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04 Jun 2024

How to publish your digital health innovation

Learn more about how to publish your health innovation or start-up.

Whether you're a beginner or regular author, hear advice about where to publish your work, how to navigate the submission process and what you should think about before writing your manuscript.

We'll also be sharing top tips from editors to maximise your chance of acceptance.


Ashley McKimm, Editor-in-Chief, BMJ Innovations

Helen Surana, Deputy Editor, BMJ Innovations


 Welcome again to the  fourth  BMJ Future Health webinar. It might be the fifth actually, but we're so excited to be bringing you these great sessions. And to start off with, if you've missed some already and you're surprised that this is the fourth in a series, then you can go back to the BMJ Future Health webinar and look at the other ones.

But today it's really very much about Our wheelhouse and our specialist subject on how to publish your digital health innovation. And how the subtitle Ashley's given it is how to write about the service, not the product. I should just quickly introduce myself. My name's Helen Serrana. I'm one of the editors here at BMJ.

I've got a medical background, but a long I was going to say checkered, but a long history at BMJ where I've worked since retiring as a junior anesthetist about 15 years ago. My expertise goes across a number of products, but most recently I've been working on the journals and I've been working as a deputy editor to our speaker today, who is Ashley McKim. Ashley is editor in chief of BMJ Innovations, and that's the main hat he's wearing today. so much for joining us. But he's also director of partnership development at BMJ. So if any of you are involved with organizations that have worked with BMJ in a number of ways, you might have come across Ashley already.

He's got a background as a medical doctor and as a journalist and has edited a number of manuscripts in his time, Ashley. So I'm going to hand over to you now and but I'm going to stick around and ask you a few questions as we go along and anyone else, if you want to ask Ashley questions.

Other than,  can you publish my manuscript about the process of publication and, or anything Ashley says, please do put them in the chat and the Q and A, and we'll ask the ones that need asking as we go along or at the end. Over to you, Ashley. 

Wonderful. Thanks, Helen. And please do ask questions.

I'd rather have questions from you than Helen towards the end as well. She does have tough questions as we go forward. So welcome. Thanks for joining us today. This is going to be a bit of a crash course in getting published. So don't expect you're going to be able to leave here with a comprehensive knowledge, but this is an introduction to thinking about how we publish your digital health innovation as well.

And I may regret saying this, but we're very happy as well to have individual conversations afterwards as well. So please do reach out by email and we want to help you, our job as editors is really to help you publish and help you to produce the best manuscript you can as well. So hopefully today we'll do a bit of an introduction to that.

So I'm going to start first of all, with a little bit of a history lesson. So this Although it's called the Provincial Medical and Surgical Journal, it was actually the precursor to the BMJ. And hopefully you've all heard of the BMJ, or we're not doing our job properly, but this is what the first issue looked like back in October the 3rd, 1840. 

Looks a bit more like what it does these days, still very text based, back at the turn of the century. But BMJ, from that very first issue of the journal, has tried to be at the cutting edge. of medical innovation. We've tried to publish some of the big discoveries in medicine over the years, and hopefully some of your innovations, some of your startups, digital health products, are things that we want to publish as well.

Those things that are going to shape the next couple of hundred years of medicine and health as well. BMJ, Over that time we published really important things like James Simpson's discovery of chloroform. You can see the picture there, a bit of an accidental discovery, but we published that back in 1847. We published Joseph Lister's papers on antisepsis, and I think what's really interesting about Joseph Lister was that his theories about stopping infection, which was a big problem in surgery at the time, were not trusted by doctors. He was kicked out of meetings in Vienna and Paris and London.

And over 10 years, he published papers in the BMJ working with the editors. And those papers were essentially the start of peer review and evidence based medicine. And it was publishing those papers that actually give credibility to Joseph Lister's papers and theories around antisepsis.  We also published a link between the mosquito and malaria, and we published a link between smoking and lung cancer back in the 1950s as well.

Over that time, we've tried to publish the latest findings in medicine and health, and we're here to talk about a lot of journals today, but really BMJ Innovations, which is a relatively new journal within BMJ that's focused on particularly digital health and pioneering medical devices. So hopefully some of the things that you're working on in your organizations as well. 

We'll talk a bit more about BMJ Innovations later,  but it publishes. original research, it publishes narrative and systematic reviews, and it also publishes early stage innovation reports. And these are new, this is a really novel type of paper, and we'll talk a bit more about this today as well, which is designed to publish that really early stage work that you might have.

So this is before you've gone on to multicenter trials.  We're trying to speed up the rate of getting new ideas, new innovations out there to share with other people. And this type of paper helps you do that. It's designed to share early stage work. It has to be already in situ. So it has to be testing in a clinical environment.

It has to be working with patients or the population you're targeting as well. But it's a great way to Share your work in a great way to publish for the first time if you haven't published as well. We'll talk a bit more about that later on, but I'm going to just. mention that this session today is not just all about academic publishing.

We'll talk a bit more about the types of publishing, the types of work that you might do to hit your objectives. But this was just an example from some of you might know Tamsin Hollenbraun, but Tamsin published a paper during COVID. It was a medical device she developed for testing for glue earing kids.

It was published in BMJ, but it was But I think the bit to take away was that as well as having that academic journal publication, it was picked up in 41 news outlets around the world, everywhere from the Daily Mail to the Independent to Bangladesh and the US as well. And she got lots of coverage in the press and in magazines as well.

