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How to write a cover letter for journal submission

Download our cover letter template.

When you submit your article to a journal, you often need to include a cover letter. This is a great opportunity to highlight to the journal editor what makes your research new and important. The cover letter should explain why your work is perfect for their journal and why it will be of interest to the journal’s readers.

When writing for publication, a well-written cover letter can help your paper reach the next stage of the manuscript submission process – being sent out for  peer review . So it’s worth spending time thinking about how to write a cover letter to the journal editor, to make sure it’s going to be effective.

To help you, we’ve put together a guide to explain how to write a cover letter for journal article submission. You will receive cover letter instructions of what you should include and what you shouldn’t, and a word template cover letter.

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What should my cover letter include?

Before you start to write, please check the  instructions for authors  (IFAs) of your chosen journal, as not all journals will require one. You should also check the IFAs for any journal specific information on what to include. This may include a list of relevant articles written by you or your co-authors that have been or are currently being considered for publication in other journals.

Key points to include in your letter to the editor:

Editor’s name (you can usually find this on the journal page on  Taylor & Francis Online ).

Your manuscript’s title.

Name of the journal you are submitting to.

Statement that your paper has not been previously published and is not currently under consideration by another journal.

Brief description of the research you are reporting in your paper, why it is important, and why you think the readers of the journal would be interested in it.

Contact information for you and any  co-authors .

Confirmation that you have no  competing interests  to disclose.

Things to avoid:

Don’t copy your abstract into your cover letter, instead explain in your own words the significance of the work, the problem that is being addressed, and why the manuscript belongs in the journal.

Don’t use too much jargon or too many acronyms, keep language straightforward and easy to read.

Avoid too much detail – keep your cover letter to a maximum of one page, as an introduction and brief overview.

Avoid any spelling and grammar errors and ensure your letter is thoroughly proofed before submitting.

Click to enlarge your PDF on key information to include in your cover letter .

Cover letter template

If you need further help to write a cover letter for a journal, you can download and use our sample template as a guide.

You might find that the submission system for your chosen journal requires your cover letter to be submitted into a text box rather than as a separate document, but it is still a good idea to write a draft first to make sure you have included everything.

Always make sure to check the journal’s  instructions for authors  for any specific additional information to include.

Submission ready

Use our submission checklist  to make sure you’ve included everything you need to.

If you need more guidance, take a look at our other  information and resources to help you make your submission .

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Consider the Taylor & Francis Rapid Technical Review service to help you meet your deadline, through peer-review-like comments on your manuscript.

Related resources

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How to Write a Cover Letter for Your Manuscript? Here are the Tips and Examples

• 3 minute read

Table of Contents

A cover letter is often the first thing an editor reads when reviewing your submission. As your first pitch to the editor, the cover letter helps them gauge the suitability of your manuscript for publication in their journal. Imagine your work shaping the future of your field, gathering citations, and sparking discussions. A powerful cover letter is thus the first step to making that vision into a reality.   

In this article, we will guide you through the process of writing an effective cover letter and explain how you can get it right every time with examples. First, let us get started with the basics!  

Getting the Basics Right  

When writing a cover letter, it is crucial to address the editor by their correct and complete name¹ . If there are multiple co-editors, you can address your letter to the right person, based on their specialization or designated responsibilities. If unsure, it is okay to go with a more general salutation, such as “Dear Editors”¹ .   

Presenting your Research  

Provide a clear and concise title for your submission and specify whether it is an article, communication, review, perspective, or a manuscript belonging to some other category. If the journal guideline recommends, consider including a list of all authors in the manuscript.   

After covering the preliminary information, briefly explain your paper’s central theme or focus to give the editor an idea of its contents. Ensure this stays a brief outline, without going into too much detail.   

Conveying the Importance of Your Work  

How you communicate the impact of your work can make or break your cover letter. To make a strong impression on the editor, articulate the significance of your research clearly, emphasizing its relevance to the field. Additionally, show how your work aligns with the journal’s scope and mission.  

Including a Formal Declaration  

Some journals require a set of declarations from you to ensure that your manuscript adheres to its ethical code and the larger ethical standards of scientific publishing. Here are the required declarations in a cover letter:  

• Originality of work:  
• Confirm that your work is original and has not been published elsewhere. This tells the editor your research is unique.  
• Conflict of interest statement:  
• Be clear about any potential conflicts of interest. This includes any personal, financial, or professional connections that might affect your research.  
• Funding source (if applicable):  
• Tell where your research funding came from, if any. This includes any support or grants from organizations.   

Including Personal Suggestions for Reviewers on a Separate Page (optional)  

If there is no part of the submission process that collects researcher suggestions for reviewers, and there are special requests from the researcher for reviewers (e.g., recommending the inclusion or suggesting the exclusion of a specific reviewer, etc.), you may also make a note about this in the cover letter.  

Combining these five points, here is a good example of a cover letter for researchers’ reference:  

(This image is intended to demonstrate the norms of formatting and tone of expression in a cover letter, it is to be used only by the researcher as a reference in writing² .)  

Conclusion  

A strong cover letter can go a long way in ensuring success for researchers looking to publish their manuscripts! Your cover letter is the opening act, setting the stage for how editors perceive your manuscript. So, look at it not as just another formality but as a crucial opportunity to make a strong impression.   

Understanding what to include, what is optional, and what is best left unsaid can be tricky. That is where our team of experts at Elsevier Language Services can step in. We will provide personalized recommendations and expert guidance to help you craft a cover letter that perfectly complements your manuscript. Reach out to us today to make a great first impression and embark on a successful academic journey!  

Reference  

• Nicholas, D. (2019). How to choose a journal and write a cover letter. Saudi Journal of Anaesthesia, 13(5), 35. https://doi.org/10.4103/sja.sja_691_18  
• Loyola University Chicago. (n.d.). JCSHESA Sample Cover Letter. https://ecommons.luc.edu/jcshesa/cover_letter_template.pdf  

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How to Write an Effective Cover Letter for Journal Submission

Craft your cover letter for journal submission the right way with our expert tips! Learn how to grab editors’ attention and stand it out.

When it comes to submitting a manuscript for publication in a journal, many authors focus solely on the quality of their research and the clarity of their writing. While these are important factors, it’s easy to overlook the role that a well-crafted cover letter can play in the submission process. A cover letter can be the key to getting your manuscript noticed by the editor and ultimately accepted for publication. In this article, we’ll explore the importance of a cover letter for journal submissions and provide tips for crafting an effective one.

What is a Cover Letter for Journal Submission?

A cover letter for journal submission is a document that accompanies a manuscript when it is submitted for publication in an academic or scientific journal. The purpose of the cover letter is to introduce the author and their work to the editor of the journal and to provide any additional information that may be relevant to the manuscript or the submission process. Furthermore, its purpose is to introduce the manuscript to the editor and provide additional information about the research and its significance. The cover letter should be concise and focused, typically no more than one page.

What Should be Included in the Cover Letter?

A cover letter should include several key elements to effectively introduce your manuscript. It’s important to personalize the letter for the specific journal, use a professional tone, and proofread carefully for errors. To make sure your cover letter is effective, there are several key elements that you should include:

Addressee’s Information and Date of Submission

Your cover letter should start with the date of submission, followed by the name and address of the editor or editorial staff who will be reviewing your manuscript. This information should be current and accurate to ensure your submission is directed to the right person.

Opening Salutation

The opening salutation of your cover letter should be professional and courteous, addressing the editor or editorial staff by name, starting with “Dear…”. Don´t forget to include the title and position of the editor you are addressing.

Purpose Statement and Administrative Information

Your cover letter should have a clear statement of the purpose of your research and the journal to which you are submitting your manuscript. You should also include any administrative information required by the journal, such as the type of manuscript (e.g. original research, review article, case report) and the number of words or pages.

Summary of Main Research Findings and Implications

One of the most important elements of your cover letter is a summary of the main findings and implications of your research. This summary should be concise and focused, highlighting the most important aspects of your research and why it is significant to the field.

Statements or Information Required by the Journal

Many journals require specific statements or information to be included in the cover letter. This may include a statement that the manuscript has not been previously published or is not under consideration for publication elsewhere, or a list of potential conflicts of interest or funding sources that may have influenced the research.

Previous Contact with the Journal

If you have had previous contact with the journal, such as submitting a previous manuscript or attending a conference sponsored by the journal, it is important to mention this in your cover letter. This information can help establish a connection between you and the editor, which may increase the chances of your manuscript being accepted.

Conflict of Interests and Financial Disclosures

It is important to disclose any potential conflicts of interest or financial disclosures that may have influenced the research. This information can help ensure transparency and maintain the integrity of the research.

Your cover letter should include a statement indicating that all authors have read and approved the manuscript and that the work is original and not plagiarized. This information can help establish the credibility of the research and the integrity of the authorship.

Suggested Reviewers

Suggested Reviewers are generally considered a best practice and are often recommended by journals. Providing a list of suggested reviewers can help to ensure that the manuscript is reviewed by individuals who have the appropriate expertise and background to evaluate the work, and can help to speed up the review process by reducing the time needed for the editor to identify potential reviewers. This can help expedite the review process and increase the likelihood of your manuscript being accepted.

Concurrent/Duplicate Submissions

An important consideration when submitting a manuscript for publication is concurrent or duplicate submissions. Concurrent submissions occur when a manuscript is submitted to more than one journal at the same time. Duplicate submissions occur when a manuscript is submitted to the same journal more than once.

In the cover letter, you should clearly state whether the manuscript has been submitted elsewhere or whether it has been previously published. If the manuscript is under consideration elsewhere, you should provide the name of the journal and the date of submission. If the manuscript has been previously published, you should provide the citation for the publication.

Closing Salutation

When closing a cover letter for journal submission, it’s important to maintain a professional and courteous tone. A common closing salutation is “Sincerely,” followed by your name. However, some alternatives that are also appropriate include “Best regards,” “Thank you for your time and consideration,” or “Respectfully.” Whichever salutation you choose, make sure it matches the tone of your letter and conveys your appreciation for the editor’s consideration.

Request to Exclude Reviewers

A request to exclude reviewers is a common feature of a cover letter for journal submission, particularly in cases where the author has concerns about potential conflicts of interest or bias that could affect the review process.

When making a request to exclude reviewers, the author should provide a clear and concise explanation of the reasons for the request and should provide specific details about any potential conflicts of interest or concerns that they may have. It is also important to note that some journals may have specific guidelines or policies regarding requests to exclude reviewers, and authors should familiarize themselves with these guidelines before making a request.

In general, it is recommended that authors provide a minimum of three to five potential reviewers who are not affiliated with the author or their institution, in order to provide a broad range of expertise and perspectives. When making a request to exclude reviewers, it is also important to provide alternative suggestions for potential reviewers who could be considered in their place.

Tips for Writing a Journal Submission Cover Letter

A well-crafted cover letter can help your manuscript stand out and increase your chances of being accepted for publication. Here are some tips for writing an effective journal submission cover letter.

One of the most important tips for writing a journal submission cover letter is to proofread it carefully. Typos, spelling errors, and grammatical mistakes can detract from the professional image you want to project. Make sure to read the letter multiple times and have someone else read it over as well to catch any errors you may have missed.

Keep the Cover Letter Brief

Another important tip is to keep the cover letter brief and to the point. The cover letter should provide a brief introduction of the manuscript and the key findings, as well as any other information that is necessary for the editor to understand the importance and relevance of the manuscript. The letter should be no more than one page in length.

Review Examples of Cover Letters

It can be helpful to review examples of cover letters for journal submissions to get an idea of the style, tone, and content that is appropriate. You can search for examples online or ask colleagues who have submitted manuscripts for publication for their advice. When reviewing examples, pay attention to the language used, the level of detail provided, and the overall organization and structure of the letter. This can help you craft a cover letter that is professional, informative, and effective.

Cover Letter Template for a Journal Article Submission

A cover letter is an important component of manuscript submission for publication in a journal. Using a template can help ensure that your cover letter includes all the necessary information and follows the proper format. Here is a guide to creating a cover letter template for a journal article submission.

The header should include your contact information, including your name, affiliation, and contact details (address, phone number, and email address), the date of submission, and the name and address of the journal.

Opening Paragraph

The opening paragraph should provide a brief introduction to the manuscript and its key findings. This paragraph should also mention the purpose of the manuscript and why it is relevant to the journal’s readership. You may also want to mention any previous correspondence or contact with the journal.

Body Paragraphs

The body of the cover letter should include several paragraphs that provide more detail about the manuscript. This may include a summary of the methods used, key results and findings, and implications for future research. You may also want to mention any notable limitations or challenges encountered during the research process.

It is also important to address any specific requirements or requests from the journal, such as a particular format for tables or figures, or specific information to be included in the manuscript. You should also mention any funding sources or conflicts of interest that may be relevant.

Closing Paragraph

The closing paragraph should reiterate the significance of the manuscript and its contribution to the field. You may also want to mention any potential reviewers for the manuscript or suggest reviewers who would be appropriate. Finally, you should include a polite and professional closing, such as “Sincerely” or “Best regards”, followed by your name and signature.

Common Expressions for Cover Letters

When writing a cover letter for journal submission, it’s important to use appropriate and professional language. Here are some common expressions that can be used in cover letters:

“We are pleased to submit our manuscript…”

“The research reported in this manuscript addresses a significant gap in the literature…”

“We believe this manuscript will be of interest to your readership because…”

“Our findings have important implications for future research in this field.”

“We would like to thank the reviewers and editors for their time and consideration.”

“We look forward to hearing from you regarding the status of our manuscript.”

“Thank you for your time and consideration.”

These expressions can be used to convey important information in a professional and concise manner. When using these expressions, it’s important to tailor them to the specific journal and to make sure they are appropriate for the content of your cover letter.

Journal Submission Tips and Hacks from the Experts

Submitting a journal article can be a challenging and sometimes frustrating process. However, by following some tips and hacks from the experts, you can increase your chances of success. Here are some tips and hacks to help you submit your article to a journal:

Choose the Right Journal

Before submitting your article, make sure you choose the right journal. Consider factors such as the journal’s scope, readership, and impact factor. Make sure your article fits with the journal’s focus and aims.

Read the Guidelines

Read the journal’s submission guidelines carefully and follow them closely. Pay attention to formatting, length, and other requirements. Failure to follow the guidelines could result in your article being rejected without review.

Get Feedback

Before submitting your article, get feedback from colleagues or mentors. Ask them to read your manuscript and provide constructive criticism. This can help you identify potential weaknesses and improve the quality of your article.

Write a Strong Abstract

Your abstract is often the first thing that editors and reviewers will read. Make sure it is clear, concise, and provides a compelling summary of your article. Highlight the key findings and implications of your research.

Use Clear and Concise Language

Use clear and concise language when writing your article. Avoid jargon, technical terms, and complex language that could be difficult for readers to understand. Write in a way that is accessible to a broad audience.

Address Reviewer Comments

If your article is rejected or requires revisions, make sure you carefully address all reviewer comments. Be thorough and professional in your responses. This can increase your chances of acceptance in future rounds of review.

Keep Records

Keep records of all correspondence with the journal, including submission dates, reviewer comments, and decisions. This can help you stay organized and keep track of the progress of your article.

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How to Write a Cover Letter for Journal Submission

If you’re looking for solid advice on how to write a strong journal submission cover letter that will convince journal editors to review your research paper, then look no further! We know that cover letters  can  impact an editor’s decision to consider your research paper further.

This guide aims to explain (1) why you should care about writing a powerful cover letter, (2) what you should include in it, and (3) how you should structure it. The last segment will include a free downloadable submission cover letter template with detailed how-to explanations and some useful phrases. Finally, be sure to get journal manuscript editing , cover letter editing , and other academic editing services by Wordvice’s professional editors to ensure that you convey an academic style and error-free text, along with including all of the most important content.

Why does a good cover letter matter?

While your research paper’s role is to prove the merits of your research, a strong introductory cover letter is your opportunity to highlight the significance of your research and “sell” its concept to journal editors.

While your research paper’s role is to prove the merits of your research, a strong introductory cover letter is your opportunity to highlight the significance of your research and “sell” its concept to journal editors.

Sadly, we must admit that part of the decision-making process of whether to accept a manuscript is based on a business model. Editors must select articles that will interest their readers. In other words, your paper, if published, must make money . When it’s not quite clear how your research paper might generate interest based on its title and content alone (for example, if your paper is too technical for most editors to appreciate), your cover letter is the one opportunity you will get to convince the editors that your work is worth further review.

In addition to economic factors, many editors use the cover letter to screen whether authors can follow basic instructions . For example, if a journal’s guide for authors states that you must include disclosures, potential reviewers, and statements regarding ethical practices, failure to include these items might lead to the automatic rejection of your article, even if your research is the most progressive project on the planet! By failing to follow directions, you raise a red flag that you may be careless, and if you’re not attentive to the details of a cover letter, editors might wonder about the quality and thoroughness of your research. This is not the impression you want to give editors!

What to Include in a Cover Letter for a Journal Submission

We can’t stress this enough: Follow your target journal’s instructions for authors ! No matter what other advice you read in the vast webosphere, make sure you prioritize the information requested by the editors of the journal you are submitting to. As we explained above, failure to include required statements will lead to an automatic “ desk rejection ”.

With that said, below is a list of the most common elements you must include in your cover letter and what information you should NOT include:

Essential information:

• Editor’s name (when known)
• Name of the journal to which you are submitting
• Your manuscript’s title
• Article type (review, research, case study, etc.)
• Submission date
• Brief background of your study and the research question you sought to answer
• Brief overview of methodology used
• Principle findings and significance to scientific community (how your research advances our understanding of a concept)
• Corresponding author contact information
• Statement that your paper has not been previously published and is not currently under consideration by another journal and that all authors have approved of and have agreed to submit the manuscript to this journal

Other commonly requested information:

• Short list of similar articles previously published by the target journal
• List of relevant works by you or your co-authors that have been previously published or are under consideration by other journals. You can include copies of those works.
• Mention of any prior discussions with editor(s) (for example, if you discussed the topic with an editor at a conference)
• Technical specialties required to evaluate your paper
• Potential reviewers and their contact information
• If needed, reviewers to exclude (this information is most likely also requested elsewhere in online submissions forms)

Other disclosures/statements required by the journal (e.g., compliance with ethical standards, conflicts of interest , agreement to terms of submission, copyright sign-over, etc.)

What you should NOT do:

• Don’t use too much jargon or include too many acronyms.
• Don’t over-embellish your findings or their significance. Avoid words such as “novel,” “first ever,” and “paradigm-changing.” These types of statements show bias and will make the editor question your ability to assess your work’s merits objectively.
• Don’t name-drop. Listing people who might endorse your paper and discussing authors’ reputations do not interest editors. They want to know if your content fits their criteria, so focus solely on addressing that point.
• Don’t write a novel. While you want to adequately explain your work and sell its concept to editors, keep your cover letter to a maximum of one page. The letter is only meant to be an introduction and brief overview.
• Avoid humor . As much as we want to grab the editors’ attention, there are too many ways in which humor can go wrong!

How to Structure a Cover Letter

You should use formal language in your cover letter. Since most submissions are delivered electronically, the template below is in a modified e-mail format. However, if you send your cover letter on letterhead (PDF or hard copy by mail), move your contact information to the upper-left corner of the page unless you use pre-printed letterhead, in which case your contact information should be centered at the top of the letter.

