Manuscript Requirements

Article Categories
Medical Decision Making publishes original research articles, reviews, tutorials, brief reports, technical notes, letters to the editor, essays, case studies, commentaries, editorials, and “rounds.” MDM does not consider previously published articles for publication. For more information, please see Author Information. Descriptions of these article categories are provided below and include guidelines for manuscript word count. Word count is based on the body text of the manuscript, excluding the abstract, acknowledgments, figure legends, and references. Although exceptions to word limit recommendations are sometimes granted, manuscript acceptance is more likely when authors stay within these guidelines. These limits do not apply to material that can be published in a Web-only format, however. Authors should indicate which materials (if any) in their submission may be published in Web-only format (e.g., methodologic appendices, certain figures, evidence tables).

Original research articles (3,000-5,000 words).

Reviews (3,500 words). MDM considers systematic reviews as well as informal, narrative reviews.

Tutorials (5,000 words). Authors are encouraged to consult with the editor-in-chief before submitting a tutorial. Prospective authors should provide an outline of the tutorial with an estimated word count. MDM is interested in tutorials about techniques and software for advanced mathematical, statistical, and economic modeling. Authors are encouraged to include hyperlinks to online materials that can be used in the tutorial.

Brief reports, technical notes, and letters to the editor (1,500 words). Brief reports describe preliminary or limited results of original research—ideally illustrating a new methodologic approach or a new feature of an established methodology. Technical notes describe and propose an approach to a methodologic issue that is part of a larger model or analysis.

Editorials (1,500 words). The journal regularly publishes editorials, which are considered as a result of a presubmission inquiry or invitation only.

Rounds (5,000 words). MDM has an ongoing, occasional series in the areas of clinical decision making rounds and policy decision making rounds. Typically, clinical decision making rounds illustrate the application of a decision model to an individual patient. Policy rounds describe the role of an actual decision model, cost-effectiveness analyses, or other type of mathematical model in actual policy decisions, including, for example, a clinical practice guideline or a national coverage policy decision. The ideal submission of this kind would include detailed information about the problem addressed, collaboration among modelers and decision makers in framing questions, the development and results of the model, and how the model influenced (or failed to influence) a decision. Rounds manuscripts can be a single submission or a pair of manuscripts that conform to the word count restriction noted.

Manuscript Format and Style
Although MDM accepts files submitted in Microsoft Office Word (*.doc) format, we cannot accept those in Microsoft Word 2007 (*.docx) format. Please convert Microsoft Word 2007 files to an alternative Microsoft Word format with a *.doc extension before submission. Manuscripts submitted in TeX/LaTeX format are acceptable; however, MDM requires that a PDF version of the manuscript accompany these submissions.

Authors should write for a sophisticated general medical readership and follow principles of clear scientific writing. Aim for clear, concise, and logically organized presentations. Avoid convoluted sentences and use the active voice whenever possible. MDM largely conforms to the Uniform Requirements for Manuscripts Submitted to Biomedical Journals (April 2010) developed by the International Committee of Medical Journal Editors.

In addition, for randomized trials, adherence to the most recent CONSORT statement and checklists is encouraged. Other CONSORT statements, such as STARD or STROBE, may also be useful for structuring research manuscripts. For systematic reviews, MDM recommends following the reporting guidelines in chapter 5, Standards for Reporting Systematic Reviews, in the 2011 Institute of Medicine report, Finding What Works in Health Care: Standards for Systematic Reviews.

Abbreviations. With the exception of units of measure (see also below), the use of abbreviations is strongly discouraged. The first time an abbreviation appears in a manuscript—unless it is a unit of measure (eg, mL)—it should be preceded by the words for which it stands.

Drug names. Although MDM encourages the use of generic names for all drugs noted in a manuscript, proprietary names may be added in parentheses on first mention at author discretion.

Units of measure. All units of measure should be expressed in conventional units with Système International units provided in parentheses throughout the text. Conventional units should also be used in figures and tables with conversion factors provided in legends or footnotes. In accordance with the Uniform Requirements for Manuscripts Submitted to Biomedical Journals, however, manuscripts containing only Système International units will not be returned to authors for that reason.

