing, monitoring and treatment is needed to help determine if inpatient care is needed and according to CMS, it should be very rare that observation services exceed 48 h and are usually less than 24 h (New referencence) [ 2 ]. Observation status is considered outpatient for CMS billing purposes. As a hospital system, status determination has an impact on the amount billed for services provided. This is due to the higher reimbursement rates by the Center for Medicaid and Medicare services (CMS) for encounters designated as inpatient which is billed under Medicare part A and usually reimbursed at a higher rate than services designated as outpatient services which are billed under Medicafare part B [ 3 , 4 ]. Although services provided to patients hospitalized for inpatient services are almost always of a longer duration than those provided for patients designateted as outpatient, the higher reimbursement rates for inpatient services remains true even when these services are similar to those assigned an outpatient designation. Six of the 10 most common reasons for short inpatient stays were also among the 10 most common reasons for observation stays [ 3 ]. However, short inpatient stays were far more costly to Medicare than observation stays [ 3 ]. Medicare paid an average of $5,142 per short inpatient stay, but it paid an average of $1,741 per observation stay [ 3 ]. To deter hospitals from designating a patient as inpatient when an observation stay may have been appropriate, CMS established the recovery audit program tasked with finding and correcting improper claims to the Medicare program [ 4 ]. Data available after creation of this program showed that a large amount of money is being recouped yearly. The amount of money recouped by Medicare based on these programs increased from $939 million in 2011, to $2.4 billion in 2012, to $3.8 billion in 2013 [ 3 ]. RAC recoupment reduced in subsequent years for several reasons including hospital’s increased use of appeals and increased compliance but primarily was a result of RAC’s change to the program in 2014 due to industry feedback about the overzealous nature of the RAC program in its previous state [ 5 ]. RAC recoupment dropped to $24.33 million in 2017, $73.03 million in 2018 and to $162.03 million in 2019 [ 6 , 7 , 8 ].

Inpatient versus outpatient status designation also has financial consequences for the patients too. Patients are often responsible for higher payments under Medicare part B as they may be liable for up to 20% co-insurance for expenses incurred during their stay [ 9 ]. Medicare fee-for-service and Medicare advantage enrollees must be provided with the Medicare Outpatient Observation Notice (MOON) according to CMS rules [ 10 ]. This notifies patients that they are outpatient receiving observation services and not inpatient.

The classification of a patient as either inpatient or outpatient is made by the patient’s admitting physician but CMS has established a rule to guide physicians known as.

a length of stay benchmark [ 2 , 11 ]. Providers billing Medicare for services are encouraged to follow this benchmark in determining a patient’s status at time of hospitalization as either inpatient or Observation. This information can be found on the Inpatient Prospective Payment System (IPPS-2014) final rule and states that a provider should designate patients whose hospitalization are expected to span less than two midnights as outpatient based on medical necessity with two notable exemptions: Procedures appearing on the CMS’s inpatient-only procedure list and a “rare and unusual” circumstance in which inpatient admission would be reasonable regardless of length of stay [ 12 ]. Due to the complexity of status determinations and the monetary advantage an inpatient designation confers, it is not surprising to see large variability between hospitals in the application of outpatient versus inpatient status [ 3 , 6 ]. To assist physicians with making this occasionally complex decision and as required by Medicare Conditions of Participation, most hospital systems establish a utilization review (UR) team which often comprises of physicians, nurse case managers and physician advisors who have higher levels of expertise with the insurance related rules. Commercial tools such as InterQual (McKesson Corporation, San Francisco, CA) and MCG (formally known as Milliman Care Guidelines; MCG Health, LLC, Seattle, WA) are also available to help define inpatients versus outpatients [ 13 , 14 ] but CMS guidelines including the 2-midnight LOS benchmark takes precedence over these tools.

At Stanford Health Care, ensuring compliance with CMS guidelines on hospitalization status (Inpatient versus outpatient) is monitored by the UR team which comprises of nurse case managers, providers and physician advisors with expertise in insurance and CMS guidelines. Nurse case Managers review each patient’s designation within twenty-four hours of hospitalization and prior to discharge for compliance with CMS criteria for an inpatient stay with a physician advisor readily available for more complex cases. If a patient is admitted as inpatient and does not meet length of stay criteria or any of the exceptions listed on Medicare guidelines, the UR team including the nurse case manager can then make recommendations to the patient’s treating provider who ultimately is responsible for making the decision on whether the patient should remain in inpatient admission status or if the patient should be changed to an Observation status.” The billing code associated with this change in status is known by CMS as a “condition code 44” [ 1 ]. After a condition code 44 is performed, SHC bills for outpatient services and is reimbursed based on Medicare fee service for outpatient services (Medicare Outpatient Prospective Payment Schedule). Unless the patient requires observation services for at least 8 h, the inpatient part B charges are not captured or billed.

Despite the efforts of our nurse case managers and UR team, there are often cases of patients who are admitted and discharged in an inpatient admission status but upon retrospective review prior to billing CMS are found not to meet the medical necessity or the length of stay benchmark for an inpatient stay. CMS can deny these claims if billed under Medicare Part A for inpatient services if they also find them not reasonable and necessary [ 11 ].