ANNOTATED TEMPLATE Journal Submissions Cover Letter

[Journal Editor’s First and Last Name][, Graduate Degree (if any)] TIP: It’s customary to include any graduate degrees in the addressee’s name. e.g.,  John Smith, MD or Carolyn Daniels, MPH [Title] e.g.,  Editor-in-Chief, Managing Editor, Co-Editors-in-Chief [Journal Name] [Journal Address] [Submission Date: Month Day, Year]

Dear Dr./Mr./Ms. [Editor’s last name]:

TIP: Where the editor’s name is not known, use the relevant title employed by the journal, such as “Dear Managing Editor:” or “Dear Editor-in-Chief:”. Using a person’s name is best, however.

TIP: Use “Ms.” and never “Mrs.” or “Miss” in formal business letters.

TIP:  Never   use “Dear Sirs:” or any similar expression. Many editors will find this insulting, especially given that many of them are female!

[Para.1: 2–3 sentences]  I am writing to submit our manuscript entitled, [“Title”] for consideration as a [Journal Name][Article Type]. [One to two sentence “pitch” that summarizes the study design, where applicable, your research question, your major findings, and the conclusion.]

e.g.,  I am writing to submit our manuscript entitled, “X Marks the Spot” for consideration as an  Awesome Science Journal  research article. We examined the efficacy of using X factors as indicators for depression in Y subjects in Z regions through a 12-month prospective cohort study and can confirm that monitoring the levels of X is critical to identifying the onset of depression, regardless of geographical influences.

TIP: Useful phrases to discuss your findings and conclusion include:

• Our findings confirm that…
• We have determined that…
• Our results suggest…
• We found that…
• We illustrate…
• Our findings reveal…
• Our study clarifies…
• Our research corroborates…
• Our results establish…
• Our work substantiates…

[Para. 2: 2–5 sentences]  Given that [context that prompted your research], we believe that the findings presented in our paper will appeal to the [Reader Profile] who subscribe to [Journal Name]. Our findings will allow your readers to [identify the aspects of the journal’s  Aim and Scope  that align with your paper].

TIP: Identify the journal’s typical audience and how those people can utilize your research to expand their understanding of a topic. For example, if many of your target journal’s readers are interested in the public policy implications of various research studies, you may wish to discuss how your conclusions can help your peers to develop stronger policies that more effectively address public concerns.

TIP: Include context about why this research question had to be addressed.

e.g.,  “Given the struggle policymakers have had to define proper criteria to diagnose the onset of depression in teenagers, we felt compelled to identify a cost-effective and universal methodology that local school administrators can use to screen students.”

TIP: If your paper was prompted by prior research, state this. For example, “After initially researching X, Y approached us to conduct a follow-up study that examined Z. While pursuing this project, we discovered [some new understanding that made you decide the information needed to be shared with your peers via publication.]”

e.g.,  Given the alarming increase in depression rates among teenagers and the lack of any uniform practical tests for screening students, we believe that the findings presented in our paper will appeal to education policymakers who subscribe to  The Journal of Education . Although prior research has identified a few methods that could be used in depression screening, such as X and Y, the applications developed from those findings have been cost-prohibitive and difficult to administer on a national level. Thus, our findings will allow your readers to understand the factors involved in identifying the onset of depression in teenagers better and develop more cost-effective screening procedures that can be employed nationally. In so doing, we hope that our research advances the toolset needed to combat the concerns preoccupying the minds of many school administrators.

[Para 3: Similar works]  “This manuscript expands on the prior research conducted and published by [Authors] in [Journal Name]” or “This paper [examines a different aspect of]/ [takes a different approach to] the issues explored in the following papers also published by [Journal Name].”

TIP: You should mention similar studies recently published by your target journal, if any, but list no more than five. If you only want to mention one article, replace the preceding sentence with “This paper [examines a different aspect of]/ [takes a different approach to] the issues explored by [Authors] in [Article Title], also published by [Journal Name] on [DATE].”

[Para. 4: Additional statements often required]  Each of the authors confirms that this manuscript has not been previously published and is not currently under consideration by any other journal. Additionally, all of the authors have approved the contents of this paper and have agreed to the [Journal Name]’s submission policies.

TIP: If you have previously publicly shared some form or part of your research elsewhere, state so. For example, you can say, “We have presented a subset of our findings [at Event]/ [as a Type of Publication Medium] in [Location] in [Year].”

e.g.,  We have since expanded the scope of our research to contemplate international feasibility and acquired additional data that has helped us to develop a new understanding of geographical influences.

[Para. 5: Potential Reviewers]  Should you select our manuscript for peer review, we would like to suggest the following potential reviewers/referees because they would have the requisite background to evaluate our findings and interpretation objectively.

• [Name, institution, email, expertise]

To the best of our knowledge, none of the above-suggested persons have any conflict of interest, financial or otherwise.

TIP: Include 3–5 reviewers since it is likely that the journal will use at least one of your suggestions.

TIP: Use whichever term (“reviewer” or “referee”) your target journal uses. Paying close attention to a journal’s terminology is a sign that you have properly researched the journal and have prepared!

[Para. 6: Frequently requested additional information]  Each named author has substantially contributed to conducting the underlying research and drafting this manuscript. Additionally, to the best of our knowledge, the named authors have no conflict of interest, financial or otherwise.

[Your Name]

Corresponding Author Institution Title Institution/Affiliation Name [Institution Address] [Your e-mail address] [Tel: (include relevant country/area code)] [Fax: (include relevant country/area code)]

Additional Contact [should the corresponding author not be available] Institution Title Institution/Affiliation Name [Institution Address] [Your e-mail address] [Tel: (include relevant country/area code)] [Fax: (include relevant country/area code)]

Quick Cover Letter Checklist Before Submission

• Set the font to Arial or Times New Roman, size 12 point.
• Single-space all text.
• Use one line space between body paragraphs.
• Do not indent paragraphs.
• Keep all text left justified.
• Use spelling and grammar check software. If needed, use a proofreading service or cover letter editing service  such as Wordvice to review your letter for clarity and concision.
• Double-check the editor’s name. Call the journal to confirm if necessary.

Writing a Cover Letter for Journal Submission [Free Template]

• Research Process
• Peer Review

Journal cover letters are your chance to lobby on behalf of your manuscript. This AJE Journal Cover Letter Guide offers some useful tips for getting them right. It also includes a free journal cover letter template.

Updated on September 20, 2018

The cover letter accompanying your journal submission is your chance to lobby on behalf of your manuscript. The letter is far from just a formality and should be written with the same care as your manuscript's text (if not more). Ultimately, your cover letter is designed to influence the decision of the editor to send your manuscript out for peer review. The letter will argue that your manuscript is a good fit for the journal you are submitting it to and highlight your most important findings. Let us help you produce the most effective cover letter possible.

Getting ready to submit your manuscript? Download our comprehensive Free Journal Cover Letter Writing Guide with Template .

A cover letter should be written like a standard business letter :

Address the editor formally by name, if known. Include your contact information, as well. This information is probably available through the journal's online submission system, but it is proper to provide it in the cover letter, too.

Begin your cover letter with a paragraph that states the name of the manuscript and the names of the authors. You can also describe what type of manuscript your submission is (research article, review, case report, etc.). In this first paragraph and the next, describe the rationale behind your study and the major findings from your research. You can refer to prior work that you have published if it is directly related.

Next, write a short paragraph that explains why your manuscript would be a good fit for the journal. Do not simply state that your manuscript is “of interest to the field” or “novel.” Address specific aspects of the journal's Aims & Scope statement. If the journal expresses interest in research with a clinical application, be sure to highlight the importance of your work in terms of clinical implications. If the journal mentions that it focuses on nanostructured materials, explain how your work involved such materials. Even if your work is not a perfect fit for the journal, be sure to address some of the Aims & Scope statement, and explain why your manuscript would be of interest to the journal's readers.

Finally, close with a brief paragraph indicating the following:

• The manuscript is original (i.e., you wrote it, not copied it)
• No part of the manuscript has been published before, nor is any part of it under consideration for publication at another journal
• There are no conflicts of interest to disclose
• A list of potential reviewers (only if requested by the journal)
• Any researchers who should NOT review your manuscript

Together, this information provides assurance to the editor that your manuscript merits consideration for publication in their journal and that you are interested specifically in their journal. Sometimes great science will be reviewed regardless of the cover letter, but a well written cover letter is useful for the vast majority of scientists who want to make their research stand out.

Best of luck with your research! If you have any questions about your cover letter, write us anytime.

Ben Mudrak, PhD

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Cover Letter for Journal Submission Templates

Download a Microsoft Word template for a standard journal cover letter (also available with instructions in Chinese , Japanese , Korean , Portuguese , and Spanish ).

Writing and formatting

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The cover letter gives you the opportunity to present an overview of your manuscript to the editor.

Your cover letter should include

• The objective and approach of your research
• Any novel contributions reported
• Why your manuscript should be published in this journal
• Any special considerations about your submission
• Related papers by you and/or your fellow authors (published or under consideration)
• Previous reviews of your submission
• Previous submissions of your manuscript to that journal
• Previous communication you’ve had with journal staff

You’re encouraged to submit previous communications as they can help expedite the review process. If you have any of the following, you can submit them as ‘Supplementary file for editors only’:

• Copies of related papers
• Previous editors’ comments and your responses
• Previous reviewers’ comments and your responses

NIH Employees

If you or any of your co-authors are NIH employees, you will have to submit a completed and signed NIH Publishing Agreement and Manuscript Cover Sheet according to NIH’s Employee Procedures .

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Cover letters

A good cover letter can help to “sell” your manuscript to the journal editor. As well as introducing your work to the editor you can also take this opportunity to explain why the manuscript will be of interest to a journal's readers, something which is always as the forefront editors’ mind. As such it is worth spending time writing a coherent and persuasive cover letter.

The following is an example of a poor cover letter:

Dear Editor-in-Chief, I am sending you our manuscript entitled “Large Scale Analysis of Cell Cycle Regulators in bladder cancer” by Researcher et al. We would like to have the manuscript considered for publication in Pathobiology. Please let me know of your decision at your earliest convenience. With my best regards, Sincerely yours, A Researcher, PhD

Instead, check to see whether the journal’s Instructions for Authors have any cover letter requirements (e.g. disclosures, statements, potential reviewers). Then, write a letter that explains why the editor would want to publish your manuscript. The following structure covers all the necessary points that need to be included.

• If known, address the editor who will be assessing your manuscript by their name. Include the date of submission and the journal you are submitting to.
• First paragraph: include the title of your manuscript and the type of manuscript it is (e.g. review, research, case study). Then briefly explain the background to your study, the question you sought out to answer and why.
• Second paragraph: you should concisely explain what was done, the main findings and why they are significant.
• Third paragraph: here you should indicate why the readers of the journal would be interested in the work. Take your cues from the journal’s aims and scope. For example if the journal requires that all work published has broad implications explain how your study fulfils this. It is also a good idea to include a sentence on the importance of the results to the field.
• To conclude state the corresponding author and any journal specific requirements that need to be complied with (e.g. ethical standards).

TIP: All cover letters should contain these sentences:

• We confirm that this manuscript has not been published elsewhere and is not under consideration by another journal.
• All authors have approved the manuscript and agree with its submission to [insert the name of the target journal].

Submission checklist

Before submitting your manuscript, thoroughly check its quality one more time. Evaluate it critically—could anything be done better?

Be sure that:

• The manuscript follows the Instructions for Authors
• All files are in the correct file format and of the appropriate resolution or size
• The spelling and grammar are correct
• You have contact information for all authors
• You have written a persuasive cover letter

Back │ Next

Cover letters

A good cover letter will help "sell" your manuscript to the journal editor. it is not enough to send a manuscript to a journal editor like this:.

Dear Editor-in-Chief,

I am sending you our manuscript entitled "Large Scale Analysis of Cell Cycle Regulators in bladder cancer" by Researcher et al. We would like to have the manuscript considered for publication in Pathobiology.

Please let me know of your decision at your earliest convenience.

With my best regards,

Sincerely yours,

A Researcher, PhD

Instead, check to see whether the journal's Instructions for Authors have any cover letter requirements (e.g., disclosures, statements, potential reviewers).

Then, write a letter that explains why the Editor would want to publish your manuscript:

Common phrases:

• Please find enclosed our manuscript, "[manuscript title]" by [first author's name] et al., which we would like to submit for publication as a [publication type] in [name of the journal].
• To our knowledge, this is the first report showing...
• We believe our findings would appeal to the readership of [journal name].
• Please address all correspondence to:
• We look forward to hearing from you at your earliest convenience.

All cover letters should contain these sentences:

• We confirm that this manuscript has not been published elsewhere and is not under consideration by another journal.
• All authors have approved the manuscript and agree with its submission to [insert the name of the target journal].

Submission checklist Before submitting your manuscript, thoroughly check its quality one more time. Evaluate it critically-could anything be done better?

Be sure that:

• The manuscript follows the submission guidelines
• All files are in the correct file format and of the appropriate resolution or size
• The spelling and grammar are correct
• You have contact information for all authors
• You have completed online registration for the submission process for your target journal
• You have written a persuasive cover letter

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How to Write a Cover Letter When Submitting Your Research Paper

Albert chan on july 3, 2018 at 12:00 am.

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• Write the cover letter with your institution’s letterhead to demonstrate professionalism and reliability.
• Personalise the cover letter by addressing the journal’s editor by their name.
• State the article type of your manuscript at the beginning of your cover letter (original research article, methodology, case report, etc.)
• Provide the full details of all the authors, including email address and phone number, in your cover letter.
• Explain briefly the research goals and results in one or two sentences.
• Explain the importance of your study: what will the paper’s contribution to the literature be? What impact will the paper have in the research field?
• Tell the editor why you think the study is best suited for the journal, and why the journal’s readers will be interested in the study.
• Declare that the manuscript (in whole or in part) has not been submitted or published in other journals, all authors have read and agreed to the content of the manuscript, you have complied with all ethical and reporting guidelines and have received ethical approval from the relevant committee(s).
• Disclose all potential conflicts of interest (if any).
• Thank the editor for taking the time to read your cover letter and consider your paper for submission.
• Keep the content of the cover letter brief, concise and courteous.

Don’t

• Mention any published literature without citation.
• Provide any personal information which is unrelated to the submission.
• Mention any previous publication records unless it is related to this research.
• Mention any potential professional benefits you may gain from the publication of this work.
• Provide research information that can be found in the paper.
• Copy and paste the abstract and paper content in the cover letter.
• Use complex sentence structures.
• Glorify your past research papers or any of your academic prestige in the cover letter.

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Writing effective cover letters for journal submissions: Tips and a Word template

When you need to submit a cover letter with your manuscript, you'll probably write it just before submission. Like many other authors, you may find yourself wondering what to write and taking longer than you expected, causing last-minute delays and stress.

To help you write effective cover letters—and to write them quickly and easily—in this article we offer some tips on layout and appropriate wording. Also, you can download our template cover letter (Word file) to help you save time writing and help you remember to include standard author statements and other information commonly required by journals.

If you are submitting a revised paper to the same journal, note that the response letter to the reviewers is different from the cover letter used at initial submission. You can find tips and a template on writing effective response letters to the reviewers in our previous article .

Many journals require a cover letter and state this in their guidelines for authors (alternatively known as author guidelines, information for authors, guide for authors, guidelines for papers, submission guide, etc.). For some journals, a cover letter is optional or may not be not required, but it's probably a good idea to include one.

Why do some journals ask for cover letters?

Cover letters can be helpful to journal staff in the following ways.

1. Cover letters that include standard statements required by the journal allow the journal staff to quickly confirm that the authors have (or say they have) followed certain ethical research and publishing practices.

These statements assert that the authors followed standard practices, which may include (i) adhering to ethical guidelines for research involving humans ( Declaration of Helsinki ), involving animals ( ARRIVE guidelines ), or falling under institutional guidelines; (ii) obtaining ethics approval from institutional review boards or ethics committees; (iii) obtaining informed consent or assent from participants; (iv) complying with authorship criteria (e.g., ICMJE criteria ); (v) confirming no duplicate submissions have been made; and (vi) recommending reviewers for your paper, which may include specifying peers that you prefer not be contacted.

2. Cover letters can summarize your manuscript quickly for the journal editor, highlighting your most important findings and their implications to show why your manuscript would be of interest.

Some journals, such as Nature, state that while a cover letter is optional, it provides "an excellent opportunity to briefly discuss the importance of the submitted work and why it is appropriate for the journal." Some publishers, such as Springer , recommend that you write a cover letter to help "sell" your manuscript to the journal editor.

3. Cover letters that contain all of the information required by the journal (as stated in the guideline for authors) can indicate that you have spent time carefully formatting the manuscript to fit the journal's style. This creates a good first impression. Addressing the letter to a named editor at the journal also shows that you took the time to write your letter (and by extension, your manuscript) with care and considered the fit with the journal beyond just impact factor.

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What makes an effective cover letter?

Cover letters should be short—preferably no more than 1 page—and they often use single line spacing. The content can be broadly divided into six sections:

• Addressee's information and date of submission
• Opening salutation
• Purpose statement and administrative information
• Summary of main research findings and implications
• Statements or information required by the journal
• Closing salutation and your contact information

Let's look at some tips for each section. And don't forget to download the template , which shows these tips already in place.

1. Addressee's information and date of submission

• Check the journal's website for the name of the editor who handles submissions; this could be the Managing Editor or an editor assigned to your geographical region. If no handling editor is named, address your cover letter to the Editor-in-Chief. Some journals ask that you identify a specific editor for your specialty.
• Write the name of the addressee in the top left corner of the page.
• Write the date beneath. To minimize the number of line breaks used in your cover letter (and help keep it to one page of text), you can put the date to the right if you wish.
• Note that dates written as numerals only can be confusing: 02/03/2017 can be read "2 March 2017" in British and "3 February 2017" in American English. Using the format "3 February 2017" or "February 3, 2017" is clear.

2. Opening salutation

• Write the title and last name of the addressee (exclude the first name); for example, "Professor Brown" or "Dr. Baker" (British English: "Dr Baker").
• If you can't find a named editor on the journal website, then you can use the opening salutation "Dear Editor".
• At the end of the opening salutation, you can use a comma or a colon; that is, "Dear Dr. Baker," or "Dear Dr. Baker:" (British English uses the comma; American English uses either, but the colon is considered more formal).

3. Purpose statement and administrative information

• Clearly state the purpose of your letter (that you are submitting a manuscript) and then state your manuscript title, author names (or first author "Brown et al."), and article type (e.g., original paper).
• Be sure to use the journal's own terminology to refer to the article type; for example, some journals use the term "Regular Articles" for a full research paper, whereas others use "Original Submissions", "Full Papers", "Original Articles", among others.
• See the downloadable Word template for an example sentence that presents this information clearly and concisely.
• If your submission consists of many files, consider summarizing them in one short sentence so that the journal editor is sure all of the files have been received; for example, "There are 8 files in all: 1 main manuscript file, 1 highlights file, 3 figure files, 1 table file, 1 supplementary data file, and 1 supplementary figures file".

4. Summary of main research findings and implications

• In a new paragraph, summarize the purpose of your research (the research gap or problem it addresses), the main findings, and finally the implications of these findings. This is your main chance to highlight the value of your work to the journal editor, so keep this short and focused. (Journal editors may receive thousands of submissions annually, and many fulfill editing duties on top of their own research and teaching schedule, so you should strive to make their jobs easier by providing as concise a summary as possible.)
• Be sure to tailor your statements so that they're in line with the readership of the journal. For example, if you are submitting to a more general journal that has a diverse readership, underscore the possible impact your findings could have in multiple fields. Conversely, if you are submitting to a publication with narrow scope, you can write about your findings in highly focused terms.
• Avoid simply reproducing sentences verbatim from the abstract—which the journal editor will likely read next. Instead, if you take sentences from your abstract as a base to work from, then try to craft a much shorter summary that clearly fits the journal's focus and that highlights the implications of your work for the journal's readers. In fact, Nature guidelines state specifically to "avoid repeating information that is already present in the abstract and introduction."
• When stating that you think your work is a good fit for the journal, be sure not to use exaggerated flattery. Avoid using words like "esteemed" and "prestigious" to describe the journal: "We believe that these findings will be of interest to the readers of your esteemed/prestigious journal."
• It's helpful to the journal editor to state if your work directly relates to a paper published by another author in the same journal. Also, mention if your study closely relates to or extends your previously published work, so it is clear why your submitted manuscript is novel or important enough to publish.

