How to write the paperHow to write the paper

Rhinology will not refuseWytske Fokkens

Year 2011:

Rhinology submitted: 271

Rhinology accepted: 53

Chance: 53/271 = 20%

references

Good paperGood paper

• Novelty

• Good review of the literature

• Good data

• Strong statistics

• Clear presentation

• Though provoking discussion

(Co-) Editor(Co-) Editor• After rapid screening, the paper :+ Is acceptable as it is+ Cannot be

accepted for publication because of : - Fatal flaw in experimental design (10-20% of papers) - Findings are largely repetitive of previously published information- Findings represent minor incremental advance over previous information - Trial of a new drug closely related to a previously described one, with no significantly different features or advantages - Poor english, leading to incomprehensible manuscript+ Has been sent to reviewer

Title, abstract and keywordsTitle, abstract and keywords

• title = advertisement for your paper– do not promise things you can not deliver

• write the abstract last• title and abstract are used by the reviewer and

reader to have a general idea about the paper • keywords are essential to find your paper: use

MESH terms and try them out in pubmed

General commentsGeneral comments

• Although the manuscript is well written and interesting I think it would better fit in a Journal with the main focus ...................

Review SummaryReview Summary

Top 10%

Top 25%

Top 50%

Lower 50%

Lower 25%

Significance of research

Originality of Research:

Experimental Design and Quality of Data:

General questionsGeneral questionsIs there any question of violation of the journal's policy on research involving animals and human beings? Yes No

Is an editorial needed? Yes NoIf yes, will you volunteer to write the editorial within a month? Yes No

RecommendationRecommendation

Recommendation

Accept

Manuscript Requires Revision

RejectWould you be willing to review a revision of this manuscript? Yes No

CommentsCommentsCOMMENTS FOR THE EDITORPlease enter the reasons for your recommendations as to the acceptability or rejection for this paper

COMMENTS FOR THE AUTHOR(S)Do not include any statement that will indicate your judgment as to the acceptability of the paper. If possible, submit your comments in the following order:1)General comments2)Specific comments for revision: a) major; b) minor.

Review SummaryReview SummaryTop 10%

Top 25%

Top 50%

Lower 50%

Lower 25%

Significance of research

Originality of Research:

Experimental Design and Quality of Data:

Significance of researchSignificance of research

High:• Deviated nasal septum hinders

intranasal sprays: A computer simulation study

• Sinonasal malignant melanoma:ananalysis of 115 cases

• Endoscopic Sinus Surgery Training Courses: Benefit and Problems

• A Multicenter Evaluation to Systematically Improve Surgical Training

Low:• Different Reactions of Human

Nasal and Eustachian Tube Mucosa After Hyperbaric Oxygen Exposure – A Pilot Study

• Is There Any Difference In Sexual Function Scores In PatientsWith Pollen and Mite Induced Allergic Rhinitis?

• University of Pennsylvania smell identification test: Application to Turkish population

Originality of Research:Originality of Research:

• The added value is rather limited. It looks to me as an open door, which is explicited.

• In which type of setting could this questionnaire be useful?

• This study is well performed but the novelty of the results is not very high

• I do not see how this work may improve knowledge or clinical practice.

• As of a first impression, the subject has no novelty to show nor does the therapeutic modality described.

• This is a very important paper in the clinical setting.

• This is groundbreaking reseach for learning more about central olfactory processing

• The paper will add to the literature in a useful way.

• This is a well written paper describing a study that I wish I had done myself!

Experimental Design Experimental Design and Quality of Data:and Quality of Data:

• It is a real pity to waste so much energy and resources to perform this study because results are of no real value due to a flawed study design.

Experimental Design Experimental Design and Quality of Data:and Quality of Data:

• the study design does not allow to answer the hypothesis put forward

• Several major methodological concerns arise when reading the manuscript

• I think the paper is well written and ambitious. However, there are some major flaws in the design and presentation of the data.

M & MM & M

• What has to be written down to repeat the experiment with the same outcome or understandable other outcome

• Why, Who, what, where, when, and how

• Use (cochrane) checklists

M & MM & Mfollow the international

standards or statements

• CONSORT The CONSORT statement is intended to improve the reporting of RCT’s, to enable readers to understand the trial design and correctly interpret the results (www.consort-statement.org)

• PRISMAPrisma stands for Preferred Reporting Items for Systematic Reviews and Meta-Analyses (www.prisma-statement.org/)

• STROBE statementThe STROBE statement: Strengthening the Reporting of Observational Studies in Epidemiology is a good checklist for preparing a publication of an observational study (www.strobe-statement.org).

www.emgo.nl (in english!)

