Effective Biomedical Writing

1. Effective Biomedical Writing Rebecca A. Bartow, Ph.D. Instructor Western Kentucky UniversityBowling Green, Kentucky

2. A scientific experiment, no matter how spectacular the results, is not completed until the results are published. In fact, the cornerstone of the philosophy of science is based on the fundamental assumption that original research must be published; only thus can new scientific knowledge be authenticated and added to the existing data base called scientific knowledge. • From How to Write and Publish a Scientific Paper, by Robert A. Day

3. Organization of a Scientific Paper: the IMRAD Approach • I—Introduction: What problem (question) • was studied? • M—Methods: How was the problem • studied? • R—Results: What were the findings? • A—and • D—Discussion: What do these findings • mean?

4. The Title A good title should • Accurately, completely, and specifically identify the main topic. • Be unambiguous. • Be concise. • Begin with an important word to attract intended readers. • Be a label suitable for indexing. • Be informative or declarative. • Include animal species. • Avoid subtitles.

5. Examples • Endogenous Nitric Oxide Protects Against Platelet Aggregation and Cyclic Flow Variations in Stenosed Arteries in Dogs • Esmolol Improves Airway Function in Patients Who Have Asthma • Impaired Pulmonary Function in Newborn Lambs Anesthetized with Halothane • Rapid Accumulation of Eosinophils in Lung Lesions in Guinea Pigs Infected with Mycobacteriumtuberculosis

6. Title Exercise • Results of Studies of the Effects of Endothelin-1 on Isolated Vascular Beds from Rats with Normal Blood Pressure and Those That are Spontaneously Hypertensive • Development and Characterization of an In Vivo Central Venous Catheter C. albicans Biofilm Model • Effect of Liver Disease on the Cardiovascular Response to Nicardipine • Isolation of Antigens from Monkeys Using Complement-fixation Techniques • A Study of the Expression of p53 in Melanoma Tissue • A Double-Catheter Technique for Caudally Misdirected Catheters in the Umbilical Artery

7. The Abstract • A good abstract should • State the principal objectives and scope of the investigation. • Describe the methods used. • Summarize the results. • State the principal conclusions. • Be brief (250 words maximum). • Avoid abbreviations and jargon.

8. Introduction • What question (problem) was studied? • The answer is the Introduction. • Funnel organization. • General area. Nature and scope of problem (Known). • Previous findings. Review pertinent literature. • Gap or general problem (Unknown). • Hypothesis or research question—signal. • Method of investigation. • Catches and keeps the reader’s attention. • Recommended length = 1 to 2 pages. • Present and past tense.

9. IntroductionExample • Several general anesthetics, including barbiturates, are known to depress the bronchomotor response to vagus nerve stimulation. The site of the depression, however, has not been determined. To identify which site in the vagal motor pathway to the bronchioles is most sensitive to depression by barbiturates, we used isolated rings of ferret trachea in which we simulated this pathway at four different sites before and after exposure to barbiturates. Note: Guide your reader by using the same key terms throughout your paper.

10. Signaling the Question • To determine whether . . . • To determine which . . . • The purpose of this study was . . . • Therefore, we tested the hypothesis that . . . • This report describes experiments designed to determine whether . . .

11. Describe what was done to answer the research question. Give full details of the chosen methodology. Logical order, usually chronological. Study design—brief statement. Include institutional review and approval. Preparation/materials/subjects, described adequately. Protocol. Analytical methods. Subheadings. Figures and tables. Recommended length = as long as necessary to describe what you did: no unnecessary details and no results. Past tense. Materials and Methods How was the problem studied?The answer is the Methods.

12. Results • What were the findings? • The answer is the Results. • Logically answers the research question. Most important result first. • Presents the representative data from THIS STUDY ONLY. • Uses tables, graphs, photographs, and drawings for data. • Text supplements rather than repeats data in the visual. • Correlates the results with the methods. • Data agree within the section and with those data given in other sections and visuals. • Recommended length = brief and uncluttered. • Past tense.

13. Results • Introduce each experimental section with a clear description of the experimental design and aims. • To detect proteins transiently expressed in prenatal brain, we compared the protein maps…. • Describe data and trends concisely. • Avoid: As shown in Figure 2, antisense treatment blocked all expression… • Better: Antisense treatment blocked all expression…(Figure 2). • Put large amounts of data in figures and tables. If one or a few determinations are presented, they should be described in the text. • Tables—best for showing exact values • Figures—best for showing trends, relationships, and effects

14. Discussion • What do these findings mean? • The answer is the Discussion. • Discuss—not recapitulate—the Results.

15. Components • Beginning • Answer the question posed in the introduction; signal. Ending of the introduction: ". . . to test whether abnormal coronary vasoconstriction detected by hyperventilation testing before angioplasty, increases the likelihood of restenosis." Beginning of the Discussion: “In our study, the presence of abnormal coronary vasoconstriction, detected on hyperventilation testing before angioplasty, was associated with an increased likelihood of restenosis in patients with unstable angina and single-vessel coronary disease."

16. Components • Middle • Interpretation of what is known. • Summarize evidence for each conclusion. • Comparisons with others. • Ambiguous results, discrepancies with others—presented objectively. • Unexpected findings. • Limitations.

17. Components • End • Strong conclusion. • Signal. • Application, implications, speculation. • Future work, only if necessary. • Format • Present tense; active voice. • 3 to 4 double-spaced pages (750-1000 words). • Never apologize. • No new ideas. Discusses this study.