Common phrases in this paragraph:

Summarizing the purpose of your research

• This study presents/summarizes/examines…
• X remains a problem for (engineers/software developers/local government). In this study, we (examined/investigated/developed and tested)…

Presenting your main results

• Our main findings/results were that…
• The most interesting/important findings were that…
• Most importantly, our findings can improve/reduce/help…

Highlighting the relevance of your findings

• These findings should enable (engineers/doctors/local government) to…
• We believe that these findings will be of interest to the readers of your journal.

5. Statements or information required by the journal

• In this new paragraph, provide any statements that the journal requires be included in your cover letter. Be sure to review the journal's guidelines to know what information you should provide.
• Some journals or publishers have very specific requirements. For example, PLOS requires that authors describe any prior interactions with the journal in the cover letter, as well as suggest appropriate Academic Editors from the journal's editorial board to handle the submission.
• Some journals require that sentences are provided verbatim in the cover letter. The guidelines will tell you to copy and paste the sentence provided in quotation marks into the cover letter. For example, Springer states that cover letters should contain two specific sentences: "We confirm that this manuscript has not been published elsewhere and is not under consideration by another journal" and "All authors have approved the manuscript and agree with its submission to [insert the name of the target journal]."
• Several statements pertaining to research and publication ethics are commonly required by journals across a broad range of fields. These are given in our downloadable Word template . When using the template, you can retain the statements in full, revise them slightly as appropriate to your circumstances, replace them with any similar wording required by the journal, or delete them if they do not fit your specific situation.

Previous contact with the journal

• We state that we have had no previous contact with the journal regarding this submission.
• We previously contacted the journal to inquire about/to check whether…

Conflict of interests and financial disclosures

• The authors have no conflicts of interest to declare.
• X.Y. advises Company A and has received lecture fees from Company B.
• This study was supported by a grant from Z.
• No financial support was received for this study/work.
• A.B. conceived the study, analyzed the data, and drafted the manuscript; C.D. analyzed the data…
• All authors have approved the manuscript and agree with its submission to the journal.
• All authors approved the final version of the manuscript and agree to be accountable for all aspects of this work.

Suggested reviewers

• Potential reviewers for our manuscript are:
• We believe that the following individual(s) would be well suited to reviewing our manuscript.

Request to exclude reviewers

• We request that the following individual(s) not be approached to review our manuscript (because…).

Concurrent/duplicate submissions

• We declare that this manuscript has not been published before, in whole or in part, and is not currently being considered for publication elsewhere.
• This study was presented in part at…
• This study was previously published in Japanese (citation) and…

6. Closing salutation and your contact information

• Briefly thank the journal editor for considering the manuscript and follow this with the full contact information of the corresponding author (name, academic degrees or professional qualifications; affiliation and postal address; telephone (and fax); email).
• Be sure to maintain a collegial tone to leave the journal editor with the best impression as he or she finishes reading your cover letter and moves on to evaluate your manuscript.
• Avoid statements that could be construed as presuming to give instructions to the editor. For example, "we look forward to your review of our manuscript" implicitly directs the editor to review your paper. Also, we look forward to hearing from you "at your earliest convenience/as soon as possible" implicitly directs the editor to communicate with you quickly; instead, simply use a neutral but polite phrase such as "we look forward to hearing from you" or "we look forward to hearing from you in due course".
• A suitable closing salutation is "Sincerely," or "Yours sincerely,"

Although the cover letter is not, strictly speaking, a part of your manuscript, it can affect how your submission is perceived by the journal editor. A cover letter that is tailored to the journal, introduces your work persuasively, and is free from spelling and grammatical errors can help prime the editor to view your submission positively before he or she even looks over your manuscript.

We hope our tips and Word template can help you create professional, complete cover letters in a time-effective way. Our specialist editors, translators, and writers are available to help create or revise the content to be error-free and, as part of our additional comprehensive Guidelines for Authors service , we can ensure the cover letter includes all of the statements required by the journal.

Lastly, just as a reminder for members of ThinkSCIENCE's free annual rewards program , remember to claim your reward of free editing or translation of one cover letter alongside editing or translation of a full paper before the end of the March!

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• Articles should ideally be no more than 11 typeset pages
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We allow the use of up to 6 keywords/key phrases that can be used for indexing purposes. These should represent the main content of the submission.

Your manuscript text file should start with a title page that shows author affiliations and contact information, identifying the corresponding author with an asterisk. We recommend that each section includes an introduction of referenced text that expands on the background of the work. Some overlap with the Abstract is acceptable. Large Language Models (LLMs), such as ChatGPT , do not currently satisfy our authorship criteria . Notably an attribution of authorship carries with it accountability for the work, which cannot be effectively applied to LLMs. Use of an LLM should be properly documented in the Methods section (and if a Methods section is not available, in a suitable alternative part) of the manuscript. In response to emerging information, advice, guidance and policy around artificial intelligence (AI), we have created a dedicated AI section in our  Editorial Policy page . Please familiarize yourself with this content and comply with relevant policies.

For the main body of the text, there are no specific requirements. You can organise it in a way that best suits your research. However, the following structure will be suitable in many cases:

• Introduction
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You should then follow the main body of text with:

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Please note, footnotes should not be used. 

We do not automatically include page or line numbers in the materials sent to Editorial Board Members and reviewers. Please consider including those in your manuscript; this can help facilitate the evaluation of the paper and makes giving feedback on specific sections easier.

You may include a limited number of uncaptioned molecular structure graphics and numbered mathematical equations if necessary. Display items are limited to 8 ( figures and/or tables ). However, to enable typesetting of papers, we advise making the number of display items commensurate with your overall word length. So, for Articles of 2,000 words or less, we suggest including no more than 4 figures/tables. Please note that schemes should not be used and should be presented as figures instead.

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Supplementary information should be combined and supplied as a single separate file, preferably in PDF format.

A submission template is available in the Overleaf template gallery to help you prepare a LaTeX manuscript within the Scientific Reports formatting criteria.

In your cover letter, you should include:

• The affiliation and contact information of your corresponding author
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Finally, you should state whether you have had any prior discussions with a Scientific Reports Editorial Board Member about the work described in your manuscript.

For revised manuscripts, you should provide all textual content in a single file, prepared using either Microsoft Word or LaTeX. Please note, we do not accept PDF files for the article text of revised manuscripts. Make sure you:

• Format the manuscript file as single-column text without justification.
• Number the pages using an Arabic numeral in the footer of each page.
• Use the default Computer Modern fonts for your text, and the 'symbols' font for any Greek characters.
• Supply any figures as individual files.
• Combine and supply any Supplementary Information as a separate file, preferably in PDF format.
• Include the title of the manuscript and author list in the first page of the Supplementary Information file.

If you do not wish to incorporate the manuscript text and figures into a single file, please provide all textual content in a separate single file, prepared using either Microsoft Word or LaTeX.

If you’re submitting LaTeX files, you can either use the standard ‘Article’ document class (or similar) or the wlscirep.cls file and template provided by Overleaf . For graphics, we recommend your use graphicx.sty. Use numerical references only for citations.

Our system cannot accept .bib files. If you prepare references using BibTeX (which is optional), please include the .bbl file with your submission (as a ‘LaTeX supplementary file’) in order for it to be processed correctly; this file is included automatically in the zip file generated by Overleaf for submissions. Please see this help article on Overleaf for more details.

Alternatively, you can make sure that the references (source code) are included within the manuscript file itself. As a final precaution, you should ensure that the complete .tex file compiles successfully on its own system with no errors or warnings, before submission.

Scientific Reports is read by a truly diverse range of scientists. Please therefore give careful thought to communicating your findings as clearly as possible.

Although you can assume a shared basic knowledge of science, please don’t expect that everyone will be familiar with the specialist language or concepts of your particular field. Therefore:

• Avoid technical jargon wherever possible, explaining it clearly when it is unavoidable.
• Keep abbreviations to a minimum, particularly when they are not standard.
• If you must use an abbreviation, make sure you spell it out fully in the text or legend the first time it appears.
• Clearly explain the background, rationale and main conclusions of your study.
• Write titles and abstracts in language that will be readily understood by any scientist.

We strongly recommend that you ask a colleague with different expertise to review your manuscript before you submit it. This will help you to identify concepts and terminology that non-specialist readers may find hard to grasp.

We don’t provide in-depth copy editing as part of the production process. So, if you feel your manuscript would benefit from someone looking at the copy, please consider using a copy editing or language editing service. You can either do this before submission or at the revision stage. You can also get a fast, free grammar check of your manuscript that takes into account all aspects of readability in English.

We have two affiliates who can provide you with these services: Nature Research Editing Service and American Journal Experts . As a Scientific Reports author, you are entitled to a 10% discount on your first submission to either of these.

Claim 10% off English editing from Nature Research Editing Service

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Please note that the use of an editing service is at your own expense, and doesn’t ensure that your article will be selected for peer-review or accepted for publication.

We don't impose word limits on the description of methods. Make sure it includes adequate experimental and characterisation data for others to be able to reproduce your work. You should:

• Include descriptions of standard protocols and experimental procedures.
• Only identify commercial suppliers of reagents or instrumentation when the source is critical to the outcome of the experiments.
• Identify sources for any kits you use in your procedures.
• Include any experimental protocols that describe the synthesis of new compounds.
• Use the systematic name of any new compound and put its bold Arabic numeral in the heading for the experimental protocol, indicating it thereafter by its assigned, bold numeral.
• Describe the experimental protocol in detail, referring to amounts of reagents in parentheses, when possible (eg 1.03 g, 0.100 mmol).
• Use standard abbreviations for reagents and solvents.
• Clearly identify safety hazards posed by reagents or protocols.
• Report isolated mass and percent yields at the end of each protocol.

If you’re reporting experiments on live vertebrates (or higher invertebrates), humans or human samples, you must include a statement of ethical approval in the Methods section (see our detailed requirements for further information on preparing these statements).

We don’t copy edit your references. Therefore, it’s essential you format them correctly, as they will be linked electronically to external databases where possible. At Scientific Reports , we use the standard Nature referencing style. So, when formatting your references, make sure they:

• Run sequentially (and are always numerical).
• Sit within square brackets.
• Only have one publication linked to each number.
• Only include papers or datasets that have been published or accepted by a named publication, recognised preprint server or data repository (if you include any preprints of accepted papers in your reference list, make sure you submit them with the manuscript).
• Include published conference abstracts and numbered patents, if you wish.
• Don’t include grant details and acknowledgements.

Sorry, we cannot accept BibTeX (.bib) bibliography files for references. If you are making your submission by LaTeX, it must either contain all references within the manuscript .tex file itself, or (if you’re using the Overleaf template) include the .bbl file generated during the compilation process as a ‘LaTeX supplementary file’ (see the "Manuscripts" section for more details).

In your reference list, you should:

• Include all authors unless there are six or more, in which case only the first author should be given, followed by 'et al.'.
• List authors by last name first, followed by a comma and initials (followed by full stops) of given names.
• Use Roman text for Article and dataset titles, with only the first word of the title having an initial capital and written exactly as it appears in the work cited, ending with a full stop.
• Use italics for book titles, giving all words in the title an initial capital.
• Use italics for journal and data repository names, abbreviating them according to common usage (with full stops).
• Use bold for volume numbers and the subsequent comma.
• Give the full page range (or article number), where appropriate.

Published papers:

Printed journals Schott, D. H., Collins, R. N. & Bretscher, A. Secretory vesicle transport velocity in living cells depends on the myosin V lever arm length. J. Cell Biol . 156 , 35-39 (2002).

Online only Bellin, D. L. et al . Electrochemical camera chip for simultaneous imaging of multiple metabolites in biofilms . Nat. Commun . 7 , 10535; 10.1038/ncomms10535 (2016).

For papers with more than five authors include only the first author’s name followed by ‘ et al. ’.

Books: Smith, J. Syntax of referencing in How to reference books (ed. Smith, S.) 180-181 (Macmillan, 2013).

Online material:

Babichev, S. A., Ries, J. & Lvovsky, A. I. Quantum scissors: teleportation of single-mode optical states by means of a nonlocal single photon. Preprint at https://arxiv.org/abs/quant-ph/0208066 (2002).

Manaster, J. Sloth squeak. Scientific American Blog Network http://blogs.scientificamerican.com/psi-vid/2014/04/09/sloth-squeak (2014).

Hao, Z., AghaKouchak, A., Nakhjiri, N. & Farahmand, A. Global integrated drought monitoring and prediction system (GIDMaPS) data sets.  figshare   https://doi.org/10.6084/m9.figshare.853801 (2014).

Please keep any acknowledgements brief, and don’t include thanks to anonymous referees and editors, or any effusive comments. You may acknowledge grant or contribution numbers. You should also acknowledge assistance from medical writers, proof-readers and editors.

You must supply an Author Contribution Statement as described in the Author responsibilities section of our Editorial and Publishing Policies .

Please be aware:

• The author name you give as the corresponding author will be the main contact during the review process and should not change.
• The information you provide in the submission system will be used as the source of truth when your paper is published.

You must supply a competing interests statement . If there is no conflict of interest, you should include a statement declaring this.

Your statement must be explicit and unambiguous, describing any potential competing interest (or lack thereof) for EACH contributing author. The information you provide in the submission system will be used as the source of truth when your paper is published.

Examples of declarations are:

Competing interests The author(s) declare no competing interests.

Competing interests Dr X's work has been funded by A. He has received compensation as a member of the scientific advisory board of B and owns stock in the company. He also has consulted for C and received compensation. Dr Y and Dr Z declare no potential conflict of interest.

You must include a Data Availability Statement in all submitted manuscripts (at the end of the main text, before the References section); see ' Availability of materials and data ' section for more information.

If your research includes human or animal subjects, you will need to include the appropriate ethics declarations in the Methods section of your manuscript.

For experiments involving live vertebrates and/or higher invertebrates, your Methods section must include a statement that:

• Identifies the institutional and/or licensing committee that approved the experiments, including any relevant details.
• Confirms that all experiments were performed in accordance with relevant named guidelines and regulations.
• Confirms that the authors complied with the ARRIVE guidelines.

For experiments involving human subjects (or tissue samples), your Methods section must include a statement that:

• Confirms that informed consent was obtained from all participants and/or their legal guardians.

Please note that:

• Study participant names (and other personally identifiable information) must be removed from all text/figures/tables/images.
• The use of coloured bars/shapes or blurring to obscure the eyes/facial region of study participants is not an acceptable means of anonymisation. For manuscripts that include information or images that could lead to identification of a study participant, your Methods section must include a statement that confirms informed consent was obtained to publish the information/image(s) in an online open access publication.

Supplementary Information

You should submit any Supplementary Information together with the manuscript so that we can send it to referees during peer-review. This will be published online with accepted manuscripts.

It’s vital that you carefully check your Supplementary Information before submission as any modification after your paper is published will require a formal correction.

Please avoid including any "data not shown" statements and instead make your data available via deposition in a public repository (see ' Availability of materials and data ' for more information).

If any data that is necessary to evaluate the claims of your paper is not available via a public depository, make sure you provide it as Supplementary Information.

We do not edit, typeset or proof Supplementary Information, so please present it clearly and succinctly at initial submission, making sure it conforms to the style and terminology of the rest of the paper.

To avoid any delays to publication, please follow the guidelines below for creation, citation and submission of your Supplementary Information:

You can combine multiple pieces of Supplementary Information and supply them as a single composite file. If you wish to keep larger information (e.g. supplementary videos, spreadsheets [.csv or .xlsx] or data files) as another separate file you may do so.

Designate each item as Supplementary Table, Figure, Video, Audio, Note, Data, Discussion, Equations or Methods, as appropriate. Number Supplementary Tables and Figures as, for example, "Supplementary Table S1". This numbering should be separate from that used in tables and figures appearing in the main article. Supplementary Note or Methods should not be numbered; titles for these are optional.

Refer to each piece of supplementary material at the appropriate point(s) in the main article. Be sure to include the word "Supplementary" each time one is mentioned. Please do not refer to individual panels of supplementary figures.

Use the following examples as a guide (note: abbreviate "Figure" as "Fig." when in the middle of a sentence): "Table 1 provides a selected subset of the most active compounds. The entire list of 96 compounds can be found as Supplementary Table S1 online." "The biosynthetic pathway of L-ascorbic acid in animals involves intermediates of the D-glucuronic acid pathway (see Supplementary Fig. S2 online). Figure 2 shows...".

Remember to include a brief title and legend (incorporated into the file to appear near the image) as part of every figure submitted, and a title as part of every table.

Keep file sizes as small as possible, with a maximum size of 50 MB, so that they can be downloaded quickly.

Supplementary video files should be provided in the standard video aspects: 4:3, 16:9, 21:9.

If you have any further questions about the submission and preparation of Supplementary Information, please email: [email protected] .

Please begin your figure legends with a brief title sentence for the whole figure and continue with a short description of what is shown in each panel. Use any symbols in sequence and minimise the methodological details as much as possible. Keep each legend total to no more than 350 words. Provide text for figure legends in numerical order after the references.

Please submit any tables in your main article document in an editable format (Word or TeX/LaTeX, as appropriate), and not as images. Tables that include statistical analysis of data should describe their standards of error analysis and ranges in a table legend.

Include any equations and mathematical expressions in the main text of the paper. Identify equations that are referred to in the text by parenthetical numbers, such as (1), and refer to them in the manuscript as "equation (1)" etc.

For submissions in a .doc or .docx format, please make sure that all equations are provided in an editable Word format. You can produce these with the equation editor included in Microsoft Word.

You are responsible for obtaining permission to publish any figures or illustrations that are protected by copyright, including figures published elsewhere and pictures taken by professional photographers. We cannot publish images downloaded from the internet without appropriate permission.

You should state the source of any images used. If you or one of your co-authors has drawn the images, please mention this in your acknowledgements. For software, you should state the name, version number and URL.

Number any figures separately with Arabic numerals in the order they occur in the text of the manuscript. Include error bars when appropriate. Include a description of the statistical treatment of error analysis in the figure legend.

Please do not use schemes. You should submit sequences of chemical reactions or experimental procedures as figures, with appropriate captions. You may include in the manuscript a limited number of uncaptioned graphics depicting chemical structures - each labelled with their name, by a defined abbreviation, or by the bold Arabic numeral.

Use a clear, sans-serif typeface (for example, Helvetica) for figure lettering. Use the same typeface in the same font size for all figures in your paper. For Greek letters, use a 'symbols' font. Put all display items on a white background, and avoid excessive boxing, unnecessary colour, spurious decorative effects (such as three-dimensional 'skyscraper' histograms) and highly pixelated computer drawings. Never truncate the vertical axis of histograms to exaggerate small differences. Ensure any labelling is of sufficient size and contrast to be legible, even after appropriate reduction. The thinnest lines in the final figure should be no smaller than one point wide. You will be sent a proof that will include figures.