WHYWHY

• Unfortunately, I cannot recommend publication of this paper, as I really am not sure what it is trying to do.

• The reason(s) why the authors decided to look for a correlation between nasal eosinophils and nasal airflow in children with only rhinitis and rhinitis and asthma cannot be found neither in the introduction nor in the discussion.

M & M WHOM & M WHO• The study population is ill-defined

• Too little subjects per group

• Groups are not comparable

• Almost half of the patients in the data base were excluded from the analyses

• Definitions of the disease groups, inclusion and exclusion criteria,

• There is no indication of exclusion criteria for this study

• The heterogeneity of the patient population represents a draw-back of the study hampering strong conclusions of the study.

M & M WHATM & M WHAT

• Please define what you mean by `no recurrence?`• The definition of allergic rhinitis and asthma should

be included in the study, as well as the techniques and reagents for measurement of ECP and EPO

• The randomisation method is not described, as well as the blinding procedure.

• What is meant by `blade baseline`

M & M WhereM & M Where

• It is not clear where the biopsies were taken

• One cannot investigate if there is a higher exposure by doing measurements in one area only

• Why were cultures always obtained from maxillary sinus

M & M WhenM & M When• What provocation and symptom scoring intervals were used

• it is not clear whether the study was carried on when the patients are symptomatic or not.

• The time interval between the first and second lavage is not clear stated.

• It would be useful to indicate how many months of the year

• nasal lavage should follow acoustic rhinometry measurements to avoid generating a reaction of the mucosa by the lavage itself that may influence the measurements with the rhinometer

M & M HOWM & M HOW

• Both questionnaires are not validated• Surgical technique is not clear - how many branches

have been detected in every procedure, how many branches have been clipped

• How many courses were administered over what time frame before failure was determined

• How does your MEMM type 2b differ from the classic Caldwell Luc operation?

• How was recurrence of nasal polyps determined?

M & M HOWM & M HOWStatisticsStatistics

• Did the data show a normal distribution, otherwise non-parametric tests should be used

• You used a t-test without stating that the assumptions for this test are not violated.

• Many tests were done on each polymorphism and specific allergens: wouldn’t a correction for multiple testing have been appropriate in this section?

• You just mention 3 statistical methods without any indication on how will you use them

ResultsResults

• The chapter "results" is written very poorly• All 42 patients should be included in the final

analysis. The remaining 17 should be responders instead of “no users”.

• In the results the discussion of efficacy needs a more detailed explanation

• on page "Only 15% (90) of respondents lived alone, the...." What are these results used for?

Discussion

• The discussion is solely focused on the results of the study misregarding that there may be other studies that have investigated the described issues.

• Discussion is poor: it is mainly a quick list of results. A true discussion of obtained results is lacking. Negative results (eye symptoms) are not discussed

• The manuscript is rewarding - however, the authors are kindly asked to moderate the respective speculations e.g. by changing the title and / or shortening the paragraph `discussion`

Conclusions based on resultsConclusions based on results• Cannot claim this based on these results, the small

sample size and the methodological flaws of this study

• The authors conclude that .... treatment attenuates the response to nasal allergen challenge with respect to PNIF. However they do not discuss the magnitude of this effect, nor have they investigate the effect on nasal symptoms such as blockage

• I think this is a very questionable conclusion not backed up by the data shown in the ms.

• The final conclusion should be based solely on the data presented.

Tables and figuresTables and figures

• Figure 1 cannot be read in it's present pdf format• table 2 and fig 2 are different presentations of the

same data. • Figure 2 provides no further relevant information as

given in the text. This figure should be omitted. • Figure1. Not clear. It should include a legend briefly

explaining the results presented. Why the numbers of subjects do not correspond to those presented in the methods section.

AvoidableAvoidable• Unfortunately the Tables which represent an essential part

of the results are not included in the manuscript, making an assessment impossible. 

• The numbers of patients in the tables do not match in between tables

• 25 subjects were enrolled; minus 5 (ineligible), minus 2 (withdrawn) = 18 Only 16 subjects have completed the study. What happened to the other 2?

• There is no mentioning of written informed consent

• The literature in this manuscript is limited lacking many important papers

LanguageLanguage

• The paper has multiple errors in English grammar, which is disturbing. Please revise the text according to proper language.

• Some english sentences seem to be written in less fluent english. A native speaker and writer could filter out these irregularities with ease.

• In addition, a lot of typing errors or wrong words needs to be corrected and the text would benefit from comments of a medical expert native speaker.

Take HomeTake Home

• use helicopter view

• see your paper as the reviewer will see it. Review your own paper, be critical

• follow the international standards or statements (consort, prisma, strobe)