Uniform Requirements for Manuscripts Submitted to Biomedical Journals (JAMA 1993;269:2282-6)*

*The following requirements were excepted from the Uniform Requirements. The introduction and sections felt not to be relevant for JOSMC due to its electronic format have been left out.

SUMMARY OF REQUIREMENTS

Type the manuscript double-spaced, including title page, abstract, text, acknowledgments, references, tables and legends for illustrations. Each manuscript component should begin on a new page, in the following sequence: title page, abstract and keywords, text, acknowledgments, references, tables (each table, complete with title and footnotes, on a separate page), and legends for illustrations.

The submitted manuscript should be accompanied by a covering letter, as described under "Submission of a manuscript," and by permissions to reproduce previously published material or to use illustrations that may identify human subjects. Follow the journal's instructions for transfer of copyright. Authors should keep copies of everything submitted.

PRIOR AND DUPLICATE PUBLICATION

Readers of primary source periodicals deserve to be able to trust that what they are reading is original, unless it is clearly stated that the article is being republished by choice of the author and editor. The bases of this position are international copyright laws, ethical conduct and cost-effective use of resources.

Most journals do not wish to consider for publication a paper on work that has already been reported in a published paper or is described in a paper submitted or accepted for publication elsewhere, in print or in electronic media. This policy does not usually preclude consideration of a paper that has been rejected by another journal or of a complete report that follows publication of a preliminary report, such as an abstract or a poster displayed for colleagues at a professional meeting. Nor does it prevent consideration of a paper that has been presented at a scientific meeting if not published in full in a proceedings or similar publication. Press reports of the meeting will not usually be considered as breaches of this rule, but such reports should not be amplified by additional data or copies of tables and illustrations.

When submitting a paper an author should always make a full statement to the editor about all submissions and previous reports that might be regarded as redundant publication of the same or very similar work. Copies of such material should be included with the submitted paper to help the editor decide how to deal with the matter. The author should alert the editor if the work includes subjects about whom a previous report has been published. Any such work should be referred to and referenced in the new paper.

Multiple publication - that is, the publication more than once of the same study, irrespective of whether the wording is the same - is rarely justified. Secondary publication in the same or other language is one possible justification, provided all of the following conditions are met.

The authors have received approval from the editors of both journals concerned; the editor concerned with secondary publication must have a photocopy, reprint or manuscript of the primary version.

The priority of the primary publication is respected by a publication interval of at least 1 week (unless specifically negotiated otherwise by both editors).

The paper for secondary publication is intended for a different group of readers and is not simply a translated version of the primary paper; an abbreviated version will often be sufficient.

The secondary version reflects faithfully the data and interpretations of the primary version.

A footnote on the title page of the secondary version informs readers, peers and documenting agencies that the paper has been published in whole or in part and states the primary reference. A suitable footnote might read as follows: 'This article is based on a study first reported in the [title of journal, with full reference]."

Permission for such secondary publication should be free of charge.

If duplicate publication occurs, authors should expect editorial action to be taken. At the least, prompt rejection of the manuscript should be expected; if, because the editor was unaware of the violations, the article has already been published, then a notice of duplicate publication will probably be published with or without an author's explanation or approval.

Preliminary release, usually to public media, of scientific information described in a paper that has been accepted but not yet published is a violation of the policies of many journals. In a few cases, and only by arrangement with the editor, preliminary release of data may be acceptable - for example, to warn the public of health hazards.

PREPARATION OF A MANUSCRIPT

Use double spacing throughout, including title page, abstract, text, acknowledgments, references, tables, and legends for illustrations. Begin each of the following sections on separate pages: title page, abstract and key words, text, acknowledgments, references, individual tables, and legends. Number the pages consecutively, beginning with the title page. Type the page number in the upper or lower right-hand corner of each page.

TITLE PAGE

The title page should carry the following: (a) the title of the article, which should be concise but informative; (b) the preferred given name, initials and last name of each author, with the highest academic degree(s) and the institutional affiliation; (c) the name of the department(s) and institution(s) to which the work should be attributed; (d) disclaimers, if any, (e) the name and address of the author responsible for correspondence about the manuscript; (f) the name and address of the author to whom requests for reprints should be addressed or a statement that reprints will not be available from the authors; (g) the source(s) of support in the form of grants, equipment, drugs or all of these; and (h) a short running head or foot line (no longer than 40 characters, counting letters and spaces), placed at the foot of the title page and identified.