• Figures divided into parts should be labelled with a lower-case, bold letter ( a, b, c and so on) in the same type size as used elsewhere in the figure.
• Lettering in figures should be in lower-case type, with only the first letter of each label capitalised.
• Units should have a single space between the number and the unit, and follow SI nomenclature (for example, ms rather than msec) or the nomenclature common to a particular field.
• Thousands should be separated by commas (1,000).
• Unusual units or abbreviations should be spelled out in full or defined in the legend.
• Scale bars should be used rather than magnification factors, with the length of the bar defined on the bar itself rather than in the legend.

In legends, please use visual cues rather than verbal explanations such as "open red triangles". Avoid unnecessary figures: data presented in small tables or histograms, for instance, can generally be stated briefly in the text instead. Figures should not contain more than one panel unless the parts are logically connected; each panel of a multipart figure should be sized so that the whole figure can be reduced by the same amount and reproduced at the smallest size at which essential details are visible.

At the initial submission stage, you may choose to upload separate figure files or to incorporate figures into the main article file, ensuring that any figures are of sufficient quality to be clearly legible.

When submitting a revised manuscript, you must upload all figures as separate figure files, ensuring that the image quality and formatting conforms to the specifications below.

You must supply each complete figure as a separate file upload. Multi-part/panel figures must be prepared and arranged as a single image file (including all sub-parts; a, b, c, etc.). Please do not upload each panel individually.

Please read the digital images integrity and standards section of our Editorial and Publishing Policies . When possible, we prefer to use original digital figures to ensure the highest-quality reproduction in the journal. When creating and submitting digital files, please follow the guidelines below. Failure to do so, or to adhere to the following guidelines, can significantly delay publication of your work.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

1. Line art, graphs, charts and schematics

For optimal results, you should supply all line art, graphs, charts and schematics in vector format, such as EPS or AI. Please save or export it directly from the application in which it was made, making sure that data points and axis labels are clearly legible.

2. Photographic and bitmap images

Please supply all photographic and bitmap images in a bitmap image format such as tiff, jpg, or psd. If saving tiff files, please ensure that the compression option is selected to avoid very large file sizes. Please do not supply Word or Powerpoint files with placed images. Images can be supplied as RGB or CMYK (note: we will not convert image colour modes).

Figures that do not meet these standards will not reproduce well and may delay publication until we receive high-resolution images.

3. Chemical structures

Please produce Chemical structures using ChemDraw or a similar program. All chemical compounds must be assigned a bold, Arabic numeral in the order in which the compounds are presented in the manuscript text. Structures should then be exported into a 300 dpi RGB tiff file before being submitted.

4. Stereo images

You should present stereo diagrams for divergent 'wall-eyed' viewing, with the two panels separated by 5.5 cm. In the final accepted version of the manuscript, you should submit the stereo images at their final page size.

If your paper contains statistical testing, it should state the name of the statistical test, the n value for each statistical analysis, the comparisons of interest, a justification for the use of that test (including, for example, a discussion of the normality of the data when the test is appropriate only for normal data), the alpha level for all tests, whether the tests were one-tailed or two-tailed, and the actual P value for each test (not merely "significant" or "P < 0.05"). Please make it clear what statistical test was used to generate every P value. Use of the word "significant" should always be accompanied by a P value; otherwise, use "substantial," "considerable," etc.

Data sets should be summarised with descriptive statistics, which should include the n value for each data set, a clearly labelled measure of centre (such as the mean or the median), and a clearly labelled measure of variability (such as standard deviation or range).

Ranges are more appropriate than standard deviations or standard errors for small data sets. Graphs should include clearly labelled error bars. You must state whether a number that follows the ± sign is a standard error (s.e.m.) or a standard deviation (s.d.).

You must justify the use of a particular test and explain whether the data conforms to the assumptions of the tests. Three errors are particularly common:

• Multiple comparisons: when making multiple statistical comparisons on a single data set, you should explain how you adjusted the alpha level to avoid an inflated Type I error rate, or you should select statistical tests appropriate for multiple groups (such as ANOVA rather than a series of t-tests).
• Normal distribution: many statistical tests require that the data be approximately normally distributed; when using these tests, you should explain how you tested your data for normality. If the data does not meet the assumptions of the test, you should use a non-parametric alternative instead.
• Small sample size: when the sample size is small (less than about 10), you should use tests appropriate to small samples or justify the use of large-sample tests.

You should identify molecular structures by bold, Arabic numerals assigned in order of presentation in the text. Once identified in the main text or a figure, you may refer to compounds by their name, by a defined abbreviation, or by the bold Arabic numeral (as long as the compound is referred to consistently as one of these three).

When possible, you should refer to chemical compounds and biomolecules using systematic nomenclature, preferably using IUPAC . You should use standard chemical and biological abbreviations. Make sure you define unconventional or specialist abbreviations at their first occurrence in the text.

You should use approved nomenclature for gene symbols, and employ symbols rather than italicised full names (for example Ttn, not titin). Please consult the appropriate nomenclature databases for correct gene names and symbols. A useful resource is Entrez Gene .

You can get approved human gene symbols from HUGO Gene Nomenclature Committee (HGNC), e-mail: [email protected] ; see also www.genenames.org .

You can get approved mouse symbols from The Jackson Laboratory, e-mail: [email protected] ; see also www.informatics.jax.org/mgihome/nomen .

For proposed gene names that are not already approved, please submit the gene symbols to the appropriate nomenclature committees as soon as possible, as these must be deposited and approved before publication of an article.

Avoid listing multiple names of genes (or proteins) separated by a slash, as in 'Oct4/Pou5f1', as this is ambiguous (it could mean a ratio, a complex, alternative names or different subunits). Use one name throughout and include the other at first mention: 'Oct4 (also known as Pou5f1)'.

Scientific Reports is committed to publishing technically sound research. Manuscripts submitted to the journal will be held to rigorous standards with respect to experimental methods and characterisation of new compounds.

You must provide adequate data to support your assignment of identity and purity for each new compound described in your manuscript. You should provide a statement confirming the source, identity and purity of known compounds that are central to the scientific study, even if they are purchased or resynthesised using published methods.

1. Chemical identity

Chemical identity for organic and organometallic compounds should be established through spectroscopic analysis. Standard peak listings (see formatting guidelines below) for 1H NMR and proton-decoupled 13C NMR should be provided for all new compounds. Other NMR data should be reported (31P NMR, 19F NMR, etc.) when appropriate. For new materials, you should also provide mass spectral data to support molecular weight identity. High-resolution mass spectral (HRMS) data is preferred. You may report UV or IR spectral data for the identification of characteristic functional groups, when appropriate. You should provide melting-point ranges for crystalline materials. You may report specific rotations for chiral compounds. You should provide references, rather than detailed procedures, for known compounds, unless their protocols represent a departure from or improvement on published methods.

2. Combinational compound libraries

When describing the preparation of combinatorial libraries, you should include standard characterisation data for a diverse panel of library components.

3. Biomolecular identity

For new biopolymeric materials (oligosaccharides, peptides, nucleic acids, etc.), direct structural analysis by NMR spectroscopic methods may not be possible. In these cases, you must provide evidence of identity based on sequence (when appropriate) and mass spectral characterisation.

4. Biological constructs

You should provide sequencing or functional data that validates the identity of their biological constructs (plasmids, fusion proteins, site-directed mutants, etc.) either in the manuscript text or the Methods section, as appropriate.

5. Sample purity

We request evidence of sample purity for each new compound. Methods for purity analysis depend on the compound class. For most organic and organometallic compounds, purity may be demonstrated by high-field 1H NMR or 13C NMR data, although elemental analysis (±0.4%) is encouraged for small molecules. You may use quantitative analytical methods including chromatographic (GC, HPLC, etc.) or electrophoretic analyses to demonstrate purity for small molecules and polymeric materials.

6. Spectral data

Please provide detailed spectral data for new compounds in list form (see below) in the Methods section. Figures containing spectra generally will not be published as a manuscript figure unless the data are directly relevant to the central conclusions of the paper. You are encouraged to include high-quality images of spectral data for key compounds in the Supplementary Information. You should list specific NMR assignments after integration values only if they were unambiguously determined by multidimensional NMR or decoupling experiments. You should provide information about how assignments were made in a general Methods section.

Example format for compound characterisation data. mp: 100-102 °C (lit. ref 99-101 °C); TLC (CHCl 3 :MeOH, 98:2 v/v): R f = 0.23; [α] D = -21.5 (0.1 M in n-hexane); 1 H NMR (400 MHz, CDCl 3 ): δ 9.30 (s, 1H), 7.55-7.41 (m, 6H), 5.61 (d, J = 5.5 Hz, 1H), 5.40 (d, J = 5.5 Hz, 1H), 4.93 (m, 1H), 4.20 (q, J = 8.5 Hz, 2H), 2.11 (s, 3H), 1.25 (t, J = 8.5 Hz, 3H); 13 C NMR (125 MHz, CDCl 3 ): δ 165.4, 165.0, 140.5, 138.7, 131.5, 129.2, 118.6, 84.2, 75.8, 66.7, 37.9, 20.1; IR (Nujol): 1765 cm- 1 ; UV/Vis: λ max 267 nm; HRMS (m/z): [M] + calcd. for C 20 H 15 C l2 NO 5 , 420.0406; found, 420.0412; analysis (calcd., found for C 20 H 15 C l2 NO 5 ): C (57.16, 57.22), H (3.60, 3.61), Cl (16.87, 16.88), N (3.33, 3.33), O (19.04, 19.09).

7. Crystallographic data for small molecules

If your manuscript is reporting new three-dimensional structures of small molecules from crystallographic analysis, you should include a .cif file and a structural figure with probability ellipsoids for publication as Supplementary Information. These must have been checked using the IUCR's CheckCIF routine, and you must include a PDF copy of the output with the submission, together with a justification for any alerts reported. You should submit crystallographic data for small molecules to the Cambridge Structural Database and the deposition number referenced appropriately in the manuscript. Full access must be provided on publication.

8. Macromolecular structural data

If your manuscript is reporting new structures, it should contain a table summarising structural and refinement statistics. Templates are available for such tables describing NMR and X-ray crystallography data. To facilitate assessment of the quality of the structural data, you should submit with the manuscript a stereo image of a portion of the electron density map (for crystallography papers) or of the superimposed lowest energy structures (≳10; for NMR papers). If the reported structure represents a novel overall fold, you should also provide a stereo image of the entire structure (as a backbone trace).

Registered Reports are original research articles which undergo peer-review prior to data collection and analyses. This format is designed to minimize publication bias and research bias in hypothesis-driven research, while also allowing the flexibility to conduct exploratory (unregistered) analyses and report serendipitous findings. If you intend to submit a Registered Report to Scientific Reports , please refer to detailed guidelines here .

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Contact Monica Mungle for help if edits are needed to the top section.

Original Investigation

Brief report, research letter, systematic review (without meta-analysis), consensus statement, special communication, clinicopathological challenge, images in dermatology, letter to the editor, letter in reply, observation.

• Randomized Clinical Trial
• Parallel-Design Double-blind Trial
• Crossover Trial
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• Cluster Trial
• Nonrandomized Clinical Trial

Meta-analysis

• Cohort Study
• Case-Control Study
• Cross-sectional Study
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• Economic Evaluation
• Decision Analytical Model
• Comparative Effectiveness Research
• Genetic Association Study
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Manuscript Submission

Copies of previous editorial and reviewer comments, cover letter, manuscript style, manuscript components, recommended file sizes, manuscript file formats, abbreviations, units of measure, names of drugs, devices, and other products, gene names, symbols, and accession numbers, reproduced and re-created material, online-only supplements and multimedia.

What to Expect

Editorial and Peer Review

Authorship form and publishing agreement, publication.

• Postpublication Online Commenting

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Corrections, previous publication, related manuscripts and reports, and preprints, previous or planned meeting presentation or release of information, embargo policy, open access, research article public access, depositing in repositories, and discoverability.

Editorial Policies for Authors

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Authorship criteria and contributions, role of the corresponding author, changes in authorship, name change policy, group authorship, conflicts of interest and financial disclosures, funding/support and role of funder/sponsor, data access, responsibility, and analysis, acknowledgment section, equator reporting guidelines, use of causal language, timeliness of data, statistical methods and data presentation, reporting demographic information for study participants, ethical approval of studies and informed consent, patient identification, use of ai in publication and research, personal communications and unpublished data, manuscripts that pose security risks.

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Contact Information

JAMA Dermatology , Kanade Shinkai, MD, PhD, Editor, UCSF Department of Dermatology, 1701 Divisadero St, 3rd Floor, San Francisco, CA 94115; email: [email protected] . Send inquiries about submitting manuscripts by email. Manuscripts should be submitted online at http://manuscripts.jamaderm.com .

Determine My Article Type

Categories of articles.

Original Investigation full info

Clinical trial Meta-analysis Intervention study Cohort study Case-control study Epidemiologic assessment Survey with high response rate Cost-effectiveness analysis Decision analysis Study of screening and diagnostic tests Other observational study

• ≤5 tables and/or figures
• Structured abstract

Data Sharing Statement

Follow EQUATOR Reporting Guidelines

Brief Report full info

Short reports of original studies or evaluations or unique, first-time reports of clinical case series.

Case reports are not included in this section; see Observation.

• 15 references
• ≤3 tables and/or figures

Research Letter full info

Concise, focused reports of original research. Can include any of the study types listed under Original Investigation.

• ≤6 references
• ≤2 small tables and/or figures
• No Abstract or Key Points

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Clinical Review and Education

Systematic Review (without meta-analysis) full info

Critical assessments of the literature and data sources pertaining to clinical topics, emphasizing factors such as cause, diagnosis, prognosis, therapy, or prevention.

Systematic Reviews without meta-analysis are published as Reviews; those with meta-analysis are published as Original Investigations (see Meta-analysis ).

• 50-75 references
• A PRISMA-style flow diagram should be included as an online supplement
• Include a table with ratings of the quality of the studies/evidence
• Subtitle should be "A Systematic Review"

Consensus Statement full info

This article type requires a presubmission inquiry. See the "full info" below for requirements and contact information.

These manuscripts comment on a disease, public health policy, or therapy intervention, often resulting from the work of a consensus conference convened to offer recommendations or to set policy.

• Follow SQUIRE Reporting Guidelines
• Requires a presubmission inquiry

Special Communication full info

This journal publishes very few of these types of articles.

These manuscripts describe an important issue in clinical medicine, public health, health policy, or medical research in a scholarly, thorough, well-referenced, systematic, and evidence-based manner.

• 50 references
• ≤4 tables and/or figures

Clinicopathological Challenge full info

Presents an actual patient scenario about a specific disease or condition with an accompanying clinical image.

• "What Is Your Diagnosis?" with 4 single-phrase plausible diagnosis options with 1 being preferred
• Case presentation: 250 words
• Discussion: 500-600 words
• ≤10 references
• ≤3 small figures (no figure insets)
• Patient permission may be needed

Images in Dermatology full info

A visual image of an interesting and unique dermatological observation with a brief description of the clinical issue.

• 1-2 images (figures)
• No online-only material
• ≤4 references

Viewpoint full info

Addresses any important topic relevant to the care of patients with dermatologic conditions or professional matters unique to dermatologists. May be focused on clinical medicine, public health, research, innovation, ethics, health policy, or health law.

• 1200 words (or 1000 words with 1 small table or figure)
• ≤7 references at submission
• ≤3 authors, with no more than 2 affiliations per author

Correspondence

Letter to the Editor full info

Letters discussing a recent article in this journal should be submitted within 4 weeks of the article's publication in print.

• ≤5 references (1 of which should be to the recent article)

Letter in Reply full info

Replies by authors of original articles to letters from readers.

Observation full info

Short reports of 1 or 2 complicated or unique cases.

• No more than 7 authors

Study Types

Determine my study type.

Randomized Clinical Trial full info

A trial that prospectively assigns participants to intervention or comparison groups to study the cause-and-effect relationship between an intervention and a health outcome. Interventions include but are not limited to drugs, surgical procedures, devices, behavioral treatments, educational programs, dietary interventions, quality improvement interventions, process-of-care changes, and the like.

• ≤5 tables and/or figures, including CONSORT flow diagram
• Subtitle should be "A Randomized Clinical Trial"
• Trial registration and ID
• Trial protocol
• CONSORT checklist
• Follow CONSORT Reporting Guidelines

Parallel-Design Double-blind Trial full info

A randomized trial that prospectively assigns participants to 2 or more groups to receive different interventions. Participants and those administering the interventions are unaware of which intervention individual participants are receiving.

Crossover Trial full info

A trial in which participants receive more than 1 of the treatments under investigation, usually in a randomly determined sequence, and with a prespecified amount of time (washout period) between sequential treatments.

Equivalence and Noninferiority Trial full info

A trial designed to assess whether the treatment or intervention under study (eg, a new intervention) is no worse than an existing alternative (eg, an active control). In these trials, authors must prespecify a margin of noninferiority that is consistent with all relevant studies and within which the new intervention can be assumed to be no worse than the active control.

Cluster Trial full info

A trial that includes random assignment of groups rather than individuals to intervention and control groups.

Nonrandomized Clinical Trial full info

A trial that prospectively assigns groups or populations to study the efficacy or effectiveness of an intervention but in which the assignment to the intervention occurs through self-selection or administrator selection rather than through randomization. Control groups can be historic, concurrent, or both. This design is sometimes called a quasi-experimental design.

• ≤5 tables and/or figures, including a trial flow diagram
• Subtitle should be "A Nonrandomized Clinical Trial"
• TREND checklist

Meta-analysis full info

A systematic review that includes a statistical technique for quantitatively combining the results of multiple studies that measure the same outcome into a single pooled or summary estimate.

• Subtitle should include "A Meta-analysis"
• Follow PRISMA Reporting Guidelines or MOOSE Reporting Guidelines

Cohort Study full info

An observational study that follows a group (cohort) of individuals who are initially free of the outcome of interest. Individuals in the cohort may share some underlying characteristic, such as age, sex, diagnosis, exposure to a risk factor, or treatment.

• Follow STROBE Reporting Guidelines

Case-Control Study full info

An observational study designed to determine the association between an exposure and outcome in which study participants are selected by outcome. Those with the outcome (cases) are compared with those without the outcome (controls) with respect to an exposure or event. Cases and controls may be matched according to specific characteristics (eg, age, sex, or duration of disease).

Cross-sectional Study full info

An observational study of a defined population at a single point in time or during a specific interval, in which exposure and outcome are ascertained simultaneously.

Case Series full info

An observational study that describes a selected group of participants with similar exposure or treatment and without a control group. A case series may also involve observation of larger units such as groups of hospitals or municipalities, as well as smaller units such as laboratory samples.

• Follow Reporting Guidelines

Economic Evaluation full info

A study using formal, quantitative methods to compare 2 or more treatments, programs, or strategies with respect to their resource use and expected outcomes. This includes cost-effectiveness, cost-benefit, and cost-minimization analyses.

• Follow CHEERS Reporting Guidelines

Decision Analytical Model full info

A mathematical modeling study that compares consequences of decision options by synthesizing information from multiple sources and applying mathematical simulation techniques, usually with specific software. Reporting should address the relevant non-cost aspects of the CHEERS guideline.

Comparative Effectiveness Research full info

A study that compares different interventions or strategies to prevent, diagnose, treat, and monitor health conditions to determine which work best for which patients, under what circumstances, and are associated with the greatest benefits and harms.

• Follow ISPOR Reporting Guidelines

Genetic Association Study full info

A study that attempts to identify and characterize genomic variants that may be associated with susceptibility to multifactorial disease.

