Quick Writing Guide for Epidemiology
John Grady Heller 
Forward
If I had to teach a class on writing for scientific products & deliverables, I wouldn’t use this as a guide.
On the off chance that someone has actually read this post, I should point out that there are a few reasons I am changing my entire approach to writing papers. This approach was cobbled together in a struggle to understand how to do some very vague task that nobody could or would explain to me, and I did the best to provide something helpful. I meant well, but some of the advice here is just not good in reality. E.g. the Zettelkasten system is really not appropriate for scientific note taking, the Belcher book is a starting point and I never really arrived at a concise application, and there are simply better ways of doing things that I have discovered with the help of an ADHD coach and learning specialist. These notes also represent a struggle in which I just needed a little bit of specialized help - I’ll be sure to post about that whenever I am confident that I have that figured out, because I know I am not the only person who would benefit from that understanding.
I’ve cut some of the nonsense out just now. Most of this post can probably be ignored, but the suggested section structures are simply what I have observed in scientific writing - those stand for themselves, and well, of course you should mimic the style of authors in your field. They are your audience in reality, and that speaks their language to them.
When I write about my newer, refocused writing strategies, I will delete this page.
This is the remains of a guide to provide a basic structure to communicate research findings from Epidemiologic research, primarily through a journal article.
The presented flowcharts and ideas concerning article structure are suggestions based on general conventions and observations from quality papers in epidemiologic journals, but each publisher may have differing requirements and collaborators may feel strongly about some specific details. One should do what makes sense in their case for each scientific product. In fact, the most useful tip I can provide is to simply look at articles in the journal or field that you want to publish as guides and inspiration.
When considering the audience, usually the instructions are to consider whether or not the intended audience is a group of professionals, or a layman. I’m here to tell you that that is not good enough and you must be more specific if you want to be published. Each day research becomes more specialized, with not only scientific jargon, but specialist jargon, and layers of layers of conventions and expectations. If you want to publish in an epidemiologic journal, you must know not only what Epidemiologists or Clinicians expect, but also what the editors and readers themselves expect.
1.4 - Section 1 Summary
The main theme of this section is organization, and maybe also using critical thinking. To start your project, critically engage with your topic, question it until you have a question for which the answer is interesting, and from that point be surgical in how you approach the projects you will create.
After this point, this guide is more focused on assembling the parts of an article, so it is mostly assumed that you have an idea and have conducted the analysis, or are able to do the analysis as you write.
Section 2 - Product Foundational Writing
2.1 - Formally Outline the Research Question
Assuming you already have an idea and a question that you think will be interesting for your audience, and worth investing your time in, there are some rules-of-thumb you can use to formalize your question so that it is publication-ready. One form that is popular is the PICOT format, which involves the following (in a table so you can copy/paste):
| Population: | |
| Intervention/Exposure: | |
| Comparison: | |
| Outcome: | |
| Time: |
Where population is the sample, the intervention is the exposure or treatment in the exposure group, comparison is the comparison or reference group, the outcome is the metric or measure you will use to examine the effectiveness of the intervention/exposure, and time is the time periods that should be considered (the duration and/or intervals).
Then combine the table components into a scientific question, and use this to guide filling out the table in the next steps.
There are other forms of research question also, such as PCC (population, concept, context), PEO (Population, Exposure, Outcome), SPIDER, SPICE, ECLIPSE… etc. For more frameworks, see Booth et al.1 These forms are helpful as a checklist, and at this point I assume you have a quality question to be put into one of these formats based on [1.1 - Literature and Notes].
2.2 - Defining the Gap
In general, understanding the “gap in the literature” that is being addressed is a good idea for even informal proposals and protocols, and expected by most researchers in published works. It is important to understand what is a compelling argument for your research project. This is no longer explicitly required by NIH grant proposals – but the same information is required in some form. For a simple gap statement, consider statements that generally answer the following questions:
What has been done currently?
What has not been done currently?
Why should it be done? (What is the payoff – OR – what is currently the issue?)
2.3.C - Data Needed
List as many ofthe required variables for your analysis as you can - exposures, and outcomes, and any other explanatory variables. This is essentially to help you plan and request data if that is part of the project.
Appendix A provides a table that you can fill out to make sure this is all covered.
