Information for Contributors / Authors

Preparation of manuscript
Special Report. Uniform requirements for manuscripts submitted to biomedical journals. N Eng J Med 1991: 324: 424-8.

Type the manuscript on white bond paper, 216 x 279 mm (8.5 x 11 inches) or ISO A4 (212 x 297 mm), with margins of at least 25 mm (1 inch). Type only on one side of the paper. Use double spacing throughout including title page, abstracts, text, acknowledgments, references, tables, and legends for illustrations. Begin each of the following sections on separate pages: title page, abstract and key words, text, acknowledgments, references, individual tables, and legends. Number pages consecutively beginning with the title page. Type the page number in the upper of lower right-hand corner of each page.

Title page

The title page should carry (a) the title of the article, which should be concise but informative; (b) first name, middle initial, and last name of each author, with highest academic degree (s) and institutional affiliation; (c) name of department (s) to which the work should be attributed; (d) disclaimers, if any; (e) name and address of author responsible for correspondence about the manuscripts (f) name and address of author to whom request for reprints should be address or statement that reprints will not be available from the author; (g) source (s) of support in the form of grants, equipment, drugs, or all of these; and (h) a short running head or foot line of no more than 40 characters (count letters and spaces) placed at the foot of the title page and identified.


All persons designated as authors should qualify for authorship. The order of authorship should be a joint decision of the co-authors. Each author should have participated sufficiently in the work to take public responsibility for the content.

Authorship credit should be based only on substantial contributions (a) to conception and design, or analysis and interpretation of data; (b) to drafting the article of revising it critically for important intellectual content; (c) on final approval of the version to be published. Conditions (a), (b), and (c) must all be met. Participation solely in the acquisition of funding or the collection of data does not justify authorship. General supervision of the research group is also not sufficient for authorship. Any part of an article to its main conclusion must be the responsibility of at least one author.

A paper with corporate (collective) authorship must specify the key persons responsible for the article; others contributing to the work should be recognized separately (see Acknowledgments).

Editors may require authors to justify the assignment of authorship.

Abstract and key words

The second page should carry an abstract of no more than 150 words for unstructured abstracts or 250 words for structured abstracts. The abstract should state the purpose(s) of the study or investigation, basic procedures (selection of study subjects or laboratory animals; observational and analytical methods), main findings (give specific data and their statistical significance, if possible), and the principal conclusions. Emphasize new and important aspects of the study or observation.

Below the abstract provide, and identify as such, 3-10 key words or short phrases that will assist indexers in cross indexing the article and may be published with the abstract. Use terms from the medical subject heading (MeSH) list of Index Medicus; if suitable MeSH terms are not yet available for recently introduced terms, present terms may be used.


The text of observational and experimental articles is usually but not necessarily divided into sections with the headings: Introduction, Methods, Results, and Discussion. Long articles may need subheadings within some sections to clarify their content, especially the Methods, Results and Discussion sections.


State the purpose of the article. Summarize the rationale for the study or observation. Give only strictly pertinent references and do not review the subject extensively. Do not include data or conclusions from the work being reported.


Describe your selection of the observational or experimental subjects (patients or laboratory animals, including controls) clearly. Identify the methods, apparatus (manufacturer, name and address in parentheses), and procedures in sufficient detail to allow other references to established methods including statistical methods. Provide references and brief descriptions for methods that have been published but are well known; describe new or substantially modified methods, give reasons for using them, and evaluate chemicals used, including generic name(s), dose(s), and route(s) of administration.


Describe statistical methods with enough detail to enable a knowledgeable reader with access to the original data to verify the reported results. When possible, quantify findings and present them with

appropriate indicators of measurement error or uncertainty (such as confidence intervals). Avoid sole reliance on statistical hypothesis testing, such as the use of p values, which fails to convey important quantitative information. Discuss eligibility of experimental subjects. Give details about randomization, Describe the methods for and success of any blinding of observations. Report treatment complications. Give number of observations. Report losses to observation (such as dropouts from a clinical trial). References for study design and statistical methods should be according to standard works (with pages stated) when possible rather than to papers in which the designs or methods were originally reported. Specify any general-use computer programmes used.