• Follow STREGA Reporting Guidelines

Diagnostic/Prognostic Study full info

A prospective study designed to develop, validate, or update the diagnostic or prognostic accuracy of a test or model.

• Follow STARD Reporting Guidelines or TRIPOD Reporting Guidelines

Quality Improvement Study full info

A study that uses data to define, measure, and evaluate a health care practice or service to maintain or improve the appropriateness, quality, safety, or value of that practice or service.

Survey Study full info

A survey study includes a representative sample of individuals who are asked to describe their opinions, attitudes, or behaviors. Survey studies should have sufficient response rates (generally ≥60%) and appropriate characterization of nonresponders to ensure that nonresponse bias does not threaten the validity of the findings.

• Follow AAPOR Best Practices for Survey Research
• Optional: Survey instrument as supplemental file

Qualitative Study full info

A study based on observation and interview with individuals that uses inductive reasoning and a theoretical sampling model and that focuses on social and interpreted, rather than quantifiable, phenomena and aims to discover, interpret, and describe rather than to test and evaluate. This includes mixed-methods studies that combine quantitative and qualitative designs in a sequential or concurrent manner.

• Follow SRQR Reporting Guidelines or COREQ Reporting Guidelines

These reports typically include randomized trials (see Clinical Trial ), intervention studies, cohort studies, case-control studies, epidemiologic assessments, other observational studies, surveys with high response rates (see Reports of Survey Research ), cost-effectiveness analyses and decision analyses (see Reports of Cost-effectiveness Analyses and Decision Analyses ), and studies of screening and diagnostic tests (see also Reports of Diagnostic Tests ). A study type is required. Each manuscript should clearly state an objective or hypothesis; the design and methods (including the study type and setting and dates, patients or participants with inclusion and exclusion criteria and/or participation or response rates, or data sources, and how these were selected for the study); the essential features of any interventions; the main outcome measures; the main results of the study; a discussion section placing the results in context with the published literature and addressing study limitations; and the conclusions and relevant implications for clinical practice or health policy. Data included in research reports must be original and should be as timely and current as possible (see Timeliness of Data ). Follow EQUATOR Reporting Guidelines .

A structured abstract is required; for more information, see instructions for preparing Abstracts for Reports of Original Data . A list of 3 Key Points is required (see guidance on preparing Key Points ). Maximum length: 3000 words of text (not including abstract, tables, figures, acknowledgments, references, and online-only material) with no more than a total of 5 tables and/or figures.

These manuscripts are short reports of original studies or evaluations or unique, first-time reports of clinical case series (3 or more cases) or a single case with extensive laboratory evaluations (eg, genetic analysis). Follow EQUATOR Reporting Guidelines . A structured abstract is required; for more information, see instructions for preparing Abstracts for Reports of Original Data . A list of 3 Key Points is required (see guidance on preparing Key Points ). Recommended length: 1200 words (not including abstract, tables, figures, acknowledgments, references, and online-only material) with no more than a total of 3 tables and/or figures and no more than 15 references.

Research Letters are concise, focused reports of original research. These should not exceed 600 words of text and 6 references and may include up to 2 tables or figures. Online supplementary material is only allowed for brief additional and absolutely necessary methods but not for any additional results or discussion. The text should include the full name, academic degrees, and institutional affiliation for each author and the email address for the corresponding author. Other persons who have contributed to the study may be indicated in an Acknowledgment, with their permission, including their academic degrees, affiliation, contribution to the study, and an indication if compensation was received for their role. Letters must not duplicate other material published or submitted for publication. In general, Research Letters should be divided into the following sections: Introduction, Methods, Results, and Discussion. They should not include an abstract or key points, but otherwise should follow all of the guidelines in Manuscript Preparation and Submission Requirements . Letters not meeting these specifications are generally not considered.

The journal will consider 1 type of review article:

Systematic Reviews

Titles for these Reviews should include a concise description of the main topic. Use specific and not overly broad wording for the title; the type of review should be indicated in the subtitle. For example:

Behavioral Treatment of Obesity: A Systematic Review

Systematic Reviews are critical assessments of the literature and data sources pertaining to clinical topics, emphasizing factors such as cause, diagnosis, prognosis, therapy, or prevention. Systematic Reviews without meta-analysis are published as Reviews; those with meta-analysis are published as Original Investigations (see Meta-analysis ). Systematic Reviews should address a specific question or issue that is relevant for clinical practice and provide an evidence-based, balanced, patient-oriented review on a focused topic. Follow EQUATOR Reporting Guidelines .

The basic structure of manuscripts reporting Systematic Reviews should include the following: Abstract (structured abstract of no more than 350 words); Introduction (150-250 words); Methods (150-250 words); Results (1000-1250 words, with the following subsections, if appropriate, depending on the specific question or issue addressed: Pathophysiology, Clinical Presentation, Assessment and Diagnosis, Treatment, and Prognosis); Discussion (1000 words); and Conclusions (2-3 sentences).

The Results section must include a table with ratings of the quality of the studies/evidence included in the Systematic Review. If recommendations are included, another Table should present the quality of the evidence used to support the recommendations.

Maximum length: 3000 words of text (not including abstract, tables, figures, acknowledgments, references, and online-only material), with no more than a total of 5 tables and/or figures and no more than 50-75 references. For an example of a published Systematic Review, see JAMA . 2014;312(6):631-640 and below for the general structure of a Systematic Review article.

Specific Components of a Systematic Review

Key Points (75-100 words)

This feature provides a quick structured synopsis of the Review, following 3 key points: Question, Findings, and Meaning. Limit to no more than 100 words. This is different from the Abstract.

Question: What are the most effective medical treatments for adult chronic sinusitis? Findings: In this systematic review, symptoms of chronic sinusitis were improved with saline irrigation and topical corticosteroid therapy compared to no therapy. Compared with placebo, 3-week courses of systemic corticosteroids or oral doxycycline were associated with reduced polyp size, and a 3-month course of macrolide antibiotic was associated with improved symptoms in patients without polyps. Meaning: First-line therapy for chronic sinusitis should begin with daily topical intranasal corticosteroid in conjunction with saline irrigation; subsequent therapies should be based on the patient's polyp status and severity of symptoms.

Abstract (350 words)

A structured abstract is required; Systematic Review articles should include a structured abstract of no more than 350 words using the headings listed below.

Importance: Include 1 or 2 sentences describing the clinical question or issue and its importance in clinical practice or public health. Objective: State the precise primary objective of the review. Indicate whether the review emphasizes factors such as cause, diagnosis, prognosis, therapy, or prevention and include information about the specific population, intervention, exposure, and tests or outcomes that are being reviewed. Evidence Review: Describe the information sources used, including the search strategies, years searched, and other sources of material, such as subsequent reference searches of retrieved articles. Methods used for inclusion of identified articles and quality assessment should be explained. Findings: Include a brief summary of the number of articles included, numbers of various types of studies (eg, clinical trials, cohort studies), and numbers of patients/participants represented by these studies. Summarize the major findings of the review of the clinical issue or topic in an evidence-based, objective, and balanced fashion, with the highest-quality evidence available receiving the greatest emphasis. Provide quantitative data. Conclusions and Relevance: The conclusions should clearly answer the questions posed if applicable, be based on available evidence, and emphasize how clinicians should apply current knowledge. Conclusions should be based only on results described in the abstract Findings subsection.

Introduction (150-250 words)

The first 2 to 3 sentences of the Introduction should draw in readers such that they want to continue reading the article and should establish the importance of the Review. Reviews should include the clinical question or issue and its importance for general medical practice, specialty practice, or public health. The first paragraph should provide a general summary of the clinical problem (eg, obesity). The next paragraph should focus on the specific aspect of the clinical problem the article will explore (eg, treatments for obesity). The epidemiology of the disease or condition should be briefly summarized and generally should include disease prevalence and incidence. The third paragraph should discuss exactly what material will be covered in the Review (eg, obesity treatments reported in trials with a minimum follow-up of 2 years including 80% of the original cohort).

Methods/Literature Search (150-250 words)

The literature search should be as current as possible, ideally with end dates within a month or two before manuscript submission. A search of the primary literature should be conducted, including multiple bibliographic databases (eg, PubMed/MEDLINE, Embase, CINAHL, PsycINFO). This can be facilitated by collaborating with a medical librarian to help with the search.

Briefly describe characteristics of the literature searched and included in the review, following the PRISMA reporting guidelines , including the bibliographic databases and other sources searched, search terms used, dates included in the search, date the literature search was conducted, screening process, language limitations, and inclusion and exclusion criteria. The rating system used to evaluate the quality of the evidence should be specified (see table below) and the methods used to evaluate quality should be described, including number of quality raters, how agreement on quality ratings was assessed, and how disagreements on quality ratings were resolved.

The highest-quality evidence (eg, randomized clinical trials, meta-analyses, systematic reviews, and high-quality prospective cohort studies) should receive the greatest emphasis. Clinical practice guidelines ordinarily should not be used as a primary component of the evidence base for the systematic review, although relevant guidelines should be addressed in the Discussion section of the article.

The search methods should be described in sufficient detail so the search can be reproduced based on the information provided in the manuscript. A summary of the methods of the literature search including this information should be included in the main article; details can be included in an online-only supplement. A PRISMA-style flow diagram showing this information should also be included as an online-only supplement. In addition, a completed PRISMA checklist should be submitted for the items completed that apply to systematic reviews (the checklist items that apply to meta-analyses do not need to be completed for systematic reviews without meta-analysis). The checklist will be used during review but will not be published.

Results (1000-1250 words)

First, briefly report the results of the literature search, including the number of articles reviewed and included, numbers of various types of studies (eg, clinical trials, cohort studies) included, and the aggregate numbers of patients included in the reviewed studies. Also provide a brief summary of the quality of the evidence. Details of this information can be included in a PRISMA-style flow diagram and table(s).

Next, the subsections listed below should generally appear in the Results sections of most Reviews although all of these subsections may not be necessary for some topics, depending on the specific question or issue addressed. The word counts following each subsection are suggested to assist with keeping the overall Results section limited to 1000-1250 words.

Pathophysiology (150-250 words). Provide a brief overview of the pathophysiology of the disease. The intent is to provide readers with sufficient background information about the underpinnings of a disease to provide context for the rest of the article. Clinical Presentation (150-250 words). Briefly describe the clinical characteristics that result in a patient seeking medical care for the condition or what features of the disease should lead a clinician to evaluate or treat it. Assessment and Diagnosis (250-300 words). Describe the clinical examination for evaluation of the disease and explain the most salient physical examination findings. If laboratory or imaging studies are necessary, provide the sensitivity and specificity and diagnostic accuracy of these tests and consider providing positive and negative likelihood ratios. Sequences of diagnostic tests are best presented as algorithms or in tables. Treatment (250-500 words). Treatments should be based on the most recently available and highest level of evidence. Treatment options should be summarized in the text and presented in detail in tables along with an indication of the strength of evidence supporting the individual treatments. In general, treatment recommendations should be supported by a systematic review of the literature, either performed by the author of the Review or published in the form of a high-quality review or guideline. If possible, the costs for various treatments should be provided. Prognosis (100-150 words). A section outlining the overall prognosis for the condition, once treated, should be included. Discussion (Approximately 1000 words)

Key findings should be summarized in the first paragraph of the Discussion section. All statements made should be supported by evidence. It is very important to not simply list findings from the studies reviewed. This information is best presented in tables. The Discussion should provide a critical synthesis of data and information based on the results of the review, an assessment of the quality of studies summarized, and a description of how studies can be interpreted and used to guide clinical practice. The limitations of the evidence and of the review should be discussed, and gaps in evidence should be addressed. A discussion of controversial or unresolved issues and topics in need of future research also should be included.

Clinical Practice Guidelines: In the Discussion section, describe current clinical practice guidelines, relevant to the topic of the review, if available, and whether the conclusions of this review agree with, or disagree with, the current clinical practice guidelines. If this is done and there is more than 1 guideline, a table should be prepared comparing the major features that differ between the guidelines. Guideline quality should be discussed using the standards outlined for the JAMA Clinical Guidelines Synopsis .

Conclusions

Include a 2- to 3-sentence summary of the major conclusions of the review.

Construct tables that summarize the search results and include a summary of the strength of the evidence. Tables summarizing treatments should have information organized by category of treatment and then by individual treatments. Columns should include the name of the treatment, strength of evidence supporting the treatment, the treatment's effect (preferably shown as the treatment's effect as compared to control on the measured outcome together with 95% confidence intervals), adverse effects, and very brief comments, if necessary. Lengthy text-based tables should be avoided. Additional or lengthy tables may be published online only, if justified.

Ratings of the quality of the evidence. Tables summarizing evidence should include ratings of the quality of the evidence. Use the rating scheme listed below with ratings of 1-5 for Reviews that include individual studies (modified from the Oxford Centre for Evidence-based Medicine for ratings of individual studies).

There are several other preferred systems for rating the quality of evidence in Review articles. For Reviews that synthesize findings from numerous studies into a single summary recommendation, use the rating scale shown above or the Oxford Centre for Evidence-based Medicine's Levels of Evidence and Grades of Recommendation or the recommendations in the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines . For reviews that include diagnostic studies, use The Rational Clinical Examination Levels of Evidence table .

Follow additional instructions for preparation and submission of Tables .

For ratings of recommendations, the grade of recommendation should be ranked as 1, 2A, or 2B depending on the quality of the evidence. The Table should consist of 3 or 4 columns: grade of recommendation, risk/benefit/costs, and the quality of the evidence (A, B, or C) for either treatment/prevention/screening and/or prognosis.

A PRISMA-style flow diagram should be included as an online supplement that summarizes the results of the literature search and the numbers of articles/records/studies and patients/participants represented in the studies identified, screened, eligible, and included in the final review.

Additional figures that illustrate pathophysiology or clinical presentation may be considered. We encourage videos, if appropriate, to illustrate a point made or process described in the Review.

Follow additional instructions for preparation and submission of Figures and Video .

These manuscripts comment on a disease, public health policy, or therapy intervention; these often result from the work of a consensus conference convened to offer recommendations or to set policy. Statements must follow SQUIRE reporting guidelines . A structured abstract is required; for more information, see instructions for preparing structured Abstracts for Reviews . Maximum length: 3000 words of text (not including abstract, tables, figures, references, and online-only material), with no more than a total of 5 tables and/or figures, and 50-75 references. All submissions require a presubmission inquiry to [email protected] .

Note: This journal publishes very few of these types of articles. These manuscripts describe an important issue in clinical medicine, public health, health policy, or medical research in a scholarly, thorough, well-referenced, systematic, and evidence-based manner.

A structured abstract is required. Maximum length: 3000 words of text (not including tables, figures, or references) with no more than a total of 4 tables and/or figures and no more than 50 references. For a recently published example, see JAMA . 2019;322(20):1996-2016 .

Clinicopathological Challenge presents an actual patient scenario about a specific disease or condition with an accompanying clinical image.

Clinical Challenge

Clinical Challenge presents an actual patient scenario about a specific disease or condition with an accompanying clinical image.

Authors should provide 4 single-phrase plausible diagnosis options with one of these being the most correct response for the question "What Is Your Diagnosis?" Manuscripts should include a brief discussion of the relevant clinical issues and provide well-supported (evidence-based) explanations for why 1 of the 4 potential diagnoses is correct and the other options are not. For a recently published example, see JAMA Dermatology . 2021;157(9):1116-1117 .

All diagnostic and treatment recommendations should be supported by referencing recent authoritative texts or journal articles. Preferably, these recommendations should be supported by governmental or multisociety guidelines, clinical trials, meta-analyses, or systematic reviews. The text should have a maximum length of 850 words, consisting of no more than 250 words for the case presentation, question, and 4 one-sentence answers, followed by no more than 600 words that include the diagnosis and a brief discussion. There should be no more than 3 authors. At least 1 of the authors, ideally the corresponding author, should have sufficient expertise and experience with the topic. There should be no more than 10 references, and no more than 2 small figures totaling 3 image components (Figure 1, with no more than 2 components, for the case presentation; and Figure 2, with no more than 1 component, for the diagnosis and discussion). Please note: If the discussion includes a Figure, the word count for the discussion should be no more than 500 words.

Provide a short title that briefly describes the disease entity or case presentation and does not include the diagnosis. Do not include the patient's race, ethnicity, or country of origin in the title or the first line of the article. If this information is clinically relevant and necessary, it can be included in the case description.

In addition, the JAMA Network Patient Permission form must be completed and signed by the patient (or a family member if the patient has died, is a minor, or is an adult without decisional capacity) and included at the time of manuscript submission. Please read Patient Identification before submitting your manuscript.

The image and case presentation should be from the same patient and must not have been published previously. In some cases, additional figures may be included to accompany the answer explanations (see description of additional figure(s) above). All images submitted should be high-quality .jpg or .tif files. Submit the original version of all image files at the highest resolution possible without labels. In general, the original image file should have a minimum resolution of 350 dpi at a width of about 5 inches. Do not increase the original resolution, resize, or crop the image; where applicable, we will crop to maintain patient confidentiality. If any labels, arrowheads, or A/B panel indicators are desired, provide a separate labeled version of the figure(s) for reference. All labels will be reformatted to journal style.

For more information on how to submit figures, see Figures .

We would like to receive common problems presenting uncommonly, rather than unusual or rare conditions (ie, "zebras"). These cases should be of interest to clinicians; they should be problems that clinicians are likely to encounter and have an outstanding image that illustrates the disorder and contributes to the diagnostic challenge.

Manuscripts not meeting these guidelines will not be considered.

This feature is intended to provide a high-quality visual image of an interesting and unique dermatological observation. These include clinical images of skin diseases (ie, photographs, photomicrographs, and other images) that enhance the understanding of cutaneous pathophysiology and improve clinicians' ability to diagnose and treat skin disorders.

A 500-word description of the clinical issue, the patient's presentation and findings, and the image should be included. There should be no more than 2 images (figures), 4 references, and no more than 3 authors. Online supplementary material is not allowed.

If the patient(s) described in these manuscripts is identifiable, a Patient Permission form must be completed and signed by the patient(s) and submitted with the manuscript. Omitting data or making data less specific to deidentify patients is acceptable, but changing any such data is not acceptable.

Viewpoints may address virtually any important relevant to the care of patients with dermatologic conditions or professional matters unique to dermatologists. May be focused on clinical medicine, public health, research, discovery, prevention, ethics, health policy, or health law and generally are not linked to a specific article. Viewpoints should be well focused, scholarly, and clearly presented but should not include the findings of new research or data that have not been previously published.

Viewpoints must have no more than 3 authors. Editors encourage diversity of gender, race, ethnicity, geographic location, and discipline for Viewpoint authors, and the first author should have sufficient expertise and experience with the topic to provide an authoritative opinion. The text should include the full name, academic degrees, and no more than 2 institutional affiliations for each author. Maximum length: up to 1200 words of text—or 1000 words of text with 1 small table or figure—and no more than 7 references, which should be as current as possible. Viewpoints not meeting these guidelines will not be considered.

For additional guidance, see this Viewpoint with tips for authors writing Viewpoints.

Letters discussing a recent article in this journal should be submitted within 4 weeks of publication of the article in print. 3 Letters received after 4 weeks will rarely be considered. Letters should not exceed 400 words of text and 5 references, 1 of which should be to the recent article. Letters may have no more than 3 authors. The text should include the full name, academic degrees, and a single institutional affiliation for each author and the email address for the corresponding author. Letters must not duplicate other material published or submitted for publication and should not include unpublished data. Letters not meeting these specifications are generally not considered. Letters being considered for publication ordinarily will be sent to the authors of the original article, who will be given the opportunity to reply. Letters will be published at the discretion of the editors and are subject to abridgement and editing for style and content. To read more about Letters, see the AMA Manual of Style .

