Opinion
Editorials represent the opinions of the authors and JAMA and not those of the American Medical Association.
EDITORIAL
Editorial Matters Guidelines for Writing Effective Editorials Phil B. Fontanarosa, MD, MBA
Virtually every scientific journal publishes editorials or other opinion articles that accompany research articles or other reports or that present views and perspectives of the editors of the journal related to a published article, current issue, or journal policy. The most effective editorials are concise and detailed, authoritative and scholarly, and insightful and thoughtprovoking. Given these desirable attributes of editorials, yet considering that many editorials are written with tight timelines, this article is intended to provide guidance for writing effective and informative editorials to accompany research articles. Editorials that accompany research articles are intended to provide perspective and texture to help with interpretation and application of the study findings, or to underscore important aspects of the study that have major implications for clinicians or researchers. These editorials usually are solicited by the editorial staff and are intended to provide balance and caveats that help place the study finding in context and provide thoughtful and insightful information that goes beyond the issues covered in and raised by the authors of the article the editorial accompanies. Because many readers might first read the editorial to determine whether to read the article, a good editorial will also provide a concise summary of the article it accompanies and highlight the implications of the study findings for clinical care, research, or health policy.
Editorial Format and Content The title of an editorial is important and must be carefully prepared. The title should indicate the topic being addressed so the editorial will be identified in literature searches. The use of subtitles or questions in titles of editorials can be effective in signaling the content discussed, imparting context, and perhaps drawing interest in reading the editorial. However, as with the titles of other articles, titles of editorials should not be trite or flippant or possibly be construed as trivializing a disease process or condition. Although the length and format of editorials can vary widely by journal, most editorials in general medical journals are relatively concise and usually occupy no more than approximately 2 printed pages. For JAMA, this translates to approximately 1200 to 1300 words of text with approximately 10 references, or approximately 9 or 10 average-sized paragraphs. A suggested approach to formulating a logical framework for an editorial that accompanies and comments on a research report or another article includes the following: (1) an introductory paragraph that introduces the topic, describes the
issue, and perhaps presents a statement of the problem that the accompanying study addresses; (2) a summary of the study, including the study design, numbers of study participants, and numerical data (such as absolute event rates) for the key outcomes—having this amount of detail helps ensure that readers will not have to turn back to the article to understand the editorial; (3) a description of the key caveats and limitations of the study, especially those not acknowledged by the authors of the article; (4) a balanced discussion that places the findings of the study in context with other relevant research; (5) a comment about the clinical or policy implications of the study findings and perhaps discussion about the next steps in research; and (6) a strong, evidence-based conclusion that presents a clear take-home message for readers. Several recent editorials have followed this general approach and have presented a cogent, cohesive, and compelling discussion of important insights that advanced understanding of the article they accompanied.1-3
Issues to Consider For some journals, editorials solely represent the opinions of the authors, whereas for other journals, editorials represent the position of the journal and a position that the journal editors agree with, similar to editorials published in major newspapers that reflect the opinion of the publication or the editorial page editors. Editorials published in JAMA include the following statement: “Editorials represent the opinions of the authors and JAMA and not those of the American Medical Association.” However, for virtually all journals, an invitation to write an editorial is not a “license to preach.” Accordingly, authors should refrain from making unsubstantiated claims, leveling hypercritical or overly negative comments about the article about which they are commenting, or extrapolating the discussion far beyond the study findings. Editorialists also should avoid interjecting excessive opinion or attempting to use the editorial platform to advance a personal or professional agenda. Most journal editors ensure that editorials have a fairly consistent content, style, and tone. For instance, to ensure clarity, editorials should avoid including highly technical language, jargon, or numerous abbreviations that may be familiar to some specialists or subspecialists in a certain discipline but will be confusing for many readers from other disciplines. Assertions that include data (eg, disease prevalence) or statements about specific facts derived from other sources should include appropriate references. Statements about interpretation of the findings from the study the editorial is accompa-
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Copyright 2014 American Medical Association. All rights reserved.