2.7 - Working with Collaborators
The criteria for authorship (International Committee of Medical Journal Editors (ICMJE) definition) are as follows:
Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND
Drafting the work or reviewing it critically for important intellectual content; AND
Final approval of the version to be published; AND
Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Defining an Author – beyond the ICMJE definition, there is the 14 suggested contributor roles from CRediT (https://credit.niso.org/)
Conceptualization
Methodology
Software
Validation
Formal analysis
Data curation
Writing – original draft
Writing – review and editing
Visualization
Supervision
Project administration
Funding acquisition
The example CRediT statement from their website is:
Zhang San: Conceptualization, Methodology, Software Priya Singh.: Data curation, Writing- Original draft preparation. Wang Wu: Visualization, Investigation. Jan Jansen: Supervision.: Ajay Kumar: Software, Validation.: Sun Qi: Writing- Reviewing and Editing, …
It is usually helpful to discuss these roles and the expected time spent on the project up front.
Section 3 - Article Composition
This section is the bullet notes of usual and suggested components of an article, along with typical flowcharts of article sections. Much of this comes from Writing Your Journal Article in 12 Weeks,2 however some of this is my own convention - the mesostructures and flowcharts - which are empirical observations from reading journal articles in general.
3.1 Title
Be specific.
Describe what is going on in your research. Avoid attempting jokes, and do not place a question mark or question in the title.
Should be 5-21 words - not too long.
Include keywords if possible (consider MeSH terms)
3.2 The Abstract
There is an Abstract structure table in Appendix C that one can fill out to get started.
Is it self-contained? – Try to write the abstract so that someone might be able to cite the paper by only reading the abstract.
Belcher suggests the following rough guidelines:2
Methods in only one or two sentences
Findings/results only one to two sentences
Recommendations are about one sentence
In reality, these are general starting points; the correct answer is to adequately describe the study and use the full amount of characters or words allowed
Provide key findings plainly, up front
Use strong verbs; e.g. exploring/examining -> argues, demonstrates
- Basically, try to avoid being vague
Include relevant keywords (use MeSH on demand to process abstract – it will list MeSH keywords for you)
Use Past-tense, to tell what you did
Always use active voice (e.g., say “we analyzed the data,” NOT “the data were analyzed.”)
3.3 Section Mesostructures
The following sections cover the sections in a research article, and the components usually found in those sections. There are bullet points, and a flowchart, for each section suggesting a general structure and flow.
3.3.1 Introduction
Start with a hook - or at least set the tone
- Can be a statement of issue significance, interesting fact, historical opening, or perhaps a general subject statement or critical opening
Give basic information on your subject (literature review)
There is a table for literature review in Appendix B.
Go from more general focus to more specific
Locate your research within the body of research found in literature - how does it relate to, continue or change current literature suggestions?
Provide relevant theories or information that your audience may be missing
Provide indication of significance
Provide gap
Provide aim(s)
Significance and Gap are often two paired together and are logically intertwined
Structure Flowchart:
3.3.2 Methods
Sample and sampling procedure
State measurement instruments and methods
Population and location
Describe variables
No statistics description/tutorial if it is an established method
No results in the Methods section
Structure Flowchart:
3.3.3 Results
Standardize tables and graphs; unless otherwise instructed:
table names go above tables
Figure names go below figures
Provide interpretation of results – what do you see in your results?
1-2 paragraphs per figure or table (each figure or table should be interpreted in writing, and if it does not add to the paper reconsider its inclusion)
A summary of the overall interpretation of evidence
Do not repeat table information in text – just interpret table
Organize results around variables
No methods or discussion in results
Structure Flowchart:
3.3.4 Discussion & Conclusion
Discuss
Inference – the meaning of the results section
Check for common biases: check Delgado-Rodriguez & Llorca for a list.3
- Which way would the bias pull the results? Is it negligible or large? Is there a way to check (i.e., performing a correction and checking before and after significance)?
Ethical considerations?
Limitations
Discuss each result in the results section (check with good example papers)
Conclude
Did you confirm your hypothesis/achieve your aims?
State significance
Relate your findings to the current understanding in literature
Suggest further research
These are also a “pyramid,” but goes in reverse order to intro/background – start with specifics and then go back to general
Structure Flowchart:
Section 4 - Editing
4.1 - Macro-editing
The article should follow the following general structure. This is probably already well-known by anyone reading this, but here it is just for reference:
Introduction
Introduction to general subject of investigation
Review of literature
Statement of hypothesis
Methods
Specific Methods
Procedures
Materials and instruments
Experiment
Context and setting
Population or sample
Results
- Report results
Discussion
Validity of methods and findings
Context within current scholarly literature
4.2 - Micro-editing
Micro-editing is the checking of grammar and focusing on individual sentences. This is the last phase of the paper writing process, so naturally the macrostructure and mesostructures should be fairly well established. Conversely, any ability to incorporate micro-editing in earlier stages is fine, but it is really not required and might slow you down.
