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 Table of Contents  
Year : 2019  |  Volume : 2  |  Issue : 2  |  Page : 18-20

Article writing in medicine

Department of Orthopaedics, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India

Date of Submission30-Sep-2019
Date of Decision30-Sep-2019
Date of Acceptance01-Oct-2019
Date of Web Publication21-Oct-2019

Correspondence Address:
Dr. Ritesh Runu
Department of Orthopaedics, Indira Gandhi Institute of Medical Sciences, Patna - 800 014, Bihar
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/JODP.JODP_12_19

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Scientific publications started in 1665 by the Royal Society of London. The use of scientific literature increased for practice of medicine as well as by law agencies. With the advent and spread of the Internet, the publications of journals and articles have increased. Several guidelines are made by various organizations to maintain a standard writing format for research publications. Even then the research misconduct has increased. Plagiarism, duplicate publications, salami publications, gift authorships, and authorship conflicts are few of the major misconducts. To reduce it among writers and editors, the knowledge of the rules and regulations of article writing and journal publication needs regular update.

Keywords: Article, authorship, conflict of interest, plagiarism, publication

How to cite this article:
Runu R. Article writing in medicine. J Orthop Dis Traumatol 2019;2:18-20

How to cite this URL:
Runu R. Article writing in medicine. J Orthop Dis Traumatol [serial online] 2019 [cited 2020 Jun 5];2:18-20. Available from: http://www.jodt.org/text.asp?2019/2/2/18/269581

  Introduction Top

Any new information, after proper scrutiny when presented in a manner which allows its re-verification, is known as a scientific communication. It first started 350 years ago by the Royal Society of London. It was established by King Charles in 1662, and the first publication was done in 1665, Philosophical Transactions.[1] The scientific communications contribute to the present understanding of the knowledge. It helps in the development of science and its practice.[2] Article writing is part of professional activity, which improves the level of understanding of the subject and helps in dissemination of knowledge among the peer group. With ages, the medical practice has changed by constant observation, review of practice, discussions, new discoveries, and consideration of law and social needs. The continuous research on various topics and its publication has helped in the development of human race.

Its importance was highlighted by Walsh 2010 – “writing is important because it is used extensively in higher education and in the workplace. If students don't know how to express themselves in writing, they won't be able to communicate well with professors, employers, peers or just about anyone else. Much of professional communication done in writing: proposal, memos, reports, applications, preliminary interviews, E-mails and more are part of the daily life of a college student or a successful graduate.”[3]

In this process, many discrepancies have crept in the form of false publications and plagiarism.[2],[4] The malpractices in paper publication are due to pressure to publish, to gain points for promotion or monetary benefits.[5] In 1978, at Vancouver, British Columbia, Canada, the International Committee of Medical Journal Editors formulated the guidelines for articles in journals.[6] In 1997, a group of editors met under the leadership of Mike Farthing in the United Kingdom to formulate the ethical guidelines for authors and editors.[7]

Considering the guidelines, most of the journals today get a peer review of the articles to select the relevant articles for publications. The articles without relevance and with discrepancies are rejected for further improvements. Many a time, a paper comes from a nonrepresentative, thin population area, and it is rejected because it does not represent the larger population. In this scenario, we miss an essential data related to that population.[8] Here, we discuss the components of paper writing and how to improve it.

  How to Write an Article Top

Scientific article[9] writing was like a monograph or crude presentation in the beginning. The authors used to present their observation and results in the form of a story. Sir Austin Bradford Hill, a British statistician, proposed the method for scientific writing in 1965.[10] He developed four basic questions for article writing. They were – (1) Why do you start? – Introduction, (2) How did you do? – Materials and methods, (3) What did you find? – Results, (4) What does it mean? – Discussion. This pattern of writing is called Introduction, Materials and Methods, Results, and Discussion (IMRAD) in medical literature, which makes it structured and reduces the time for editor and reviewer to judge the quality of article. This pattern of article writing is universally accepted nowadays.[6] For writing purpose, the authors can follow the order as (1) Materials and methods, (2) Results, (3) Introduction, (4) Discussion, (5) Conclusion, (6) Limitations, and (7) Abstract.[11],[12],[13]

Any study starts with material selection after topic finalization. The subject recruitment and methods of the study need strict definition. This section should be well written so that the study can be reproduced. A well-written materials and method section ensures the publication of article. The type of study, inclusion criteria, exclusion criteria, steps of interventions, methods of data collection, and method of statistical analysis should be written in this section. Ethical clearance detail should be given in this section. A flowchart can simplify the description of method section in complex studies.[12],[14]

The data collected out of the study make the results section. This section should start with the details of the study materials. Any process of randomization and group description should be detailed here.[15] In this section, data mentioned in the method section should appear in a step-wise manner.[16] No new data should appear without its description in the method section. In today's era of meta-analysis, this section is more important.[15] It can have charts, diagrams, and tables. Each of the representations should be labeled properly. It should supplement the text for better understanding.[15] For drug trials, the CONSORT guideline is followed. It is Consolidated Standards of Reporting Trials, which has a flowchart showing recruitment, randomization, division and data collection, follow-up, and analysis in trial cases. Results should be specific and unambiguous.[15] No adjectives should be used. The presentation of table should be clear and have raw data rather than inferences.

