2.3.6 Presentation and National Meetings
Once the study is complete, or during a planned interim analysis, the communication of study results is often done in a multifactorial way including presentation at national meetings. This is often the first opportunity to communicate important results to colleagues and to receive feedback. By their nature, presentations at national meetings are very short relative to the full publication. Most large meetings include options for either oral or poster presentation. Oral presentation typically involves a slide review of the study aims and hypothesis, and a short review of the background, followed by methods, results, and conclusions. This must be communicated in a short period of time, typically 8 to 12 minutes. The message should be kept relatively simple with two to three main points that are communicated. Fewer slides that are carefully worded and presented communicate much more than very densely written slides and rapid speech. The presenter should always be highly respectful of his or her time allocation and allow for a question and answer session.
2.3.7 Manuscript Writing
Many investigators fall short at the final stage of the scientific process. The classical writers’ block has prevented many excellent studies from being fully published. Each investigator has his or her own style of writing and overcoming writers’ block. One of the most valuable methods is to remind ourselves that the manuscript does not have to be perfect on the first draft. It is often easier to edit a manuscript than to write a manuscript. For this reason, simply getting the ideas down on paper can overcome the most challenging obstruction. With current voice recognition technology, this can be done simply by dictating a manuscript. Begin by assembling all the key elements of the study, such as tables, figures, and the previous grant submission. Large aspects of the manuscript may have been previously written, such as the background section of the grant, which should change little other than a timely update of the most recent literature. The methods section should largely be identical to the methods written in the original grant application. The results also should largely reflect the key data elements including figures and tables. The discussion is perhaps the most difficult to write. A discussion section should generally follow a general sequence as outlined in the following:
• Summarize your key findings.
• Discuss how your findings compared to literature that supports the results.
• Discuss how your findings extend knowledge compared to other studies.
• Discuss how your findings may conflict with other published results and explain why these differences exist.
• Discuss the strengths and limitations of your study.
• Discuss the implications and conclusions of your study.
• Discuss what future research should be done.
2.4 Ethics
Scientific exploration, particularly studies that involve commercial devices, has potential for conflicts of interest. Scientific misconduct occurs when we lose sight of our primary goal, to discover new knowledge, and instead focus on personal gains. We have recently published a summary of the key ethical issues in scientific publication and how to prevent them.10,11 Common ethical problems include the following.
2.4.1 Conflict of Interest
Conflicts of interest should be clearly declared and should err on the side of overdisclosure even if the author feels there may not be a direct conflict of interest. It is better to allow the reader to decide if the conflict of interest is present and how it might influence the scientific study. Examples include consulting fees or equity interest in a commercial product or company related to the study.
2.4.2 Registration of Clinical Trials and Underreporting of Negative Trials
The ICMJE guidelines, to which many journals adhere, require clinical trials to be registered at the outset of the study.12 According to the ICMJE, a clinical trial is defined as “any research study that prospectively assigns human participants or groups of humans to one or more health-related interventions to evaluate the effects on health outcomes.”12 Some studies, such as a retrospective chart review, do not require registration. All studies that meet this definition should be listed on one of the many acceptable registration sites such as:
• www.umin.ac.jp/ctr/index/htm
• https://eudract.ema.europa.eu/
2.4.3 Falsification of Data
Although this is the most dangerous of all ethical issues, it is often very difficult to detect. Most issues of data falsification come to light through collaborators who have questions about the authenticity of data and raise these concerns to either institutional leadership or journal editors.
2.4.4 Plagiarism
The ability to copy and paste text material and the broadly available content throughout the World Wide Web have made plagiarism an increasingly common practice. On the other hand, software tools to search text within any manuscript and compare it to other published work have made it very easy to detect plagiarism.10,11
A more challenging issue is the reuse of text by the same author, so called “text recycling.” Authors must remember that the copyright of published manuscript belongs to the journal and cannot be reused verbatim. Direct reuse should be quoted and referenced with permission from the original source or preferably rewritten in new words.
2.5 Manuscript Submission and Review Process
Most medical journals follow a standard process for submission and review, although new online open access journals are changing this process. For most journals, the approach is to submit a manuscript, typically through a website. The journal’s managing editors and chief editor typically screen manuscripts to identify those that should be sent for full peer review. Many competitive journals may not send some manuscripts out for review.
Once an article clears the initial screening, it is typically sent for review to two or more independent experts in a field. They provide a critical review of the manuscript and often make a recommendation regarding whether manuscripts should be published and what improvements should be made. The decision on whether manuscripts should be published is ultimately made by the editorial team and chief editor. Most journals prioritize studies that are novel, well designed, well written, and appropriate for the audience of the journal. For this reason, the authors should carefully select the most appropriate journal. It is a common mistake to choose a journal simply based on the reported impact factors. Ultimately, the goal of publishing manuscripts is to communicate the new knowledge with the audience that is most likely to benefit, as opposed to the most widely read or cited journals.