E DI TO R IA L
BJD
British Journal of Dermatology
Writing style: abstract thoughts
DOI: 10.1111/bjd.13181 ‘Spend as much time on your title and abstract as you spend on the rest of the paper’, so says Kevin Eva, when advising others on how to write a paper.1 This editorial focuses on abstracts (titles were covered in a previous editorial).2 Like the overture to an opera, the trailer to a film, or the prologue stage to the Tour de France, the abstract of a paper has an importance and significance out of all proportion with its length. The purpose in each of these preceding examples is to interest the audience sufficiently to ensure their engagement with what follows. If authors fail to write a concise, informative and scholarly abstract it is unlikely that the intended audience, perhaps reading the abstract in PubMed, will read the paper. If nobody reads the paper, what was the point in doing the research? A wellwritten abstract is therefore essential to direct potential readers towards your research. Journal readers have limited time and are highly selective in their choices of journal reading.3 Most readers use electronic searches or content lists from favoured journals to identify potentially interesting papers.3 These data dissemination and retrieval systems operate almost exclusively at the level of titles and abstracts. Thus, an opaque title and turgid abstract raise the prospect of no readers or citations for your research paper. In contrast, an informative and engaging title combined with a carefully crafted and concise abstract will act as a flashing beacon for your research paper, attracting the target audience and perhaps others to the full manuscript. So, what are the elements of a great abstract? To answer this question, a good place to start is the aims and scope of the journal, followed by the instructions for authors. For the BJD, the aims and scope are as follows: ‘The BJD strives to publish the highest quality dermatological research. In so doing, the journal aims to advance understanding, management and treatment of skin disease and improve patient outcomes.’ These two short sentences give potential authors a clear idea of what the BJD is all about: research that is not of the highest quality will be rejected; furthermore, the research must aim to advance the understanding, management and treatment of skin disease and improve patient outcomes. Authors should therefore ask themselves, does our research paper have the potential to improve patient outcomes? Does the research advance our understanding, management or treatment of skin disease? If so, these points must be clearly articulated in the abstract. The BJD instructions to authors concerning abstracts are as follows: ‘Authors submitting original articles [to the BJD] should note that structured abstracts are required. The structured abstract should adopt the format: background, objectives, methods, results, conclusions. Abstracts should contain no citations to previously published work.’ © 2014 British Association of Dermatologists
It is your belief that the original research you and your team have done is top quality and is a good fit for the aims and scope of the BJD. How best to respond to the five sections of the structured abstract format? Most journals expect abstracts to be about 150–300 words long. Most professional writers and editors recommend sentences in the 15- to 20word range.1 Therefore, each of the five sections of a BJD abstract requires just two to four sentences. This means that there is no room for flowery, imprecise or loose language; every word must count. The AMA Manual of Style has some tips on how this can be achieved: ‘narrative expressions, such as “X is described”, “Y is discussed”, “Z is also reviewed”, do not add meaning to an abstract and should be avoided.’4 For each of the five sections of the BJD structured abstract, the AMA Manual of Style includes the following: ‘Background (context): Begin the abstract with a sentence or two explaining the clinical (or other) importance of the study question.’ ‘Objective: State the precise objective or study question addressed in the report (e.g. “To determine whether. . .”). If more than one objective is addressed, indicate the main objective and state only key secondary objectives. If an a priori hypothesis was tested, state that hypothesis.’ The AMA Manual of Style divides Methods into five subsections: ‘Design: Describe the basic design of the study. State the years of the study and the duration of follow-up. If applicable, include the name of the study (e.g. the Framingham Heart Study).’ Additionally, authors can mention prospective registration in a trial registry. ‘Setting: Describe the study setting to assist readers to determine the applicability of the report to other circumstances, for example, general community, a primary care or referral centre, private or institutional practice, or ambulatory or hospitalized care.’ ‘Patients or other participants: State the clinical disorders, important eligibility criteria, and key sociodemographic features of patients. Provide the numbers of participants and how they were selected, including the number of otherwise eligible individuals who were approached but refused. If matching was used for comparison groups, specify the characteristics that are matched. In follow-up studies, provide the number of patients withdrawn because of adverse effects. For selection procedures, use the terms, if appropriate: random sample (where random refers to a formal, randomized selection in which all eligible individuals have a fixed and usually equal chance of selection); population-based sample; referred sample; consecutive sample; volunteer sample; convenience sample.’ British Journal of Dermatology (2014) 171, pp205–206