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Opinion Editorial
nying should be appropriate based on study design. Inferences about causality should be reserved for findings from clinical trials, whereas inferences from findings based on observational studies or meta-analyses should be described with noncausal language in terms of associations or relationships. In addition, for most editorials, readers will benefit much more from having an editorialist present a balanced discussion of the issues based on the available evidence rather than presenting his or her personal perspective, opinion, or anecdotal experience about a topic. Accordingly, personal pronouns such as I or we with self-reference to the authors of the editorial usually are not necessary to include. Perhaps more important, to help ensure that editorials are unbiased, the editors routinely request that prospective authors disclose potential conflicts of interest at the time the authors are invited to prepare an editorial. The editors evaluate this information carefully to determine whether the invited author should prepare the editorial, and evaluate the content of the editorial in light of any disclosure information to help ensure that the editorial is as objective, unbiased, and evidence-based as possible. Because of the relatively brief length of editorials, every sentence is important. Writing and meaning must be clear and terminology used must be carefully chosen and precise. For instance, the use of the collective or royal we to refer to society, the medical profession, or some other entity usually is ambiguous and should be replaced with the specific group to whom we refers. Similarly, the term provider is ambiguous and may refer either to various types of clinicians, such as physicians, nurses, or other health care practitioners; or to various health care delivery entities, such as hospitals, clinics, or other sites; or at times, to both. This term also should be avoided, and instead the group or entity referred to should be speciARTICLE INFORMATION
REFERENCES
Author Affiliation: Dr Fontanarosa is Executive Editor, JAMA.
1. Cappola AR. Testosterone therapy and risk of cardiovascular disease in men. JAMA. 2013;310(17): 1805-1806.
Corresponding Author: Phil B. Fontanarosa, MD, MBA, JAMA, 330 N Wabash Ave, Chicago, IL 60611 ([email protected]). Conflict of Interest Disclosures: The author has completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.
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fied. Moreover, use of the term provider does not recognize the level of professionalism that should be accorded to physicians, especially in a medical journal like JAMA that serves a primary readership of more than 300 000 physician recipients of the print journal each week and reaches close to a half million physicians each week online. Authors of editorials also should avoid overused terms and phrases. For instance, the use of the term impact has become ubiquitous. As a verb (the primary definitions are “to fix firmly by or as if by packing or wedging,” “to press together,” and “to strike forcefully”),4 the use of impact generally is not correct or appropriate (especially in past tense, as impacted) and usually should be replaced with other, more precise terms, like affect or influence. Likewise, when used as a noun, eg, “having an impact” (the primary definitions are “an impinging or striking” and “a forceful contact or onset”),4 or as a modifier, eg, “being impactful,” the term has been so extensively overused that the meaning has been diluted, and more precise language (eg, having a benefit, being beneficial) virtually always could be considered. In addition, given the scholarly and circumspect tone that should characterize editorials, hackneyed phrases, such as “paradigm shift” and “call to action,” as well as embellished language, such as “urgently needed” and “dramatically increased,” usually should be replaced with more appropriate terms. Editorials are an important element of scientific journals and should help to foster informative and responsible discussion of the issues related to articles they accompany. Thoughtfully prepared editorials that use a logical framework along with concise and precise writing and a scholarly tone will be most effective in helping readers understand scientific advances and appreciate the related clinical, research, and policy issues. advanced chronic kidney disease: sins of omission or commission? JAMA. 2014;311(9):913-915. 4. Merriam-Webster’s Collegiate Dictionary. 11th ed. Springfield, MA: Merriam-Webster Inc; 2003.
2. Feero WG. Clinical application of whole-genome sequencing: proceed with care. JAMA. 2014;311(10): 1017-1019. 3. Winkelmayer WC, Turakhia MP. Warfarin treatment in patients with atrial fibrillation and
JAMA June 4, 2014 Volume 311, Number 21
Copyright 2014 American Medical Association. All rights reserved.
Downloaded From: http://jama.jamanetwork.com/ by a Western Oregon University User on 05/29/2015
jama.com
Editorials represent the opinions of the authors and JAMA and not those of the American Medical Association.
