I mean, welcome 2021. This is an opportunity for us to obviously get back to our routine lectures and discussions. And one of the things that Alexei and I had talked about was I know that there is an increasing interest in many from Russia to potentially submit manuscripts to ideally our journal. And I think that often there is a lack of official training in our residency or in our fellowship as to how to potentially write a manuscript and how to put a manuscript together. So I thought that this would be a great opportunity for us to sit and discuss what are some of the things that we look for when you are writing a manuscript and what are some of the things that would hopefully increase the likelihood of publication when writing a scientific manuscript. And certainly, I will be happy to obviously answer questions at any point at the end of the discussion. But also, if you do wish to interrupt at any point, that would be totally fine as well. So I think that certainly when we look in the journal as to what are the criteria for publication, I know that in many institutions, there's different reasons for publications. And ideally, we're all publishing to advance the field of gynecologic oncology. We want to make sure that obviously we publish good research to help our patients and help our colleagues in the management of disease. So what are some of the things that we look for as high priority? And what are some of the things that we don't really give very high priority and therefore low priority? When looking at high priority publications, typically one of the things that we want to see is, of course, obviously new and original research. And that's always very appealing to any journal. Certainly, when you provide a new addition to the literature, something that hasn't been published before, that is always very, very appealing. So of course, obviously, prospective randomized trials are going to get published absolutely very easily. And it just depends on the trial. And it depends on how the trial was designed that will determine which journal it will go to. If obviously considering that often when many of us look and say, well, writing a prospective randomized trial takes too long. And of course, obviously, that's going to take two, three years to complete. So what are some of the other things that could potentially be of interest to any journal when looking at publications? And certainly, when you look at retrospective literature, so say, for example, you have information in your hospital about a particular patient population, a particular disease site. Obviously, then that will also be appealing, provided that it is a large retrospective series. So generally, if you're looking at publishing on a particular topic that has already been published, ideally, you want to have the highest number of that particular topic. So say, for example, if you say, well, I want to publish on cervical neuroendocrine carcinoma. Of course, that's a rare disease. But if you have a series of 200 or 300 neuroendocrine carcinomas of the cervix, of course, that's going to be very appealing to any journal. Also, interestingly, anytime data contradicts previously published results, that is also appealing. So for example, if in a certain patient population, it shows that the complication rate may be 20%, after a particular surgery, and all the papers consistently show 18%, 20%, 22%, but all of a sudden, in your series, you show that because of something unique that you did, that complication rate is 5% or 3%. Then of course, obviously, that's also very interesting to the publishers and the reviewers. Also, reviews on relevant topics. A lot of times you might say, well, in our hospital, we don't have a database or we have to look for all of this information, but ideally, I want to write something that will get published and something that will provide a benefit to our community of gynecologic oncologists. So actually, a review, be it a systematic review or a meta-analysis, but a review that is well-written is also very appealing to the journals. As an example, you might say, well, I want to write a review on mucinous carcinomas of the ovary. And if that is a well-written review, recently, about a year ago, there was a review on mucinous carcinomas of the ovary in the New England Journal of Medicine. So one of the highest-ranked journals publishing a review on something, you might say, well, I mean, certainly that's something that I could have done and that's something that's feasible, but it has to be obviously very well-written. And then of course, obviously, there are journals who take videos of new techniques or videos of a particular surgery, and that may also be appealing in terms of a publication for you. And then the other thing is that for videos, many journals actually will use that as something that you can reference in your CV, in your curriculum vitae. So that's also important. Now, things that are low-priority typically are things like a letter to the editor or a commentary or an editorial, and definitely not case reports. Most journals today do not like to publish case reports because typically for the journal, ideally what the journal wants is that the papers that are published in the journal are referenced routinely, and case reports are typically not referenced very routinely. They might be interesting to you or to your department, but they typically don't get referenced a lot. And one of the other things also that I highlight is that very low-priority, do not get involved in a project where we're just gonna show what somebody else actually showed. So, you know, say for example, you say, well, we wanna know about what are the results of endometrial cancer laparoscopy outcomes, Blahin-Konstantin. Well, you know, most likely you're gonna show that it is okay and laparoscopy can be performed. So that's what they call as a Me Too paper, sort of like, oh, I saw the same thing in my center. Those usually don't have much appeal and usually shouldn't waste your time doing that because then most journals are gonna reject it. Because again, they're gonna say, what's new? You haven't shown anything. Yeah, but we wanted to see in our center, in Moscow, what it was like. Well, but what makes you think that in Moscow is gonna be different than anywhere else? So that's also important. Now, the other element is finding a topic of interest. And I think it's important to look at the literature and research to assure what