The chances of getting your manuscript accepted and published by a journal can go up by avoiding common mistakes and understanding how the evaluation process works, according to editors in a CHEST 2020 session who offered tips for getting a paper published. How to Get Published: Tips From the Editors will be available for viewing until February 1, 2020.

“Understanding the process and what people involved in the process are thinking as they look at the manuscript will help you a lot,” said Darren Taichman, MD, PhD, deputy editor of the New England Journal of Medicine. Dr. Taichman offered advice for how to make your paper look its best while Peter Mazzone, MD, MPH, FCCP, editor in chief of the journal CHEST®, which aims to be the most important source of clinically relevant research and patient management guidance for pulmonary, critical care, and sleep medicine clinicians worldwide, provided insight into what he looks for when evaluating a paper.

The first step is evaluating the research question, he said.

“We hope that the research question is nicely summarized in a single sentence that describes the population being studied, predictors, and the outcomes being evaluated,” Dr. Mazzone continued. “And then our team’s job is to say: Is this research potentially impactful? Is this a research question that needs to be answered, that our audience will like to know the answer, or that might impact the way they manage their patients?”

To do so, the team might answer a few questions: Was the study hypothesis clearly stated? Were the study findings novel? If the study findings were not novel, did they provide support in an area in which uncertainty exists and/or confirm/refute the findings from less rigorous research?

“That’s step one, and it’s extremely important,” Dr. Mazzone said. “So important that we adjusted the style of the abstract, that we ask you to put your research question right in the abstract. We want you to state the research question as a question and include the key features of the study (study population, predictors, and outcomes.)”

From there, the reviewers provide feedback about the importance of question and study methodology. This includes looking at the clarity of the inclusion and exclusion criteria; the selection, measurement, and evaluation of the predictors and outcome; the assessment of model accuracy; and whether and how the prediction model might have relevance in clinical practice.

The next area that crosses study methodology is survival analysis, Dr. Mazzone said, and when that is used, the reviewers look at if the purpose was clearly stated and the method used to estimate and compare survival functions, in addition to the analytical and graphical reporting.

Another area that crosses study methodologies is health-related quality of life (HRQOL), which is evaluated on several pillars: the appropriateness of the HRQOL measure, the validity and reliability of the HRQOL measure, and the explanation and interpretation of the HRQOL results.

Specific study designs also require certain evaluations. 

“We’ll want to look at the selection of the study population,” he said about case-control studies. “Was the population clearly described? Was the definition of a case clearly described, based on clinical standards and free of potential bias? Was the selection of control subjects free of bias?”

The reviewers also evaluate the exposure/risk factors and if they were clearly described, and the strength and validity of the association noted.

For cross-sectional studies, reviewers again look at the study population in addition to the exposure, outcomes, and relevant covariates. The third type of observational study design Dr. Mazzone reviewed was Cohort studies, which had similar pillars to the other two. He also reviewed the evaluation behind economic evaluation studies, interpreting genomics data, and statistical reporting guidelines. Things considered for the last item include:

• Reporting of design and statistical analysis
• Reporting of inference and P values
• Reporting of multivariable models and diagnostic tests
• Discussion, interpretation, and conclusions

“You may thing you think your research is sound but it still gets rejected,” he said. “There are limitations to how much we (journal CHEST®) can accept. There’s been a growth in manuscripts accepted in COVID-19.”

The rate of acceptance still stays 8%.

To improve author experience, the journal has also made several adjustments:

• Friendlier web interface for author instructions
• Allowing all article formatting to be submitted
• Artificial intelligence in submission system to minimize data entry, developing templates
• High-quality, timely reviews, statistical reviews
• Provide guiding documents about formatting at time of revision
• Redesigned journal webpage to make journal articles easier to access; English language assistance; art assistance
• Thank you-letters to authors
• Social media attention

“We consider our job very seriously in hope that you submit your work to us,” he said. “We’ll do our best to provide an understanding of our view of the importance of the research, your study methodology, and provide you with the best experience you can have.”

Advice to make your paper look its best

Getting a paper published is not just a democratic process, Dr. Taichman shared. Editorial decisions are made in part of the important contributions of peer reviewers, but also the journal readers, the pipeline, and the journal priorities. However, there are things you can control.

1. The biggest mistake is not paying enough attention to the needs of the reader, Dr. Taichman said. “Be a reviewer for journals. You’ll see what it is that pleases you as a reviewer and thus what to do and not to do when preparing your own paper.”
2. Organization is key. “Give me what I want, tell me what the question is and tell me quickly. … You also want to give me what I want where I expect it to be. Methods with methods, results with results. It sounds infantile and simplistic, but so many papers fall apart because people don’t follow those rules.”
3. Rules of good writing apply.
   1. Every paragraph has a topic sentence.
   2. Every paragraph stays on topic.
   3. Every paragraph has a conclusion.
4. Avoid jargon and annoying abbreviations. Don’t make life harder for the reader.
5. Keep it short. Be concise. Get to the point. Less is almost always better. Do not exceed the word limit.
6. Recognize the difference between association and causation. Recognize the difference between statistically significant and clinically significant. “If you don’t look out for these things, once again, it will make it look like you’re not in touch with what the limits of your science are and the reviewers and editors won’t think as highly of your writing, and thus, your paper,” he said.
7. And when you think you’re done, Dr. Taichman continued, walk away. Don’t read your paper again for a couple of days. “It is amazing how often when we are struggling with the language and getting it done, we are so engrossed in it, we fail to see how nonsensical some of our writing is and how there are mistakes there.” He also suggested printing your paper to identify typographical errors and reading it out loud.