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Workshop presented at a Training Program for Supervisors of Family Medicine residents organized by the Ministry of Health / Saudi Commission for the Health Professions in Riyadh on 8th June 2010 by Professor Omar Hasan K Kasule Sr MB ChB (MUK), MPH (Harvard), DrPH (Harvard) Professor of Epidemiology and Bioethics Faculty of Medicine King Fahd Medical City Riyadh EM omarkasule@yahoo.com, WEB: http://omarkasule.tripod.com
1.0 CLARITY
1.1 The goal of scientific writing is clarity. The essential information must be communicated effectively. This requires that the author does not lose the forest for the trees by providing a lot of details that do not communicate a clear and definitive message.
1.2 Clear writing is not only a help for the reader but also helps the writer clarify his or her thinking. Scientific writing is in the first place communication with the self. It shows the writer whether what is communicated is clear to himself. A writer who has no clarity about any subject will definitely fail in communicating it to others.
2.0 CLEAR SENTENCES
2.1 Short concise sentences: Writing a good sentence involves both good choice and good arrangements of words. Short sentences are preferred. A sentence is considered overloaded if it has more than 20 words. Each sentence should have only one idea or piece of information. Stringing several ideas together in a sentence is bad writing.
2.2 Use of personal pronouns: Personal pronouns like ‘I’ and ‘we’ can be used in the paper. They help avoid the use of passive sentences that make the writing weak.
2.3 Use of verbs: Subject-verb agreement is a common mistake. The verb and the subject it refers to must agree. It is wrong to write ‘the student prefer’. The correct form is ‘the student prefers’. Helping verbs should not be omitted. It is wrong to write ‘the skin was opened and the peritoneum exposed’. The correct way is to write ‘the skin was opened and the peritoneum was exposed’.
2.4 Active and passive sentences: Each sentence should be active and should have an action verb. Passive sentences should be avoided. The action verb should be a principal part of the sentence and not hidden in a phrase or a clause within the sentence. It is better to write ‘ the drug lowered blood pressure’ than to write ‘ the drug caused lowering of blood pressure’. Noun clusters of more than 2 nouns should be avoided. It is better to write ‘indicators of blood pressure’ than to write ‘blood pressure indicators’. An adjective should not be added to a noun cluster. It is better to write ‘chronic disease of the heart’ than to write ‘chronic heart disease’. Care must be taken to make sure that the pronouns refer to the right nouns. It the pronoun-noun relation may not be clear in a sentence with 2 or more nouns or pronouns leading to confusion in meanings. In a worst case scenario a pronoun in a sentence may refer to a missing or unknown noun.
2.5 Parallel ideas: Parallelism helps avoid repetition thus improving the flow of the writing. It is for example better to write ‘cases had high blood pressure but controls did not’ than to write ‘ cases had high blood pressure but controls did not have high blood pressure. Hower writers often make mistakes with parallel ideas. Confusions arise when the parallel ideas equal logic or importance are joined by ‘and’, ‘or’, or ‘but’. Confusions also arise with the use of paired conjunctions such as ‘both… and …’, either… or …, ‘neither … nor …’ and ‘not only … but ….’. Care must be taken to make sure that the 2 parallel ideas are similar in form. It is good write ‘blood pressure was assessed and pulse pressure was calculated’ and not ‘blood pressure was assessed and pulse pressure assessed’. The term ‘compared to’ is overused and if often misused. It is better to use terms like ‘higher’, ‘greater’, or ‘lower’ to compare parallel things. Parallel ideas being compared must be equal or similar. It is better to write ‘results of this study are similar to results of previous studies’ and not ‘results of this study are similar to previous studies. It is possible to write more than 2 parallel ideas in a sentence but this must be discouraged.
2.6 Use of parentheses: Sentences, clauses, or phrases can be inserted in the middle of another sentence as a parenthesis enclosed within commas. Care must be taken to make sure that the general flow of the writing is smooth and intelligible.
2.7 Expressions often misused: The term ‘compared with’ is often confusing and should be avoided; use .more than’ or ‘less than’. ‘Could not’ meaning ‘unable to’ is sometimes confused with ‘did not’ meaning the action was not carried out irrespective of ability. ‘Did not’ is not the same as ‘failed to’. The term ‘marked’ or ‘markedly’ are misused widely. They have no meaning unless some form of quantification is attached to them. The term ‘significantly’ is wrongly used instead of ‘significant’ to indicate statistical significance.
3.0 PARAGRAPHS
3.1 Topic sentence and message: A paragraph starts with a topic sentence that is an overview of the message contained in that paragraph. The topic sentence must be short and simple. Each paragraph should convey only one message. Key terms are repeated in the paragraph for clarity and accuracy. The sentences following the topic sentence provide details and support for the topic sentence.
3.2 Paragraph organization: All steps of the logic relating to the paragraph message should be presented in the right order with no missing steps. The following are alternative logical orders of paragraph organization: least to most important, most to least important, concise to the detailed, time chronological order, problem followed by solution, or solution followed by the problem.
3.3 Links and transitions: Link terms such as ‘which is’ should be used when moving from one group of ideas to another. Transitions ensure continuity in the paragraph. These may be words, phrases, clauses, or sentences. Examples of transitions are: ‘therefore’, ‘thus’, ‘in addition’, ‘in contrast’, ‘however’, ‘for example’, and ‘on the other hand’. Transitions can be placed within sentences or can be placed between sentences.
3.4 Consistency: There must be consistency in the order in which information is mentioned. If certain objects were mentioned in a certain order in the introduction, they must be mentioned in the same order all through the writing. The writer should maintain a consistent viewpoint all through the paper and not appear to be jumping from point to point.