So if you are thinking about reach Don't just think about this as, targeting the academic audience. If you've got a an evidence based strong paper that's published in an academic journal, it's much more likely that the press, your potential journals, websites, social media bloggers will pick it up as well.

So this is a foundation that helps to build everything else off as well.  Before I get into the agenda for today, just a very quick plug for BMJ New Ventures, which if you haven't heard about it is BMJ's a bit within BMJ that supports startups and entrepreneurs in health as well. So we can help you with advice, but also help you with both cash and in kind investment as well.

So if you're interested check out the website BMJ New Ventures as well. Hopefully this will be a discussion today. We want to have a bit more of a chat. So hopefully Helen and you can also submit your questions as we go through, but I'm going to talk a little bit about your challenge as authoring papers and, trying to help you think about, what you're trying to achieve, which is really the first question that we want to tackle.

I'm going to talk a little bit about why innovation and improvement publications are actually a really hot place to be at the minute and really good for you to publish work in. talk a bit about what we do as editors, so you can understand how you can help us and also help yourself to get through the process of writing a paper as well.

And we'll come back to some top tips at the end to try and maximize your chances of getting published as well.  There's no need to write stuff down. This is all on the BMJ author hub that you can access through that URL. There's lots of really good tools in there to help you think about writing What to talk about before you submit your paper how to promote your paper after being published as well.

And you'll find lots of really digestible content, lots of good videos in there as well for some of our editors to help you through the journey. As I said at the beginning, we're there to help you. I think often people think that editors are difficult. We want to reject your paper, but actually we want to help you get published and we want to help you  create the best paper because once it's published, It's there forever.

So you want to have the best publication that goes into any journal, whether that's BMJ or elsewhere as well.  And on that website, you'll find some of the things I'm covering today, top tips you'll hear. And from some of our editors, you'll see some of the frameworks I talk about as well. So do add that to your list of things to check as you're writing out.

First question is why publish and where to publish?  Before the BMJ, if you can believe it, there was more scientific and academic journals. This was, we believe, the first  academic journal from back in the 1600s.  And since then, the scientific and academic Space is balloons and the amount of publications is really huge.

And the reason I'm mentioning this is because it's all well and good in publishing, but if nobody reads your paper, it's pretty pointless as well. The MJ is part of the problem. We've got no, 70 odd different journals at the MJ. So we're going to try and help you today to navigate those and think about which journal to choose, because the journal you choose is really going to influence who you're.

All right. impacting who you're going to reach and how you're going to try and change their practice or change their decision making as well.  Just as a bit of an overview of why it's good at the minute to be able to do this. This is a view of what happened during COVID and during COVID we saw a huge acceleration in papers.

I think a lot of people were trapped at home plenty of their free time to, to write up work as well. So they submitted a lot of work during COVID and things have slowly died down since then. As well. So  You know, you're probably at an advantage in Western Europe, in the UK, English speaking is, your advantage.

Traditionally, publishing is really being Western Europe, US focused as well. But over time, things are catching up, we're competing now, not just against people submitting work from your own country, but we're seeing a huge volume of work coming from emerging countries and emerging research organizations.

China's publishing a lot of output in India as well.  And that, that plane feels being leveled up. Things like chat GPT are helping people to write. In English, better, if they're submitted in an English journal, that's going forward. Again,  don't use ChatGPT. Write your paper. This is one of the takeaways from today is that it's a great tool for helping you to improve your content.

But at the minute, it's very easy to spot and actually, every paper that we get at BMJ is run through our plagiarism software and we'll pick up work that's come in through ChatGPT as well.  And we'll talk a bit about the process for publication.  The BMJ our flagship journal you'll submit in to, to the journal.

We have a great editorial team who will work through and do some initial checks on that as well. We have academic peer reviewers and in most of our journals at BMJ, we also have patient reviewers as well. And we'll be asking you as you go through your process to talk about how patients were involved.

So again, if you haven't started doing work yet, or you're going to do work, think about how you can involve, patients in your work going forward, because that's, really important to start as well. 

Ashley just while you're on that previous slide, I think it would be really helpful just to have a quick comment about peer review.

And how one of the things that makes it frustratingly slow for you to get your, sometimes get your manuscript backed is because the job of the editor is to find those peer reviewers.  So it's a bit of a plea that if you're asked, do say yes, but also we, if you're unsure about what being a peer reviewer is, or you don't feel supported to be a peer reviewer, do ask the editor for help or get involved because it's a really useful way.

And in this field, particularly a really interesting way of seeing what other people do. And that is a great way to learn what other people are submitting. I just thought I'd point that out.  Put that in there at this stage, actually. 

Yeah, and I would say it's a great place to start, and we'll talk a little bit later on if you've not published before, where to start with publishing and being a peer reviewer is a great way to understand how, the process works.

And peer review is not designed to be critical of your paper. Peer review is designed to help you make the best paper possible. Think about it. If you're doing a startup, it's a bit like pitching to some venture capital companies. They're going to go in and interrogate what you've done and give you advice about how to improve it as well.

So use peer review as a really positive process. And if you get a chance to be a peer reviewer, do take it. It's a really good way to understand the process going forward as well. I was just talking about the BMJ acceptance rate, BMJ innovations used to have a lot higher. It's been a lot more competitive.

If we've had a lot more. papers being submitted, but you'll see the acceptance rate is 12%. That seems quite scary. It seems like you've got a one in 10 chance to get accepted, but actually different types of papers in the journal have different acceptance rates as well. And also, we'll come into the reasons why We have initial rejections later on, but a lot of that is just down to people submitting papers that are not appropriate for that journal.