EDITORIAL
Editorial Matters Guidelines for Writing Effective Editorials Phil B. Fontanarosa, MD, MBA
Virtually every scientific journal publishes editorials or other opinion articles that accompany research articles or other reports or that present views and perspectives of the editors of the journal related to a published article, current issue, or journal policy. The most effective editorials are concise and detailed, authoritative and scholarly, and insightful and thoughtprovoking. Given these desirable attributes of editorials, yet considering that many editorials are written with tight timelines, this article is intended to provide guidance for writing effective and informative editorials to accompany research articles. Editorials that accompany research articles are intended to provide perspective and texture to help with interpretation and application of the study findings, or to underscore important aspects of the study that have major implications for clinicians or researchers. These editorials usually are solicited by the editorial staff and are intended to provide balance and caveats that help place the study finding in context and provide thoughtful and insightful information that goes beyond the issues covered in and raised by the authors of the article the editorial accompanies. Because many readers might first read the editorial to determine whether to read the article, a good editorial will also provide a concise summary of the article it accompanies and highlight the implications of the study findings for clinical care, research, or health policy.
Editorial Format and Content The title of an editorial is important and must be carefully prepared. The title should indicate the topic being addressed so the editorial will be identified in literature searches. The use of subtitles or questions in titles of editorials can be effective in signaling the content discussed, imparting context, and perhaps drawing interest in reading the editorial. However, as with the titles of other articles, titles of editorials should not be trite or flippant or possibly be construed as trivializing a disease process or condition. Although the length and format of editorials can vary widely by journal, most editorials in general medical journals are relatively concise and usually occupy no more than approximately 2 printed pages. For JAMA, this translates to approximately 1200 to 1300 words of text with approximately 10 references, or approximately 9 or 10 average-sized paragraphs. A suggested approach to formulating a logical framework for an editorial that accompanies and comments on a research report or another article includes the following: (1) an introductory paragraph that introduces the topic, describes the
issue, and perhaps presents a statement of the problem that the accompanying study addresses; (2) a summary of the study, including the study design, numbers of study participants, and numerical data (such as absolute event rates) for the key outcomes—having this amount of detail helps ensure that readers will not have to turn back to the article to understand the editorial; (3) a description of the key caveats and limitations of the study, especially those not acknowledged by the authors of the article; (4) a balanced discussion that places the findings of the study in context with other relevant research; (5) a comment about the clinical or policy implications of the study findings and perhaps discussion about the next steps in research; and (6) a strong, evidence-based conclusion that presents a clear take-home message for readers. Several recent editorials have followed this general approach and have presented a cogent, cohesive, and compelling discussion of important insights that advanced understanding of the article they accompanied.1-3
Issues to Consider For some journals, editorials solely represent the opinions of the authors, whereas for other journals, editorials represent the position of the journal and a position that the journal editors agree with, similar to editorials published in major newspapers that reflect the opinion of the publication or the editorial page editors. Editorials published in JAMA include the following statement: “Editorials represent the opinions of the authors and JAMA and not those of the American Medical Association.” However, for virtually all journals, an invitation to write an editorial is not a “license to preach.” Accordingly, authors should refrain from making unsubstantiated claims, leveling hypercritical or overly negative comments about the article about which they are commenting, or extrapolating the discussion far beyond the study findings. Editorialists also should avoid interjecting excessive opinion or attempting to use the editorial platform to advance a personal or professional agenda. Most journal editors ensure that editorials have a fairly consistent content, style, and tone. For instance, to ensure clarity, editorials should avoid including highly technical language, jargon, or numerous abbreviations that may be familiar to some specialists or subspecialists in a certain discipline but will be confusing for many readers from other disciplines. Assertions that include data (eg, disease prevalence) or statements about specific facts derived from other sources should include appropriate references. Statements about interpretation of the findings from the study the editorial is accompa-
jama.com
JAMA June 4, 2014 Volume 311, Number 21
Copyright 2014 American Medical Association. All rights reserved.