AUTHORSHIP

All persons designated as authors should qualify for authorship. The order of authorship should be a joint decision of the co-authors. Each author should have participated sufficiently in the work to take public responsibility for the content.

Authorship credit should be based only on substantial contributions to (a) either conception and design or else analysis and interpretation of data and to (b) drafting the article or revising it critically for important intellectual content and on (c) final approval of the version to be published. All three conditions must be met. Participation solely in the acquisition of funding or the collection of data does not justify authorship. General supervision of the research group is also not sufficient for authorship. Any part of an article critical to its main conclusions must be the responsibility of at least one author.

Editors may require authors to justify the assignment of authorship.

Increasingly, multicenter trials are attributed to a corporate author. All members of the group who are named as authors, either in the authorship position below the title or in a footnote, should fully meet the criteria for authorship as defined in the "Uniform requirements." Group members who do not meet these criteria should be listed, with their permission, under Acknowledgments or in an appendix (see Acknowledgments).

ABSTRACT AND KEY WORDS

The second page should carry an abstract (of no more than 150 words for unstructured abstracts or 250 words for structured abstracts). The abstract should state the purposes of the study or investigation, basic procedures (selection of study subjects or laboratory animals observational and analytic methods), main findings (specific data and their statistical significance, if possible) and the principal conclusions. Emphasize new and important aspects of the study or observations.

Below the abstract provide, and identify as such, 3 to 10 key words or short phrases that will assist indexers in cross-indexing the article and that may be published with the abstract. Use terms from the medical subject headings (MeSH) list of Index Medicus; if suitable MeSH terms are not yet available for recently introduced terms, present terms may be used.

TEXT

The text of observational and experimental articles is usually - but not necessarily - divided into sections with the headings Introduction, Methods, Results and Discussion. Long articles may need subheadings within some sections, especially Results and Discussion, to clarify their content. Other types of articles, such as case reports, reviews and editorials, are likely to need other formats. Authors should consult individual journals for further guidance.

Introduction

State the purpose of the article. Summarize the rationale for the study or observation. Give only strictly pertinent references, and do not review the subject extensively. Do not include data or conclusions from the work being reported.

Methods

Describe clearly your selection of the observational or experimental subjects (patients or laboratory animals, including controls). Identify the methods, apparatus (manufacturer's name and address in parenthesis) and procedures in sufficient detail to allow other workers to reproduce the results. Give references to established methods, including statistical methods (see below); provide references and brief descriptions for methods that have been published but are not well known; describe new or substantially modified methods, give reasons for using them and evaluate their limitations. Identify precisely all drugs and chemicals used, including generic name(s), dosage(s) and route(s) of administration.

Ethics

When reporting experiments on human subjects indicate whether the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional or regional) and with the Helsinki Declaration of 1975, as revised in 1983. Do not use patient's names, initials or hospital numbers, especially in illustrative material.

When reporting experiments on animals indicate whether the institution's or the National Research Council's guide for, or any national law on, the care and use of laboratory animals was followed.

Statistics

Describe statistical methods in enough detail to enable a knowledgeable reader with access to the original data to verify the reported results. When possible quantify findings and present them with appropriate indicators of measurement error or uncertainty (such as confidence intervals).

Avoid sole reliance on statistical hypothesis testing, such as the use of p values, which fails to convey important quantitative information. Discuss eligibility of experimental subjects. Give details about randomization. Describe the methods for and success of any blinding of observations. Report treatment complications. Give numbers of observations. Report losses to observation (such as dropouts from a clinical trial). When possible, references for study design and statistical methods should be to standard works (with page numbers stated) rather than to the papers in which the designs or methods were originally reported. Specify any general-use computer programs used.

Put general descriptions of methods in the Methods section. When data are summarized in the Results section specify the statistical methods used to analyze them. Restrict tables and illustrations to those needed to explain the argument of the paper and to assess its support. Use graphs as an alternative to tables with many entries; do not duplicate data in graphs and tables. Avoid non-technical uses of technical terms in statistics, such as "random" (which implies a randomizing device), "normal," "significant," "correlation" and "sample." Define statistical terms, abbreviations and most symbols.

