Abstract

In their professional practices, physicians often face unexpected situations or chance on innovative proposals and ideas. As a result of their training and competence, they usually come up with hypotheses to be tested and research is conducted. This research is completed and their results submitted for presentations at conferences as free communications. Nevertheless, the realization of this creative process is only complete when a scientific manuscript is published in a journal. At this ultimate stage, most efforts seem not be brought to a standstill1,2. There are several reasons why scholars, interns, residents, graduate students and even experienced physicians may find it difficult to move forward from congress' abstracts to full manuscripts published in journals. However, the most significant hindrance rests with the difficulty writing the mere 25-30 paragraphs of an original manuscript. Many freeze and give up in front of a blank paper or a blinking cursor on a blank word processor's page on the monitor screen. In the previous manuscript3, we analyzed and suggested improvements to the process of peer review. In this point of view, we propose a practical strategy to systematize the writing of scientific paragraphs, aiming to simplify the task of scientific writing. This way, our intent is to increase the rate of publication of full manuscripts based on several outstanding abstracts presented annually at major medical conferences, and facilitate the currently overburdened process of peer review. The format of scientific communication has been evolving greatly over the centuries4-7, making reading more objective and standardized. One of the important tools in this process is the IMRaD format4,5,7, an acronym derived from the initials of the main sections of a manuscript - introduction, methods, results and discussion. Throughout the twentieth century, the IMRaD format has been increasingly applied, accounting for about 10% of the manuscripts in the 1950s, being dominant in the 1960s, and reaching 80% in the 1970s7. Presently, IMRad is the format recommended and adopted by the main medical journals all over the world, including the ABC (Arquivos Brasileiros de Cardiologia). In addition to the IMRaD format, original manuscripts submitted for publication should meet specific standards and rules of each journal. Although a fairly uniform pattern tends to prevail, there are differences that should be observed at the time of writing. For instance, the number of words is limited to 4,500 in ABC and 5,000 in JACC, including text and references. Considering that the references are usually limited to 30-40, and have around 1,000 words, circa 3,500-4,000 are left for the text's body, i.e., to be used in the 25-30 paragraphs of IMRaD, representing about 130 words each. In the pursuit for evidence and objective data, as a convenience sample, all original manuscripts published in the January 2012 and 2013 editions of ABC and JACC journals have been analyzed (the first two numbers of these months for the latter). There was a fairly clear trend about the total number of paragraphs and distribution of paragraphs in four sections of the IMRaD of a manuscript. For the 20 ABC's manuscripts and 34 JACC's ones, the average number of paragraphs was 28.9 and 28.2 (p = 0.703), respectively, with 1/3 of them having 25-30 paragraphs, and 57% of the total manuscripts having overall 22-33 paragraphs. This relative constancy should be observed and highlighted, considering that the topics and areas covered, as well as the background and the nationality of the authors, are quite different. Thus, this confirms the assumption that there is a basic format to be followed for an effective publication. Figure 1 illustrates the distribution of paragraphs for the various IMRaD sections in the two journals analyzed. Although there is some variability among the manuscripts, the introduction is clearly a section with fewer paragraphs (p 0.05), especially for original manuscripts of JACC, in which the sections of methods, results and discussion tend to have eight to nine paragraphs. When the distributions of paragraphs between ABC and JACC are compared, introductions and discussions tend to have more paragraphs in ABC than in JACC, respectively, 3.8 versus 2.4 (p < 0.01) and 10.4 versus 8.8 (p = 0.04). Figure 1 Comparative analysis on the number of paragraphs per section of IMRaD for original manuscripts between Arquivos Brasileiros de Cardiologia (Arq Bras Cardiol) and Journal of The American College of Cardiology (JACC). I: introduction; M: methods; R: results; ... Based on these results, in our personal experience as authors of original manuscripts and according to other authors' opinions4,8-10, a simple content model may be proposed within the IMRaD format, taking 25-30 paragraphs as standard for an original manuscript. For practical purposes, one page is considered one page in a word processor, with conventional margins and with a 1.5 line spacing and font size 11.

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