In accordance with CMS rules, SHC does not bill Medicare under Part A for these patients. Instead, Stanford, under a process known as self-denial, bills for part B services for some ancillary services that qualify per Medicare rules called “Type of bill-121” [ 15 , 16 ]. The remaining charges for services provided but not billed to Medicare are considered a write-off.

These Medicare 1-day write-offs lead to significant annual income loss for Stanford Health Care. Charge data for write-offs for fiscal year 2016–2018 were $10.8 M, $3.4 M, and $2.6 M. It should be noted that Charge data is often significantly higher than Medicare allowable charges/re-imbursement.

To reduce these Medicare 1-day write-offs, we sought to take advantage of the electronic health record system, in our case (EPIC), to incorporate a tool called best practice alert (BPA) that has been shown to be effective in the past by other healthcare systems [ 17 , 18 , 19 ] in both inpatient and outpatient setting for a variety of interventions. BPA has been used successfully to Improve efficient utilization use of resources within healthcare system, change patient clinical outcomes for specific conditions such as sepsis and increase appropriate medication use in primary care clinic setting for common medical co-morbidities such as hypertension and diabetes.

Researchers at University of Florida conducted a three-year study from 2014 to 2017 that examined the efficacy of EMR BPA in reducing repetitive laboratory test and hospital cost [ 11 ]. The intervention reduced the overall duplicates by 18% (OR = 0.82, standard error + 0.16, P-value < 0.000). In addition, in this study, the estimated cost savings was about $72,543 over 17 months in the post-intervention period [ 17 ].

A prospective study done in a University of Virginia surgical/trauma/burn ICU using a BPA aimed at identifying with patients with septic shock and promoting timely administration of antibiotics [ 19 ]. The study showed that there was a trend towards decreased time-to-antibiotics following implementation of the BPA (7.4vs4.2 h, p  = 0.057) [ 18 ].

Another study done at eight UCLA primary care setting in 2013 aimed to assess provider responses to a focused BPA alert for the intensification of blood pressure medications before versus after implementation of the chart closure hard stop (20). Results showed that among BPA that represent clear opportunities for treatment, providers ordered the indicated medication more often (41% vs. 75%) after the “chart closure” hard stop was implemented ( P  = 0.01) [ 19 ].

Based on the success of these studies, we aimed to incorporate a BPA tool into Epic with the goal of improving compliance with Medicare rules regarding appropriate inpatient status designation to Medicare 1 day write-off at Stanford Health Care.

The randomized control phase of the study took place at Stanford Health Care (SHC) which comprises of SHC-Palo Alto located in Stanford, California, and SHC-Valley Care (SHC-VA) located in Pleasanton, California, between July 18, 2019, and October 18, 2019. The BPA was non-randomized to all non-surgical services after the BPA was completed. Independent of this study, SHC collects data regarding 1-day Medicare write-offs and reported Medicare 1-day write-offs in charge dollars for every fiscal year from 2019 to 2023 as part of our BPA effect confirmation.

Patients included in the study must meet all the inclusion criteria which were: Patients must have Medicare fee for service insurance, inpatient length of stay (LOS) less than 2 midnights (Zero to one day), inpatient status designation at time of discharge, was admitted to an acute level of care and belonged to one of 37 listed hospital services at the time of signing of the discharge order. Inpatient length of stay spans the time from admission order placement by ED provider to discharge order placement. The names of the 37 non-surgical services are listed in Appendix 1. An IRB waiver (Protocol number 70,191) was obtained on a retroactive basis on 4/26/23 based on the classification of this study as quality improvement.

Problem definition

We identified that Stanford Health Care had a significant number of patients who after discharge are found by the UR committee not to meet CMS 2-midnight benchmark for inpatient status. Some of the charges incurred during the care of these patients are written-off and known as Medicare 1-day write-offs. We began by performing a root cause analysis using A3 methodology and a fish bone analysis as seen in Fig.  1 to identify what intervention would best address the issue of income loss due to Medicare 1- day write-offs. The primary initial event was incorrect designation of a patient at time of hospitalization as either observation or inpatient. The two key drivers identified in this process were the primary provider team and the nurse case manager responsible for the patient as shown in Fig.  2 . If neither the primary team nor the nurse case manager intervened in changing the patients’ designations prior to discharge, this would likely result in a Medicare write-off.

figure 1

Fishbone Analysis

figure 2

Key drivers and interventions

We identified several human factors, process/policy, equipment/supplies, and environmental/cultural issues in the Stanford healthcare system that contributed to the failure to designate a patient the appropriate hospitalization status. After evaluating each one of these factors, the intervention we identified that is most likely to achieve our goal of improving compliance with Medicare 2 midnight rule regarding the appropriate designation of patients in an inpatient status thus reducing Medicare write-offs in the Stanford health care system in the inpatient setting was the introduction of a best practice alert (BPA) in the EPIC electronic medical record system. The EPIC BPA would alert providers to resolve any discrepancy between a patient’s length of stay, the complexity of primary hospital problem and the designated hospitalization status during the discharge process but prior to completing discharge in compliance with Medicare guidelines.