hasn't been published before. And I think, again, that goes back to what is going to be new. So if you're looking at the journals that you typically read, Gynecologic Oncology, International Journal, American Journal of Obstetrics and Gynecology, all of these journals, and you're seeing papers that have already been published on your point of interest, then most likely it's not going to be very appealing. And also obviously reviewing the current literature to see what's been published already. It's also important to discuss with an expert in the field as to whether your idea is a good idea. So in other words, if you're writing about vulvar cancer lymphadenectomy, ideally talk to somebody who has experience in that area, who has an interest in that area, so that you're not replicating or you're not doing something that has already been done in multiple other papers. And then you find out at the end of the study that this has already been done and there's really nothing that is so exciting about it. And I say, not just a friend, because obviously your friends and colleagues are going to try to be nice. And then if you say, hey, I want to talk about conization and whether conization increases delivery prematurity. And you might say, oh yeah, that sounds like a great idea. Go ahead, do that. You're a very nice person. No, I mean, actually talk to somebody that is in that field and knows that field. The other element is that reviewers today, they want to know what is it that you're offering that is new. So they're going to look for in that paper where you say, everything was known up to this point. And this is what I'm actually offering that is new. So always make that very relevant in your paper. And not saying, well, this is the best paper or this is the most comprehensive paper, but offer something that is new to the literature and you have to actually document that in the paper. The other thing also is that going to abstracts or posters and meetings, I think also is helpful because then you kind of see what is happening in the field. And I think this is also important because say you're working on a project and or you have an idea on a project and you go to the meetings, a national meeting in Moscow and in St. Petersburg or anywhere in Europe or in the United States. And you see that it's already in an abstract presentation and it's already in a poster. It's very likely that that group has already submitted the paper. So therefore you may not want to restart that whole process to doing basically the same study. So I think that that's important. And then one of the things that we always say here is discuss it in a group conference. So that it is not just you and one of your colleagues thinking this is a great idea. And then all of a sudden find out three months later that two of your other colleagues have also been working on exactly the same thing. And then obviously that may bring some tension and some difficulty because it is, well, I was starting to do this first and now I have been working on this before. So always ideally as a department, always talk about what projects we're working on so people are not going to be repeating it. In terms of finding a journal, obviously it's looking at realistic expectations. And if you have a retrospective small study, most likely you're not gonna send this to the New England Journal of Medicine because you know that they're only gonna take prospective randomized trials. The other thing is also remembering that you need to determine who your target audience might be because if you want your community of gynecologic oncologists, your colleagues, to see your work, ideally then you wanna send it to a journal that is gonna be read by your colleagues. So sometimes you may say, well, I have this paper on wound drains after lymphadenectomy and you send it to a journal in general surgery. It might be accepted in that journal, but most of your colleagues are probably not gonna see that paper. So also think about where do you want to put it so that your colleagues will have access to it. Also evaluating the scope of the journal. So if you have a surgical manuscript, a surgical paper, typically you're not gonna send it to the Journal of Clinical Oncology. Yes, it's a great journal, but it mostly publishes medical things, not surgical things. So you always want to assure that to be the case. Then another tip is to look at the other articles in that journal, because you might say, well, I have a paper on gestational trophoblastic disease, but the journal really just publishes things on surgery and surgery and surgery and surgery. So that may not be a good fit for that journal. And then also looking at the impact factor, and we can talk a little bit about why that's important, but in some institutions around the world, it's not just the number of publications that you have. If, for example, you're going to go for a promotion and you go to your boss and you say, look, I have 27 publications or I have 100 publications, in some institutions, it's not just the number, but they also look at the impact factor of the journal. Because for some institutions like ours, for example, they'd rather have somebody publish 10 papers in very high impact factor journals than 80 papers in very low impact factor journals. So they also look at that as well. Now, going to writing the manuscript, you already have your idea, you've done your work, how do you write it? And how do you increase your likelihood that this is going to be published? One of the things that I think many residents, fellows, myself, when I was starting as well, we always feel that the more words that I say, the better. So the bigger the amount of material in the manuscript, the better it's going to be. And actually that's completely the opposite. You have to be very concise and to the point. Go exactly to the point that is relevant and important. The other thing is also a manuscript should tell a story. Where begins the middle and the end? So in other words, if you're writing about radical tricholectomy, you might want to say something about when the radical tricholectomy was first performed, how the papers that have been written since then have impacted the field, and then what is missing that you're going to add. So it kind of has that story and that's how it should read. The other is that it's very important not to use non-scientific language. So I think that particularly in the beginning we're all driven to say