Dr. Mohsen Rezaeian (PhD, Epidemiologist, Associate Professor)
Social Medicine Department, Rafsanjan Medical School, Rafsanjan, Iran.
Tel: +98 391 5234003
Fax: +98 391 5225209
Email: moeygmr2@yahoo.co.uk

INTRODUCTION

The preparation of a manuscript for publication seems to be a daunting task especially for the novice. Before publication of a manuscript by a well-known journal, it should successfully pass a very tough barrier called editorial peer review¹. Editorial peer review is a rather lengthy process in which the submitted article goes through a detailed inspection by the editors of the journals and peers of the authors. Peers of the authors are those people who are familiar with the subject under investigation as much as, or more than, the authors themselves. Sometimes peers might also consist of epidemiologists or biostatisticians as well as subject experts².
The chief purpose of the editorial peer review process is to detect any flaws within the manuscript before publication and provide the authors with constructive criticism in order to improve the quality of the article³. The process also includes checking that the topic is within the journal's subject, to see that the results are clear, and to make sure the text gives worthwhile information. The outcome of this process could be categorized as immediate acceptance or immediate rejections, which are rather rare. The most common outcome of this process, even for an experienced author, could be revision either with substantial or minor corrections⁴.
The aim of the present article is therefore, to provide a practical step by step guide for the health care professional about how to prepare a manuscript for publication which successfully survives the editorial peer review process. This practical guide consists of 10 interrelated questions that a given author or authorial team should ask before submitting the article for publication. These questions are as follows:

Does the article add something new to the existing knowledge?

The most important step before writing a manuscript is to ask whether the article is going to add something new to the existing knowledge. This is a fundamental question which editors of a journal and peer reviewers ask of themselves when reviewing a submitted article for publication. Therefore, before anybody else asks this important question the authors should ask it themselves¹.
This question goes back right to the time of the inception of the research project. If the research project is built on a substantial literature review with a critical view, it would be possible that the article which arises from the project will add something new to the existing knowledge.

Does the author select the most relevant journal for topic?

The second most important step before writing a manuscript is to select the most relevant journal for submission⁵. This is a very important step forward since one of the most important reasons for either immediate rejection of a manuscript or sending it back for a major revision is that it does not lie within the scope of the journal, or it does not comply with the standards of that journal⁶.
How might one find the most relevant journal for submitting his/her article? One of the best ways to fulfil this demand is to look at your literature review and find out which journal or journals publish similar works. If you find a journal by this approach you might also have a good impact on the editors of that journal because they see that you have cited the articles which they have published in their journal several times. Whenever, you find the most relevant journals do read its instructions for authors carefully and prepare your manuscript entirely based upon them.

Does a comprehensive and clear title indicate the topic in sufficient detail?

The title should be as comprehensive and clear as possible. It should be informative and short. Selecting an excellent title has a positive effect on the editors and peers. Avoid ambiguity and abbreviations as much as you can. If you have carried out a descriptive study you should add the element of time and place within your title. However, if you carried out an analytic study such as case-control, cohort or trials it is wise to add the type of your study somewhere within the title of your manuscript.
On a final note in this section, do remember that when your article gets published most people will read only the title of your article so make it clear and attractive to pursue the readers to go through the other part of your article, or at the very least the abstract.

Does a comprehensive and concise abstract prepare readers for the article?

After the title, abstract is the most important short part of your article, which you have to write using 150 to 250 words. The abstract must stand alone, be concise and also precise therefore, avoid detailed discussion or speculations. Also avoid abbreviations and cite other references if you can⁷.
There are usually two forms of abstract i.e. structured and un-structured, depending on the journal that you have already selected. A structured abstract usually has the following subtitles: Background and objectives, Materials and methods, Results and Conclusions, whilst un-structured abstracts have no such subtitles. No matter which abstract you are writing, try to explain clearly within it what exactly you did, how you did it, what were your major results and their statistical significance and of course your conclusions.

Does the article provide a clear introduction?

The introduction should be short but give an adequate account of the background and prior work and end with the aims of the present study⁵. The first paragraph of the introduction should provide the readers with the importance and the background of the topic under investigation by citing the most important previous studies.
Within the second paragraph try to explain the gap within the existing knowledge, this is very important because it implies what your paper is supposed to add to the current knowledge. Finally, within the third paragraph explain the aims of your study; the questions that you are going to answer or the hypotheses that you are going to test.

Does the article include a complete materials and methods section?

The materials and methods section is the heart of the study once the question to be answered has been specified. The materials and methods should be specified so that any other researcher can replicate the study, to confirm the findings. It is always a possibility that all the shortcomings of a given manuscript in its other areas, no matter how large it is, would be corrected in the revision. However, the major problems within the materials and methods section would not be corrected unless the research was to be carried out for a second time¹. Therefore, try to write this section in detail and clear so that someone else could repeat the investigation in an identical manner⁸. You may even use subtitles if necessary⁵.
Begin this section with the type of study, the reference and sample populations and explain how many samples and by which method did you recruit in your study. These are very important issues since if you have chosen the wrong type of study or recruited a less than needed sample size, your article is not worth publication. There are other important issues that need to be explained in this section. For instance, who carried out the measurements, and how? Have the authors considered, or how they have dealt with, the ethical issues in their research? How have they specified the inclusion and exclusion criteria? Which statistical software and which statistical tests have they applied to answer their questions, or test their hypotheses?