Intervention creation and implementation

A best practice advisory (BPA) intervention was co-developed the help of our EPIC EMR and utilization review team including a member who was an expert in Medicare compliance. Pre-specified inclusion criteria are: Patients must have Medicare fee for service insurance, inpatient length of stay (LOS) less than 2 midnights, inpatient status designation at time of discharge, hospitalization to an acute level of care and belonged to one of 37 listed hospital services listed in Appendix 1 at the time of signing of the discharge order.

The BPA which can be seen in Figure S1 fires when a provider places a discharge order for a patient who meets the inclusion criteria as stated above. The BPA would prompt the provider to discuss the patient’s inpatient status with the utilization review nurse case manager who also receives an alert. The utilization review nurse case manager consults with the utilization management team who then reviews the patient’s hospital stay for medical necessity to ensure they meet CMS’s established criteria for inpatient status designation. The utilization review’s recommendation is then passed on to the provider who attempted to place the discharge order. If the recommendation of the UR team is a change in status from inpatient to observation and the primary team agrees, the discharge order is cancelled, and the condition Code 44 process would occur. The previous inpatient order is cancelled, and an observation order would be placed followed by a new discharge order. Given that the total hospitalization time in observation status is essentnially zero, SHC does not bill CMS for comprehensive observation services.

Of note, the primary team has the option to bypass the BPA and the reason for BPA override reason would be noted. All patients that were admitted between July 18, 2019, and October 18, 2019, to SHC-Palo Alto and SHC Valley Care Medical Center were randomized to either the intervention arm (BPA fires) or control (BPA silent). A total of 88 patients met this inclusion criteria.

Chart review was then conducted and information regarding each patient’s designation as either inpatient or outpatient at time of discharge was documented. Nurse case manager notes were also reviewed for each patient to obtain information regarding whether inpatient designation was appropriate based on other criteria that may not have been known by the discharging provider. The BPA was then activated in EPIC for all patients in fiscal year 2019 and income loss attributable to Medicare 1-day write-off was obtained.

The primary outcome was the estimated number of write-offs in both intervention and control arm while the secondary outcome was the number of patients assigned observation status at time of discharge compared to those assigned an inpatient status.

Statistical analysis

We reported the frequencies and proportions of patients who were ultimately assigned to inpatient vs. observation status at discharge by the intervention (Epic BPA) and control (non-Epic BPA) groups respectively. The difference of the proportions of patients assigned to observation status was compared by the intervention group to the control group and reported along with the 95% confidence interval. We further reported frequencies and proportions write-off in patients who were assigned to the inpatient status by the intervention and control group. Fisher’s exact tests were performed to evaluate the differences between two groups in both discharge status assignment and write-offs, using a free online tool which can be found here ( https://www.socscistatistics.com/tests/fisher/default2.aspx ). p  < 0.05 is considered as statistically significant.

BPA Efficacy was calculated as the percentage of patients in the intervention group who were appropriately designated correctly either as inpatient or observation at the end of the study.

Effect confirmation

Review Medicare write-offs at the end of the fiscal year 2019 and 2020 to determine if the BPA has the effect that would be expected based on the study results above.

Sustain plan

Utilization management team’s monthly review of BPA data to ensure that providers are being reminded by nurse case managers to change patient’s designation from inpatient to observation when deemed appropriate.

A total of 88 patients were included in this study: 40 in the control arm and 48 in the intervention arm. In the intervention arm, 8 (8/48, 16.7%) had an inpatient status designation despite potentially meeting Medicare guidelines for an observation stay, comparing to 23 patients (23/40, 57.5%) patients in the control group, which is statistically significant ( p  = 0.001) (Fig.  3 ; Table  1 ).

The estimated number of write-offs in the control arm was 17 (73.9%, out of 23 inpatient patients) while in the intervention arm was 1 (12.5%, out of 8 inpatient patient) after accounting for patients who may have met inpatient criteria for other reasons based on nurse case manager note review (Fig.  3 ).

figure 3

Flow chart showing estimated number of write offs in the intervention and control arms of the study

Estimated number of write-offs was calculated using the number of patients that were not converted from inpatient to observation as a surrogate after deducting the number of patients who the nurse case manager stated met inpatient criteria based on chart review.

The percentage of patients who met inpatient criteria in the intervention arm based on chart review was used to calculate the number of patients who would have met such criteria in the control arm if all patients had been reviewed by the nurse case manager. This is because the active BPA in the intervention arm ensured that nurse case managers reviewed the patients prior to discharge. The percentage of patients who met inpatient criteria in the intervention arm (7/48 = 14.58%). Therefore, about 6 patients (0.1458*40) was calculated to have met inpatient criteria in the observation group leading to 17 (23 − 6) estimated number of write-offs in the control group.

The estimated value of the 1-day Medicare write-off averted because of the BPA is estimated to be about $329,088($5,142*16*4). This calculation is based on historical data from CMS who paid an average of $5,142 for short inpatient stays.

BPA efficacy in the intervention group was 98% (47/48). On chart review, provider for the one patient not converted to observation bypassed the BPA with comment “Will discuss with CM” but no nurse case manager note was seen so it was unclear the reason why patient was left in an inpatient status.