things that are praising of our work. So this is the greatest manuscript written out of this institution or this is the lowest complication rate ever. Those are just descriptive words and you should actually just refrain from using that. Don't use things that are so general like for example we perform this laparoscopy in the easiest manner possible. What's the easiest manner possible? That's not objective. The blood loss was less than expected. We don't know what you expected so just say the blood loss was 45 milliliters. The length of stay was three days. The approach was done as routine. Don't use that because the reader doesn't know what is routine so therefore be as concrete as possible. Again you know certainly the element of don't use this language of very short or the sentinel lymph node detection was outstanding or the complication rates were minimal because all of those things could mean very different. So for example minimal for me may be three percent and minimal for Alexei may be 15 percent. So we don't know. Just say what it was and then that's that should be the target. The other thing is also for individuals who are non-English speaking don't use Google Translate to translate your paper because often Google Translate is not the best strategy and it doesn't translate it very very well. The title. The title should represent the overall message of the paper. So often there's a title that doesn't really match with what is in that paper. That is also very very important because if you're looking and your title says quality of life after radical hysterectomy and everything in your paper is about complications you're not really saying anything about quality of life and then the title should reflect that it is something about complications. Typically the order of the authors. The first author generally is the person who wrote it and did most of the work. The last person generally is the person who was either the co-principal investigator or the person who developed the idea and is ultimately responsible for the paper. So first is whoever wrote it and did most work. Last is whoever thought about it and whoever really led the project itself. Second here we put in our institutions usually the next in contribution or whoever's going to be next in promotion and we can talk about that. The abstracts usually is a very concise 250 words or less and also the abstract should be very concrete about your results and remember a lot of times the abstract is the only thing that people will read when writing a manuscript. The introduction we always say it should not be any longer than three or four paragraphs. The first paragraph should be the background information. The second paragraph how relevant is the subject of interest and the third is what you're bringing in as the new contribution. Where is the gap in knowledge? What is the goal of your study? One of the other things also is that we stress that particularly as we say the goal of the study it shouldn't be that you have a study where you say the goal of the study was to look at complication rates, length of stay, recurrence rate, disease-free survival, and overall survival. Generally you should have one primary objective. Let's say was recurrence rates and then the secondary objectives disease-free survival, overall survival, complications, and things other than that but it should be one primary and then multiple secondaries. The methods always most journals will require you to have a statement as to your IRB approval and that's very important because also there are groups of authors who will say oh in my institution we don't need an IRB approval to to do this study and it's okay that that's why we didn't say anything about the IRB approval. You have to be careful with that because some institutions some journals will say well I want a letter from the IRB of your institution saying that for that study you don't need an IRB approval so you have to be careful in that sense. The method should also talk about the data that was collected. What was actually collected? Who was the study group? The details of ease of replication so in other words the methods it's also a an outline of how somebody else could say they did this study in Moscow. We want to repeat it in St. Petersburg and we we should get exactly the same results if we follow it exactly as they did it in Moscow. So it has to be you have to explain the methodology in terms of we included these patients, we excluded these patients, these were the criteria for defining overall survival disease free survival. So that's very important and also the methods of the statistical analysis and one thing that I would always stress is before beginning any study definitely obviously retrospective but also retrospective talk to a statistician so that you will be able to answer that question and I what I mean by that is that if for example you want to look at recurrence rates in patients with grade one endometrial cancer and you say well I have 40 patients the statistician is going to tell you in grade one endometrial cancer the recurrence rate is so low that if you compare two groups 40 patients versus another 40 patients most likely you're not going to see any difference because the recurrence rate is so low so therefore you need to talk to a statistician to make sure you have the appropriate number of patients for that study. And then of course obviously a consent if the subjects of the patients are alive or it's a prospective study. If you randomize what was the process of randomization and one of the things also is that never say a study is prospective if it was not prospective and a lot of people love to do this and say we collected data prospectively and then we look back on the results that's a retrospective study that's not a prospective study so that's very important. In the results it should reflect everything you were collecting in the methods so in other words if you say in the methods we're going to collect age, body mass index, complications, length of stay, then in the results you would want to see what was the median age, what was the body mass index, so that it reflects exactly where you're saying that you're going to be collecting. Always begin with a number of patients that were included and provide data in chronological sequence and what I mean by that is that say for example you're talking about a surgical intervention typically you begin with with the age with the stage and then