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‘Intervention(s): Describe the essential features of any interventions, including their method and duration of administration. Name the intervention by its most common clinical name, and use non-proprietary drug names.’ ‘Main outcome measure(s): Indicate the primary study outcome measurement(s) as planned before data collection began. If the manuscript does not report the main planned outcomes of a study, state this fact and indicate the reason. State clearly whether the hypothesis being tested was formulated before or after data collection.’ For Results, the AMA Manual of Style has the following advice: ‘Provide and quantify the main outcomes of the study, including confidence intervals (e.g., 95%) or P values. For comparative studies, express the differences between groups with confidence intervals. Explain outcomes or measurements unfamiliar to a general medical readership. Declare important measurements not presented in the results. As relevant, indicate whether observers were blinded to patient groupings, particularly for subjective measurements. If differences for the major study outcome measure(s) are not significant, state the clinically important difference sought and provide the confidence interval for the difference between the groups. When risk changes or effect sizes are given, indicate absolute values. Approaches such as number needed to treat to achieve a unit of benefit are encouraged when appropriate; reporting of relative differences alone is insufficient. For studies of screening and diagnostic tests, report sensitivity, specificity, and likelihood ratio. If predictive value or accuracy is given, provide prevalence or pretest likelihood as well. For all randomized controlled trials, include the results of intention-to-treat analysis, and for all surveys include response rates.’ Finally, the AMA Manual of Style concludes their advice on structured abstracts as follows for Conclusions: ‘Provide only conclusions of the study directly supported by the results, taking into account the limitations (e.g., observational study, selected population), along with implications for clinical practice, avoiding speculation and overgeneralization. Indicate whether additional study is required before the information should be used in usual clinical settings. Give equal emphasis to positive and negative findings of equal scientific merit.’ In addition to the above advice on abstracts for clinical studies, the AMA Manual of Style also includes guidance on structured abstracts for systematic reviews (including meta-analysis) and clinical reviews, and some general guidelines for all authors when preparing any type of structured abstract.4 Both novice and experienced authors are likely to find this guidance useful as an aide-memoire and tool to improve their original research writing style. Authors submitting randomized controlled trial (RCT) manuscripts to the BJD are already requested to complete the accompanying CONSORT checklist to ensure high-quality reporting. The BJD also encourages the authors of British Journal of Dermatology (2014) 171, pp205–206
RCT manuscripts to follow the CONSORT extension for structured abstracts.5 Kevin Eva concludes his chapter on titles, abstracts and authors1 with three tips to improve abstract writing, summarized (and abbreviated) as follows: ‘Plan. Spend time thinking about what messages you would like to convey and how to convey these messages effectively with minimal words. Crafting an outline or mind map of the paper before starting will help you identify the key messages. This information is invaluable in helping one to write a concise and cohesive abstract that accurately foreshadows the larger work. Write, rewrite, take a break and rewrite again. Writing is an iterative process. It creates ideas as much or more as it reflects them. Just because an abstract is short does not mean it can be written quickly. Get the ideas down on paper without regard for wording or length, consider the flow and linkage between ideas, and then start wordsmithing. Delete unnecessary words, exclude jargon and include key phrases. Get peer review. Before you ever submit your abstract or paper, share it with as many trusted colleagues as you can. You may get conflicting messages from different peers, but the aggregation of those messages should help you to identify rough spots that need more attention.’ Authors who aspire to a successful outcome when submitting an original research article to the BJD would do well to heed the advice of Kevin Eva: ‘the shortest components of most academic work are the most important because if you do not write an effective title and abstract, there is little reason to invest in writing the rest of your paper.’
Acknowledgments John Ingram and Jonathan Batchelor. Aneurin Bevan University Health Board, Newport, Gwent, U.K. E-mail: [email protected]
A. ANSTEY
References 1 Eva KW. Titles, abstracts and authors. In: How to Write a Paper (Hall GM, ed.), 5th edn. Chichester: John Wiley & Sons, 2013; 33–41. 2 Anstey A. Writing style: what’s in a title? Br J Dermatol 2014; 170:1003–4. 3 Anstey A. Reading the British Journal of Dermatology. Br J Dermatol 2013; 169:729–30. 4 JAMA and Archives Journals. Manuscript preparation. In: AMA Manual of Style: A Guide for Authors and Editors (Iverson C, Christiansen S, Flanagin A, Fontanarosa PB, Glass RM, Gregoline B, et al. eds), 10th edn. Oxford: Oxford University Press, 2007; 7–38. 5 Hopewell S, Clarke M, Moher D et al. CONSORT for reporting randomised trials in journal and conference abstracts. Lancet 2008; 371:281–3.