Data from SHC in the subsequent years showed that Medicare 1-day stay write-off charge dollars were much lower compared to the years before the BPA. The write-off charge data were $1.0 M for FY 2019, 1.07 M for FY 2020, $792K for FY 2021, $551K for FY 2022 and $571K for FY23 comapred to $10.8 M, $3.4 M, and $2.6 M for fiscal years 2016, 2017 and 2018 respeectively. Of note, charge data is often much higher than allowable Medicare charges which would represent actual Medicare 1-day write-off amount in dollars.

We incorporated a BPA to supplement the efforts of patient’s treatment provider, nurse case managers and UR team in ensuring compliance with CMS 2 midnight rule benchmark for designation of patients as inpatient or observation (Outpatient) status thereby reducing 1-day Medicare write-offs.

Like other prior studies that have shown the effectiveness of BPA as a tool with diverse impact on improving several aspects of the functioning of a healthcare system [ 17 , 18 , 19 ], our study showed that a BPA can be effective as a supplementary tool to improve compliance with guidelines in our case Medicare 2 midnight benchmark for appropriate status designation. In addition, the effects of the BPA have been sustained for several years since completion of the study in 2019 as Medicare 1-day write-offs post intervention (FY 2019 onwards) has remained consistently lower than years before the BPA was instituted.

In addition, this BPA also provides an opportunity to improve patient satisfaction in our health care system. Given that patients billed under Medicare part B often have a higher out of pocket medical bill than those billed under Medicare part A [ 7 ], using the condition code 44 process prior to discharge and providing patients with the “MOON” prepares patients as opposed to a surprise bill they may receive in the mail if a Part A self-denial is done by the hospital with retrospective billing for Medicare part B services.

Condition code 44 billing process provides additional benefit such as the concurrent review process falls within the natural workflow of the case management and UR team workflow process as opposed to a retrospective review. One of the most important aspects of utilizing a condition code 44 is to increase compliance with CMS guidelines which can lessen the risk of CMS audit for inpatient services given that condition code 44 is billed as outpatient as opposed to inpatient. Another advantage that is gained is that there is a shorter time to reimbursement when a condition code 44 process is utilized allowing hospitals to be able to allocate resources and complete other necessary projects more efficiently. Lastly, there is no effect on re-admission data for patients appropriately placed in observation status.

The BPA can be potentially modified and expanded to other status determination scenarios such as the capturing of patients in observation status who may qualify for inpatient status and medically complex patients designated as hospitalized surgical outpatient who spend at least one night in the hospital for routine recovery who may qualify for inpatient. At SHC, these cases would be referred to our physician advisor and UR team for further review.

The success of the BPA and its continued effectiveness relies greatly on full participation from all the members involved in the process which included admitting providers, nurse case managers, physician advisors and other members of the UR team. Other healthcare systems who wish to incorporate similar BPA should ensure that all the team members are fully invested and willing to participate in the intervention otherwise the efficacy rate of the intervention will likely decrease. In the future, there is potential for other types of BPA to be used in addressing other issues faced within SHC.

Limitations

One main limitation of the study is that the estimated 1-day Medicare write-off is an over-estimation. This is because charge data as reported in this study is often much higher than Medicare allowable charges which would represent the true write-off dollars. However, our finance department does apply a formula based on expected payment from that financial class to “value” the adjustment. Nonetheless, the improved compliance with Medicare 2 midnight benchmark guidelines is our desired outcome and remains a benefit.

BPA efficacy rate was less than 100% (98%) as the BPA is not a hard stop. Providers under the pressure of time may choose to bypass the Epic BPA and if case managers are not available nor assigned to the team, they may not get the alert or be able to get in touch with providers in time prior to patient discharge. This can be alleviated by also alerting a dedicated utilization management team member simultaneously to follow up in real time if the case manager is unable to do so but this may strain resources and increase workload.

We are the first to incorporate this Epic BPA tool into the discharge workflow and show its positive sustained effect in reducing Medicare 1-day write-offs. We have expanded the alerting process to a dedicated UR member for all services and health insurances.

Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

Best Practice Alert

Stanford Health Care

Center for Medicaid and Medicare Services

Inpatient Prospective Payment System

Electronic Medical Record

Recovery Audit Program

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Acknowledgements

Paul A. Heindenreich for aiding and advise in the statistical analysis of the data results. Benjamin Leung, for providing data generated from the EPIC BPA alert in a simple excel format for further analysis. Frederick III, William, MD, PhD for providing guidance on Medicare claims processing guidelines and referral to Medicare online resources cited in this paper.

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Stanford Health Care, Palo Alto, California, USA

K. Michaela Sullivan

Stanford University School of Medicine, Palo Alto, California, USA

Jason Hom, David Svec & Lisa Shieh

Quantitative Sciences Unit, Stanford University School of Medicine, Palo Alto, California, USA

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L.S., K.M.S., J.H., D.S. conceived and designed the study. O.O. and L.S. Performed the study. O.O. wrote the main manuscript text and prepared all figures and tables and YW wrote the statistics section and portion of the result section. O.O., L.S., J.H., D.S. and K.M.S. performed critical revision of the manuscripts. L.S. and O.O. were the lead investigator.

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Correspondence to Olufolarin Oke .

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A retrospective human subject determination was submitted to Stanford university’s IRB for review, and it was determined that this project does not meet the definition of human subject research as defined in federal regulations 45 CFR 46.102 or 21 CFR 50.3 and no further IRB review was required. The need for ethical approval and informed consent was waived by Stanford university’s IRB. All methods were carried out in accordance with relevant guidelines and regulations.

