Four common fatal mistakes when writing a paper: No. 1

My many years of editing experience have led me to identify four very common and unfortunately fatal mistakes that scientists and physicians make when they write their paper. These mistakes are so serious that you risk immediate rejection if you make even just one of them. Here I will describe the most important of these mistakes and show how you can avoid it.

FATAL MISTAKE 1: An inconsistent/incoherent message 

Example: prospective comparative study on a new device (FIXT) to hold the patient’s mouth open during an oral exam. The device is needed for patients with disabilities because it improves the view of the oral cavity and stops the patient from biting the examining doctor. FIXT is compared to ORALX, an existing device.

These are the key statements in the various parts of the paper:

Abstract: “FIXT is better than ORALX”.

Introduction: Devices like ORALX can be used for oral exams. Introduces FIXT. “This study will investigate the effect of FIXT on oral cavity visibility”. (no mention of ORALX in this key statement)

Methods: Cross-over study: patients examined without and then with FIXT (i.e. the patients are their own controls).

  - ORALX not mentioned anywhere in the Methods.

Results: FIXT improves visibility relative to the baseline examination

  - ORALX data mentioned, not clear whether FIXT is better than ORALX.

Discussion: “FIXT is better than ORALX”

   - long discussion about papers on ORALX and another device (HOLDX).

Conclusion: ORALX & HOLDX are good first-line devices but FIXT may be an alternative. (HOLDX was not part of the study, nor was ORALX described as a 'first-line' device anywhere in the paper).

So let's collect these key messageS:

“FIXT is better than ORALX”

“This study will investigate the effect of FIXT on oral cavity visibility”.

FIXT improves visibility relative to the baseline examination (not clear

whether FIXT is better than ORALX).

“FIXT is better than ORALX”

FIXT may be an alternative to ORALX and HOLDX.

What is the message of this paper?

The SINGLE key message should have been:

FIXT improves the visibility of the oral cavity relative to baseline and may be superior to ORALX in patients

with disabilities.

All parts of this message should have contained or conveyed in: 

Abstract

Introduction

Methods

Results

Discussion

Conclusion

Why is this such a serious error?

Because reviewers - like all scientists and physicians - are flooded with information every day. They don't want to spend an hour poring over a paper trying to discern its key message: they need that message to be immediately clear when they quickly skim through your manuscript.

How can you avoid this mistake?

After you have finished writing your paper, go to each part of your paper (Abstract etc) and copy the key message in each part. Place each message on a single page (like I did above). Does each message contain all of the same elements? If not, the messages should be reworked until you have found your key message and all sections state or help convey it.