Replies by authors should not exceed 500 words of text and 6 references. They should have no more than 3 authors.

Observations consisting of short reports of 1 or 2 complicated, unique cases. Observations highlighting novel approaches to therapy or management, or previously unreported associations or complications of dermatologic disease or treatment will be prioritized for publication. Submissions should include high-quality clinical skin and/or histopathologic images. Observations should not exceed 600 words of text (not including acknowledgment, tables, figures, acknowledgments, and references) and 6 references and may include up to 2 tables or figures. Online supplementary material is not allowed. Observations may have no more than 7 authors.

Clinical Trial

These manuscripts include reports of Randomized Clinical Trials, Parallel-Design Double-blind Trials, Crossover Trials, Equivalence and Noninferiority Trials, Cluster Trials, and Nonrandomized Clinical Trials.

The ICMJE defines a clinical trial as any research project that prospectively assigns human participants to intervention or comparison groups to study the cause-and-effect relationship between an intervention and a health outcome. 4 Interventions include but are not limited to drugs, surgical procedures, devices, behavioral treatments, educational programs, dietary interventions, quality improvement interventions, process-of-care changes, and the like. All manuscripts reporting clinical trials, including those limited to secondary exploratory or post hoc analysis of trial outcomes, must include the following:

• Copy of the original trial protocol, including the complete statistical analysis plan and any amendments. The journal recommends using the SPIRIT reporting guidelines when preparing original protocols (see Protocols ).
• CONSORT flow diagram (see Figure ).
• Completed trial checklist (see Checklist ).
• Registry at an appropriate online public clinical trial registry (see Trial Registration requirements).
• A Data Sharing Statement to indicate if data will be shared or not. Specific questions regarding the sharing of data are included in the manuscript submission system.

For additional guidance on reporting Randomized Clinical Trial, Parallel-Design Double-blind Trial, Crossover Trial, Equivalence and Noninferiority Trial, Cluster Trial, and Nonrandomized Clinical Trial, see Study Types .

Each manuscript should clearly state an objective or hypothesis; the design and methods (including the study setting and dates, patients or participants with inclusion and exclusion criteria, or data sources, and how these were selected for the study); the essential features of any interventions; the primary and secondary outcome measures (consistent with those reported in the trial protocol); the main results of the study; a discussion section placing the results in context with the published literature and addressing study limitations; and the conclusions.

A structured abstract is required, and trial registration information (registry name, trial ID, and URL) must be listed at the end of the abstract; for more information, see instructions for preparing Abstracts for Reports of Original Data . A list of 3 Key Points is required (see guidance on preparing Key Points ). Maximum length: 3000 words of text (not including abstract, tables, figures, acknowledgments, references, and supplemental material) with no more than a total of 5 tables and/or figures and no more than 50-75 references. The subtitle should include the phrase "A Randomized Clinical Trial" or, for Nonrandomized Clinical Trials, "A Nonrandomized Clinical Trial." To read more about clinical trials, see the AMA Manual of Style .

Trial Registration:

In concert with the ICMJE, JAMA Network requires, as a condition of consideration for publication, registration of all trials in a public trials registry that is acceptable to the ICMJE (ie, the registry must be owned by a not-for-profit entity, be publicly accessible, and require the minimum registration data set as described by ICMJE). 4 , 8 , 9

Acceptable trial registries include the following and others listed at http://www.icmje.org :

• anzctr.org.au
• clinicaltrials.gov
• trialregister.nl
• umin.ac.jp/ctr

All clinical trials, regardless of when they were completed, and secondary analyses of original clinical trials must be registered before submission of a manuscript based on the trial. Secondary data analyses of primary (parent) clinical trials should not be registered as separate clinical trials, but instead should reference the trial registration number of the primary trial. Please note: for clinical trials starting patient enrollment after July 2005, trials must have been registered before onset of patient enrollment. For trials that began before July 2005 but that were not registered before September 13, 2005, trials must have been registered before journal submission. Trial registry name, registration identification number, and the URL for the registry should be included at the end of the abstract and also in the space provided on the online manuscript submission form.

Authors of manuscripts reporting clinical trials must submit trial protocols (including the complete statistical analysis plan) along with their manuscripts. Protocols in non-English languages should be translated into English. This should include the original approved protocol and statistical analysis plan, and all subsequent amendments to either document. Do not submit a summary version that was published as an article in another journal. If the manuscript is accepted, the protocol and statistical analysis plan will be published as a supplement.

CONSORT Flow Diagram and Checklist:

Manuscripts reporting the results of randomized trials must include the CONSORT flow diagram showing the progress of patients throughout the trial. The CONSORT checklist also should be completed and submitted with the manuscript. 10

Figure. Profile of a Randomized Clinical Trial

Trial Protocol

These manuscripts are documents that describe the organization and plan for a randomized clinical trial, including the trial's objective(s), design, methodology, all outcomes to be measured, and statistical analysis plan. All trial protocol manuscripts must include a copy of the trial protocol including the complete statistical analysis plan (see Protocols ). All clinical trials that have begun randomization must be registered at an appropriate online public registry (see Trial Registration requirements). Follow SPIRIT Reporting Guidelines .

A structured abstract is required, and trial registration information (registry name, trial ID, and URL) must be listed at the end of the abstract; for more information, see instructions for preparing Abstracts for Trial Protocols . A list of 3 Key Points is required (see guidance on preparing Key Points ). Maximum length: 3000 words of text (not including abstract, tables, figures, acknowledgments, references, and supplemental material) with no more than a total of 5 tables and/or figures and no more than 50-75 references. The subtitle should include the phrase "A Trial Protocol."

These manuscripts are systematic, critical assessments of literature and data sources pertaining to clinical topics, emphasizing factors such as cause, diagnosis, prognosis, therapy, or prevention, and that includes a statistical technique for quantitatively combining the results of multiple studies that measure the same outcome into a single pooled or summary estimate. All articles or data sources should be searched for and selected systematically for inclusion and critically evaluated, and the search and selection process should be described in the manuscript. The specific type of study or analysis, population, intervention, exposure, and tests or outcomes should be described for each article or data source. The data sources should be as current as possible, ideally with the search having been conducted within several months of manuscript submission. Authors of reports of meta-analyses of clinical trials should submit the PRISMA flow diagram and checklist . Authors of meta-analyses of observational studies should submit the MOOSE checklist . Follow EQUATOR Reporting Guidelines .

A structured abstract is required; for more information, see instructions for preparing Abstracts for Meta-analysis . A list of 3 Key Points is required (see guidance on preparing Key Points ). Maximum length: 3000 words of text (not including abstract, tables, figures, acknowledgments, references, and online-only material), with no more than a total of 5 tables and/or figures and no more than 50-75 references. The subtitle should include the phrase "A Meta-analysis." To read more about meta-analyses, see the AMA Manual of Style .

Other Observational Studies

These manuscripts include Cohort Study, Case-Control Study, Cross-sectional Study, Case Series, Economic Evaluation, Decision Analytical Model, Comparative Effectiveness Research, Genetic Association Study, Diagnostic/Prognostic Study, Quality Improvement Study, Survey Study, and Qualitative Study. Each manuscript should clearly state an objective or hypothesis; the design and methods (including the study setting and dates, patients or participants with inclusion and exclusion criteria and/or participation or response rates, or data sources, and how these were selected for the study); the essential features of any interventions or exposures; the main outcome measures; the main results of the study; a discussion section placing the results in context with the published literature and addressing study limitations; and the conclusions and relevant implications for clinical practice or health policy. Data included in research reports must be original and should be as timely and current as possible (see Timeliness of Data ). Follow EQUATOR Reporting Guidelines .

A structured abstract is required; for more information, see instructions for preparing Abstracts for Reports of Original Data . A list of 3 Key Points is required (see guidance on preparing Key Points ). Maximum length: 3000 words of text (not including abstract, tables, figures, acknowledgments, references, and supplemental material) with no more than a total of 5 tables and/or figures and no more than 50-75 references.

Format My Manuscript

Manuscript preparation and submission requirements.

All manuscripts must be submitted online via the online manuscript submission and review system .

At the time of submission, complete contact information (affiliation, postal/mail address, email address, and telephone numbers) for the corresponding author is required. First and last names, email addresses, and institutional affiliations of all coauthors are also required. After the manuscript is submitted, the corresponding author will receive an acknowledgment confirming receipt and a manuscript number. Authors will be able to track the status of their manuscripts via the online system. After manuscript submission, all authors of papers under consideration for publication will be sent a link to the Authorship Form to complete and submit. See other details in these instructions for additional requirements. 2 , 4

As recommended by the ICMJE, "if the manuscript has been submitted previously to another journal, it is helpful to include the previous editors' and reviewers' comments with the submitted manuscript, along with the authors' responses to those comments." 4 It is not uncommon for manuscripts to have been submitted to and peer reviewed by other journals and sharing this information will not bias an editor's decision for this journal. Thus, authors are encouraged to submit these previous comments in their entirety and indicate how they have revised the manuscript in response to these comments, which may expedite the review process. In the submission system, there is a file type for Previous Peer Review and Editorial Comments.

Include a cover letter and complete contact information for the corresponding author (affiliation, postal/mail address, email address, and telephone number) and whether the authors have published, posted, or submitted any related papers from the same study (see Previous Publication, Related Manuscripts and Reports, and Preprints ).

Manuscripts should be prepared in accordance with the AMA Manual of Style , 11th edition, 2 and/or the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals . 4

Include in the manuscript file a title page, abstract, text, references, and as appropriate, figure legends and tables. Start each of these sections on a new page, numbered consecutively, beginning with the title page. Figures should be submitted as separate files (1 file per figure) and not included in the manuscript text.

We recommend individual file sizes of no more than 500 kB and not exceeding 1 MB, with the total size for all files not exceeding 5 MB (not including any video files).

For submission and review, please submit the manuscript as a Word document. Do not submit your manuscript in PDF format.

Use 10-, 11-, or 12-point font size, double-space text, and leave right margins unjustified (ragged).

The title page should be the first page of your manuscript file. It should include a manuscript title; the full names, highest academic degrees, and affiliations of all authors (if an author's affiliation has changed since the work was done, the new affiliation also should be listed); name and complete contact information for corresponding author; and manuscript word count (not including title, abstract, acknowledgment, references, tables, and figure legends).

Titles should be concise, specific, and informative. 2(p8) Please limit the length of titles to 100 characters (including spaces) for reports of research and other major articles and 60 characters for shorter article types such as opinion articles and Letters as well as for subtitles to major articles. For scientific manuscripts, do not use overly general titles, declarative titles, titles that include the direction of study results, or questions as titles. For reports of clinical trials, meta-analyses, and systematic reviews, include the type of study as a subtitle (eg, A Randomized Clinical Trial, A Meta-analysis, A Systematic Review). For reports of other types of research, do not include study type or design in the title or subtitle. Depending on the context, avoid inclusion of specific locations (eg, state, province, or country) and specific years. To read more about titles, see the AMA Manual of Style .

In the manuscript, include a separate section called "Key Points" before the Abstract.

This feature provides a quick structured synopsis of the findings of your manuscript (required only for research and review manuscripts), following 3 key points: Question, Findings, and Meaning. Limit this section to 75-100 words or less.

Question: Focused question based on the study hypothesis or goal/purpose. Limit to 1 sentence. Findings: Results of the study/review. Include the design (eg, clinical trial, cohort study, case-control study, meta-analysis). Focus on primary outcome(s) and finding(s). Do not emphasize secondary outcomes. Report basic numbers only but state if results are statistically significant or not significant; do not include results of statistical tests or measures of variance (see example below). Can include 1 to 2 sentences. Meaning: Key conclusion and implication based on the primary finding(s). Limit to 1 sentence. Example of Research Article Question: What is the immunogenicity of an inactivated influenza A vaccine with and without adjuvant? Findings: In this randomized clinical trial that included 980 adults, the proportion achieving an effective antibody response was 84% with adjuvant vs 2% without adjuvant, a significant difference. Meaning: In an influenza pandemic the use of an adjuvant with inactivated influenza A vaccine may be warranted. Include: All Journals except JNO and JHF Exclude: JNO and JHF Comments: Example of Review Article Example of Review Article Question: What are the most effective medical treatments for adult chronic sinusitis? Findings: In this systematic review, symptoms of chronic sinusitis were improved with saline irrigation and topical corticosteroid therapy compared to no therapy. Compared with placebo, 3-week courses of systemic corticosteroids or oral doxycycline were associated with reduced polyp size, and a 3-month course of macrolide antibiotic was associated with improved symptoms in patients without polyps. Meaning: First-line therapy for chronic sinusitis should begin with daily topical intranasal corticosteroid in conjunction with saline irrigation; subsequent therapies should be based on the patient's polyp status and severity of symptoms.

Include a structured abstract for reports of original data, meta-analyses, and systematic reviews. Abstracts should be prepared in JAMA Network style—see instructions for preparing abstracts below. Abstracts are not required for Editorials, Viewpoints, and special features. No information should be reported in the abstract that does not appear in the text of the manuscript. To read more about abstracts, see the AMA Manual of Style .

Abstracts for Reports of Original Data:

Reports of original data should include an abstract of no more than 350 words using the headings listed below. For brevity, parts of the abstract may be written as phrases rather than complete sentences. Each section should include the following content:

Importance: The abstract should begin with a sentence or 2 explaining the clinical (or other) importance of the study question. Objective: State the precise objective or study question addressed in the report (eg, "To determine whether..."). If more than 1 objective is addressed, the main objective should be indicated and only key secondary objectives stated. If an a priori hypothesis was tested, it should be stated. Design: Describe the basic design of the study and include the specific study type (eg, randomized clinical trial, cohort, cross-sectional, case-control, case series, survey, meta-analysis, bibliometric analysis). State the years of the study and the duration of follow-up. For older studies (eg, those completed >3 years ago), add the date of the analysis being reported. If applicable, include the name of the study (eg, the Framingham Heart Study). As relevant, indicate whether observers were blinded to patient groupings, particularly for subjective measurements. Setting: Describe the study setting to assist readers to determine the applicability of the report to other circumstances, for example, multicenter, population-based, primary care or referral center(s), etc. Participants: State the clinical disorders, important eligibility criteria, and key sociodemographic features of patients (or other study participants). The numbers of eligible participants and how they were selected should be provided, including the number approached but who refused or were excluded. For selection procedures, these terms should be used, if appropriate: random sample (where random refers to a formal, randomized selection in which all eligible individuals have a fixed and usually equal chance of selection); population-based sample; referred sample; consecutive sample; volunteer sample; convenience sample. If matching is used for comparison groups, characteristics that are matched should be specified. In follow-up studies, the proportion of participants who completed the study must be indicated.

Note: The preceding 3 sections are usually combined for accepted papers during the editing process as "Design, Setting, and Participants," but for manuscript submission these sections should be kept separate.

Intervention(s) (for clinical trials) or Exposure(s) (for observational studies): The essential features of any interventions, or exposures, should be described, including their method and duration. The intervention, or exposure, should be named by its most common clinical name, and nonproprietary drug names should be used. Main Outcome(s) and Measure(s): Indicate the primary study outcome measurement(s) as planned before data collection began. If the manuscript does not report the main planned outcomes of a study, this fact should be stated and the reason indicated. State clearly if the hypothesis being tested was formulated during or after data collection. Explain outcomes or measurements unfamiliar to a general medical readership. Results: Summary demographic information (eg, characteristics such as sex and age) and the number of study participants should be reported in the first sentence of the Results paragraph. The main outcomes of the study should be reported and quantified, including final included/analyzed sample. When possible, present numerical results (eg, absolute numbers and/or rates) with appropriate indicators of uncertainty, such as confidence intervals. Include absolute numbers and/or rates with any ratio measures and avoid redundant reporting of relative data (eg, % increase or decrease). Use means and standard deviations (SDs) for normally distributed data and medians and ranges or interquartile ranges (IQRs) for data that are not normally distributed. Avoid solely reporting the results of statistical hypothesis testing, such as  P  values, which fail to convey important quantitative information. For most studies,  P  values should follow the reporting of comparisons of absolute numbers or rates and measures of uncertainty (eg, 0.8%, 95% CI −0.2% to 1.8%;  P  =.13).  P  values should never be presented alone without the data that are being compared. See also Reporting Standards and Data Presentation . Measures of relative risk also may be reported (eg, relative risk, hazard ratios) and should include confidence intervals. Studies of screening and diagnostic tests should report sensitivity, specificity, and likelihood ratio. If predictive value or accuracy is reported, prevalence or pretest likelihood should be given as well. All randomized clinical trials should include the results of intention-to-treat analysis as well. In intervention studies, the number of patients withdrawn because of adverse effects should be given. Approaches such as number needed to treat to achieve a unit of benefit may be included when appropriate. All surveys should include response/participation rates. Conclusions and Relevance: Provide only conclusions of the study that are directly supported by the results. Give equal emphasis to positive and negative findings of equal scientific merit. Also, provide a statement of relevance indicating implications for clinical practice or health policy, avoiding speculation and overgeneralization. The relevance statement may also indicate whether additional study is required before the information should be used in clinical settings. Trial Registration: For clinical trials only (not nontrial observational studies), the name of the trial registry, registration number, and URL of the registry must be included. See Trial Registration .

Abstracts for Meta-analysis:

Manuscripts reporting the results of meta-analyses should include an abstract of no more than 350 words using the headings listed below. The text of the manuscript should also include a section describing the methods used for data sources, study selection, data extraction, and data synthesis. Each heading should be followed by a brief description:

Importance: A sentence or 2 explaining the importance of the systematic review question that is used to justify the meta-analysis. Objective: State the precise primary objective of the meta-analysis. Indicate whether the systematic review for the meta-analysis emphasizes factors such as cause, diagnosis, prognosis, therapy, or prevention and include information about the specific population, intervention, exposure, and tests or outcomes that are being analyzed. Data Sources: Succinctly summarize data sources, including years searched. The search should include the most current information possible, ideally with the search being conducted within several months before the date of manuscript submission. Potential sources include computerized databases and published indexes, registries, meeting abstracts, conference proceedings, references identified from bibliographies of pertinent articles and books, experts or research institutions active in the field, and companies or manufacturers of tests or agents being reviewed. If a bibliographic database is used, state the exact indexing terms used for article retrieval, including any constraints (for example, English language or human study participants). If abstract space does not permit this level of detail, summarize sources in the abstract including databases and years searched, and place the remainder of the information in the Methods section. Study Selection: Describe inclusion and exclusion criteria used to select studies for detailed review from among studies identified as relevant to the topic. Details of selection should include particular populations, interventions, outcomes, or methodological designs. The method used to apply these criteria should be specified (for example, blinded review, consensus, multiple reviewers). State the proportion of initially identified studies that met selection criteria. Data Extraction and Synthesis: Describe guidelines (eg, PRISMA , MOOSE ) used for abstracting data and assessing data quality and validity. The method by which the guidelines were applied should be stated (for example, independent extraction by multiple observers). Indicate whether data were pooled using a fixed-effect or random-effects model. Main Outcome(s) and Measure(s): Indicate the primary study outcome(s) and measurement(s) as planned before data collection began. If the manuscript does not report the main planned outcomes of a study, this fact should be stated and the reason indicated. State clearly if the hypothesis being tested was formulated during or after data collection. Explain outcomes or measurement unfamiliar to a general medical readership. Results: Provide the number of studies and patients/participants in the analysis and state the main quantitative results of the review. When possible, present numerical results (eg, absolute numbers and/or rates) with appropriate indicators of uncertainty, such as confidence intervals. Include absolute numbers and/or rates with any ratio measures and avoid redundant reporting of relative data (eg, % increase or decrease). Use means and standard deviations (SDs) for normally distributed data and medians and ranges or interquartile ranges (IQRs) for data that are not normally distributed. Avoid solely reporting the results of statistical hypothesis testing, such as  P  values, which fail to convey important quantitative information. For most studies,  P  values should follow the reporting of comparisons of absolute numbers or rates and measures of uncertainty (eg, 0.8%, 95% CI −0.2% to 1.8%;  P  = .13).  P  values should never be presented alone without the data that are being compared. See also Reporting Standards and Data Presentation . Meta-analyses should state the major outcomes that were pooled and include odds ratios or effect sizes and, if possible, sensitivity analyses. Evaluations of screening and diagnostic tests should include sensitivity, specificity, likelihood ratios, receiver operating characteristic curves, and predictive values. Assessments of prognosis should summarize survival characteristics and related variables. Major identified sources of variation between studies should be stated, including differences in treatment protocols, co-interventions, confounders, outcome measures, length of follow-up, and dropout rates. Conclusions and Relevance: The conclusions and their applications (clinical or otherwise) should be clearly stated, limiting interpretation to the domain of the review.

