Effective Clinical Practice
Guidance for Authors
|Note: Due to budgetary pressures on our sponsors, the American College of Physicians-American Society of Internal Medicine, Effective Clinical Practice will not be published in its current format past the May/June 2002 issue. Therefore, for the time being we will not be accepting new manusripts.|
Original manuscripts that report on the result of an intervention, the test of a hypothesis, or the effect of a natural experiment.
The word case no longer refers to a patient; instead, case reports describe the experience of a single provider, practice, hospital, or health system. Case reports may describe the effect of a change in how patients are managed, who provides their care, how practices are evaluated, or the impact of new information systems.
Manuscripts that comment on current issues in health care policy or ethical dilemmas in clinical care.
Effective Clinical Practice also has three special sections that we believe represent a unique venue for investigators to share their work. Potential contributors may e-mail us at email@example.com to receive examples of articles in each section.
Back of the Envelope
Simple, explicit estimates of how new clinical strategies affect the "bean count." Beans, in this context, can be numbers of dollars, doctors, procedures, life-years, or patients. Although we welcome formal decision analyses, the most important element here is a good idea, sound reasoning, a reliable data source, and perhaps a spreadsheet.
Patterns of Practice
Manuscripts detailing current practice patterns (e.g., testing, treatment, patient communication, or financial/legislative policies that are relevant to practice). The section is not for manuscripts that "test" a hypothesis but rather a careful description of what's really happening out there.
Unanswered Questions: Research under Construction
Manuscripts that 1) articulate the case for investigating a particular problem, 2) outline one or more possible study designs, and 3) honestly acknowledge the limitations of the proposed approach.
Author Queries prior to Submission
We encourage authors to ask about the appropriateness of their manuscript for Effective Clinical Practice. One of the best ways to test the waters is to e-mail the abstract to firstname.lastname@example.org.
The editors of Effective Clinical Practice put a premium on making material accessible to readers. We ask that authors write simply. To ensure that the organization of the paper is obvious, we encourage frequent use of subheadings. Although this is often done in the Methods section (e.g., Overview, Setting, Measures), we encourage authors to consider them for the Results and Discussion as well.
Brevity is important. The article should be between 1500 and 3000 words (excluding take-home points, abstract, tables, and other ancillary content). We encourage authors to develop creative ways to economize on words. For example, literature reviews can be synthesized in a table and many elements of the study design can be illustrated in a figure. To help ensure that our interest in brevity does not sacrifice relevant methodologic detail, we will also consider appendices.
Take-Home Points and Abstracts
A short listing of up to five central points should accompany each manuscript. Specific guidance on take-home points appears on the next page. All manuscripts, except commentaries, should have a structured abstract (no more than 250 words). The specific abstract headings for each journal section may be tailored to the material presented.
Visual displays of information are enthusiastically encouraged. Tables should be used to display precise numeric data. They can also be used to display distinct categories of qualitative information involving multiple units (e.g., to explain a series of measures or to summarize a series of articles). Figures may range from conventional displays of quantitative data (e.g., bar graphs or histograms) to innovative displays of qualitative information (e.g., schematics). We suggest that authors communicate their primary result in a figure. We also encourage the use of tables and figures to communicate the methods.
References should be numbered consecutively in the order in which they are first mentioned in text (or tables or legends) with Arabic numerals. Reference listings should use the form adopted by the U.S. National Library of Medicine, including the abbreviations of journal titles. All authors and editors are listed when there are six or fewer; when there are seven or more, the first three are listed and followed by "et al." Books:
Ringsven MK, Bond D. Gerontology and Leadership Skills for Nurses. 2d ed. Albany, NY: Delmar; 1996.
Norman JJ, Redfern SJ, eds. Mental Health Care for Elderly People. New York: Churchill Livingstone; 1996.
3. Chapter in a book.
Phillips SJ, Whisnant JP. Hypertension and stroke. In: Laragh JH, Brenner BM, eds. Hypertension: Pathophysiology, Diagnosis, and Management. 2d ed. New York: Raven Pr; 1995: 465-78.
Journals: Vega KJ, Pina I, Krevsky B. Heart transplantation is associated with an increased risk for pancreatobiliary disease. Ann Intern Med. 1996;124:980-3.
For further guidance on manuscript preparation, see Welch HG. Preparing manuscripts for submission to medical journals: the paper trail. Eff Clin Pract. 1999; 2: 131-7, or e-mail email@example.com.