© 2014 British Association of Dermatologists
BJD
British Journal of Dermatology
Writing style: abstract thoughts
DOI: 10.1111/bjd.13181 ‘Spend as much time on your title and abstract as you spend on the rest of the paper’, so says Kevin Eva, when advising others on how to write a paper.1 This editorial focuses on abstracts (titles were covered in a previous editorial).2 Like the overture to an opera, the trailer to a film, or the prologue stage to the Tour de France, the abstract of a paper has an importance and significance out of all proportion with its length. The purpose in each of these preceding examples is to interest the audience sufficiently to ensure their engagement with what follows. If authors fail to write a concise, informative and scholarly abstract it is unlikely that the intended audience, perhaps reading the abstract in PubMed, will read the paper. If nobody reads the paper, what was the point in doing the research? A wellwritten abstract is therefore essential to direct potential readers towards your research. Journal readers have limited time and are highly selective in their choices of journal reading.3 Most readers use electronic searches or content lists from favoured journals to identify potentially interesting papers.3 These data dissemination and retrieval systems operate almost exclusively at the level of titles and abstracts. Thus, an opaque title and turgid abstract raise the prospect of no readers or citations for your research paper. In contrast, an informative and engaging title combined with a carefully crafted and concise abstract will act as a flashing beacon for your research paper, attracting the target audience and perhaps others to the full manuscript. So, what are the elements of a great abstract? To answer this question, a good place to start is the aims and scope of the journal, followed by the instructions for authors. For the BJD, the aims and scope are as follows: ‘The BJD strives to publish the highest quality dermatological research. In so doing, the journal aims to advance understanding, management and treatment of skin disease and improve patient outcomes.’ These two short sentences give potential authors a clear idea of what the BJD is all about: research that is not of the highest quality will be rejected; furthermore, the research must aim to advance the understanding, management and treatment of skin disease and improve patient outcomes. Authors should therefore ask themselves, does our research paper have the potential to improve patient outcomes? Does the research advance our understanding, management or treatment of skin disease? If so, these points must be clearly articulated in the abstract. The BJD instructions to authors concerning abstracts are as follows: ‘Authors submitting original articles [to the BJD] should note that structured abstracts are required. The structured abstract should adopt the format: background, objectives, methods, results, conclusions. Abstracts should contain no citations to previously published work.’ © 2014 British Association of Dermatologists
It is your belief that the original research you and your team have done is top quality and is a good fit for the aims and scope of the BJD. How best to respond to the five sections of the structured abstract format? Most journals expect abstracts to be about 150–300 words long. Most professional writers and editors recommend sentences in the 15- to 20word range.1 Therefore, each of the five sections of a BJD abstract requires just two to four sentences. This means that there is no room for flowery, imprecise or loose language; every word must count. The AMA Manual of Style has some tips on how this can be achieved: ‘narrative expressions, such as “X is described”, “Y is discussed”, “Z is also reviewed”, do not add meaning to an abstract and should be avoided.’4 For each of the five sections of the BJD structured abstract, the AMA Manual of Style includes the following: ‘Background (context): Begin the abstract with a sentence or two explaining the clinical (or other) importance of the study question.’ ‘Objective: State the precise objective or study question addressed in the report (e.g. “To determine whether. . .”). If more than one objective is addressed, indicate the main objective and state only key secondary objectives. If an a priori hypothesis was tested, state that hypothesis.’ The AMA Manual of Style divides Methods into five subsections: ‘Design: Describe the basic design of the study. State the years of the study and the duration of follow-up. If applicable, include the name of the study (e.g. the Framingham Heart Study).’ Additionally, authors can mention prospective registration in a trial registry. ‘Setting: Describe the study setting to assist readers to determine the applicability of the report to other circumstances, for example, general community, a primary care or referral centre, private or institutional practice, or ambulatory or hospitalized care.’ ‘Patients or other participants: State the clinical disorders, important eligibility criteria, and key sociodemographic features of patients. Provide the numbers of participants and how they were selected, including the number of otherwise eligible individuals who were approached but refused. If matching was used for comparison groups, specify the characteristics that are matched. In follow-up studies, provide the number of patients withdrawn because of adverse effects. For selection procedures, use the terms, if appropriate: random sample (where random refers to a formal, randomized selection in which all eligible individuals have a fixed and usually equal chance of selection); population-based sample; referred sample; consecutive sample; volunteer sample; convenience sample.’ British Journal of Dermatology (2014) 171, pp205–206