It may be about, not following simple things, lack of structure, too many words, not targeted or audience not submitted in the right space. But if you submit, a a quality early stage innovation report, you're probably about, 1 in 3 chance of getting published as well. And we will work with you, in the process of doing that.

If it's not accepted, don't panic. You will learn a lot as you go through the process as well.  Don't ever quote this fact, but this is to give you a bit of a sense that actually it takes a long time to get new ideas into practice. It's, not technically 17 years, but  our role at BMG Innovations is trying to speed that up.

We want to try and get those new ideas into medicine quicker. We want, if we want to improve healthcare and make healthcare better, we need to get these new ideas into practice a lot sooner as well. We want you to help do that. We want to get your ideas out more quickly and, a lot of people say, why do we publish and how do we publish?

I think probably if you're coming from your own startup, your own idea, one of the things you're going to want to do is raise product awareness among potential customers as well. And you saw from Tamsyn at the very beginning.  Publishing in an academic or a scientific journal isn't just for the scientific audience, it gives the credibility to what you're doing for other people to pick it up in other media as well.

And this can be, in what's often seen as soft validation, it can be picked up, you may be picked up if you're lucky in the New York Times or Time Out or GQ, one of these, softer journals and magazines is out there as well. But also you get that scientific validation, you have that evidence To back up that work that's there and having, that citable paper that's in a journal, and that can be any journal, but we'll talk about the quality journals.

Hopefully you'll choose BMJ today. We're going to talk about, the principles of submitting into any journal,  but you'll have seen, from some of the previous slides. There's been an explosion. There's about 35, 000 academic journals out there these days. If you go back to, when the BMJ was founded, you were in the thousands.

So there's been a huge explosion in journals. So it's not just about getting published. It's about thinking about  where you're publishing and who you're publishing to going forward as well. Some of the other reasons that you'll be perfectly aware of is your, if you're an academic space, you'd be wanting to develop a fundable track records.

And I should say in the startup space, having a scientific paper is really great when you're going to go and pitch your product for investment as well. So you're going to pitch to VC companies and you can have a peer reviewed publication. That's really helpful to demonstrate the impact and the efficacy of your product as well.

And don't see this as a one off process. I say to people, if you're  beginning an innovation, beginning a startup, think about your journey. Think about the different stages you're going to publish. You might start off with a case report. You might start off with a early stage innovation report, but you're going to want to, as you go through your Development of that product or device target people like healthcare leaders.

You might want to target people in the healthcare improvement space. You might want to target clinical experts as well. So think about your journey. And I'd say think about that from almost the point at which you come up with the idea. Think about how you're going to publish things.  

Sorry, Ashley, you might be about to say this, but I was just thinking that it's a, it is a great point to say that it's also, and we probably won't go into it in too much depth at this stage, is that there are different types of manuscript and report that are appropriate at different stages in product development.

And it's really good to have a plan for that. As Ashley says, you different publish different things at different times, but  very often we see people trying to publish a clinical trial far too early Because it's not ready for that where they could have published a really, or submitted a really solid early stage innovation report. 

Different types of trials have different types of methodologies and it's really important that you pick the right  type of, Test for your intervention, and then it's reported in the right way. And I think there'll be more on that later, right? 

There will be. And I think don't get hung up on you've got one publication and one chance at it.

I think it's a journey. I probably shouldn't say this as an editor, but you've got multiple ways of getting published. You probably out of one One development, one product, you can probably get multiple papers in there. You can talk about the development of your device for innovation.

She can talk about the clinical impact for a clinical journal. You can talk about how it can improve health care for a quality improvement journal as well. So you can tackle elements of this step by step along the way. Often people try and, wait and build this into one big paper that tries to tackle too many things and fails because it's trying to address everything in 3000 words as well.

So think about your journey, think about your process, and it doesn't have to be going straight into a research paper. We'll talk a bit more about the importance of things like poster presentations at conferences, case reports a little bit later as well.  So thanks, Helen. Helen talked about the different types of paper, people see those kind of peer reviewed research papers as the gold standard. But actually, if you look at things like BMJ, often some of our most read pages at BMJ are often opinion or blogs or discussion as well.

Don't see these all having their own values, see them all having their own purpose. I'm a big fan of presenting at conferences, having a poster is a great way to test your initial thinking. You have the chance for people to come in, your peers to come and talk to you, ask questions get feedback.

So posters are a great way of thinking about getting started in that as well. Going forward. Helen, jump in. 

I've got a very important thing to say about posters, which is for the BMJ Future Health Conference, which we're launching in November, we're launching a new type of poster presentation rather than doing the normal poster presentation, which is a submission of an abstract and a review.

We are  wanting to help people to maybe do their first conference type presentation, but we want people to present problems that we think digital, that they think digital health might have an answer to. So this is almost like a stage before an early stage innovation report. It's where you've identified an issue that you want to start working on.

And it's all about describing the problem really well, but again, it's just another opportunity to communicate yourself, your ideas, your analysis of a situation. at an event where you might meet collaborators, advisors, mentors, and all those sorts of things that will help develop and innovate further. 

Yeah, great plug, Helen. And I think also don't, work your way up to a publication. Once it's published, it's very difficult to change. You have to retract a paper. That's quite rare. You want this to be the best possible paper. You can have it. You want it to have developed as well.