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Supplementary Material 1: Figure S1:

Screen shot of Epic BPA

Supplementary Material 2: Appendix 1:

List of 37 non-surgical hospital services included in the study

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Oke, O., Sullivan, K., Hom, J. et al. Quality improvement project to reduce medicare 1-day write-offs due to inappropriate admission orders. BMC Health Serv Res 24 , 204 (2024). https://doi.org/10.1186/s12913-024-10594-z

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DOI : https://doi.org/10.1186/s12913-024-10594-z

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  • Utilization review
  • Center for medicare and medicaid services (CMS)
  • Best practice alert (BPA)
  • Medicare 1-day write offs
  • Observation
  • CMS 2-midnight benchmark

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  • Indian J Endocrinol Metab
  • v.16(6); Nov-Dec 2012

Writing for publication in a medical journal

R. grant steen.

Medical Communications Consultants, LLC, 103 Van Doren Place, Chapel Hill, NC, USA

The essence of writing for publication in the medical field is distilled into a dozen precepts to guide the anxious author. These precepts focus on the attitude of the writer, rather than the mechanics of writing. A medical author must strive to be the following: Original, honest, innovative, organized, careful, clear, modest, fair-minded, frank, persistent, rigorous, and realistic. These attributes are essential because there is a new climate of skepticism among the lay public as to the validity of scientific and medical claims. This climate has encouraged journal editors to be demanding of authors and to be especially vigilant about plagiarism; originality of all contributions is therefore essential.

I NTRODUCTION

There is always a danger in writing about writing. The effort can look presumptuous, in that few writers are truly in a position to tender advice; more medical writers are workmanlike than inspired. Writing a paper about writing a paper can also seem futile because guidelines have to be so broad as to be vague. Practical advice about writing a research report is necessarily different from advice about writing a systematic review or a case report.

Still, there can be no doubt that scientists writing their first paper need guidance, and such guidance can be hard to find. With full awareness that this effort may seem both presumptuous and futile, the lessons of a career in writing are distilled into a few precepts to guide the anxious author. These precepts focus on the attitude of the writer, and leave practical advice as to the mechanics of writing to other authors.[ 1 ]

B E O RIGINAL

Lack of originality is the cardinal sin in a creative field. Using the words or thoughts of someone else without adequately crediting that person is plagiarism.[ 2 ] Lack of originality can include plagiarism of words, of ideas, or of one's own already published work. Plagiarism can have serious consequences, including retraction of papers, suspension or firing of authors, and other legal actions.[ 2 ] In fact, up to 29% of all papers retracted were faulted for some form of plagiarism,[ 3 ] and authors in India have been responsible for about 6% of retractions worldwide.[ 4 ] Some believe that India cannot emerge as a global player in science and medicine until plagiarism is reduced, so a “National Plan of Action” has been proposed.[ 5 ]

A distinction has been made between theft of words and theft of data.[ 3 ] Theft of words is clearly plagiarism, but theft of data is a more serious crime that has been called data fabrication. Theft of words can happen inadvertently, whereas theft of data is always a calculated act. As scientists, our first duty is to defend the authenticity of data; the originality of words is more a concern of writers and publishers, which many scientists do not aspire to be. Though this viewpoint is controversial, plagiarism of words could be considered error, whereas plagiarism of data must be considered fraud.[ 3 ]

The essence of plagiarism is that the writer claims something as his own when it is not his to claim.[ 6 ] Failing to give credit where credit is due amounts to theft from the owner of that material. Such theft may not be a material loss to the owner since in academic circles, no exchange of money is usually involved. Yet, it is certainly a material gain to the person who appropriates such material, making the plagiarist seem more creative or more diligent or more intelligent than is warranted.[ 6 ]

Plagiarism can be hard to avoid, especially when writing in English for the first time.[ 7 ] Authors often have difficulty expressing their ideas or using the idiom of science. Some authors believe it is a form of flattery to use the words of a mentor, or that there is little harm in borrowing phrases that may describe findings better than more original words. Yet, the attitude in science is that recycling of words without attribution is a crime.[ 7 ] Interestingly, when plagiarism-detection software was used to assess all submissions to a single journal, 11% of manuscripts were found to have some degree of plagiarism, with the average extent of theft in plagiarized manuscripts amounting to about 25% of the text.[ 8 ] Generally, the extent of plagiarism was highest in the Materials and Methods section,[ 8 ] confirming that plagiarism is most likely in describing experimental methods.