Does the article give the findings in a proper way?

This section must be written based on the aims of the study that you have specified at the end of the introduction section. The findings should be presented so as to lead from the overall structure to more sophisticated methods for fine detail using visual aids such as tables, diagrams, illustrations and maps. Try to very briefly discuss any visual aids that are used and correctly cross reference them within the texts. Furthermore, double-check all your data within the texts and the visual aids¹.
Explain exactly which statistical test has been carried out to test which hypothesis. Do not interpret your results; this is a matter for the discussion section. Outline your findings prior to the discussion section.
Does the article include a complete discussion section?

The direction of discussion section is completely the opposite of the introduction section. Here the authors move from the details of their study to complete the picture and put everything in its proper context. Therefore, you should begin this section with the most important findings of your study whilst avoiding any over-estimations of your results. Then move on to compare your findings with similar studies and discuss the possible mechanism of similarities and dissimilarities¹.
You should also point out any limitations of your study and their possible impact on your results. This is good practice because it shows the editors and reviewers that you are well aware of the limitations of your study. You may also provide some suggestions for future studies. At the end of this section you may conclude what your results really mean and how these results should be used in practice. However, be careful not to expand your conclusions beyond what is really supported by your findings.

Does the article acknowledge the efforts?

It is important to acknowledge every person or organisation that helps authors all through their investigation, up to writing the manuscript. This list might include the organisation which provides the researchers with the proper funding, or those colleagues who critically read the earlier drafts of the manuscript. This has a good impression on the editors and peers and if they want you to revise and resubmit your article based on their comments, you may acknowledge their help as well.

Does the article include a complete reference list?

The reference list is among the sections that are first read by the editors and peers (9), therefore, it is vitally important that this list consists of the most up to date and reliable articles in the relevant field. By reliable articles, it is meant as those articles that were published in the peer reviewed journal. The use of less reliable sources such as websites, theses or articles that were published by the journals without peer review policy should not be used or they should be used as little as possible¹. It is also suggested not to list reference books within references. However, if you feel that is absolutely vital to do that, you should provide the reader with the exact pages of the book on your reference list¹⁰.
There is no standard rule which says how many references one needs to write an original article. However, the standard rule is that one should use all the relevant and latest literature on the topic under investigation¹¹. Therefore, it is always better to use more, rather then less references⁸. It is more desirable that the reviewers and editors ask the authors to decrease the number of their references, than to ask them to increase them in order to contain all the relevant literature. Finally, references should be written well and according to the journal's instruction.

Preparation of a manuscript for publication needs careful considerations. The most important issue is to write only about those topics, which add something new to the current knowledge. The second vital issue is to select the most relevant journal for submission taking into account its instructions. The body of the manuscript should consist of a clear and attractive title, a concise abstract, a well-written introduction, materials and methods, findings and discussion sections. Finish your article with acknowledging those who helped you all through this overwhelming task and also an up-to-date list of references.

1. Rezaeian M. How to successfully leave behind the peer review process? J Rafsanjan Univ Med Sci. 2008; 7(1): 1-4. [Farsi]
   
2. Constantine NA. Peer Review Process. In Baslaugh S. Edi. Encyclopaedia of Epidemiology. Second Volume. California: SAGE Publications, Inc. 2008; pp: 794-65.
   
3. Rezaeian M. Post-Publication Peer Review. J Rafsanjan Univ Med Sci. 2007; 6(4): 217-218. [Farsi]
   
4. Bauer J. Intricate journey: the path of a manuscript from submission to publication. J Perianesth Nurs. 1998; 13(2): 95- 98.
   
5. Rosenfeldt FL, Dowling JT, Pepe S, Fullerton MJ. How to write a paper for publication. Heart Lung Circ. 2000; 9(2): 82- 87.
   
6. Pierson DJ. The top 10 reasons why manuscripts are not accepted for publication. Respir Care. 2004; 49(10): 1246- 1252.
   
7. Thrower PA. Writing a Scientific Paper: I. Titles and Abstracts. Carbon. 2007; 45: 2143-2144.
   
8. Coleman R. Tips to improve your manuscript and make the editor happy. Acta Histochem. 2007;109(5): 343-346.
   
9. El-Serag HB. Scientific manuscripts: the fun of writing and submitting. Gastrointest Endosc. 2006; 64(6 Suppl): S19-22.
   
10. Thrower PA. Writing a Scientific Paper: II. Introduction and references. Carbon. 2008; 46: 183-184.
    
11. Singer AJ, Hollander JE. How to write a manuscript. J Emerg Med. 2009; 36(1): 89-93.