Submit three copies of the manuscript (including all figures and tables) to: Editor, Effective Clinical Practice, VA Outcomes Group-111ECP, White River Junction, VT 05009 or send them via e-mail to firstname.lastname@example.org. Submissions must be in English, be double-spaced, and have all pages numbered. Manuscripts are considered for publication with the understanding that they have not been published elsewhere and that they have been submitted solely to Effective Clinical Practice. The cover letter should 1) indicate this understanding; 2) disclose financial interests or other commitments that represent potential conflict of interest; and 3) identify a corresponding author (and provide his or her address, e-mail address, telephone number, and fax number). Unless specifically requested, submitted manuscripts, photographs, and letters are not returned.
Many manuscripts will have no doubt been submitted to other journals and will have been reviewed previously. When submitting your manuscript, please include prior reviews, even if you have not responded to them. (If you have responded, include your response in the cover letter.) Previous external reviews often identify areas for improvement. And sometimes they completely miss the mark. The criticisms contained in a review are useful information for us, but will not dictate our editorial decision. You should know, however, that substantive reviews (complimentary or critical) may obviate the need to send the manuscript out for further peer review. Thus, previous reviews may streamline the editorial process—they will not determine the outcome.
Unlike most journals, Effective Clinical Practice targets its editorial effort early in the review process. We work hard to better prepare manuscripts that interest us for external review and frequently request changes beforehand. Although this may seem like an additional step in the review process, only manuscripts that we would like to publish receive this effort. Our intent is to make it easier for outside reviewers to focus on content and specific methodologic issues. This "front loading" of effort also allows us to promptly return manuscripts that do not interest us. We strive not to tie up a manuscript unnecessarily—most of our rejections are communicated within 2 or 3 weeks.
The editors welcome submissions for the Letters section. Letters should be double-spaced, not exceed 300 words, and not have more than three references. Send three copies and a cover letter clearly indicating whether the letter is intended for publication.
Articles published in Effective Clinical Practice are indexed by the National Library of Medicine. Abstracts are available on PubMed (http://www.ncbi.nlm.nih.gov/PubMed/).
Reprints are available. An order form is included in the package containing proofs for author review. Reprints in quantities that exceed 100 may also be ordered by contacting the Effective Clinical Practice Reprints Coordinator at 800-523-1546 ext. 2657; fax: 215-351-2644; or e-mail: email@example.com.
Take Home Points
Take-home points are three to five brief statements that appear in a box at the end of each original article. A take-home point may motivate the reader to care about a problem, give some sense of the method used to address it, convey the primary result, or disclose a caveat or implication. Although there is no single correct approach, attempts should be made to address the following questions when composing take-home points:
- Why did you do this study? (provide some context about the topic investigated)
- What did you do? (a brief statement of the method)
- What did you find? (convey the major findings)
- Given what you know, what would you suggest others do? (consider the iimplications)
Effective Clinical Practice Presentation Guidelines
Make the organization of the manuscript explicit.
- Provide a structured abstract; tailor the specific headings for each section to the material presented.
- Use subheadings frequently throughout the Methods, Results, and Discussion sections.
Help readers interpret your numbers.
- If you are reporting ratio measures (e.g., relative risks or odds ratios), make sure that absolute event rates are displayed prominently.
- When absolute event rates are known, convert odds ratios into relative risks.
- If you are reporting results based on multivariate adjustment, make sure that crude results are also reported.
- If you are reporting results by using a scale or scoring system, please provide the following information:
- Range (highest and lowest possible)
- Direction (is higher better or worse?)
- Clinical correlations (what does a score of 50 mean? what is a change of 5 points equivalent to?)
Make methodologic details accessible.
When reporting the effect of an intervention: Provide a concise, yet informative, description of what the intervention involved (something more than “quality improvement process” or “1-day workshop”). Various components of the intervention should be detailed in a table (or an appendix).
When reporting survey data: Provide exact language of questions (and response categories) for the items that constitute the primary result. This is best done when reporting the results (in a table, figure, or text in the results section) rather than the methods. Include a copy of the survey instrument with the submission.
Look for opportunities to communicate visually.
- Illustrate the study design and/or sample selection by using a flow diagram.
- Summarize supporting literature in a table.
- Communicate the primary result by using a figure.
- Consider using figures to report multiple confidence intervals.
- When sample sizes are small (e.g., < 100), consider plotting individual data points.
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