Self-plagiarism, the act of extensively borrowing words from one's own published work, is strongly discouraged.[ 9 ] Some people dismiss this practice by saying that it is impossible to steal anything from oneself, and that self-plagiarism is no worse than laziness. But the net result of repeated self-plagiarism is that the productivity of a researcher is artificially elevated. Thus, a degree of deception is involved in self-plagiarism.[ 9 ] Because professional advancement and scientific reputation depend upon research productivity, self-plagiarism is a form of theft from the scientific establishment. As a practical matter, some journals use a guideline that up to 30% of the words in a paper can be recycled by an author from a previous paper, but no data, whatsoever, can be recycled.[ 10 ]

B E H ONEST

Writers must be scrupulously, unrelentingly, and totally honest in their work because any dishonesty will eventually be discovered and fabricated or falsified data is judged harshly.[ 3 , 4 , 11 – 13 ]

Science is generally thought to be self-correcting; scientists are eager to criticize new work and to fault established wisdom. For example, there has been an ongoing debate as to whether the results presented a century ago by Gregor Mendel, the father of modern genetics, are too good to be true.[ 14 ] Mendel bred pea plants together in various combinations to understand how individual plant traits are expressed through the generations. His work was eventually accepted as the first physical evidence of genes. However, R. A. Fischer, the father of modern statistics, did a detailed statistical analysis and concluded that Mendel's data were too close to the ideal expected if experiments had involved a larger sample size. This suggests that Mendel may have “edited” his data after collecting it,[ 14 ] a transgression that would now be called data falsification.[ 3 ] The point is not that Mendel was dishonest; we cannot know this with certainty. Yet, we do know that his results are still being examined and questioned more than a century after the fact.

B E I NNOVATIVE

Attacking the same problems with the same tools will often yield the same results; it can be useful to approach an old problem in a new way. For example, personalized medicine has caused a paradigm shift in oncology; the idea that each patient should be treated in a way individually tailored to the genes unique to their tumor has caused a great deal of excitement. Yet, it is only recently that the idea of personalized medicine has come to diabetology.

For many years, the goal of treatment of type II diabetes mellitus (T2DM) has been to lower glycemic levels as close to normal as is safely possible.[ 15 ] Tight glycemic control is known to reduce complications of the disease that affect the eye, kidney, and nerve. Although T2DM is heterogeneous – in terms of presentation and pathogenesis – patients tend to be treated in similar ways. Hence, it cannot be surprising that current T2DM therapies often fail to achieve glycemic control, particularly over the long term. Somewhat more than half of all diabetics achieve the goal of glycosylated hemoglobin (HbA1c) <7%, so patients are at risk of eventual diabetic complications.[ 15 ] Insight into the genetic variability that probably underlies the heterogeneity in clinical presentation is an innovative clinical strategy. Identification of the Kir6.2 mutations as potentially responsible for several forms of maturity-onset diabetes, as well as a better understanding of the polygenic nature of T2DM, suggests that personalized medicine may enable better glycemic control in patients.[ 15 ]

B E O RGANIZED

There is a specific structure to a science paper, as formal and as circumscribed as haiku poetry (see http://www.ijem.in/contributors.asp ). If writers do not use that structure, they are unlikely to get published. This may seem a trivial point in that a good idea badly argued is more easily fixed than a bad idea well argued. But people are busy; if an author does not organize his writing, why would anyone read it?

The key thing in writing science papers is to first finalize the data. All tables and figures should be put in final form before anything else is attempted. Then throw out your preconceptions and look at the data with a fresh eye; what story do the data tell? Jot down conclusions looking at the data as a new reader would, without thinking about what you were trying to prove. Sometimes the story that emerges is not the story you intended to tell, but as long as the story is driven by data, the story is worth telling in a paper.

B E C AREFUL

It is often little details that trip up big ideas. Recently, Einstein's theory of relativity seemed at risk, because European physicists had detected subatomic particles known as neutrinos that seemed to be moving faster than the speed of light.[ 16 ] Yet, newer evidence suggests that the excess speed of neutrinos may really have been excess zeal of the neutrino-detecting scientists.[ 17 ] When the apparatus used to make the measurement was carefully examined, a loose wire was found that made neutrinos appear to move faster than they were actually going.[ 17 ]

A misplaced decimal point, a cut-and-paste error in a table, a crucial typo, a tiny miscalculation – each of these minor errors has sunk many papers. Check every number two or three times, then put the paper aside, come back to it with fresh eyes, and check it again. The accuracy of the data is the first concern; you cannot have good science without reliable numbers.

The ideas in science are so complex that the words used to describe those ideas should be simple. Verbal excess and flowery language must be avoided; prose should be clear and direct. Acronyms never add clarity, though they can sometimes help with economy of words; nevertheless, acronyms do more harm than good.

Clarity is especially important in the Results section, the beating heart of a paper.[ 1 ] Writers should lead readers through the results with clear, direct sentences. Writing should convey competence and professional authority and that is often accomplished by writing in first person and using the active voice. Active voice emphasizes the agent of an action; passive voice emphasizes the result of an action. “We analyzed the results” is clearer than “The results were analyzed,” because the latter formulation leaves open the question of who performed the action.

In a paper, as in a mathematical formula, less is more. Clarity can only be achieved by direct thinking, which is associated with direct writing. Precision of thought is important, and concision of words is a useful marker for it. It is easier to generate confusion with many words than with few. If concision reveals a paucity of ideas, then do not write more; think more. The most important biology paper of the last century was extremely short – Watson and Crick's description of the structure of DNA in Nature [ 18 ] was scarcely a page long – yet, it revolutionized biology.

B E M ODEST

It is a major mistake to claim too much credit, whether for the strength of your data or for the originality of your ideas. Science is an iterative process by which we approach the truth in tiny steps. None of us would be where we are without people before us who blazed a trail; none of us could have followed that trail without mentors and colleagues. Modesty is not merely appealing; it is essential.