18. References • Should • Include only significant, published works. • Use the correct format. Consult a current copy of the journal. • Be checked against the information in the original publications.

19. SIMPLE WORDS Employ or utilize = use Finalize or terminate = end Initial = first Initiate = start Impact = affect Perform = do Prior to = before Significant = important, great, major (reserve use for statistical meaning) Subsequently = after Sufficient = enough AVOID EUPHEMISMS Sacrificed = killed Euthanized = killed Expired = died Females = women Males = men

20. Use Transition Words to Indicate Relationships • Cause or reason: Contrast: • Because In contrast • Since (time) However • Example: Nevertheless • For example Although • Sequence: Conclusions: • First Therefore • Addition: Thus • In addition In conclusion • Furthermore In summary

21. Avoid Useless Words and Phrases • Clearly • Interestingly • It is evident • It is apparent • As a matter of fact • It is of interest to note • With reference to

22. Avoid Wordiness • Take into consideration = consider • Lend support to = support • Arrive at a conclusion = conclude • Have a preference for = prefer • Conduct an investigation = investigate • Serve as a substitute = substitute • Become aware of = aware • At this point in time = now • Due to the fact that = because • A majority of = most

23. Avoid Redundancy • The samples were pale blue in color. • The percentage of positive results was 88%. • The component parts were assembled. • The phantom is cylindrical in shape. • We obtained a consensus of opinion on the format.

24. Word Usage • Affect/Effect/Impact • Include/Consist of/Comprise • Increase/Augment/Enhance • Regime/Regimen • Patient/Case • While/Whereas • That/Which • CetB mutants, which are tolerant to colicin E2, have an altered… • CetB mutants that are tolerant to colicin E2 have an altered….

25. Check the Antecedent • Anthropometric measurements were made in the field by trained personnel, and they were found to be similar. • The left leg became numb at times, and she walked it off. …On her second day, the knee was better, and on the third day, it disappeared. • Approvals were obtained from the Institutional Review Boards and informed consents from their parents. • Calibration curves were derived using miniature piglets that translated TOBEC readings into estimates of FFM and TBW.

26. Subject-Verb Separation • The design of the experiment, in terms of a clear control and the practicability of timing the reactions precisely, although compensations were included to address these factors, was not entirely successful. • The design of the experiment was not entirely successful because of the failure to establish a clear control and time reactions, although compensations were included to address these factors.

27. Find the Lapse in Noun-Verb Agreement • The immobilized antibody beads were washed and lactase eluted with 350 µL 2% Laemmli sample buffer containing 2% ß-mercaptoethanol. • The relative proportion of the 2 polypeptides were calculated as a percentage of the total mass of immunoprecipitated lactase.

28. Find the Verb Converted to a Noun Action in the Subject • Evaporation of ethanol from the mixture occurred rapidly. • Measurements of blood pH were made with a radiometer capillary electrode. • Prolongation of life in third world countries for infants with diarrhea has been accomplished with oral hydration solutions. • Determination of the isotopic enrichment of the compounds was carried out by GC-MS.

29. Put the Action in a New Verb • At least two analyses were made on each sample. • The infusion of tyramine produced a decrease in cutaneous blood flow. • These agents exert their action by inhibition of synthesis of cholesterol by the liver.

30. The Importance of Grammar and Syntax • Using a fiberoptic microscope, dogs were immunized with sheep red blood cells. • After standing in boiling water for an hour, examine the flask. • Employing a straight platinum wire rabbit, sheep and human blood agar plates were inoculated. • Lying on top of the intestine, you will see a small transparent thread. • A large mass of literature has accumulated on the cell walls of staphylococci.

31. Always • SpellCheck. • Proofread. • Check your references. • Proofread. • Ask colleague to read. • Proofread. • Proofread.

32. The End

33. Title Page Abstract Introduction Methods Results Discussion Acknowledgments References Tables Figure Legends Figures Form

34. Title PageComponents • Title • Authors (and degrees, if requested by the journal) • Institutional affiliation • Running head • Present addresses • Grant support (either on title page or acknowledgment page) • Person to whom correspondence should be addressed

35. Comparison With Earlier Work • Own work first: • Our finding that protein-deficient guinea pigs had fewer circulating T lymphocytes than chow-fed guinea pigs 2 weeks after infection agrees with other work in which malnourished mice had lower IL-2 levels (12) and decreased numbers of T lymphocytes after infection (25). • Other's work first: • Other work showed that malnourished animals had lower IL-2 levels (12) and fewer T lymphocytes after infection (25) than well nourished animals; our results agree with those findings.

36. Comparison with Others • Example: • The high incidence (26%) of postpartum maternal hemorrhage recorded in this review was not unexpected; Heys found a 24% increase in his large series in Manchester.

37. Acknowledgment • Intellectual assistance. • Technical help. • Special equipment or materials. • Outside financial assistance (including grants, contracts, or fellowships).

38. Summary of Conclusions • In conclusion, we have shown that endogenously produced nitric oxide protects against cyclic flow reductions in stenosed and endothelium-injured coronary and femoral arteries by inhibiting platelet aggregation. In addition, our studies show that an endothelium-dependent vasodilator, acetylcholine, constricts femoral arteries with injured endothelium and increases the severity of cyclic flow reductions.

39. Discrepancies with Others • Example: • In our study in guinea pigs, the T gamma cell population was unresponsive to antigenic stimulation, even in the presence of syngeneic accessory cells, whereas T gamma cell populations from patients with tuberculosis showed antigenic reactivity (9,11). This discrepancy may be due to differences in enrichment techniques used to obtain purified populations.