Results

Present your results in logical sequence in the text, tables and illustrations. Do not repeat in the text all the data in the tables or illustrations: emphasize or summarize only important observations.

Discussion

Emphasize the new and important aspects of the study and the conclusions that follow from them. Do not repeat in detail data or other material given in the Introduction or the Results section. Include in the Discussion section the implications of the findings and their limitations, including implications for future research. Relate the observations to those of other relevant studies. Link the conclusions with the goals of the study but avoid unqualified statements and conclusions not completely supported by your data. Avoid claiming priority and alluding to work that has not been completed. State new hypotheses when they are warranted, but clearly label them as such. Recommendations, when appropriate, may be included.

ACKNOWLEDGEMENTS

At an appropriate place in the article (title-page footnote or appendix to the text; see the journal's requirements) one or more statements should specify the following: (a) contributions that need acknowledging but do not justify authorship, such as general support by a department chair; (b) acknowledgments of technical help, (c) acknowledgments of financial and material support, specifying the nature of the support: and; d) financial relationships that may pose a conflict of interest.

Persons who have contributed intellectually to the paper but whose contributions do not justify authorship may be named and their function or contribution described - for example, "scientific advice." "critical review of study proposal," "data collection" or "participation in clinical trial." Such persons must have given their permission to be named. Authors are responsible for obtaining written permission from persons acknowledged by name, because readers may infer their endorsement of the data and conclusions.

Technical help should be acknowledged in a paragraph separate from those acknowledging other contributions

REFERENCES

Number references consecutively in the order in which they are first mentioned in the text. Identify references in text, tables and legends for illustrations by arabic numerals in parenthesis. References cited only in tables or in legends should be numbered in accordance with a sequence established by the first identification in the text of the particular table or illustration.

Use the style of the examples that follow, which are based, with slight modifications, on the formats used by the US National Library of Medicine in Index Medicus. The titles of journals should be abbreviated according to the style used in Index Medicus. Consult List of Journals Indexed in Index Medicus, published annually as a separate publication by the library and as a list in the January issue of Index Medicus.

Try to avoid using abstracts as references; unpublished observations and personal communications may not be used as references, although references to written, not oral, communications may be inserted (in parenthesis) in the text. Include among the references papers accepted but not yet published; designate the journal and add "in press" in parenthesis. Information from manuscripts submitted but not yet accepted should be cited in the text as "unpublished observations" (in parenthesis).

The references must be verified by the author(s) against the original documents.

Examples of correct forms of references follow.

ARTICLES IN JOURNALS

Standard journal article (List all authors, but if the number exceeds six list six followed by "et al".)

You CH, Lee KY Chey RY, Menguy R. Electrogastrographic study of patients with unexplained nausea, bloating, and vomiting. Gastroenterology 1980 Aug; 79(2): 311-4.

As an option, if a journal carries continuous pagination throughout a volume the month and issue number may be omitted.

You CH, Lee KY, Chey RY, Menguy R Electrogastrographic study of patients with unexplained nausea, bloating and vomiting. Gastroenterology 1980;79:311-4.

Goate AM. Haynes AR, Owen MJ, Farrall M, James LA, Lai LY, et al. Predisposing locus for Alzheimer's disease on chromosome 21. Lancet 1989;1:352-5.

Organization as author

The Royal Marsden Hospital Bone-Marrow Transplantation Team. Failure of syngeneic bone-marrow graft without preconditioning in post-hepatitis marrow aplasia. Lancet 1977;2:742-4.

No author given

Coffee drinking and cancer of the pancreas [editorial]. BMJ 1981;283:628.

Article in a foreign language

Massone L, Borgbi S, Pestarino A. Piccini R, Gambini C Localisations palmaires purpuriques de la dermatite herpetiforme. Ann Dermatol Venereol 1987; 114:1545-7.

Volume with supplement

Miagni F, Rossoni G, Berti F. BN-5202I protects guinea-pig from heart anaphylaxis. Pharmacol Res Commun I988;20 Suppl 5:75-8.

Issue with supplement

Gardos G, Cole JO Haskell D, Miarby D, Paine SS, Moore P. The natural history of tardive dyskinesia. J Clin Psychopharmacol 1988;8(4 Suppl):31S-37S.