Currency may be presented in US dollars, Canadian dollars, British pounds, or Euros. If the study was not conducted in the United States, authors may wish, for the benefit of readers, to provide the rate of exchange to US dollars at the time the study was conducted in the Methods section (e.g., November 2012: 1 Euro = 1.30 US dollars).

Numbers and statistics. Equations should be typed exactly as they are to appear in the final manuscript. Authors are encouraged review recommendations from the Annals of Internal Medicine regarding the presentation of percentages and statistical measures such as error measures, P values, and trends. Likewise, authors are encouraged to consult guidelines from the American Psychological Association for information on presenting statistical results.

Manuscript Components
Manuscript components should appear in the following sequence: title page, abstract, text, acknowledgments (if any), references, tables, figure legends, figures, and appendices (if any). All pages should be numbered consecutively, starting with the title page. Tables and figures should be numbered and appear together in sequence.

Title page. Provide a main title and subtitle (if any) for the manuscript. If the study is a randomized trial, systematic review, or meta-analysis, authors must add that descriptor to the subtitle (e.g., Effectiveness of a decision aid for patients with asthma: a randomized trial). Provide a running head of no more than 50 letters and spaces; author name(s) exactly as it (they) should appear in print, including highest degree(s) earned; name of department(s) and institution(s) where the work was done; meeting(s) at which the work was presented (if any); grant or other financial support (if any); contact information for the corresponding author and for the author to receive reprint requests. Specify also the word count for the text of the manuscript, excluding the abstract and references.

The statement that follows should be included (1) in the cover letter and (2) as a footnote on the title page:

Financial support for this study was provided [choose one: entirely or in part] by a [choose one: grant from or contract with] [insert name(s) of the funding source(s), whether a company, government agency, philanthropic foundation, institute, etc.]. The funding agreement ensured the authors’ independence in designing the study, interpreting the data, writing, and publishing the report. [The following sentence should be inserted, if applicable:] The following author(s) is/are employed by the sponsor: [identify employees].

During the submission process, the author is asked to identify keywords from two lists: APPLICATION AREAS and DETAILED METHODOLOGY. The editors use these author-selected keywords to match the manuscript to reviewers who have pertinent expertise. Authors are encouraged to review these keyword lists carefully—and completely—before making selections to ensure that the best possible keywords are chosen for the manuscript.

Abstract. Word for word, the abstract is probably the most important part of a manuscript. Editors use the abstract to decide whether the article is of interest for MDM. Reviewers use it to decide whether to accept an invitation to review the manuscript. Once the manuscript is published, readers use the abstract to decide whether they want to read the article.

Authors are encouraged to take extra time to write a good, clear abstract that addresses all of these “audiences.” Describe why readers will find the article interesting, address the critical points of the methods and results, and list your most important conclusions, including clinical or policy implications. Think about the words and phrases that will help readers and researchers locate your published article—and use them in the abstract.

Abstracts must accompany all submissions except editorials and brief reports. Structured abstracts (275 words) are required for cost-effectiveness studies and systematic reviews, including meta-analyses. Structured abstracts are preferred, but not required, for other original research manuscripts. For brief reports, abstracts (175 words) are optional. The editor-in-chief retains the right to request a structured abstract for any article. The table provided (see above) shows required (bold) and optional headings for structured abstracts based on the methodology used.

Text. For original research—including economic analyses, systematic reviews, and meta-analyses—use four main headings when arranging manuscript text: Introduction, Methods, Results, and Discussion.

Introduction. Set up the context of the research for readers concisely. Keep the Introduction section brief. Avoid repeating background or theory that can be found in textbooks or previously published articles; cite those sources instead. Always end the Introduction section with a clear statement of the study’s objectives or hypotheses.

Methods. For studies involving humans, describe in the Methods section how participants were assembled and selected as well as the sites or setting from which they were recruited. Then, describe study procedures, including any interventions, measurements, and data collection techniques. Use figures to diagram study processes, including the flow of participants through the study. Provide the number of subjects at each stage of recruitment and follow-up, including the number of subjects who declined to participate and the number of individuals who completed follow-up protocols.

For studies that have numeric data and use statistical inference, include a subsection that describes the methods used for statistical analysis, documenting also the statistical software used.