Statistical analysis can be a separate paragraph or it can be part of the results. According to Altmann et al., “the purpose of statistical methods is to provide a straightforward factual account of scientific evidence derived from a piece of research.”[17] If a study is well planned initially and data collection is as per plan, then the outcome is valid. On several occasions, the data are either nonrepresentative or inadequate for statistical analysis. Hence, involvement of the statistician is essential at the beginning of the study.

The outcome of the study is discussed in the section of discussion. It is structured, and each component of the study and results are discussed. Vitse and Poland have suggested first paragraph to summarize the key findings without repeating them in the article. In the second paragraph, the explanation of findings is given. How it adds to the present knowledge should be written. The next paragraph should detail the possible mechanism and explanation of results. The strength and weakness of the article should be written next. Possible controversies and questions raised in the study should be written in the end.[17]

Abstract is defined by the American Psychological Association – “it is a brief, comprehensive summary of the content of the article; it allows the reader to survey the contents of an article quickly, and like a little, it enables abstracting and information services to index and retrieve articles.”[3] It is used by editors, reviewers, readers, funding agency, conference scientific committee, and indexing agency for segregating the article and to accept or reject.[18] A concise and well-written abstract attracts the attention. It can be descriptive, informational, structured, or unstructured.[18] Informational and structured abstracts are preferred because it is written in IMRAD pattern, and it contains all the information in short, for example, conference abstracts. It should be revised once the main article is revised. Unstructured abstract is also accepted, especially in social sciences. It may be used in science, but lots of data may get lost.[11]

Conclusion should be short and clearly answers the question raised in introduction. It should make recommendation or should direct for further investigations.

  Problems in Article Writing Top

The first and foremost problem is poor and inefficient writing. Especially in clinical branches where clinicians engaged in patient care have difficulty in article writing.[19] It is due to large number of patients, poor infrastructure for research, poor incentives, lack of enthusiasm, and high rejection rate in indexed journals.[12] To improve, several journals publish the writing tips.[20] Some centers focus on the writing skills of the students.[3] The junior doctors need engagement in research process to inculcate the methodology of research and to promote them to take this field.[2] Research is not the waste of time but a scientific investment.[2]

Research misconduct is a major issue today. With the addition of the Internet, the flow of information has become fast, but it is not reliable.[8],[21] Misconduct as defined by the Royal College of Physicians of Edinburg – as any behavior by a researcher, whether intentional or not, that fails to scrupulously respect the high scientific and ethical standards. Various types of research misconduct include fabrication or falsification of data, plagiarism, problematic data presentation or analysis, failure to obtain ethical approval by research ethics committee or to obtain the subject's informed consent, inappropriate claims of authorship, duplicate publication, and undisclosed conflict of interest.[22],[23]


It is stealing of idea, duplication of matter without acknowledging the original author.[24] This has been highlighted from time to time by authors and editors. It is unlawful, and the principal author is liable to be punished.[23] Self-plagiarism is quoting the content written by the same author. It is only allowed when the author has copyright of the content. With the inclusion of intellectual property rights, this has been addressed and highlighted.[4],[13],[16],[22] Rogers has provided recommendation to avoid plagiarism – use of quotation mark around words taken verbatim from a source, change no part of a quotation within the context of the sentence, use single marks for a quotation within a quotation, use ellipses for a part of the quotation omitted, use brackets around added words, limit the use of direct quotes, and attempt to paraphrase the information derived from a variety of sources using one's own words.[25] It is the cause of rejection of 10–15 manuscripts every year in the Indian J Orthopaedics.[23]

Duplicate publication

Known as redundant publication, duplicate publication[5],[13],[16],[23] involves publication of the same content in the same format in more than one journal.[24] Criteria for duplicate publications are identical content, highly similar articles with minimal modifications, sequential articles about the development of work, and similar articles for various disciplines.[4] Salami publication is when publication of same data is done in multiple articles in piecemeal. This is done to gain more points in interviews and for personal gain. To prevent this practice, a submission is taken from all the authors.

Authorship issues

All persons designated as authors should qualify for authorship. Each author should have participated sufficiently in the work to take public responsibility for it. Authorship credit should be based only on substantial contributions to: (a) conception and design, or analysis and interpretation of data; (b) drafting the article or revising it critically for important intellectual content; and on (c) final approval of the version to be published. Conditions (a-c) must all be met.[5] The criteria to acknowledge include sources of funding, provision of expert technical assistance, review and critique of a manuscript, assistance with statistical analysis and interpretation, or participation in the formulation of ideas or planning of a project.[4] Any person associated with the manuscript preparation who have helped should be acknowledged. Where a person is made author or co-author only being in relation with one of the authors is known as gift authorship. This is not acceptable.


Conflicts refer to when an author's relationship with an entity inappropriately affects the study design, conduct, reporting, or interpretation due to financial gain or through gains in reputation and prestige.[6] It has its bearing on the results which can affect the public health once published. Hence, it needs full disclosure. Nonresearch articles are more liable to be canceled than research articles.[26]

Pharmaceutical companies that sponsor the research are financially oriented. They get goal-oriented results. The economic aspect of research is always secondary for academic institute where public health is primary. The main beneficiary of research is patients and the practicing doctors.[2] Hence, research should be patient oriented.

With the present state of research and publications, authors and editors are suggested to submit authentic articles only.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

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