with the intraoperative complications, blood loss, then the length of stay, then the long-term outcomes so everything happens in the sequence of how it happened in real life so you wouldn't start the results by saying out of 300 patients the recurrence rate was three percent and the length of stay was five days and then the intraop blood loss was this so it's kind of like everything is sort of like mixed so always in the same sequence that you saw the patient. Incredibly important one of the often main reasons why papers get rejected right away is that if a reviewer and I know of many reviewers that will go straight to the tables and if they see that your total number of patient was 250 and your categories of stage add up to 230 and your categories of grade add up to 270 and your category of procedures adds up to a different number then you basically say none of these numbers are correct so therefore reject so make sure always look to to make sure that if in the abstract you put complication rate was 23 percent then in the results it says 23 percent that if you say you have 250 patients that all of the all of the patients add up to 250 to make sure that everything adds up and of course obviously then provide the data that will be of interest to the reader in the results do not interpret the data don't say surprisingly we found that the blood loss was five milliliters or we were very encouraged that the length of stay was two days this the result is not for your opinion it doesn't matter if you were surprised it doesn't matter if you were encouraged the results is basically to show the facts the data the numbers that's it you just shouldn't interpret it as to whether you think it's high or you think it's low or whether you were impressed or not impressed so that's uh very important to just state the facts and then lastly in the discussion always begin with a single statement as to what is your overall finding what is the main takeaway message and not like a general comment of you know overall this surgery provides a great outcome for patients yeah that could be said about basically anything uh explain what were your results basically in this study we found that there was no difference in complication rates between patients who had a full lymphadenectomy versus sentinel lymph node mapping period that's your finding that's your result do not repeat the results so do not repeat well we found that it was 54.6 and we determined that the length of stay was seven days all of that it's already in the results not in the discussion um you have to place it in context of the published literature so why are your findings similar or different from the literature and explain the reasons why you shouldn't just say in our study we found that there were no complications and in the literature every other paper shows that the complication rate is 70 and you you can't just leave it out like that you have to say well the reason for this might be x y and z um also include comparisons to major articles so if you're talking about just as an example if you're talking about um laparoscopic surgery in uterine cancer you have to talk about the study gog lab 2 or the study the lace study which were the biggest prospective randomized studies in that topic so you shouldn't refer to a small study from you know i don't know taiwan or united states where they talk about this uh this particular topic um always including the strengths and the weaknesses of the of the study and uh and be realistic again about the strengths not just saying this is a really great paper because it's from our group and we're really famous uh obviously you know provide valuable strengths or weaknesses and then also what are the future directions what should we what should we learn from this and many reviewers will also ask you based on the findings that you had so say for example you say well in our institution we found that with the use of this medication the complication rates after surgery were lower a lot of times you know the reviewers will say so now in your institution do you only use that medication or do you still use the five other medications that we were used to using so i'll propose what what you're doing in in terms of your own practice um in the in the current time um and then also don't make editorial statements don't make statements like you know we feel that this is a great contribution to the literature or we consider that this is the strongest paper um in the last 10 years these are only your personal opinions these are your editorial so certainly should not include that type of information and as it pertains to the references always look at the guide for authors always double check the spelling and specifics of the citation um keep the references only to relevant ones and what i mean by that is that you you have two papers that looked at laparoscopy uterine cancer prospective studies you can use those two as the main references rather than putting 15 references of smaller papers that basically showed the same thing and then also uh think about including references of a potential reviewer so you know if you're writing a topic about pathology that anaplotkin has written about 10 papers then of course obviously use those references because high likelihood that anaplotkin is going to be reviewing your paper so she is going to be very alert and aware as to whether you're referencing her work in this particular topic this is again uh just information if you look here at the international committee of medical journal editors it'll tell you what the authorship should be um how the draft uh the article should be revised and and and certainly the the the responsibility of uh of each author and that's i think very very important this is what happens when the journal uh the manuscript comes to the journal we basically make a decision to accept right away that never happens um reject right away and that means that we don't think it's actually going to ever have a chance of being published um or um minor revisions major revisions or reject with review and we can talk about um those specific categories as well so with that i'll uh finish there and uh and i'll be happy to answer any questions you you might have with regards to the um to the presentation or anything else related to that to that topic hello pedro what does mean irb

IRB

Institutional Review Board

research studies

human subjects

ethical guidelines

participant rights

welfare