And actually doing these things, submitting posters, submitting abstracts, going to events actually helps you. To do that as well going forward. So see this as a journey is probably the one of the most important takeaways for today. And as you say, as we go through this, please do pop your questions in the chat box.

We'll take those as we go through. This is quite an intense one hour. We're going to try and get through lots of stuff,  but do send your questions through and we can take those as we go through the session today. Just very quickly.  What you're doing, if you're working in healthcare improvement, if you're working in innovation, it's a great place to be.

And just very quickly, this is a graph of mortality and morbidity in England. It's over the last sort of hundred years or so. It shows that it's gone down quite clearly over that time. And a lot of that has been down to, big innovations in history, immunization, things like antibiotics, anesthesia, sanitations.

And, what the BMJ did, team did a couple of years ago was plotting this is essentially quality and safety reports. So this is more iterative change. And we're moving, I think, from a lot of big fundamental major innovations in health over the years now to focusing on the iterative changes as well.

So there's more opportunity as we move forward for you to publish those smaller iterative changes. So things like digital health apps that might tackle things like diabetes. So there's a lot of journals, a lot of interest in how we publish those iterative changes that will gradually improve the quality of healthcare as well. We're talking about any journal today. BMJ have got, 70 odd different journals. The same things we're going to talk about today apply to any journal that's out there. Just to give you a bit of a flavor of what we do, BMJ Quality and Safety, which is, one of the highest impact quality and safety journals in, in the world.

We have BMJ Open Quality which is much more focused on PDSA cycle quality improvement going forward. We have BMJ Health and Care Informatics, which is a sister journal to BMJ Innovations. It's focused really on the informatics side and AI as we move forward and BMJ Innovations, as I talked about, which is focused specifically on novel digital health and medical devices as well. 

Just to give you a bit of flavor, you probably have seen this. Discussion about open access. And this is, what BMJ has been involved in open access, but open access is really this transition from, whenever I was a doctor, you had to go to the library to read journals. It was a subscription base. 

And a lot of funders said, that's a bit unfair. If you're from a low income country, you can't afford it. And even though BMJ made our journals free in low income countries, funders said actually, we want you to. publish in a different way, which is making your publication open access. So the model for supporting the publishing industry move from subscription pays to the author pays.

And that's why these days, some of our journals are called open access and you will hopefully find that your institution usually has an agreement with BMJ that covers the cost of that. So things like BMJ OpenQuality is open access. BMJ Innovations is a hybrid journal, which is no fee for publication.

It's a subscription journal, but you can choose to make it open access as well. So that's just a fundamental thing to understand whenever you're thinking about submitting that some journals may require you to pay a fee. Often that would be covered if you're coming from a an institution, an academic institution.

But if you're publishing privately, you may have a fee to pay on that as well. On the plus side, it means that your paper will be open to anybody to read from all over the world as well. Anything you want to add to that, Helen?  And you're on mute. 

So definitely not. I think I think it come understanding the vagaries of the public publishing industry are probably a bit beyond what we want to do for this event. But if people have questions around that then we are happy to answer them. Aaron Govins asked a question is which is the best journal or number one rated journal in the world in terms of quality and quantity.

So Aaron, I just answer that by saying, There are a number of different ways of measuring what you mean by best, and one of the things that the most common one is called impact factor,  and a little bit like the iTunes podcast charts, which you might be familiar with, then journals are classed against their peers in subject areas.

So there is no one best journal in the world, because obviously if you've got a paper that would make a huge impact in one area of medicine, it probably isn't relevant to a lot of readers in another area. We talk about the big four, which are the BMJ, New England Journal of Medicine JAMA and, actually, which is the fourth and the big four?

Oh, the Lancet, yeah, I sometimes forget the Lancet, but those four are the called general medical journals. And, but although some of them focus a bit more on the internal medicine, I think the BMJ is the broadest of those. And so even within those, there's different features of those four journals that jostle for ranking within, that are, that's the biggest area, and those are considered the top of most medical journals.

But then there's other medical advances that might be in, in other journals, published in, in journals that are more specific to their topic area like thorax for respiratory medicine, which BMJ publishes or heart for cardiovascular. And so selecting the journal is really not about going for the number one because they will obviously have the highest highest impact factor, but they'll be the hardest to get into.

So you wouldn't. likely even get your manuscript to to be reviewed by an editor if everything about it wasn't perfect by the rules of that journal to start with, in terms of having all your references right, having the right permissions, having the right making sure all your your institution was okay, and all those sorts of things that really, it's really tough to get into And even then, They are selecting to maintain their position of impact.

Now, impact factor is based on how many people are cited  and cited. Citations are something that the journal editors become expert at looking for if they work to raise their impact factor. So if you, so they're looking for articles that are gonna change practice. The way they think they're gonna change practice is by getting a lot of citations.

So other researchers refer to that paper. When they're writing their own papers and taking things on. So highly citable research is the research and the manuscripts that those high impact factor journals are looking for.  The interesting thing and the really great thing about open access, I believe, is that  not  All science is worthy of report.

And sometimes when we do when we, when things don't go well, that's when we learn the most from it. And so open access means there are a number of journals, for example, BMJ open, which do not look to increase impact factor. They look to publish research that should be accessible. And therefore that's a really important area of publishing to avoid looking at the right ones. 