Volume with part

Hanly C. Metaphysics and innateness: a psychoanalytic perspective. Int J Psychoanal 1988;69(Pt 3):389-99.

Issue with part

Edwards L, Meyskens F, Levine N. Effect of oral isotretinoin on dysplastic nevi. J Am Acad Dermatol 1989; 20(2 Pt I):257-60.

Issue with no volume

Baumeister AA. Origins and control of stereotyped movements. Monogr Am Assoc Ment Defic I978;(3):353-84.

No issue or volume

Danoek K. Skiing in and through the history of medicine. Nord Miedicinhist Arsb 1982;86-100.

Pagination in roman numerals

Ronne Y. Ansvarsfall. Blodtransfusion till fe patient. Vardfacket 1989;13:XXVI-XXVII.

Type of article indicated as needed

Spargo PM, Manners JM. DDAVP and open heart surgery [letter]. Anaesthesia 1989:44:363-4.

Fuhrmian SA. Joiner KA. Binding of the third component of complement C3 by Toxoplasma gondii [abstract]. Clin Res 1987;35:475A.

Article containing retraction

Shishido A. Retraction notice: Effect of platinum compounds on murine lymphocyte mitogenesis [Retraction of Alsabti EA, Ghalib ON, Salem MH. In: Jpn J Med Sci Biol 1979; 32:53-65]. Jpn J Med Sci Biol l980;33:235-7.

Article retracted

Alsabti EA, Ghalib ON, Salem MH. Effect of platinum compounds on murine lymphocyte mitogenesis [Retracted by Shishido A. In: Jpn J Med Sci Biol 1 980;33:235-7]. Jpn J Med Sc Biol 1979;32:53-65.

Article containing comment

Piccoli A, Bossatti A. Early steroid therapy in IgA nephropathy: still an open question [comment]. Nephron 1989; 51:289-91 I. Comment on: Nephron 1988;48:12-7.

Article commented on

Kohayashi Y, Fujii K, Hiki Y, Tateno S, Kurokawa A, Kamiyama M. Steroid therapy in IgA nephropathy: a retrospective study in heavy proteinuric cases [see comment]. Nephron 1988;48:12-7 Comment in; Nephron 1989; 51:289-91.

Article with published erratum

Schofield A. The CAGE questionnaire and psychological health [published erratum appears in Br J Addict 1989; 84:701]. Br J Addict 1988;83:761-4.

BOOKS AND OTHER MONOGRAPHS

Personal author(s)

Colson JH, Armour WJ. Sports injuries and their treatment. 2nd rev. ed. London: S. Paul, 1986.

Editor(s) or compiler(s) as author(s)

Diener HC, Wilkinson M, editors. Drug-induced headache. New York: Springer-Verlag, 1988.

Organization as author and publisher

Virginia Law Foundation. The medical and legal implications of AIDS. Charlottesville: The Foundation, 1987.

Chapter in a book

Weinstein L, Swartz MN. Pathogenic properties of invading microorganisms. In: Sodeman WA Jr, Sodeman WA, editors. Pathologic physiology: mechanisms of disease. Philadelphia: Saunders, 1974:457-72.

Conference proceedings

Vivian VL, editor. Child abuse and neglect: a medical community response. Proceedings of the First AMA National Conference on Child Abuse and Neglect; 1984 Mar 30-31; Chicago. Chicago: American Medical Association, 1985.

Conference paper

Harley NH. Comparing radon daughter dosimetric and risk models. In: Gammage RB, Kayc SV, editors. Indoor air and human health. Proceedings of the Seventh Life Sciences Symposium; 1984 Oct 29-31; Knoxville (TN). Chelsea (MI): Lewis, 1985:69-78.

Scientific or technical report

Akutsu T. Total heart replacement device. Bethesda (MD):National Institutes of Health, National Heart and lung Institute; 1974 Apr. Report No.: NIH-NHLI-69-2185-4

Dissertation

Youssef NM: School adjustment of children with congenital heart disease [dissertation]. Pittsburgh (PA): Univ. of Pittsburgh, 1988

Patent

Harred JF, Knight AR, McIntyre JS, inventors. Dow Chemical Company. assignee. Epoxidation process. US patent 3,654,317.1972 Apr 4.