For all studies, include a statement at the end of the Methods section that describes the role of the funding source for the study. If the study had no external funding source, or if the funding source had no role in the study, state so explicitly.

Results. This section should also be clear and concise—and it should report results only. (Implications, theories, opinions, and findings related to results should be confined to the Discussion section.) Fully describe the study sample so that readers can gauge how well the study’s findings may apply to their patients (i.e., external validity). Then, present primary findings followed by any secondary and subgroup findings. Use tables and figures to demonstrate main characteristics of participants and major findings. Avoid redundancy among text, tables, and figures.

For systematic reviews, MDM recommends following the reporting guidelines in chapter 5, Standards for Reporting Systematic Reviews, in the Institute of Medicine report, Finding What Works in Health Care: Standards for Systematic Reviews.

Discussion. Consider structuring the Discussion section as outlined below:

  • Provide a brief synopsis of key findings with particular emphasis on how the findings add to the body of pertinent knowledge.
  • Discuss possible mechanisms and explanations for the findings.
  • Compare study results with relevant findings from other published work.
  • Discuss the limitations of the study and any methods used to minimize or compensate for those limitations.
  • Mention any crucial future research directions.
  • Summarize in a straightforward and circumspect manner the clinical implications of the work. It is common, but not required, to have a separate Conclusion heading.

Tables and figures. Excessive tabular material should be avoided; most data are better presented in text or figures. Information should never be duplicated among tables, text, and figures.

Information included in a table format should be typed and double spaced. Each table should be titled and appear on its own page. Footnotes should be used in the following order: *, †, ‡, §, ||, ¶, **, ††, ‡‡, and so on. Do not use numbers or letters (i.e., AMA style) to mark footnotes.

  • During manuscript development, please keep the following suggestions in mind when preparing tables and figures:
  • Avoid pie charts and 3-D effects.
  • Whenever possible, present measures of variability in charts and graphs.
  • Avoid clutter. Remove unnecessary borders, legends (when they make the graph itself smaller), and decimal places. Space axis values so they are legible.

Graphic files in the following formats are acceptable for peer review: *.eps, *.ppt, *.psd, *.tif, and *.xls. All components of the manuscript are converted to a single PDF file to be used by editors and reviewers during the peer review process. However, when a manuscript with graphic files in these formats is accepted for publication, the authors are required to submit all figures in separate files if they have not done so earlier in the process.

Figures for accepted manuscripts must be created in graphics formats that permit object editing. Bitmap and low-resolution output from some computer programs must be redrawn prior to publication in a graphics file format (e.g., *.eps, *.ppt, *.psd, *.tif, or *.xls). ScholarOne provides helpful information to authors concerning uploading files and images for accepted manuscripts.

Acknowledgments. MDM encourages authors to acknowledge persons who have contributed to the scientific content of manuscripts or provided technical support. Authors must obtain written permission from anyone whom they wish to list in the Acknowledgments section. The corresponding author must also affirm that he or she has listed everyone who contributed significantly to the work in the Acknowledgments.

Materials taken or adapted from other sources must be accompanied by a written statement from the author and the publisher granting permission to the publisher of MDM for reproduction. Questions regarding permissions may be directed to the SAGE Publications Permissions Department.

When authors submit a manuscript, they must disclose all financial relationships (both personal and institutional) that could be viewed as presenting a potential conflict of interest or that might otherwise bias their work. (If additional clearances are required by author institutions, these formal clearance statements must be provided by the authors in the manuscript as specified by the institutions.) To prevent ambiguity, authors must state explicitly whether potential conflicts do or do not exist. Potential conflicts include, but are not limited to, any financial relationship that involves conditions or tests or treatments discussed in the manuscript and alternatives to the tests or treatments for those conditions. Financial relationships (e.g., employment, consultancies, honoraria, stock ownership or options, paid expert testimony, grants, patents received or pending, royalties) are the most easily identifiable potential conflicts of interest—and the most likely to undermine the credibility of the journal, the authors, and the science itself.

Disclosure of these relationships is essential not only for original research manuscripts but also for editorials, letters, commentary, and review articles. MDM publishes conflict of interest disclosures. When authors are uncertain whether a potential conflict of interest exists, they should err on the side of full disclosure. All such disclosures should be listed in the Acknowledgments section, at the end of the manuscript.