And the obvious answer, Aaron, is that BMJ Innovations is the best journal, if you do ask me, but I'm slightly biased as we move forward. I'm going to crack on and, before I get into how to maximize your chance of getting published, I want to just explain what we do. And Helen's touched a little bit on, on this, and what she's just said.

But our role is really to help you to guide you into how to best prepare and submit your manuscripts. We will at BMJ make sure we treat you with fairness. We are there to make sure we're objective and often sometimes we'll be doing blinded peer review it in certain journals at BMJ to make sure we comply with that.

We will have be setting some policies, particularly in my space, which is innovations. There's going to be some conflicts of interest there. If you're writing from your own startup or digital health products, and we have some special rules that you need to follow within that as well. And most importantly, our process are our main aim is to try and make sure we get you through that peer review process to.

Produce the best possible quality paper in the most rapid and effective way going forward. And, we're very open open, first of all, to answer questions from you if you've got questions before you submit, but actually, we want to make sure this process is transparent as well.

So we will give you I think hopefully really useful feedback, even if we're not able to accept your paper giving you good feedback around what were the reasons for that and how you might be able to think about where else you could publish that, how you could redesign it, how you could restructure it and giving you advice as well.

So hopefully, just by going through the submission process, you can learn and hopefully get some advice as well as we move forward.  So what do we look for as editors? I try and describe this. You probably heard of the seven wonders of the world. I describe this as the seven wonders of the publication world.

And these are things that we look for whenever we, we see your paper. So the first one is really about. Is this important? We get a BMJ thousands, if not tens of thousands of papers every single year. It gets added to the, 33, 000 journals that are right there as well with all the papers as well.

So what we're looking for is something. Is this important? This is going to help to shape clinical decision making. Is it going to have an impact on the wider world? Is this original? Is it novel? We don't want to be publishing the same paper over and over again in different journals.

Is this something that's new? And that's really tough. This, if you think about the amount of work that's out there,  trying to find something that's new and novel is really difficult.  Is it relevant to the audience? And we see this quite a lot is our audience of, Our journal going to be interested in this topic and that comes down to you a little bit about thinking about which journal to target and also when you're writing to write for that audience going forward. 

Does it have a real potential to improve decision making and this may not. I think people always assume that this always has to be positive outcomes. It has to be how we've improved, diabetes or a clinical condition. But if you've done a project, often in the quality improvement space, done a project that hasn't made a difference or has made things worse, that's really important as well, because in medicine, we are really bad at repeating the same things over and over again.

And so we're looking for, things that can improve decision making. It doesn't mean that we have to adopt what you've done. It can be a case of saying we shouldn't be doing that in the future because it hasn't worked. So that's a good thing. If your project hasn't worked, there's still a chance to get that published. We want to, we'll be looking into the transparency in this. We want to make sure that you're not plagiarizing work. We have lots of checks that go on at BMJ and, these days with AI, AI has a big problem in elucidating content as well, going forward. So we want to make sure your content is truthful, transparent.

We want our readers to trust what BMJ publishes as well. So we put a lot of work into making sure that content  is there. The other bit, and you'll see a little bit later on why this is important, but clear writing, you want people to read it. If your paper is written with lots of big technical words in a really complex way, people won't get through the first paragraph of the paper as well.

You want people to read your paper if you want to have an impact. And that's about clear writing that people want to read. And again, I'd say if you can get one of your. Your family, your peers to read this, that's a really good test of being able to read it clearly as well.  The last one is really difficult to achieve, but we look for that wow factor, something that stands out. 

We're reviewing hundreds of papers every week, and it's thinking about, why is this different? Why do we want to get excited about this paper that you published as well? How do you maximize your chance of being accepted? How do you get into that 14 percent in BMJ innovations or the 5 percent in the BMJ? First bit is, I think, choose the right journal. Thinking about who you want to read your paper, who do you want to influence, who's the appropriate people that Need to know what you've done and read that journal.

Go off and read some of the papers. Think about how the other authors have structured their papers. Look at the topics that are in there. Scroll through the latest published papers that are there to see whether your papers are a good fit for that journal.  Follow the advice for the authors. You'll see it. 

On the website there'll be lots of guidance about the word count how to structure things like the abstract what you can include in tables and references as well as you go forward to read that and think about how you structure your work you'll see sometimes that they'll reference some frameworks or statements if you're publishing for example in healthcare improvement you might be referred to the square guidelines and the square guidelines is really helpful and I'll share a slide later on about how to access these.

But these are ways of being able to structure your, your write up as well. It's almost like a template to fill in to, to write your paper as well. So look for useful information like that as you go forward.  Follow the advice, submit in the correct way. Most journals these days will be through a submission system online.

And communicate clearly and promptly with the editors. This is not going to be a quick process. People often assume, they'll be published in a week or two. Some of the papers that we're looking after, can take a year. But. innovations are relatively quick to give an instant decision about whether we're going to proceed or not proceed  the actual revision process.

It may take  123 revisions to get to a paper that we publish and that's not just us being difficult. That's trying to make sure that this paper that's going to be online forever is the best possible paper for you. And that peer review process is really helpful going forward  again a slide. Reluctant to put up, but this is from a long time ago from JAMA.

But the key takeaway is often the things that you think are important are not the things that reviewers or editors think important as well. So if you look at what reviewers and editors felt was important was that often poorly written papers with excessive jargon that are. badly structured are the bits that are seen as the biggest problem by editors and journals.