A model of scientific modesty is provided by the penultimate paragraph of Watson and Crick's famous paper on DNA:[ 18 ] “It has not escaped our notice that the specific pairing we have postulated immediately suggests a possible copying mechanism for the genetic material.”

B E F AIR -M INDED

Do not misrepresent an argument merely to demolish it as this is intellectually dishonest.[ 19 ] You cannot be certain you are right, so you cannot know that others are wrong. In science, we struggle to illuminate the darkness of ignorance and darkness always resists light.

One way to be sure you are fair-minded is to circulate your manuscript among colleagues. This is particularly valuable if you have a colleague with whom you have disagreed. A disagreement about a paper prior to submission can result in a stronger paper; a disagreement about a paper after publication can harm a career. You should also offer to review your colleague's papers prior to submission.

Flaws and weaknesses are present in every paper; be open about the blemishes in your paper. This does not diminish your work; it builds credibility for you as an investigator and opens a door for others to follow you. For example, India was estimated to have 51 million people with diabetes.[ 20 ] But this estimate was based on small, often under-powered studies done in various parts of the country, and methods were heterogeneous between studies. Component studies were weakened by differing diagnostic criteria, unconfirmed preliminary diagnoses, local, regional, and ethnic differences, poor characterization of measurement error, and spotty coverage in rural areas.[ 20 ] It may seem an error to confess such weaknesses openly in the literature, but it creates a spectacular research opportunity. Because these various weaknesses were known, a national study on the prevalence of diabetes in India was proposed.[ 20 ] When the national study was done, it was found that there are actually about 62 million people with diabetes in India,[ 21 ] 11 million more than had been predicted.[ 20 ]

B E P ERSISTENT

Your work may not be recognized as worthy of publication the first time it is submitted to a journal. This is the normal course of events; most journals will not accept a paper on first submission even from a prominent author, so the novice writer should not be discouraged.

Your paper may require a rewrite; after all, which paper cannot be improved? But it may also be true that the journal was not a good fit for your paper. The best course of action is to put the review of your manuscript in a drawer and leave it there until the sting of rebuke wears off. Then, being as dispassionate as possible, go through your manuscript with the comments in hand and see which of those comments are helpful.

If the referees enable you to see something which you did not see before, or if the referees have made an error that you can persuasively counter, then it may be possible to resubmit your manuscript to the original journal. If you cannot respond to all of the comments by either altering your manuscript or rebutting the criticism, then it may be time to pick another journal for submission. Often a clue as to which journal provides the best fit for your paper is to look at the references cited. There can be an alignment between what a journal has published in the past and what that journal is likely to publish in the future.

Many papers go through an odyssey of submission and rejection before they finally achieve publication and some papers are finally published in a journal more prestigious than the original journal of submission. Writing and submitting papers requires a thick skin and a resilient nature.

B E R IGOROUS

You can never “prove” a hypothesis; you can only fail to disprove it.[ 22 ] Of 276 studies published in Indian journals in 2009, roughly 5% claimed that an insignificant P value proved the null hypothesis. This is incorrect; if a study is inadequately powered, it likely will fail to identify a difference between treatment groups.[ 22 ]

Careful analysis of the medical literature has revealed that statistics are misused in a great many papers and in a variety of creative ways.[ 23 ] Many statistical errors have been identified, which break down into five broad categories: Flaws in study design, in data analysis, in documentation of statistical methods used, in presentation of data, and in interpretation of findings.[ 23 ] Statistical software is widely available, yet such software requires knowledge of the assumptions inherent to the statistical tests and of their limitations. Statistical errors in published papers are so common that a statistician should be involved at study inception, to minimize damaging errors.

B E R EALISTIC

If something is statistically significant, that does not mean that it is clinically significant, and clinical significance is far more important.[ 24 ] A study that enrolls a great many people and finds a tiny difference upon treatment may achieve statistical significance and still mean nothing for a patient. Reality is strained when clinical trials use composite endpoints that make the trial more likely to obtain a positive result because such endpoints also make it harder to determine if a new patient will benefit from treatment.[ 24 ] For example, the JUPITER trial[ 25 ] enrolled 17,802 apparently healthy men and women and treated them with rosuvastatin for 1.9 years. The primary outcome measure was, “the occurrence of a first major cardiovascular event, defined as nonfatal myocardial infarction, nonfatal stroke, hospitalization for unstable angina, an arterial revascularization procedure, or confirmed death from cardiovascular causes.”

This composite endpoint conflates medical events that vary greatly in severity.[ 26 ] A nonfatal stroke may not impinge much on the patient, whereas death is hard to ignore. This compound endpoint may have falsely inflated the odds that medication would be deemed helpful. The JUPITER trial may have been unrealistic in other ways as well. Cardiovascular mortality was surprisingly low, since healthy people were enrolled and the trial was prematurely terminated. Because few primary endpoints were observed, results are more prone to statistical fluke than if there had been many cardiovascular deaths over a long follow-up period. Thus, JUPITER may not present a realistic picture of the potential benefits of statins in healthy people.[ 26 ]

C ONCLUSION

I cannot promise that if all these precepts are followed, publication will follow; talent, energy, and luck are also required. I cannot promise that publication will get easier over time; each new paper presents unique difficulties. I cannot promise that every paper will garner praise and honors, once it is written up; writing is just the last step in research and strong writing cannot compensate for a weak experiment. But I can promise that seeing the first publication – or even the hundredth publication – will be a thrill.