Abstracts for Systematic Reviews or Special Communications:

Systematic Review articles should include a structured abstract of no more than 350 words using the headings listed below.

Importance:  Include 1 or 2 sentences describing the clinical question or issue and its importance in clinical practice or public health. Objective:  State the precise primary objective of the review. Indicate whether the review emphasizes factors such as cause, diagnosis, prognosis, therapy, or prevention and include information about the specific population, intervention, exposure, and tests or outcomes that are being reviewed. Evidence Review:  Describe the information sources used, including the search strategies, years searched, and other sources of material, such as subsequent reference searches of retrieved articles. Methods used for inclusion of identified articles and quality assessment should be explained. Findings:  Include a brief summary of the number of articles included, numbers of various types of studies (eg, clinical trials, cohort studies), and numbers of patients/participants represented by these studies. Summarize the major findings of the review of the clinical issue or topic in an evidence-based, objective, and balanced fashion, with the highest-quality evidence available receiving the greatest emphasis. Provide quantitative data. Conclusions and Relevance:  The conclusions should clearly answer the questions posed if applicable, be based on available evidence, and emphasize how clinicians should apply current knowledge. Conclusions should be based only on results described in the abstract Findings subsection.

Abstracts for Narrative Reviews or Special Communications:

Narrative Review articles should include a 3-part structured abstract of no more than 300 words using the headings listed below:

Importance:  An overview of the topic and discussion of the main objective or reason for this review. Observations:  The principal observations and findings of the review. Conclusions and Relevance:  The conclusions of the review that are supported by the information, along with clinical applications. How the findings are clinically relevant should be specifically stated.

Ratings of the quality of the evidence

Tables summarizing evidence should include ratings of the quality of the evidence. Use the rating scheme listed below with ratings of 1-5 for Reviews that include individual studies (modified from the Oxford Centre for Evidence-based Medicine for ratings of individual studies).

Do not use abbreviations in the title or abstract and limit their use in the text. Expand all abbreviations at first mention in the text. To read more about abbreviation use, see the AMA Manual of Style .

Laboratory values are expressed using conventional units of measure, with relevant Système International (SI) conversion factors expressed secondarily (in parentheses) only at first mention. Articles that contain numerous conversion factors may list them together in a paragraph at the end of the Methods section. In tables and figures, a conversion factor to SI should be presented in the footnote or legend. The metric system is preferred for the expression of length, area, mass, and volume. For more details, see the Units of Measure conversion table on the website for the AMA Manual of Style . 2

To read more about units of measure, click here .

Use nonproprietary names of drugs, devices, and other products and services, unless the specific trade name of a drug is essential to the discussion. 2(pp567-569) In such cases, use the trade name once and the generic or descriptive name thereafter. Do not include trademark symbols. To read more about names of drugs, see the AMA Manual of Style .

Authors describing genes or related structures in a manuscript should include the names and official symbols provided by the US National Center for Biotechnology Information (NCBI) or the HUGO Gene Nomenclature Committee . Before submission of a research manuscript reporting on large genomic data sets (eg, protein or DNA sequences), the data sets should be deposited in a publicly available database, such as NCBI's GenBank , and a complete accession number (and version number if appropriate) must be provided in the Methods section or Acknowledgment of the manuscript. To read more about gene nomenclature, see the AMA Manual of Style .

Please verify that all information and materials in the manuscript are original. The journal generally does not republish text, tables, figures, or other material from other publishers, except in rare circumstances. If you believe that you must include content that is owned by a third party, please let us know and provide information about all material that has been previously published and, when applicable, include author(s), title of article, title of journal or book or other publication, and complete citation, doi, and/or URL. The publisher or other third party's permission to reproduce in print and online and in licensed versions of this journal should be submitted when the manuscript is submitted.

See Permission to Reproduce Copyright-Protected Material Form .

The submission and publication of content created by artificial intelligence, language models, machine learning, or similar technologies is discouraged, unless part of formal research design or methods, and is not permitted without clear description of the content that was created and the name of the model or tool, version and extension numbers, and manufacturer. Authors must take responsibility for the integrity of the content generated by these models and tools. See also Use of AI in Publication and Research .

Authors are responsible for the accuracy and completeness of their references and for correct text citation. Number references in the order they appear in the text; do not alphabetize. In text, tables, and legends, identify references with superscript arabic numerals. When listing references, follow AMA style and abbreviate names of journals according to the journals list in PubMed . List all authors and/or editors up to 6; if more than 6, list the first 3 followed by "et al." Note: Journal references should include the issue number in parentheses after the volume number.

Examples of reference style:

Youngster I, Russell GH, Pindar C, Ziv-Baran T, Sauk J, Hohmann EL. Oral, capsulized, frozen fecal microbiota transplantation for relapsing Clostridium difficileinfection. JAMA . 2014;312(17):1772-1778. Murray CJL. Maximizing antiretroviral therapy in developing countries: the dual challenge of efficiency and quality [published online December 1, 2014]. JAMA . doi:10.1001/jama.2014.16376 Centers for Medicare & Medicaid Services. CMS proposals to implement certain disclosure provisions of the Affordable Care Act. http://www.cms.gov/apps/media/press/factsheet.asp?Counter=4221 . Accessed January 30, 2012. McPhee SJ, Winker MA, Rabow MW, Pantilat SZ, Markowitz AJ, eds. Care at the Close of Life: Evidence and Experience . New York, NY: McGraw Hill Medical; 2011.

For more examples of electronic references, click here .

Tables and Figures

Restrict tables and figures to those needed to explain and support the argument of the article and to report all outcomes identified in the Methods section. Number each table and figure and provide a descriptive title for each. Every table and figure should have an in-text citation. Verify that data are consistently reported across text, tables, figures, and supplementary material.

See also Tables and Figures .

Frequency data should be reported as "No. (%)," not as percentages alone (exception, sample sizes exceeding ~10,000). Whenever possible, proportions and percentages should be accompanied by the actual numerator and denominator from which they were derived. This is particularly important when the sample size is less than 100. Do not use decimal places (ie, xx%, not xx.xx%) if the sample size is less than 100. Tables that include results from multivariable regression models should focus on the primary results. Provide the unadjusted and adjusted results for the primary exposure(s) or comparison(s) of interest. If a more detailed description of the model is required, consider providing the additional unadjusted and adjusted results in supplementary tables.

Tables have a minimum of 2 columns. Comparisons must read across the table columns.

Do not duplicate data in figures and tables. For all primary outcomes noted in the Methods section, exact values with measures of uncertainty should be reported in the text or in a table and in the Abstract, and not only represented graphically in figures.

Pie charts and 3-D graphs should not be used and should be revised to alternative graph types.

Bar graphs should be used to present frequency data only (ie, numbers and rates). Avoid stacked bar charts and consider alternative formats (eg, tables or splitting bar segments into side-by-side bars) except for comparisons of distributions of ordinal data.

Summary data (eg, means, odds ratios) should be reported using data markers for point estimates, not bars, and should include error bars indicating measures of uncertainty (eg, SDs, 95% CIs). Actual values (not log-transformed values) of relative data (for example, odds ratios, hazard ratios) should be plotted on log scales.

For survival plots, include the number at risk for each group included in the analysis at intervals along the x-axis scale. For any figures in which color is used, be sure that colors are distinguishable.

All symbols, indicators, line styles, and colors in statistical graphs should be defined in a key or in the figure legend. Axes in statistical graphs must have labels. Units of measure must be provided for continuous data.

Note: All figures are re-created by journal graphics experts according to reporting standards using the JAMA Network style guide and color palette.

• Number all tables in the order of their citation in the text.
• Include a brief title for each table (a descriptive phrase, preferably no longer than 10 to 15 words).
• Include all tables at the end of the manuscript file.
• Refer to Categories of Articles for limits on the number of tables.
• NOTE: Do not embed tables as images in the manuscript file or upload tables in image formats, and do not upload tables as separate files.

Table Creation

Use the table menu in the software program used to prepare the text. Tables can be built de novo using Insert→Table or copied into the text file from another document (eg, Word, Excel, or a statistical spreadsheet).

Avoid using tabs, spaces, and hard returns to set up the table; such tables will have to be retyped, creating delays and opportunities for error.

Tables should be single-spaced and in a 10- or 12-point font (do not shrink the point size to fit the table onto the page). Do not draw extra lines or rules—the table grid will display the outlines of each cell.

Missing data and blank space in the table field (ie, an empty cell) may create ambiguity and should be avoided; use abbreviations such as NA for not applicable or not available. Each piece of data needs to be contained in its own cell. Do not try to align cells with hard returns or tabs; alignment will be imposed in the production system if the manuscript is accepted. To show an indent, add 2 spaces.

When presenting percentages, include numbers (numerator and denominator).

Include statistical variability where applicable (eg, mean [SD], median [IQR]). For additional detail on requirements for data presentation in tables, see Statistical Methods and Data Presentation .

Place each row of data in a separate row of cells, and note that No. (%) and measures of variability are presented in the same cell as in the example Table 1 below:

Table 1. Baseline Values in the Editors' Health Study

SI conversion factors: To convert cholesterol to mmol/L, multiply values by 0.0259.

Note that JAMA Network journals report laboratory values in conventional units. In a table, provide a footnote with the conversion factor to SI units. For a calculator of SI and conventional units, see the AMA Manual of Style . 2

To present data that span more than 1 row, merge the cells vertically. For example, in Table 2 the final column presents the P value for overall age comparisons.

Table 2. Blood Pressure Values Stratified by Age

The table should be constructed such that the primary comparison reads horizontally. For example, see Table 3 (incorrect) and Table 4 (correct).

Table 3. Patient Data by Study Group

Table 4. Patient Data by Study Group

If a table must be continued, repeat the title and column headings on the second page, followed by "(continued)."

Table Footnotes

Footnotes to tables may apply to the entire table, portions (eg, a column), or an individual entry.

The order of the footnotes is determined by the placement in the table of the item to which the footnote refers.

When both a footnote letter and reference number follow data in a table, set the superscript reference number first followed by a comma and the superscript letter.

Use superscript letters (a, b, c) to mark each footnote and be sure each footnote in the table has a corresponding note (and vice versa).

List abbreviations in the footnote section and explain any empty cells.

If relevant, add a footnote to explain why numbers may not sum to group totals or percentages do not add to 100%.

For more detail on the components and recommended structure of tables, see the AMA Manual of Style . 2

Number all figures (graphs, charts, photographs, and illustrations) in the order of their citation in the text. The number of figures should be limited. Avoid complex composite or multipart figures unless justified. See Categories of Articles for limits on the number of figures and/or tables according to article type.

For initial manuscript submissions, figures must be of sufficient quality and may be embedded at the end of the file for editorial assessment and peer review. If a revision is requested and before a manuscript is accepted, authors will be asked to provide figures that meet the requirements described in Figure File Requirements for Publication .

Graphs, charts, some illustrations, titles, legends, keys, and other elements related to figures in accepted manuscripts will be re-created and edited according to JAMA Network style and standards prior to publication. Online-only figures will not be edited or re-created (see Online-Only Supplements and Multimedia ).

Image Integrity

Preparation of scientific images (clinical images, radiographic images, micrographs, gels, etc) for publication must preserve the integrity of the image data. Digital adjustments of brightness, contrast, or color applied uniformly to an entire image are permissible as long as these adjustments do not selectively highlight, misrepresent, obscure, or eliminate specific elements in the original figure, including the background. Selective adjustments applied to individual elements in an image are not permissible. Individual elements may not be moved within an image field, deleted, or inserted from another image. Cropping may be used for efficient image display or to deidentify patients but must not misrepresent or alter interpretation of the image by selectively eliminating relevant visual information. Juxtaposition of elements from different parts of a single image or from different images, as in a composite, must be clearly indicated by the addition of dividing lines, borders, and/or panel labels.

The submission and publication of images created by artificial intelligence, machine learning tools, or similar technologies is discouraged, unless part of formal research design or methods, and is not permitted without clear description of the content that was created and the name of the model or tool, version and extension numbers, and manufacturer. Authors must take responsibility for the integrity of the content generated by these models and tools. See also Use of AI in Publication and Research .

When inappropriate images or image adjustments are detected by the journal staff, authors will be asked for an explanation and will be requested to submit the image as originally captured prior to any adjustment, cropping, or labeling. Authors may be asked to resubmit the image prepared in accordance with the above standards.

Acceptable Figure Files for Initial Submission and Review

Each figure for the main article may be uploaded as a separate file or appended to the end of the manuscript with the figure titles and legends. Online-only figures must be combined into the PDF of the online-only supplement (see Online-Only Supplements and Multimedia ). Note: If a revision is requested and before acceptance, authors must upload each figure for the main article as a separate file and follow the instructions in Figure File Requirements for Publication .

See the Table of Figure Requirements for additional guidance for specific types of figures for suggested resolution and file formats. In general each figure should be no larger than 1 MB.

Figure File Requirements for Publication

Each figure for the main article must be uploaded as a separate file. Online-only figures must be combined into the PDF of the online-only supplement (see Online-Only Supplements and Multimedia ).

See the Table of Figure Requirements for additional guidance and file formats for specific types of figures.

Files created by vector programs are best for accurately plotting and maintaining data points. JAMA Network journals are unable to use file formats native to statistical software applications to prepare figures for publication; most statistical software programs allow users to save or export files in digital vector formats.

Images created digitally (by digital camera or electronically created illustrations) must meet the minimum resolution requirements at the time of creation. Electronically increasing the resolution of an image after creation causes a breakdown of detail and will result in an unacceptable poor-quality image. Each component of a composite image must be uploaded separately at submission and individually meet the minimum resolution requirement.

Color photographs should be submitted in RGB mode using profiles such as Adobe RGB or sRGB. Digital cameras capture images in RGB. Do not change any color settings once the file is on the computer. Black-and-white photographs (eg, radiographs, ultrasound images, CT and MRI scans, and electron micrographs) can be submitted in either RGB or grayscale modes.

Figure Titles and Legends (Captions)

At the end of the manuscript, include a title for each figure. The figure title should be a brief descriptive phrase, preferably no longer than 10 to 15 words. A figure legend (caption) can be used for a brief explanation of the figure or markers if needed and expansion of abbreviations. For photomicrographs, include the type of specimen, original magnification or a scale bar, and stain in the legend. For gross pathology specimens, label any rulers with unit of measure. Digitally enhanced images must be clearly identified in the figure legends as enhanced or manipulated, eg, computed tomographic scans, magnetic resonance images, photographs, photomicrographs, x-ray films.

Figures With Labels, Arrows, or Other Markers

Photographs, clinical images, photomicrographs, gel electrophoresis, and other types that include labels, arrows, or other markers must be submitted in 2 versions: one version with the markers and one without. Provide an explanation for all labels, arrows, or other markers in the figure legend. The Figure field in the File Description tab of the manuscript submission system allows for uploading of 2 versions of the same figure.

Number of Figures

Refer to Categories of Articles because there may be a limit on the number of figures by article type.

General Figure Guidelines

• Primary outcome data should not be presented in figures alone. Exact values with measure of variability should be reported in the text or table as well as in the abstract.
• All symbols, indicators (including error bars), line styles, colors, and abbreviations should be defined in a legend.
• Each axis on a statistical graph must have a label and units of measure should be labeled.
• Do not use pie charts, 3-D graphs, and stacked bar charts as these are not appropriate for accurate statistical presentation of data and should be revised to another figure type or converted to a table.
• Error bars should be included in both directions, unless only 1-sided variability was calculated.
• Values for ratio data—odds ratios, relative risks, hazard ratios—should be plotted on a log scale. Values for ratio data should not be log transformed.
• For footnotes, use letters (a, b, c, etc) not symbols.
• Do not submit figures with more than 4 panels unless otherwise justified.
• See the AMA Manual of Style for more guidance on figure types and components.

For images featuring patients or other identifiable persons, it is not acceptable to use black bars across the eyes in an attempt to deidentify. Cropping may be acceptable as long as the condition under discussion is clearly visible and necessary anatomic landmarks display. If the person in the image is possibly identifiable (not only by others but also by her/himself), permission for publication is required (see Patient Identification ).

Table of Figure Requirements

To present frequency data (numbers or percentages). Each bar represents a category.

Bar graphs are typically vertical but when categories have long titles or there are many of them, they may run horizontally.

The scale on the frequency axis should begin at 0, and the axis should not be broken.

If the data plotted are a percentage or rate, error bars may be used to show statistical variability.

Acceptable File Formats for Initial Submission: .ai, .bmp, .docx, .emf, .eps, .jpg, .pdf, .ppt, .psd, .tif, .wmf, .xls

Acceptable File Formats for Revision and Publication: .ai, .emf, .eps, .pdf, .wmf, .xls

To demonstrate the relationship between 2 or more quantitative variables, such as changes over time.

The dependent variable appears on the vertical axis (y) and the independent variable on the horizontal axis (x); the axes should be continuous, not broken.

Flow diagram

To show participant recruitment and follow-up or inclusions and exclusions (such as in a systematic review).

Acceptable File Formats for Initial Submission: .ai, .docx, .emf, .eps, .jpg, .pdf, .ppt

Acceptable File Formats for Revision and Publication: .ai, .docx, .emf, .eps, .pdf

Survival plot

To display the proportion or percentage of individuals (represented on the y-axis) remaining free of or experiencing a specific outcome over time (represented on the x-axis).

The curve should be drawn as a step function (not smoothed).

The number of individuals followed up for each time interval (number at risk) should be shown underneath the x-axis.

Box-and-whisker plot (box plot)

To show data distribution from 1 or more groups, particularly aggregate/summary data.

Each element should be described (the ends of the boxes, the middle line, and the whiskers). Data points that fall beyond the whiskers are typically shown as circles.

Forest plot

To illustrate summary data, particularly in meta-analyses and systematic reviews.

The data are presented both tabularly and graphically.

The sources (with years and citations, when relevant) should comprise the first column.

Provide indicators of both directions of results at the top of the plot on either side of the vertical line (eg, favors intervention).

Typically, proportionally sized boxes represent the weight of each study and a diamond shows the overall effect at the bottom of the plot.

To display quantitative data other than counts or frequencies on a single scaled axis according to categories on a baseline (horizontal or vertical). Point estimates are represented by discrete data markers, preferably with error bars (in both directions) to designate variability.