And these are things that you can easily fix. So the takeaway from this today is that actually, think about yourself in the mind of the reader. And is this going to be structured? Is this going to be understandable for the target audience you're reading as well going forward? So a lot of the things that we see are things that you can tackle before submission as you go forward. 

So a little bit about writing your abstract and your paper. And this is going back to if you ever, train as a journalist, this is what they teach. If you write anything, as far as news or stories, these are the things that they ask you to tackle. And if you can cover these as part of your paper and part of your abstract, you're doing pretty well.

And this is really diving into, thinking about the reader, Not knowing anything about what you're doing, explaining, why you're doing what you're doing, and that will be referencing the fact that actually, we know that diabetes in, Nigeria affects X number of people.

It's a big problem, puts a big burden on the health system explaining the bit of a background and referencing some of the evidence and data about why the problem you're tackling is important. You need to explain what you're doing, that might be a digital health app to help patients improve their glucose monitoring or management, how you're doing it.

You're going to explain that through the device that you're doing and then. giving us the details. Often people will not give the background that's important. Our readers are from all over the world. They want to know whether this is a public system or a private system. They want to know whether people are paying for their own healthcare.

They want to know whether this is an inner city hospital rural hospital, whether it's an elderly population or a younger population. So if you can cover all these boxes, you're telling a really good story about what you're doing. And particularly for the abstract, helping people to get invested in.

What you're doing, then reading the rest of the paper as well. Helen, 

I was going to say, I find it useful here. And one of the criteria I use as an editor, but for researchers, remember that the fundamental principle of science and this publication business is all to do with reproducibility. And that means could someone else read your manuscript and do what you've done and get the same results?

And everything we do within a manuscript is aimed at proving that. Not that people often reproduce work, but the idea is you provide enough information that someone else can follow your recipe and get the same cakes. And that means that what you are saying is true. So when you're thinking especially about writing your methods, and especially about Describing the data sources you've used is, would someone else be able to reproduce this?

And that's really important.  

And it's a good point, I think, particularly if you're working in the medical device space, or the digital health space, or the BMG innovation space, you're going to have a bit of a conflict as well, because if you're publishing early stage work, you're going to be very protective of IP as well.

For us as editors, we have to disregard that. We want to Produce useful knowledge and as Helen said, be able to explain a bit of a recipe of how other people could reciprocate that as well. And, the bit that we may want to pick up later in the questions is, how do you negotiate that, that, Way up between protecting this kind of novel new idea and intellectual property developed, but also wanting to share how that's had an impact on health as well.

And that's often a challenge, and you may decide that actually, you can't publish until you get later on, you get that IP protection in place,  or, you may be quite happy to publish very early on, because those ideas, you're happy to be shared by other people and other people to replicate what you're doing.

To improve health care as well. So we'll maybe talk about that a little bit later just some key considerations when writing. So these are, some things that we, as editors think are important as you go through the process  is.  Be very systematic and organized and I, I recommend if you're starting a paper to, start to put down some sub headers, put down some points about what you're going to cover in each bit.

Think about, how other papers are structured. I would almost, have a couple of other papers from that journal alongside that you're referring to ones that have. Being accepted, obviously don't copy what they're doing, but use that as a bit of a structure to think about how to organize your work.

And, again, as editors, we're often very happy to look at your outline as well as you move forward. So just making sure you cover all the key points, I'd often get one of your colleagues to look at that and think, is that the right structure? Have you covered the main things within that before you even start writing?

Because once you start writing, it's very difficult to then reorganize what you're doing. And you're going to be writing to a word limit. a really tight word limit and you're going to want to cover those main points that's in that. Likewise, keep it clear, keep it concise, do what a good journalist would do and go through and cut out, unnecessary words at the end.

This is a an academic paper. It's not a piece of fiction. You're going to want to tell that story as clearly and concisely as possible. Be truthful, be reflective.  We are judging your paper on the learning. And this is a really important point, is you have to do the perfect study. If you are doing something that's really useful, that's developing learning for other people that, Get lots of credit from us as editors and, whenever we're judging a paper, it's how useful and how important this paper is going to be for other people.

If you did something that you would do differently next time, if you learned something that you will share with other people, if they're going to do the same thing about how to do it differently, that's hugely valuable for our audience as well. So do include that reflective piece in the discussions of your paper as well. Be specific. Again,  We get a lot of papers that are very vague. It will talk a population with diabetes. It's really important that we understand that it's not just a population with diabetes. It might be the over 65s in a certain country, in a certain situation, with a certain lifestyle.

We need to understand that and we'll come back to you usually to get clarity. If we don't have that be innovative. We like new novel ideas, but we also think, this has to be a realistic if you've got an amazing product, but in reality, it's never going to work in real life.

It's not going to be accepted. We need to know the limitations  of your product, your device, and what that's going to be like in the real world. And that's why we say that even for our early stage innovation reports, they have to be at least in situ have to be tested with patients or their population.

So you can get some feedback about what's working, what's not working.  The next point, number six, objective and neutral. This is really important. This is, I think, one of the big challenges that you, if you're working in this space of innovation novel ideas, digital health apps,  we see a lot of papers that are written as a marketing pitch.

It's very easy to get into, writing that this is the best product ever to tackle diabetes. This is new. This is novel. It's the only one in the world that's there. We're, And I think for the readers, not one over, but that if you want to engage the reader, you have to, this is an academic audience.

You're going to have to go in with an objective view. What works, what doesn't work. What's the learning for other people as well? Keep it neutral. We're interested in the idea. We're not interested in buying the product at this stage as well. So keep that objective, keep it neutral a number seven, keep it patient centered, not number centric.