References. Manuscript references should be double spaced and placed in order of citation. All references must be cited in the text, tables, or figure legends.

MDM’s preferred style for references is the Vancouver style. For more information, please see Uniform Requirements for Manuscripts Submitted to Biomedical Journals.

For in-text citations, number references using Arabic numerals in parentheses, in the order in which they first appear in the text. References cited in a table or figure should appear in numeric order relative to the first citation of the table or figure in the text. For example, if the last reference cited before the table or figure in question is mentioned is reference 14, and that table or figure contains five references that have not been previously cited in the text, the references in the table or figure would be numbered 15 through 19. Citations in the text would then recommence with reference 20.

During manuscript development, please keep the following suggestions in mind when preparing a reference list:

  • List all authors when there are six or fewer; when there are seven or more authors, list only the first six and add et al.
  • Do not use ibid or op cit.
  • Include an “available from” note for documents that may not be readily accessible.
  • Cite symposium presentations only from published proceedings. (Unpublished proceedings may be cited parenthetically only.)
  • When citing an article or book accepted for publication but not yet published, include the title of the journal (or name of the publisher) and the year of expected publication.
  • Include references to unpublished material in the text parenthetically; do not place unpublished sources in the References list. Obtain and submit written permission from authors to cite unpublished data and manuscripts still in press.
  • Ensure that URLs (Web site addresses) used in references are active and available as of the date of manuscript submission. References to online sources generally should include a date of access that is the same as the date of submission.

Appendix. Supplemental material should not have a separate References list. References that appear in the text and an appendix should be numbered as they appear in the text. Any references that appear only in the appendix should be added consecutively to the end of the References list in the text.

Atkins D, Best D, Briss PA, Eccles M, Falck-Ytter Y, Flottorp S, et al; GRADE Working Group. Grading quality of evidence and strength of recommendations. BMJ. 2004 Jun 19;328:1490. Accessed 2 January 2013.

Bailar JC 3rd, Mosteller F. Guidelines for statistical reporting in articles for medical journals. Amplifications and explanations. Ann Intern Med. 1988 Feb;108:266-73. Accessed 2 January 2013.

Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig LM, et al; STARD Group. Towards complete and accurate reporting of studies of diagnostic accuracy: the STARD initiative. Fam Pract. 2004 Feb;21:4-10. Accessed Accessed 2 January 2013.

Council of Science Editors. Scientific Style and Format: The CSE Manual for Authors, Editors, and Publishers. 7th ed. Reston, VA: Council of Science Editors, Rockefeller University Press;2006.

Huth EJ. Medical Style and Format: An International Manual for Authors, Editors, and Publishers. Baltimore: Lippincott Williams & Wilkins; 1987.

Institute of Medicine. Standards for reporting systematic reviews. Finding What Works in Health Care: Standards for Systematic Reviews. Washington DC: National Academies Press; 2011:195-222. Accessed 2 January 2013.

International Committee of Medical Journal Editors. Uniform Requirements for Manuscripts Submitted to Biomedical Journals. April 2010. Accessed 2 January 2013.

Philips Z, Ginnelly L, Sculpher M, Claxton K, Golder S, Riemsma R, et al. Review of guidelines for good practice in decision-analytic modelling in health technology assessment. Health Technol Assess. 2004 Sep;8:iii-iv,ix-xi,1-158. Accessed 2 January 2013.

Schulz KF, Altman DG, Moher D; CONSORT Group. CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials (24 March 2010). Ann Int Med. 2010;152. Accessed 2 January 2013.

Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000 Apr 19;283:2008-12. Accessed 2 January 2013.

von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Intern Med. 2007 Oct 16;147:573-7. Accessed 2 January 2013.

Weinstein MC, O’Brien B, Hornberger J, Jackson J, Johannesson M, McCabe C, et al; ISPOR Task Force on Good Research Practices–Modeling Studies. Principles of good practice for decision analytic modeling in health-care evaluation: report of the ISPOR Task Force on Good Research Practices–Modeling Studies. Value Health. 2003 Jan-Feb;6:9-17.

Updated: 2 January 2013, RJF