Put general description of methods in the Methods section. When data are summarized in the Results section specify the statistical methods used to analyze them. Restrict tables and figures to those needed to explain the argument of the paper and to assess its support. Use graphs as an alternative to tables with many entries; do not duplicate data in graphs and tables. Avoid non-technical use of technical terms in statistics, such as "random" (which implies a randomizing device), "normal", "significant", "correlations", and "sample". Define statistical terms, abbreviations, and most symbols.


present your results, in logical sequence in the test tables, and illustrations. Do not repeat in the text all the data in the tables or illustrations; emphasize or summarize only important observations.


Emphasize new and important aspects of the study and the conclusions that follow from them. Do not repeat in detail data or other material given in the Introduction or the Results section. Include in the Discussion section the implications of the findings and their limitations including implications for future research. Relate the observations to other relevant studies. Link the conclusions with the goals of the study and avoid unqualified statements and conclusions not completely supported by your data. Avoid claiming priority to work that has not been completed. State new hypotheses when warranted but clearly label them as such. Recommendations, when appropriate, may be included.


At an appropriate place in the article (title-page footnote or appendix to the test, one or more statements should specify (a) contributions that need acknowledging but do not justify authorship, such as general support by a departmental chairman; (b) acknowledgments of technical help; (e) acknowledgments of financial and material support, specifying the nature of the support; (d) financial relationships that may pose a conflict of interest.

Persons who have contributed intellectually to the paper but whose contributions do not justify authorship may be named and their function or contribution described e.g., "scientific advisor", "critical review of study proposal", "data collection" or "participation in clinical trial". Such persons must have given their permission to be named. Authors are responsible for obtaining written permission from persons acknowledged by name, because readers may infer their endorsement of the data and conclusions. Technical help should be acknowledged in a paragraph separate from those acknowledging other contributions.


Number references consecutively in order in which they are first mentioned in the test. Identify references in text, tables, and legends by arabic numericals in parentheses. References cited only in tables or in legends to figures should be numbered in accordance with a sequence established by the first identification in the text of the particular table or illustration.

Use the style of the examples below which are based with slight modifications on the formats used by the US National Library of Medicine used in Index Medicus Consult list of Journals indexed in Index Medicus, Published annually as separate publication by the library and as a list in the January issue of Index Medicus.

Try to avoid using abstracts as references. "Unpublished observations" and "Personal Communications" may not be used as references, although references to written, not oral, communications may be inserted (in parentheses) in the text. Include among the references, papers accepted but not yet published; designate the journal and add "In press". Information from manuscripts submitted but not yet accepted should be cited in the text as "unpublished observations" (in parentheses). The references must be verified by the author(s) against the original documents.

Examples of correct forms of references are given below:

Articles in journals
  1. Standard journal article (List all authors, but if the number exceeds six give names of three authors followed by et al).
    You CH, Lee KY, Chey RY, Menguy R. Electrogastrographic study of patients with unexplained nausea, bloating and vomiting. Gastroenterlogy 1980; 79(2): 311-4.
    As an option, if a journal carries continuous pagination throughout a volume, the month and issue number may be omitted.
    You CH, Lee KY, Choy RY, Menguy R. Electrogastrographic study of patients with unexplained nausea, bloating and vomiting. Gastroenterlogy 1980; 79: 311-4.
    Goate AM Haynes AR, Owen MJ, et al.
    Predisposing locus for Alzheimer's disease on chromosome 21. Lancet 1989; 1: 352-5.
  2. Organization as author
    The Royal Marsden Hospital Bone-Marrow Transplantation Team. Failure of syngeneic bonemarrow graft without preconditioning in post-hepatitis marrow aplasia. Lancet 1977; 2: 742-4.
  3. No author given
    Coffee drinking and cancer of the pancreas (editorial). Br Med J 1981; 283: 628.
  4. Article in a foreign language
    Massne L, Borghi S, Pestafino A, piccini R, Gambini C. Locations palmaires purpuriques de la dermatite herpetiforme. Ann Dermatol Venereol 1987; 114: 15457.
  5. Volume with supplement
    Magni F, Rossoni G, Berti F. BN-52021 protects guineapig from heart anaphylaxis. Pharmacol Res Commun 1988; 20 (Suppl) 5: 758.
  6. Issue with supplement
    Gardos G, Cole JO, Haskell D, Marby D, Paine SS, Moore PL. The natural history of tardive dyskinesia. J Clin Psychopharmacol 1988; 8(4 17. Suppl): 31 S-37S.
  7. Volume with part
    Hanly C. Metaphysics and innateness; a psychoanalytic perspective. Int J Psychoanal 1988; 69 (Pt 3): 389-99.
  8. Issue with part
    Edwards L, Meyskens F, levine N. Effect of oral isotretinoin on dysplastic nevi. J Am Acad dermatol 1989; 20(2 Pt 1): 257-60.
  9. Issue with no volume
    Baumeister AA. Origins and control of stereotyped movements. Monogr Am Assoc Ment Defic 1978; (3): 353-84.
  10. No issue or volume
    Danoek K. Skiing in and through the history of medicine. Nord Medicinhist Arab 1982: 86-100. 21.
  11. Pagination in Roman numerals
    Ansvarsfall RY. Blood transfusion in ill patient. Vardfacket 1989; 13: XXVI-XXVII.
  12. Type of article indicated as needed
    Spargo PM, Muners JM. DDAVP and open heart surgery (letter). Anesthesia 1989; 44:362-4.
    Fuhrman SA, Joiner KA. Binding of the third component of complement C3 by Toxoplasma gondii (abstract). Clin Res 1987; 35: 475A.
  13. Article containing retraction
    Shishido A. Retraction notice: Effect of platinum compounds on murine lymphocyte mitogenesis (retraction of Alsabti EA, Ghalib ON, Saleem MH. In: Jpn J Med Sci Biol 1979; 32: 53-65). Jpn J Med Set Biol 1980; 33: 235-7.
  14. Article retracted
    Alsabti EA, Ghalib ON, Salem HM. Effect of platinum compounds on murine lymphocyte mitogenesis (Retracted by Shishido A. In: Jpn J Med Sci Biol 1980; 33: 235-7]. Jpn J Med Sci Biol 1979; 32: 53-65.
  15. Article containing comment
    Piccoli A, Bossati A. Early steroid therapy in IgA nephropathy; still an open question (comment). Nephron 1989; 51: 289-91. Comment on: Nephron 1988; 48: 12-7.
  16. Article commented on
    Kobayashi Y, Fujii K, Hiki Y, Tateno S, Kurokawa A, Kamiyaina M. Steroid therapy in IgA nephropathy: a retrospective study in heavy proteinuric cases (see comments). Nephron 1988; 49: 12-7. Comment in: Nephron 1989; 51: 289-91.
  17. Article with published erratum
    Schofield A. The CAGE questionnaire and psychological health (published erratum appears in Br J Addict 1989; 84: 701). Br J Addict 1988; 83: 761-4.

Books and other monographs

  1. Personal author(s)
    Colson JH, amour WJ. Sports injuries and their treatment. 2nd ed. London: S. Paul, 1986.
  2. Editor(s), compiler as author Diener HC, Wilkinson M, editors. Drug-induced Headache. New York: SpringerVerlag, 1988.
  3. Organization as author and publisher
    Virginia Law Foundation. The medical and legal implications of AIDS. Charlottesville: The Foundation, 1987.
  4. Chapters in a book
    Weinstein L, Swartz MN. Pathologic properties of invading microorganisms. In: Sodeman WA Jr, Sodeman WA, editors. Pathologic physiology: mechanisms of disease. Philadelphia: Saunders, 1974: 457-72.
  5. Conference proceedings
    Vivian VL, editor. Child abuse and neglect: a medical community response. Proceedings of the First AMA National Conference on Child Abuse and Neglect; 1984 Mar 30-31; Chicago: American Medical Association, 1985.
  6. Conference paper: Harley NH. Comparing radon daughter dosimetric and risk models. In: Gammage RB, Kaye SV, editors. Indoor air and human health. Proceedings of the Seventh Life Sciences Symposium: 1984 Oct 29-31; Knoxville (TN). Chelsea (MI); Lewis, 1985: 69-78.
  7. Scientific and technical report: Akustsu T. Total heart replacement device. Bethesda (ML); National Institutes of Health, National Heart and Lung Institute; 1974 Apr. Report No; NH-NHLI 69-2185-4.
  8. Dissertation
    Yousef NM. School Adjustment of Children with congenital heart disease (dissertation). Pittsburgh (PA): Univ of Pittsburgh 1988.
  9. Patent
    Harred JF. Knight AR. McIntyre JS, inventors Dow chemical Company, assignee. Epoxidation process. US patent 3654, 317, 1972 Apr 4.