We want to know what, Okay. The impact is going to be on patients numbers are important. Your measurements are important, but actually, if those measurements cannot be replicated into the patient situation, the real world situation they're not hugely useful. And then the final one.  As you're going through this, don't write for us.

Don't write for the peer reviewers. Write for the readers. We will be seeing ourselves in the head of the reader of your paper. And that comes back to the structure. It comes back to the use of language. It comes back to the use of words. It comes back to the focus of that paper. It's not proving that you're the best researchers in the world.

It's talking about the idea or the product you developed going forward. So just keep this in mind as we move forward. Helen. 

I just want to go back on number six because it's the one we come up against the most on innovations but it, it comes up everywhere and it just again a reminder that pretty much every type of manuscript report asks you to consider your limitations and  some manuscripts are really interesting and really great but  people writing them you can tell are really reluctant to write what the limits of this.

Discovery or this thing might be because they feel that's negative and that will take away from it. But in fact, the opposite is true. And it a good and open and honest  discussion of the limitations of the manuscript.  give so much credibility to anything else said, if the, if we can see that the author has considered the scope, the potential reproducibility, for example, this was, this study was done in a large hospital in the UK and therefore we don't know whether it is,  Whether the device will work  in an area where there isn't good phone connection, for example, just a comment like that says, this is a problem now. 

doesn't mean it's a permanent problem and it's the end of it, but it really shows in academic work that you have reflected on some of those important things that make the manuscript worth reading. And so never shy away from criticizing your own work within the manuscript because other people will criticize it when it comes to review and more people will criticize it when it becomes public.

So it's really good to actually get ahead of all of those things by making sure you've. Covered off what you think of the important limitations of your own work. Great.  

Helen. So again, post your questions. I'm going to try and time how long I speak. We've got plenty of slides, but I'll try and leave room for questions as well.

So if you've got questions, please fire them in as soon as you've got them. So we can just time the end of this webinar to the right point as well. So before you start, even writing or I think, going back to when you think about your innovation is thinking about having a clear.

a clear problem you're going to address. And ideally, not too many problems. We get a lot of papers that people are trying to tackle lots of different things at once. Maybe an app you've developed and you're tackling obesity and diabetes and many other different conditions as well for lots of different audiences.

And that's often very difficult to write up. And the thing you're going to have to think about is, does it make sense for you to tackle all of these things all those at once? Or are you going to do a bit of a study on one of those specific clinical areas as well? So before you start, make sure you've got a clear, valid, viable problem.

And viable is important because viable when it comes to writing that up for publication is really important.  Use the correct methodology. So thinking about your methodology for how you're going to measure things. Often people will go off and do a project and then realize later on that they've measured the wrong thing or taken the wrong approach or the wrong population set.

So think clearly about how you're going to measure what your population is and how you're going to tell the story afterwards, which is really important. Keep an open mind. Do what you can to minimize bias. You'll hopefully have some support from people in the clinical space or the research in your university to help you do this. 

There's likely always to be bias in the work that you do. The important bit is you recognize that,  you minimize that where you can, but also you report upon that as well as we go forward.  agree who will be the first author. I think this is a small point, but it becomes a very difficult point whenever you get to the very end as well.

So I think it's good before you even start to think about who's going to be leading this as you go forward. Who's going to be the other authors? Who's going to be the contributors? Bear in mind that you can also acknowledge lots of people. At the end of your paper who have helped to collect data and helped you with the work as well.

You don't have to have everybody as authors. And I think it's good to try and minimize the number of authors who are working on the paper. It should be really people who are truly authors on the paper that's there.  And the final point is a personal one of mine, and it goes back to, some of the work that we did with the NHS was, we think it's really important to try and publish this work, even if the results are negative.

Again, we hope that your work will improve healthcare. If, for some reason, what you've done has made things worse, that's really important that we don't repeat the same mistakes again. And that learning, I think, is probably even more important than some of the positive learning as well. I'm not going to go through these, but you can find lots of.

Guidance for reporting. I mentioned Squire earlier, which are publication guidelines for quality improvements. You can find a lot of these on the websites. And also, if you look at a journal, it will often reference reporting guidelines there as well. 

And insist that they're followed. Your paper will be returned quickly if you have.

said you've done a randomized control trial and haven't  put in the right reporting guidelines checklist. 

Yeah. And again, all these things are good, even if you're not entirely sure what your outcome of your work is going to be. I would go off and think about all these things before you even start you Measuring the impact of your device or product as well going forward. We talked a little bit about this earlier, but I think presenting a conference is a good way. Helen talked about BMJ future health, but there's lots of other conferences out there, which is a good starting point.  Posters are great because it's really good at getting your mind to think about what are the most important bits you have to stick on a small piece of paper, and then you can expand that into an academic paper for it for a journal as well.

It's a great place to make connections. It's a great place to get real time peer review as well from people who are reading your poster and giving some feedback along the way. So do think about posters and conferences as a good starting point before you submit.  I'm going to talk a little bit now about just before submission, and this is getting into the technicalities, so we'll take any questions as they come up as well.

But, Before you get to the point of submitting is, you're going to be asked for all your author information whenever you submit, not just you, but the other authors, the contributors to your paper as well provide the details. They'll ask for your institution, they'll ask for your organization.