205
206 Editorial
‘Intervention(s): Describe the essential features of any interventions, including their method and duration of administration. Name the intervention by its most common clinical name, and use non-proprietary drug names.’ ‘Main outcome measure(s): Indicate the primary study outcome measurement(s) as planned before data collection began. If the manuscript does not report the main planned outcomes of a study, state this fact and indicate the reason. State clearly whether the hypothesis being tested was formulated before or after data collection.’ For Results, the AMA Manual of Style has the following advice: ‘Provide and quantify the main outcomes of the study, including confidence intervals (e.g., 95%) or P values. For comparative studies, express the differences between groups with confidence intervals. Explain outcomes or measurements unfamiliar to a general medical readership. Declare important measurements not presented in the results. As relevant, indicate whether observers were blinded to patient groupings, particularly for subjective measurements. If differences for the major study outcome measure(s) are not significant, state the clinically important difference sought and provide the confidence interval for the difference between the groups. When risk changes or effect sizes are given, indicate absolute values. Approaches such as number needed to treat to achieve a unit of benefit are encouraged when appropriate; reporting of relative differences alone is insufficient. For studies of screening and diagnostic tests, report sensitivity, specificity, and likelihood ratio. If predictive value or accuracy is given, provide prevalence or pretest likelihood as well. For all randomized controlled trials, include the results of intention-to-treat analysis, and for all surveys include response rates.’ Finally, the AMA Manual of Style concludes their advice on structured abstracts as follows for Conclusions: ‘Provide only conclusions of the study directly supported by the results, taking into account the limitations (e.g., observational study, selected population), along with implications for clinical practice, avoiding speculation and overgeneralization. Indicate whether additional study is required before the information should be used in usual clinical settings. Give equal emphasis to positive and negative findings of equal scientific merit.’ In addition to the above advice on abstracts for clinical studies, the AMA Manual of Style also includes guidance on structured abstracts for systematic reviews (including meta-analysis) and clinical reviews, and some general guidelines for all authors when preparing any type of structured abstract.4 Both novice and experienced authors are likely to find this guidance useful as an aide-memoire and tool to improve their original research writing style. Authors submitting randomized controlled trial (RCT) manuscripts to the BJD are already requested to complete the accompanying CONSORT checklist to ensure high-quality reporting. The BJD also encourages the authors of British Journal of Dermatology (2014) 171, pp205–206
RCT manuscripts to follow the CONSORT extension for structured abstracts.5 Kevin Eva concludes his chapter on titles, abstracts and authors1 with three tips to improve abstract writing, summarized (and abbreviated) as follows: ‘Plan. Spend time thinking about what messages you would like to convey and how to convey these messages effectively with minimal words. Crafting an outline or mind map of the paper before starting will help you identify the key messages. This information is invaluable in helping one to write a concise and cohesive abstract that accurately foreshadows the larger work. Write, rewrite, take a break and rewrite again. Writing is an iterative process. It creates ideas as much or more as it reflects them. Just because an abstract is short does not mean it can be written quickly. Get the ideas down on paper without regard for wording or length, consider the flow and linkage between ideas, and then start wordsmithing. Delete unnecessary words, exclude jargon and include key phrases. Get peer review. Before you ever submit your abstract or paper, share it with as many trusted colleagues as you can. You may get conflicting messages from different peers, but the aggregation of those messages should help you to identify rough spots that need more attention.’ Authors who aspire to a successful outcome when submitting an original research article to the BJD would do well to heed the advice of Kevin Eva: ‘the shortest components of most academic work are the most important because if you do not write an effective title and abstract, there is little reason to invest in writing the rest of your paper.’
Acknowledgments John Ingram and Jonathan Batchelor. Aneurin Bevan University Health Board, Newport, Gwent, U.K. E-mail: [email protected]
A. ANSTEY
References 1 Eva KW. Titles, abstracts and authors. In: How to Write a Paper (Hall GM, ed.), 5th edn. Chichester: John Wiley & Sons, 2013; 33–41. 2 Anstey A. Writing style: what’s in a title? Br J Dermatol 2014; 170:1003–4. 3 Anstey A. Reading the British Journal of Dermatology. Br J Dermatol 2013; 169:729–30. 4 JAMA and Archives Journals. Manuscript preparation. In: AMA Manual of Style: A Guide for Authors and Editors (Iverson C, Christiansen S, Flanagin A, Fontanarosa PB, Glass RM, Gregoline B, et al. eds), 10th edn. Oxford: Oxford University Press, 2007; 7–38. 5 Hopewell S, Clarke M, Moher D et al. CONSORT for reporting randomised trials in journal and conference abstracts. Lancet 2008; 371:281–3.
© 2014 British Association of Dermatologists