Check for active voice
Check for past tense
Check for strong verbs where appropriate
Check for conciseness (and remove doublings?)
Check for logical flow
Remove pronouns when you can
For more info on correct grammar and editing advice, the classic source to turn to is The Bedford Handbook, which is a generally well-known resource for English grammar, style, and writing conventions.4
Section 5 - Writing Checklist
Foundation
| ☐ | Read up-to-date literature |
| ☐ | Operationalize a tentative research question to guide review |
| ☐ | Have the library conduct a search if available, or conduct thorough search using pearl growing, upstream & downstream searching. |
| ☐ | Construct bibliographic review table and identify gaps while reading |
| ☐ | Identify specific aims |
| ☐ | Identify needed data |
| ☐ | Identify hypothesis and null hypothesis |
| ☐ | Identify appropriate statistical methods |
Title
| ☐ | Approximately 15 – 21 words |
| ☐ | Conciseness (limited description of the article) |
| ☐ | Does Not include question marks; however, may contain semicolons or colons |
| ☐ | Include key words (MeSH terms if possible) |
Abstract
| ☐ | Self-contained/self-explanatory |
| ☐ | Relevant keywords |
| ☐ | Strong Verbs |
| ☐ | uses the maximum allotted characters or values |
| ☐ | most focus on results |
| ☐ | no p-values in abstract |
Introduction
| ☐ | Strong first sentence (Interesting fact, critical statement, historic point, or significance statement) |
| ☐ | Adequate basic information and literature review |
| ☐ | “Inverted Pyramid” structure – start broad, move to specific |
| ☐ | Locate your research within literature |
| ☐ | Significance statement |
| ☐ | Gap in literature you are filling |
| ☐ | Aim(s) explicitly stated |
| ☐ | All the components of a formal scientific research question (e.g. PICOT) are present. |
Methods
| ☐ | Study Design |
| ☐ | Sampling and/or data acquisition |
| ☐ | Location of study |
| ☐ | Description of Population |
| ☐ | Timeframe |
| ☐ | Measures and Instruments |
| ☐ | Methods used |
Results
| ☐ | Standardize tables and graphs |
| ☐ | 2 paragraphs interpretation per figure or table |
| ☐ | Summary of results |
Discussion and Conclusion
| ☐ | Statement of study significance |
| ☐ | Study strengths |
| ☐ | Relate findings to current literature |
| ☐ | “Pyramid Structure” – move from specific to broad |
| ☐ | Discuss each result of main analysis |
| ☐ | Discuss why this topic is important to research (this is your logical backing) |
| ☐ | Limitations and biases (what do these do to your study?) |
| ☐ | Suggest further research |
| ☐ | Strong summary/conclusion for last paragraph |
Macro-editing
| ☐ | Check overall structure and flow from paragraph to paragraph |
| ☐ | Check flow chart for Introduction section |
| ☐ | Check flow chart for Methods section |
| ☐ | Check flow chart for Results sectio |
| ☐ | Check flow chart for Discussion section |
Micro-editing
| ☐ | Active voice |
| ☐ | Past tense |
| ☐ | Reduce pronouns |
| ☐ | Accurate terminology |
| ☐ | Strengthen verbs where applicable |
| ☐ | Conciseness and removal of doublings |
| ☐ | Logical flow between sentences |
Works Cited
Appendices
A - Foundational Information Worksheet
| Article Foundation | |||
| Scientific Question: | |||
| Gap in Literature: | |||
| Specific Aims: | 1° | ||
| 2° | |||
| Alternate Hypothesis: | |||
| Null Hypothesis: | |||
| Statistical Methods: | |||
| Data Needed: | Outcome Variable(s) | Exposures/Predictors | Other Explanators |
a) Y1 b) Y2 c) … |
a) X1 b) X2 c) … |
a) Z1 b) Z2 c) … |
B - Abstract Skeleton/Worksheet
| Title: | ||
| Authors: | ||
| Keywords: | ||
| Background: | ||
| Hook/Orientation | ||
| Importance of Research (gap or in general) | ||
| Aims | ||
| Methods: | ||
| Data | ||
| Timeframe, location, pop. (selection) | ||
| Main analysis method (information) | ||
| Results: | ||
| Key Results | ||
| Conclusion: | ||
| What the study did | ||
| Key Result Interpretation (what the study means in context |