We've a new policy at B& G Innovations that, you might be a doctor working in the NHS in the UK. That may be, your main role, but your paper might be about your digital health startup that you've built in your free time.  We ask you to put the organization or institution that's most relevant to that paper as your primary organization.

So if you're writing for your  commercial entity or your startup, we want to see that first of all. The reason we do that is that we believe in being as transparent as possible for authors. You will have to have submitted a conflict of interest forum. That will be. Probably at the end of your paper, which will give details about, maybe you're a co-founder, maybe you have a commercial interest in that product.

But we will also wanna have that at the top of the paper as well. For the author piece, you'll maybe have different rules for different journals. For B Innovations we want to have the organization that's most relevant to the paper you're presenting this there,  manuscript length and formatting.

Each journal will have. clear rules about the number of figures, the word count. There's no reason I think most journals like we at BIMS Innovations will be flexible. If you come back and say, the word counts 3, 000 words, but we just can't fit it in. We didn't extra 200 words because of this, or we want to include extra tables.

We want to include extra photographs. Most times the editors will say that it's fine. So if you can't fit it in, come back to us, but before you submit, make sure you've got approval. If not, make sure your paper aligns with all the criteria, because what will happen, you submit, it'll get bounced back immediately whenever it goes through those pre submission checks. Tables, figures, we'll touch on these very briefly, but just follow the rules. Supplementary files I think are really important. More and more journals are asking to upload supplementary data as well, and that's really great, You're trying to share things that can improve health care.

The more information you can share with readers, the better. So do pop those in and make sure your figures are formatted. Make sure they've got labels on the axes. That's one thing that often people forget and put them in there. References are tough. There's lots of good tools these days for making sure you collect and Create your references correctly, make sure they're the right format, make sure that your supplementary files are uploaded in the right way and referenced in the text.

Often we get lots of files that are just attached for our interest, and we don't know what to do with them. So make sure they're referenced in the text so we can check those at the relevant points. And  make sure you've you'll have some forms to fill in around conflict of interest, competing interests, ethical approval.

Again Often people don't think about ethical approval for the work that they're doing. Anything that involves people or patients will usually need ethical approval. And you will have a an ethics review board, usually in your organization. If you need advice and that come to us beforehand, but if you haven't got ethics approval and you submit a paper, it may mean that we can't publish your paper as well.

So that's something that's really important competing interests. Don't let them. Put you off publishing. BMG Innovations is designed to publish medical devices, digital health. We know often that people that are writing these papers are involved in it in some way. As much as possible, you want to distance yourself.

So it's great where you've got an independent organization, maybe a university doing the measurement of your product or your device. But if that's not the case, we have processes, we will be looking as much as possible to make sure the data you've collected is independent and there's fidelity to that data will often maybe ask for the data to go through.

We might even speak to the people who've been collecting that data to make sure as much as possible, we can demonstrate that data is correct and there isn't been a conflict of interest there as well. So you will have various statements to complete as you go through. Helen mentioned the checklists, make sure that. 

If you are submitting to a journal that requires that it's included, or you explain why not. And again, coming back to permissions, if you're including diagrams, photographs, make sure you've got permissions to include that as well. And if not make sure that you've acknowledged that and you're seeking permissions because we won't be able to publish something that we don't have permissions for at that point in time. 

The last one's really interesting. You'll see that we often request for suggestions for. for peer reviewers. And that's because often you might be working in a really niche area where you can help us by finding some people that can help to peer review your work. These should be people that are independent.

They shouldn't be people that you know personally or would have bias towards what you're doing as well. But please do help us if you can submit reviewers along the way. 

Actually, I'm just going to give you a two minute warning. 


And remind everyone that if they have any more questions, do type them in now.

And if we can get them, we will, but if not, we'll we'll get back to you. 

Yep. And do submit your questions and, do again, follow up. I'll pop my email address up on the screen at the very end as well, but just some final reminders, make sure you haven't included patient's identities in there and make sure you've got your ethical approval and you'll find lots of useful stuff the website just some final tips is read through.

Don't use metaphors, keep this clean objective concise as you go forward. I think getting people who are your peers, your family to read your work, I think is really helpful if they can understand it.  It's really helpful. I think for us as editors, we're reading again reading this as readers as well going forward.

Lots of resources as I said, go to the authors. website. And if you have any questions for me, or you need any advice, that's my email address on the screen. So we want to help you. We're your friends. We'll help you get published as well. So great. Thanks for all your input today and we look forward to seeing your papers in due course. 

Yeah, thanks so much, Ashley. And we're nearly out of time here. And I would like to direct you, Molly, if you can share your screen. I think, Ashley, you may have to stop sharing yours. Just to the fact that this recording of this webinar will be available after the event, so you can direct people towards it.

The we've got two more webinars coming up in June.  But especially for November, you can start to, you can now register and buy your ticket to attend the event in November for BMJ Future Health. And the QR code on screen is where you submit your problem. I think that's one of the questions that about submit for our problems expert that we'd love to hear what problems you're coming up against as that first part of the innovation cycle. So yes, the next webinar is on the 19th of June, and it's a really great. session from the Health Foundation talking about exciting new technologies, easing that administrative burden on healthcare, which we think is a really key ingredient to how tech can improve health. So look forward to hearing Tim Horton from the Health Foundation on that in,  on the 19th of June.

Thank you so much everyone for joining us. We're available for afterwards. We've noted all your questions. I've hoped Molly. Thank you very much. And we'll be in touch and hope to see you again soon. Thanks very much. 

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