3.5 Emphasis: A piece of scientific writing must have a specific message to convey. This requires that this message be emphasized and be given prominence. Emphasis can be achieved by putting important information in power positions (the start and the end), identifying important information with appropriate labeling and clearly stating that it is important and not leaving the implication to the reader, repetition of important facts, and labeling important information. De-emphasis is achieved by condensing, omitting or labeling less important information.
4.0 THE TITLE
The purpose of the title is to identify the main topic or message of the paper so as to attract readers. The title of the paper should contain the following: independent variable(s), dependent variable(s), the study subjects or materials, and statement of the main message like ‘to study the effect of’ , ‘to determine’ etc. A good title is unambiguous, concise, and contains important words.
5.0 ABSTRACT
5.1 The abstract is an overview of the report with a few significant details. It should be written to be read by both those who read the full paper and those who do not read the full paper. Normally the abstract should not exceed 250 words.
5.2 The abstract should mirror the sections of the paper: introduction, materials & methods, results, and discussion. The subsections of the abstract may be indicated as sub-titles. They may alternatively be signaled as follows. The research question is signaled by ‘to determine’, ‘to test the hypothesis..’, . The results are signaled as ‘we found’. The answer is signaled as ‘we found’ or ‘we concluded’. The implication or conclusion is signaled as ‘the results suggest..’ or ‘we conclude..’.
5.3 The present tense is used to state the research hypothesis and the answer. The past tense is used for the experiment. An abstract is accompanied by keywords that are used for indexing.
6.0 INTRODUCTION
6.1 The introduction should be short. It should start with stating the research question or research hypothesis and then go to elaborate. The transition should be from the known to the unknown and from the big bird’s eyeview picture to the detail.
6.2 The introduction should mention the type of study, the study subjects or materials (substances, animals, persons). In some cases the introduction may briefly mention the proposed experimental approach to answering the research question. Results should not be mentioned in the introduction. The introduction should state whether the work is new or original.
7.0 MATERIALS AND METHODS
7.1 The aim of the materials and methods section is to describe the experimental techniques in detail sufficient for another trained scientist to replicate the procedures.
7.2 The order of presentation is different for animal and clinical studies. For animal studies the order is: materials and animals, preparation, study design, interventions, methods of measurement, calculations, and data analysis. For clinical studies the order is: study subjects, inclusion criteria, exclusion criteria, study design, interventions, methods of measurement, calculations, and data analysis (Mimi Zeiger. Essentials of Writing Biomedical Research Papers. McGraw Hill New York
7.3 Independent and dependent variables should be identified. Intermediate results can be put in the materials and methods section. Final results should be put only in the results section. Details of sample size determination should be provided.
7.4 The following terms are often confused with one another: ‘measured’, ‘calculated’, ‘estimated’, and ‘determined’. Measurement is using instruments. Calculation deals with numbers and formulas. Estimation is used in two senses as an approximation in measurements or as computation of statistical parameters. Determination is a general term for getting to a conclusion by use of the 4 methods above. The term ‘study’ is generic and can be confused with experiment that refers to only some types of studies.
8.0 RESULTS
8.1 The results section presents the findings of the procedures carried out in the methods section. It should be brief and to the point.
8.2 A distinction must be made between results and data. Result refers to summary information obtained from data analysis. Data is the actual numerical information often presented in a summarized form. The result is presented followed by presentation of supporting data.
8.3 Results of hypothesis-based studies should be in the past tense. Data of descriptive studies should be in the present tense.
8.4 Data are presented in the form of tables and diagrams (figures, bar diagrams, graphs, pie-charts, maps etc). Presentation of numerical data in text should be kept to a minimum.
8.5 Only results relevant to the research hypothesis should be presented. Both negative and positive results are presented. It is considered scientific fraud to present only those results that the author thinks favor a particular hypothesis.
8.6 The results section is written in chronological order. The most important results are presented before the least important. A topic sentence is used to give an overview. Important results are put first. Figures used to present results must have a strong visual impact and must be simple.
8.7 Magnitude of change should be presented as a summary statistic such as percentage change instead of presenting the raw data. Summary statistics normally used as the mean, the median, and the proportion. The mean should be presented properly as mean +/- standard deviation or standard error of the mean (SD or SE) with units of measure indicated.
8.8 Measures of effect are normally the chisquare and the t statistics. Actual p values should be given instead of indicating <0.05 or >0.05.
8.9 When specifying the sample size the type of sample should be explained for example ‘the sample was 20 rats’ instead of the sample size was 20’.
8.10 Emphasis can be put on some results and not others. Not all the data from the study need be reported. Citing data in the text takes less space but is more difficult to read.
8.11 The following types of figures are used: line graph, scattergram, bar graph, histogram, and the frequency polygon. The title of the figure should reflect its contents. It must be labeled correctly. Symbols must be defined. The names of variables and units of measurement must be labeled appropriately. Tables must be properly titled and column headings clearly indicated. Footnotes, subscripts, and superscripts can be used.
9.0 DISCUSSION AND CONCLUSION
9.1 The discussion section states the research hypothesis, answers it, and supports the answers using data from the current study and other studies. It provides reasons to show that the answer to the question is reasonable. It explores and explains possible sources of error and bias. It also identifies and explains differences between the study results and published results.
9.2 As part of intellectual honesty the discussion section discusses the strengths as well as the weaknesses of the study and how they impact on the interpretation of the results. Issues of validity and precision are also addressed. Also discussed is whether the result is new and how important it is.
9.3 References are used to acknowledge information obtained from others. The references must be the most recent and most easily available on the subject. Review articles are better than original articles. They may be journal articles, books, Phd theses, abstracts of meetings, or conference proceedings. The reference should be put immediately after the relevant text. If there are several references in a sentence, cite each reference at the relevant point and do not wait to put all of them at the end of the sentence. References should be written using the Vancouver