Source of Support: Nil

Conflict of Interest: None declared.

R EFERENCES

IMAGES

  1. (PDF) How To Write A Scientific Article For A Medical Journal?

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  2. How to Write a Research Article

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  3. FREE 12+ Article Writing Samples & Templates in PDF

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  4. 💋 Medical research paper sample. Free Medical School Research Paper

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  5. (PDF) How to write an article: An introduction to basic scientific

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  6. How to write a medical research paper for publishing in a high impact…

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VIDEO

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  3. Research Article Writing; Professional Scientific Communication; NPTEL-PMRF Week 3 Live Session

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  5. How does a medical writing career look like? #medicalwriting #scientificwriting

  6. How to manage references

COMMENTS

  1. How To Write And Publish A Scientific Manuscript

    Write a manuscript to interpret and describe your research. After conducting a quality investigation or a study, one should put together an abstract and manuscript to share results. Researchers can write an abstract in a short amount of time, though the abstract will evolve as the full manuscript moves to completion.

  2. PDF How to write and publish a paper

    Writing research papers and using reporting guidelines Resources IMRaD Writing style Research to Publication rtop.bmj.com Core guidance on writing papers International Committee of Medical Journal Editors recommendations for manuscripts submitted to biomedical journals

  3. Successful Scientific Writing and Publishing: A Step-by-Step Approach

    We include an overview of basic scientific writing principles, a detailed description of the sections of an original research article, and practical recommendations for selecting a journal and responding to peer review comments.

  4. How to Become a Competent Medical Writer?

    Medical writing involves writing scientific documents of different types which include regulatory and research-related documents, disease or drug-related educational and promotional literature, publication articles like journal manuscripts and abstracts, content for healthcare websites, health-related magazines or news articles.

  5. How to Write a Medical Research Paper: 12 Steps (with Pictures)

    Writing a medical research paper is similar to writing other research papers in that you want to use reliable sources, write in a clear and organized style, and offer a strong argument for all conclusions you present. In some cases the research you discuss will be data you have actually collected to answer your research questions.

  6. Writing a research article: advice to beginners

    Writing research papers does not come naturally to most of us. The typical research paper is a highly codified rhetorical form [1,2]. Knowledge of the rules—som ... Publishing and Presenting Clinical Research. Baltimore, MD: Lippincott, Williams & Wilkins, 1999. Devers. KJ, Frankel RM. Getting qualitative research published. Educ Health. 2001 ...

  7. Effective Writing for Health Care

    Writing for Medical and Scientific Journals In this specialized track of Effective Writing for Health Care, you will learn strategies and develop skills to craft a compelling clinical or basic science article.

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    Title. The title should be descriptive yet concise while conveying the essential features of the contents of the article. The title should contain words that will make the article accessible to workers in the field. Clarity, brevity and above all human interest are the hallmarks of a good title.

  13. Medical Manuscript Writing: A Well-researched Guide

    These tools can be used to find all the reputable sources needed to flesh out quality medical writing. PubMed (MEDLINE): PUBMED is an extremely popular and free search engine hosted by the NIH (National institutes of Health and U.S. National Library of Medicine. It can be used to access a vast index of peer-reviewed biological and medical research.

  14. Ultimate Guide to Becoming A Medical Writer

    What Do Medical Writers Write? The expertise and contributions of medical writers and editors can be found throughout the medical community. Examples of their work include Abstracts for medical journals and medical conferences Advertisements for pharmaceuticals, devices, and other products Advisory board summaries

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    Preparing Your Study, Review, or Article for Publication in Medical Journals The majority of social, behavioral, biological, and clinical journals follow the conventional structured abstract form with the following four major headings (or variations of these headings):

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    PubMed lists journal articles back to 1947. It indexes about 5,400 journals and covers the areas of medicine, nursing, dentistry, veterinary medicine, health care systems, preclinical sciences, and related areas. Scopus is a comprehensive scientific, medical, technical and social science database. Scopus also allows for citation searching back ...

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  19. The Principles of Biomedical Scientific Writing: Introduction

    Studies available on scientific writing provide evidence emphasizing the complexity of the compositional process of writing an introduction; these studies concluded that "introduction is not just wrestling with words to fit the facts, but it is also strongly modulated by perceptions of the anticipated reactions of peer-colleagues" ( 6 ).

  20. [Writing and publication of a medical article]

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  21. PDF Genre Analysis of Moves in Medical Research Articles

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  24. Advanced Food Chemistry Article -- 2

    - Exceptional skills in scientific writing - Background in Food Chemistry is a must - Ability to deliver complex information in a professional and understandable manner. To perform excellently, you'd ideally: - Have previous experience writing scientific articles for professionals - Understand the latest trends and research in Food Chemistry

  25. Writing for publication in a medical journal

    The essence of writing for publication in the medical field is distilled into a dozen precepts to guide the anxious author. These precepts focus on the attitude of the writer, rather than the mechanics of writing.