Downloaded From: http://jama.jamanetwork.com/ by a Western Oregon University User on 05/29/2015
2179
Opinion Editorial
nying should be appropriate based on study design. Inferences about causality should be reserved for findings from clinical trials, whereas inferences from findings based on observational studies or meta-analyses should be described with noncausal language in terms of associations or relationships. In addition, for most editorials, readers will benefit much more from having an editorialist present a balanced discussion of the issues based on the available evidence rather than presenting his or her personal perspective, opinion, or anecdotal experience about a topic. Accordingly, personal pronouns such as I or we with self-reference to the authors of the editorial usually are not necessary to include. Perhaps more important, to help ensure that editorials are unbiased, the editors routinely request that prospective authors disclose potential conflicts of interest at the time the authors are invited to prepare an editorial. The editors evaluate this information carefully to determine whether the invited author should prepare the editorial, and evaluate the content of the editorial in light of any disclosure information to help ensure that the editorial is as objective, unbiased, and evidence-based as possible. Because of the relatively brief length of editorials, every sentence is important. Writing and meaning must be clear and terminology used must be carefully chosen and precise. For instance, the use of the collective or royal we to refer to society, the medical profession, or some other entity usually is ambiguous and should be replaced with the specific group to whom we refers. Similarly, the term provider is ambiguous and may refer either to various types of clinicians, such as physicians, nurses, or other health care practitioners; or to various health care delivery entities, such as hospitals, clinics, or other sites; or at times, to both. This term also should be avoided, and instead the group or entity referred to should be speciARTICLE INFORMATION
REFERENCES
Author Affiliation: Dr Fontanarosa is Executive Editor, JAMA.
1. Cappola AR. Testosterone therapy and risk of cardiovascular disease in men. JAMA. 2013;310(17): 1805-1806.
Corresponding Author: Phil B. Fontanarosa, MD, MBA, JAMA, 330 N Wabash Ave, Chicago, IL 60611 ([email protected]). Conflict of Interest Disclosures: The author has completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.
2180
fied. Moreover, use of the term provider does not recognize the level of professionalism that should be accorded to physicians, especially in a medical journal like JAMA that serves a primary readership of more than 300 000 physician recipients of the print journal each week and reaches close to a half million physicians each week online. Authors of editorials also should avoid overused terms and phrases. For instance, the use of the term impact has become ubiquitous. As a verb (the primary definitions are “to fix firmly by or as if by packing or wedging,” “to press together,” and “to strike forcefully”),4 the use of impact generally is not correct or appropriate (especially in past tense, as impacted) and usually should be replaced with other, more precise terms, like affect or influence. Likewise, when used as a noun, eg, “having an impact” (the primary definitions are “an impinging or striking” and “a forceful contact or onset”),4 or as a modifier, eg, “being impactful,” the term has been so extensively overused that the meaning has been diluted, and more precise language (eg, having a benefit, being beneficial) virtually always could be considered. In addition, given the scholarly and circumspect tone that should characterize editorials, hackneyed phrases, such as “paradigm shift” and “call to action,” as well as embellished language, such as “urgently needed” and “dramatically increased,” usually should be replaced with more appropriate terms. Editorials are an important element of scientific journals and should help to foster informative and responsible discussion of the issues related to articles they accompany. Thoughtfully prepared editorials that use a logical framework along with concise and precise writing and a scholarly tone will be most effective in helping readers understand scientific advances and appreciate the related clinical, research, and policy issues. advanced chronic kidney disease: sins of omission or commission? JAMA. 2014;311(9):913-915. 4. Merriam-Webster’s Collegiate Dictionary. 11th ed. Springfield, MA: Merriam-Webster Inc; 2003.
2. Feero WG. Clinical application of whole-genome sequencing: proceed with care. JAMA. 2014;311(10): 1017-1019. 3. Winkelmayer WC, Turakhia MP. Warfarin treatment in patients with atrial fibrillation and
JAMA June 4, 2014 Volume 311, Number 21
Copyright 2014 American Medical Association. All rights reserved.
Downloaded From: http://jama.jamanetwork.com/ by a Western Oregon University User on 05/29/2015
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