Other published material

  1. Newspaper article
    Rensberger B, Specter B. CFCs may be destroyed by natural process. The Washington Post 1989 Aug 7; Sect. A: 2 (col 5).
  2. Audiovisual
    AIDS epidemic: the physician's role (video recording). Cleveland (OH): Academy of Medicine of Cleveland, 1987.
  3. Computer file
    Renal system (computer programme). MS-DOS version. Edwardsville (KS); Medi-Sim, 1988.
  4. Legal material
    Toxic Substance Control Act; Hearing on S. 776 Before the subcommittee. On the Environment of the Senate Common. On Commerce. 94'" Cong., Ist Sess. 343 (1975).
  5. Map
    Scotland [topographic map]. Washington: National Geographic Society (US). 1981.
  6. Book of the Bible
    Ruth 3: 1-18. The Holy Bible. Authorized King James version. New York; Oxford Univ. press, 1972.
  7. Dictionary and similar references
    Ectasia. Dorland's illustrated medical dictorary. 27th ed. Philadelphia: Saunders, 1988, 527.
  8. Classical material
    The Winter's Tale: act 5, scene 1, lines 13-16. The complete works of William Shakespeare. London: Rex, 1973.

Unpublished material

  1. In press
    Lillywhite HB, Donald JA. Pulmonary blood, flow regulation in an aquatic snake. Science. In Press.


Type each table double-spaced on a separate sheet. Do not submit table as photographs. Number tables consecutively in the order of their first citation in the text and supply a brief legend for each. Give each column a short or abbreviated heading. Place explanatory matter in footnotes, not in the heading. Explain in footnotes all nonstandard abbreviations that are used in each table.

Identify statistical measures of variations such as standard deviation and standard error of the mean.

Do not use internal horizontal and vertical rules.

Be sure that each table is cited in the text.

If you use data from another published or unpublished source obtain permission and acknowledge fully.

The use of too many tables in rotation to the length of the text may produce difficulties in the layout of pages. Examine issues of the journal to estimate how many tables can be used per 1000 words of text.


Submit the required number of complete sets of figures. Figures should be professionally drawn and photographed free hand or typewritten lettering is unacceptable. Instead of original drawings, roentgenograms, and other material send sharp, glossy black-and-white photographic prints, usually 127x173 mm (5x7 inch) but no larger than 203x254 mm (9x10 inch). Letters, numbers, and symbols should be clear and even throughout; and of sufficient size that when reduced for publication each item would still be legible. Titles and detailed explanations should be given in the legends for illustrations, not on the illustrations themselves.

Each figure should have a label pasted at its back indicating the number of the figure, author's name, and top of the figure. Do not write on the back of figures or scratch or mark them by using paper clips. Do not bend figures or mount them on cardboard.

Photomicrographs must have internal scale markers. Symbols, arrows, or letters used in the photomicrographs should contrast with the background.

If photographs of persons are used, either the subjects must not be identifiable or their pictures must be accompanied by written permission to use the photographs.

Figure should be numbered consecutively according to the order in which they have been first cited in the text. If a figure has been published, acknowledge the original source and submit written permission from the copyright holder to reproduce the material. Permission is required irrespective of authorship or publisher, except for documents in the public domain.

For illustrations in colour, send the colour negatives, positive transparencies, or colour prints. Accompanying drawings marked to indicate the region to be reproduced may be useful to the editor. Illustrations in colour will be published only if the author pays for the extra cost.

Legend for illustrations / tables

Type legends for illustrations/tables double-spaced, starting on separate page, with Arabic numerals corresponding to the illustrations. When symbols, arrows, numbers, or letters are used to identify parts of the illustrations, identify and explain each one clearly in the legend. Explain the internal scale and identify method of staining in photomicrographs.

Units of measurement

Measurement of length, height, weight and volume should be reported in metric units (meter, kilogram, or liter) or their decimal multiples.

Temperatures should be given in degrees Celsius. Blood pressures should be given in millimeters of mercury.

All haematologic and clinical-chemistry measurements should be reported in the Metric system in terms of the International System of Units (SI). Editors may request conventional or non-SI Units to be added by the authors before publications.

Abbreviations and symbols

Use only standard abbreviations. Avoid abbreviation in the title and abstract. The full term for which an abbreviation stands should precede its first use in the text unless it is a standard unit measurement.


Special Report. Uniform requirements for manuscripts submitted to biomedical journals. N Eng J Med 1991: 324: 424-8.

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