OTHER PUBLISHED MATERIAL

Newspaper article

Rensberger B, Specter B: CFCs may be destroyed by natural process. The Washington Post 1989 Aug 7; Sect A:2(col 5).

Audiovisual

AIDS epidemic: the physician's role [videorecording]. Cleveland (OH): Academy of Medicine of Cleveland, 1987.

Computer file

Renal system [computer program]. MS-DOS version. Edwardsville (KS): Medi-Sim, 1988.

Legal material

Toxic Substances Control Act Hearing on S.776 Before the Subcomm. on the Environment of the Senate Comm. on Commerce, 94th Cong., 1st Sess. 343 (1975).

Map

Scotland [topographic map]. Washington: National Geographic Society (US), 1981.

Book of the Bible

Ruth 3:1-18. The Holy Bible. Authorized King James version. New York: Oxford Univ. Press, 1972.

Dictionary and similar references

Ectasia. Dorland's illustrated medical dictionary. 27th ed. Philadelphia: Saunders, 1988:527.

Classical material

The Winter's Tale: act 5, scene 1, lines 13-16. The complete works of William Shakespeare. London: Rex, 1973.

UNPUBLISHED MATERIAL

In press

Lllywhite HD, Donald JA. Pulmonary blood flow regulation in an aquatic snake. Science. In press.

TABLES

Type each table double spaced on a separate sheet. Do not submit tables as photographs. Number tables consecutively in the order of their first citation in the text and supply a brief title for each. Give each column a short or abbreviated heading. Place explanatory matter in footnotes, not in the heading. Explain in footnotes all nonstandard abbreviations that are used in each table. For footnotes use the following symbols, in this sequence: *, §, , **, §§, etc.

NOTE: Some of the symbols suggested in the Uniform Guidelines have been left out in these instructions and should not be used in submissions to JOSMC. They are not contained in the ISO Latin-1 character set used in HTLM documents.

Identify statistical measures of variation such as standard deviation and standard error of the mean. Do not use internal horizontal or vertical rules. Be sure that each table is cited in the text. If you use data from another published or unpublished source, obtain permission and acknowledge fully.

The use of too many tables in relation to the length of the text may produce difficulties in the layout of pages. Examine issues of the journal to which you plan to submit your paper to estimate how many tables can be used per 1000 words of text.

The editor, on accepting a paper, may recommend that additional tables containing important backup data too extensive to publish be deposited with an archival service, such as the National Auxiliary Publication Service in the United States, or be made available by the authors. In that event an appropriate statement will be added to the text. Submit such tables for consideration with the paper.

ILLUSTRATIONS

Submit the required number of complete sets of illustrations, or "figures." Figures should be professionally drawn and photographed; freehand or typewritten lettering is unacceptable. Letters, numbers and symbols should be clear and even throughout and of sufficient size that when reduced for publication will still be legible. Titles and detailed explanations belong in the legends, not on the illustrations themselves.

If photographs of persons are used, either the subjects must not be identifiable or their pictures must be accompanied by written permission to use the photographs.

Figures should be numbered consecutively in the order of their first citation in the text. If a figure has been published acknowledge the original source and submit written permission from the copyright holder to reproduce the material. Permission is required irrespective of authorship or publisher, except for documents in the public domain.

LEGENDS FOR ILLUSTRATIONS

Type legends for illustrations double spaced, starting on a separate page, with arabic numerals corresponding to the illustrations. When symbols, arrows, numbers or letters are used to identify parts of an illustration, identify and explain each one clearly in the legend. Explain the internal scale and identify the method of staining in photomicrographs.

UNITS OF MEASUREMENT

Measurements of length. height, weight and volume should be reported in metric units (metre, kilogram, litre etc.) or their decimal multiples.

Temperatures should be given in degrees Celsius. Blood pressures should be given in millimetres of mercury.

Hematologic and clinical chemistry measurements should be reported in the metric system in terms of the International System of Units (SI). Editors may request that alternative or non-SI units be added by the author before publication.

ABBREVIATIONS AND SYMBOLS

Use only standard abbreviations. Avoid abbreviations in the title and in the abstract. The full term for which an abbreviation stands should precede its first use in the text unless it is a standard unit of measurement.