Scatterplot

To show individual data points plotted according to coordinate values with continuous, quantitative x- and y-axis scales.

A curve that is generated mathematically may be fitted to the data to summarize the relationship among the variables.

Illustration

To explain physiological mechanisms, describe clinical maneuvers and surgical techniques, or provide orientation to medical imaging.

Required minimum resolution for publication: ≥350 ppi

Acceptable File Formats for Initial Submission: .ai, .docx, .eps, .jpg, .pdf, .ppt, .psd., tif

Acceptable File Formats for Revision and Publication: .ai, .eps, .jpg, .pdf, .psd, .tif

Photographs and other clinical images

To display clinical findings, experimental results, or clinical procedures, including medical imaging, photomicrographs, clinical photographs, and photographs of biopsy specimens.

Legends for photomicrographs should include details about the type of stain used and magnification.

Acceptable File Formats for Initial Submission: .eps, .jpg, .pdf, .ppt, .psd, .tif

Acceptable File Formats for Revision and Publication: .eps, .jpg, .psd, .tif

Line drawings

To illustrate anatomy or procedures.

Line drawings are almost always black and white.

Required minimum resolution for publication: ≥600 ppi

Acceptable File Formats for Initial Submission: .docx, .jpg, .pdf, .ppt, .psd, .tif

Acceptable File Formats for Revision and Publication: .jpg, .psd, .tif

Authors may submit supporting material to accompany their article for online-only publication when there is insufficient space to include the material in the print article. This material should be important to the understanding and interpretation of the report and should not repeat material in the print article. The amount of online-only material should be limited and justified. Online-only material should be original and not previously published.

Online-only material will undergo editorial and peer review with the main manuscript. If the manuscript is accepted for publication and if the online-only material is deemed appropriate for publication by the editors, it will be posted online at the time of publication of the article as additional material provided by the authors. This material will not be edited or formatted; thus, authors are responsible for the accuracy and presentation of all such material.

Online-only material should be submitted in a single Word document with pages numbered consecutively. Each element included in the online-only material should be cited in the text of the main manuscript (eg, eTable in the Supplement) and numbered in order of citation in the text (eg, eTable 1, eTable 2, eFigure 1, eFigure 2, eMethods). The first page of the online-only document should list the number and title of each element included in the document.

Online-Only Text

Online-only text should be set in Times New Roman font, 10 point in size, and single-spaced. The main heading of the online-only text should be in 12 point and boldface; subheadings should be in 10 point and boldface.

Online-Only References

All references cited within the online-only document must be included in a separate reference section, including those that also were cited in the main manuscript. They should be formatted just as in the main manuscript and numbered and cited consecutively in the online-only material.

Online-Only Tables

Online-only tables should be inserted in the document and numbered consecutively according to the order of citation as eTable 1, eTable 2, etc. All online-only tables should be cited in the relevant text of the main manuscript. The text and data in online tables should be Arial font, 10 point in size, and single-spaced. The table title should be set in Arial font, 12 point, and bold. Headings within tables should be set in 10 point and bold. Table footnotes should be set in 8 point and single-spaced. See also instructions for Tables above. If a table runs on to subsequent pages, repeat the column headers at the top of each page. Wide tables may be presented using a landscape orientation.

If data are better displayed in a separate Excel file, this can be submitted, provided that the Excel file is cited as an eTable and is numbered in the order cited in the text. If multiple Excel files of data are submitted, these should be placed in a single Excel file, with multiple tabs (sheets) at the bottom of the file. The first tab (sheet) should include a table of contents with eTable numbers and titles, and the subsequent tabs (sheets) should be labeled as eTable 1, eTable 2, etc. Please note: the journal is not a data repository; large data sets should be deposited into publicly accessible data repositories, and a link should be provided in the Methods or Results section and the Data Sharing Statement .

Online-Only Figures

Online-only figures should be inserted in the document and numbered consecutively according to the order of citation as eFigure 1, eFigure 2, etc. All online-only figures should be cited in the relevant text of the main manuscript. Figure titles should be set in Arial font, 12 point, bold, and single-spaced. Text within figures should be set as Arial font, 10 point. Figure legends should be set in 8 point and single-spaced. Graphs and diagrams should be exported directly out of the software application used to create them in a vector file format, such as .wmf, and then inserted into the Word document. Image file formats such as .jpg, .tif, and .gif are generally not suitable for graphs. Photographs, including all radiological images, should be prepared as .jpg (highest option) or .tif (uncompressed) files at a resolution of 300 dpi and width of 3-5 inches, but the resolution of photographic files with an original resolution <300 dpi should not be increased digitally to achieve a 300-dpi resolution. Photographs should be inserted in the document with the "Link to File" button turned off. Wide figures may be presented using a landscape orientation.

For editorial and review of an initial submission, submit videos according to the following specifications:

• Acceptable file formats: .mov, .wmv, .mpg, .mpeg, .mp4, or .avi
• Maximum file size: ≤25 MB
• Preferred dimensions: 1920x1080 (HD) or greater (4k UHD footage is acceptable)
• Minimum dimensions: 640 pixels wide by 360 pixels deep
• Recommended frame rate: 24 fps (or 23.976 fps), 25 and 30 fps (or 29.97 fps)
• Maximum length: ≤5 minutes
• Desired aspect ratio: 4:3 (standard) or 16:9 (widescreen)
• If compression is required to reduce file size for uploading, please use a minimum bit rate of 10,000 kbit/s – 20,000 kbit/s
• When filming, please use a landscape orientation, not a portrait orientation. This is especially important when filming video or taking photographs with a smartphone or a mobile device.

Verify that the videos are viewable in QuickTime or Windows Media Player before uploading.

For each video, provide an in-text citation (eg, Video 1). At the end of the manuscript file, include a title (a brief phrase, preferably no longer than 10 to 15 words) and a caption that includes the file format and a brief explanation for each video. The same title and caption must be entered in the designated fields in the manuscript submission system when uploading each video. If multiple video files are submitted, number them in the order in which they should be viewed.

If patient(s) are identifiable in the video, authors must submit a Patient Permission form completed and signed by each patient. See also Patient Identification .

If the author does not hold copyright to the video, the author must obtain permission for the video to be published in the journal. This permission must be for unrestricted use in all print, online, and licensed versions of the journal.

NOTE: If your manuscript and accompanying videos are accepted for publication, the video files will be placed into a journal video frame and will be edited by JAMA Network video production staff according to journal style. In addition, a JAMA Network staff person may contact you to resubmit your videos to meet our production specifications. For example, a larger size may be needed, and if your videos were submitted with embedded text such as titles, annotations, labels, or captions, we will ask you to remove the text at this stage and resubmit the video without text, and JAMA Network video production will re-create all text using our house style.

Guidelines for Optimal Video Quality

• Use plenty of diffuse light; avoid shadows.
• Use the appropriate white-balance based on your lighting conditions. Different cameras have different settings, but most have presets for incandescent (yellow) light, fluorescent light, daylight, and tungsten light. Please make sure to select the correct one so that the color of your footage renders accurately.
• Do not overexpose the image; a bit underexposed is preferable.
• Use a tripod. This is especially important in close-ups.
• Avoid excessive zooming. Use the optical zoom only; do not use a digital zoom.
• Turn off all camera special effects.
• Avoid using autofocus. Manual focus is more accurate. Keep the camera at a fixed distance from the subject.
• Instruct people on camera to speak clearly and face the camera when speaking. Try to avoid large movements while speaking or immediately after speaking. Allow pauses before and after speaking for easier editing.
• If the situation permits, ensure that individuals being filmed are not wearing white clothing or clothing with busy patterns or stripes, especially shirts, jackets, and ties. Subdued medium blue, brown, tan, beige, and green colors all work well for shirt and clothing choices.
• Do not include an introduction by the physician as a "talking head" explaining a procedure. All footage should be of the procedure or relevant subject matter only.
• Record a few extra seconds before and after each cut or after changing the camera's position. This allows for easier editing.

Additional Considerations for Filming Surgical Procedures

• Coordinate with the surgical staff to establish a vantage point for the camera that has a clear view of the surgical field.
• Before the procedure, if the situation permits, identify the surgical staff's positions for access into and out of the surgical field to ensure there is no immediate obstruction of the camera.
• During the procedure, avoid typical obstructions of the camera's main view such as arms reaching across the field or soiled surgical sponges. Where possible, keep the heads, hands, and any instruments away from the immediate sightline of the camera. This will ensure that all moments of the procedure are captured in full view and focus.
• If the situation permits a choice of glove type, use brown or tan. White gloves reflect bright light; vividly colored surgical gloves can distract the viewer from the teaching point of the video.
• If the situation permits, avoid rapid movements for procedural steps that should be noticed and understood. To demonstrate a key moment or use of an instrument, movement that is deliberate and steady will allow a standard camera to focus properly.

For editorial and review of an initial submission, submit audio files according to the following minimum requirements:

• Acceptable file formats: .mp3, .wav, or .aiff
• Maximum file size: 25 MB
• To achieve the best quality, use a setting of 256 kbps or higher for stereo or 128 kbps or higher for mono.
• Sampling rate should be either 44.1 kHz or 48 kHz.
• Bit rate should be either 16 or 24 bit.
• To avoid audible clipping noise, please make sure that audio levels do not exceed 0 dBFS.

For each audio file, provide an in-text citation. At the end of the manuscript, include a title (a brief phrase, preferably no longer than 10-15 words) and a caption that includes the file format and a brief explanation for each audio.

NOTE: If your manuscript is accepted for publication, JAMA Network video production staff may contact you to request an original uncompressed audio file in .wav or .aiff format. There is no maximum file size requirement for publication at this stage.

After Submission

Authors will be sent notifications of the receipt of manuscripts and editorial decisions by email. During the review process, authors can check the status of their submitted manuscript via the online manuscript submission and review system . Authors should not disclose the fact that their manuscript has been submitted to anyone, except coauthors and contributors, without permission of the editor.

All submitted manuscripts are reviewed initially by one of the editors. Manuscripts are evaluated according to the following criteria: material is original and timely, writing is clear, study methods are appropriate, data are valid, conclusions are reasonable and supported by the data, information is important, and topic has general interest to readers of this journal. From these basic criteria, the editors assess a paper's eligibility for publication. Manuscripts with insufficient priority for publication are rejected promptly. Other manuscripts are sent to expert consultants for peer review. The journal uses a single-anonymized peer review process: peer reviewer identities are kept confidential (unless reviewers choose to reveal their names in their formal reviews); author identities are made known to reviewers. The existence of a manuscript under review is not revealed to anyone other than peer reviewers and editorial staff. Peer reviewers are required to maintain confidentiality about the manuscripts they review and must not divulge any information about a specific manuscript or its content to any third party without prior permission from the journal editors. Reviewers are instructed to not submit confidential manuscripts, abstracts, or other text into a chatbot, language model, or similar tool. At submission, authors may choose to have manuscripts that are not accepted by the journal referred to one of the JAMA Network specialty journals and/or JAMA Network Open along with reviewers' comments (if available). Information from submitted manuscripts may be systematically collected and analyzed as part of research to improve the quality of the editorial or peer review process. Identifying information remains confidential. Final decisions regarding manuscript publication are made by an editor who does not have any relevant conflicts of interest.

Authors may appeal decisions. All appeals are reviewed by the editor in chief, on a case-by-case basis, or a designated editor if the editor in chief is recused from the review.

After Revision/Acceptance

All authors are required to complete an Authorship Form and Publishing Agreement. See Authorship Criteria and Contributions .

Accepted manuscripts are edited in accordance with the AMA Manual of Style , 2 and returned to the corresponding author (or her/his designee) for approval. Authors are responsible for all statements made in their work, including changes made during editing and production that are authorized by the corresponding author.

Authors should not disclose the fact that their manuscript has been accepted to anyone, except coauthors and contributors, until it is published without permission of the editor or as described in the guidance on Previous or Planned Meeting Presentaton or Release of Information and Embargo Policy .

If accepted for publication, all articles are generally published Online First and then again in a print/online issue.

After Publication

Postpublication correspondence.

For accepted manuscripts, the corresponding author will be asked to respond to letters to the editor.

Reprints and e-prints may be ordered online when the edited manuscript is sent for approval to the corresponding author.

Requests to publish corrections should be sent to the editorial office. Errors and requests for corrections are reviewed by editors and authors, and, if warranted, a Correction notice summarizing the errors and corrections is published promptly and linked online to the original article, and the original article is corrected online with the date of correction. 15

First and last authors of peer-reviewed articles are eligible to receive CME credit. See CME From the JAMA Network .

About Previous Release of Information, Embargo, and Access

Manuscripts are considered with the understanding that they have not been published previously and are not under consideration by another publication.

Copies of all related or similar manuscripts and reports by the same authors (ie, those containing substantially similar content or using the same, similar, or a subset of data) that have been previously published or posted electronically or are under consideration elsewhere must be provided at the time of manuscript submission. All related previously published articles should be cited as references and described in the submitted manuscript along with explanation of how the submitted manuscript differs from the related previously published article(s).

Manuscripts that have been previously posted on a preprint server may be submitted for consideration for publication. When the manuscript is submitted, authors must provide information about the preprint, including a link to it and a description of whether the submitted manuscript has been revised or differs from the preprint.

See also Previous or Planned Meeting Presentation or Release of Information and Research Article Public Access, Depositing in Repositories, and Discoverability.

Meeting presentation: A complete manuscript submitted to the journal following or prior to presentation at a scientific meeting or publication of preliminary findings elsewhere (ie, as an abstract) is eligible for consideration for publication. Authors considering presenting or planning to present the work at an upcoming scientific meeting should indicate the name and date of the meeting on the manuscript submission form. For accepted papers, the editors may be able to coordinate publication with the meeting presentation. Authors of submitted papers, including those accepted but not yet published, should not disclose the status of such papers during such meeting presentations that occur before the work is published. Authors who present information contained in a manuscript that is under consideration by this journal during scientific or clinical meetings should not distribute complete reports (ie, copies of manuscripts) or full data presented as tables and figures to conference attendees or journalists. Publication of abstracts in print and online conference proceedings, as well as posting of slides or videos from the scientific presentation on the meeting website, is acceptable. However, for manuscripts under consideration by this journal, publication of full reports in meeting proceedings or online, issuing detailed news releases reporting the results of the study that go beyond the meeting abstract, or participation in formal news conferences will ordinarily jeopardize chances for publication of the submitted manuscript in this journal. 5 Media coverage of presentations at scientific meetings will not jeopardize consideration, but direct release of information through press releases or news media briefings may preclude consideration of the manuscript by this journal. 5 Rare instances of papers reporting public health emergencies should be discussed with the editor. Authors submitting manuscripts or letters to the editor regarding adverse drug or medical device reactions, reportable diseases, etc, should also report this information to the relevant government agency.

Authors should not release information about accepted manuscripts via social media until publication.

See also Previous Publication, Related Manuscripts and Reports, and Preprints . For more information, see the AMA Manual of Style .

Authors should not disclose the fact that their manuscript has been accepted to anyone, except coauthors and contributors, without permission of the editor until it is published. All information regarding the content and publication date of accepted manuscripts is strictly confidential. Unauthorized prepublication release of accepted manuscripts and information about planned publication date may result in rescinding the acceptance and rejecting the paper. This policy applies to all categories of articles, including research, review, opinion, correspondence, etc. Information contained in or about accepted articles cannot appear in print, audio, video, or digital form or be released by the news media until the specified embargo release date. 2 , 5 See also Previous or Planned Meeting Presentation or Release of Information .

Authors have the option to choose the type of Publishing Agreement, either (1) a free no-fee public access option or (2) one of two author-pay open access options. These options will be available for authors to request at the time of manuscript submission. Reviewers and editors will be unaware of the request for open access until after a final decision is made. For detailed information on public access, open access (including fees, waivers, and discounts), copyright, and licensing, please see below.

• Copyright Transfer. In consideration of the action of the American Medical Association (AMA) in reviewing and editing this submission (manuscript, tables, figures, video, audio, and other supplemental files for publication), I hereby transfer, assign, or otherwise convey all copyright ownership, including any and all rights incidental thereto, exclusively to the AMA, in the event that such work is published by the AMA.
• Federal Employment. I was an employee of the US federal government or that of another nation when this work was conducted and prepared for publication; therefore, it is not protected by the Copyright Act, and copyright ownership cannot be transferred.
• Work for Hire. I am employed by an institution that considers this submission a "work made for hire" and that requires an authorized representative of the institution to assign copyright on my behalf.
• Eligibility: Available only for authors of manuscripts reporting research funded by a not-for-profit foundation or agency or unfunded research. Note: If your open access funding source is commercial, only a CC-BY-NC-ND license is available.
• Author requirements: Payment of $5000 and transfer of a publication license to the journal.
• License rights: Immediate open access on journal website on the day of publication, retention of copyright, and a CC-BY license that permits others to distribute, remix, tweak, and build on the work, even commercially, without permission, provided that credit is given to the original authors and journal.
• Eligibility: Available for authors of manuscripts reporting research funded by a commercial funding source.
• Author requirements: Payment of $5000 and grant of a publication license to the journal.
• License rights: Immediate open access on journal website on the day of publication and a CC-BY-NC-ND license that permits others to distribute the work without permission, provided that credit is given to the original authors and journal and that the article is not altered or used commercially.
• Open Access Waivers and Discounts Waivers and discounts on open access article processing charges are available for eligible authors from Hinari Core Offer countries with limited resources.

The journal makes all research articles free public access 12 months after publication on the journal website or immediately for articles published under an open access license.

Authors of research articles may deposit the accepted version of the manuscript (ie, the peer-reviewed manuscript that you submitted on which this decision is based) in a repository of your choice on or after the date of publication provided that it links to the final published version on the journal website. You may not deposit the published article (version of record), which is the final copyedited, formatted, and proofed version published by the journal. The journal will deposit a copy of the published research article into PubMed Central (PMC) at the time of publication, where it will be publicly available 12 months after publication or immediately if you have purchased an open access license. A few weeks after publication, you may obtain your PMCID on the PMC site at https://www.ncbi.nlm.nih.gov/pmc/pmctopmid/ . These options apply only to research articles. Non-research articles may not be deposited into repositories.

In addition, the journal will add metadata to all article to ensure web-based search engine discoverability and will provide publicly discoverable information about your article to PubMed/Medline and numerous other bibliographic databases on the day of publication.

Author Responsibilities

Most of the JAMA Network journals' editorial policies for authors are summarized in these instructions. Citations and links to the AMA Manual of Style: A Guide for Authors and Editors 2 and other publications with additional information are also provided.

Each author should have participated sufficiently in the work to take public responsibility for appropriate portions of the content. 2 One or more authors should take responsibility for the integrity of the work as a whole, from inception to published article. According to the guidelines of the International Committee of Medical Journal Editors (ICMJE), 4 authorship credit should be based on the following 4 criteria:

• substantial contributions to conception or design of the work, or the acquisition, analysis, or interpretation of data for the work; and
• drafting of 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.

Each author should be accountable for the parts of the work he or she has done. In addition, each author should be able to identify which coauthors are responsible for specific other parts of the work and should have confidence in the integrity of the contributions of any coauthors.

All those designated as authors should meet all 4 criteria for authorship, and all who meet the 4 criteria should be identified as authors. Those who do not meet all 4 criteria should be acknowledged (see Acknowledgment Section ).

All authors (ie, the corresponding author and each coauthor) must read, complete, and submit an electronic Authorship Form with required statements on Authorship Responsibility, Criteria, and Contributions; Confirmation of Reporting Conflicts of Interest and Funding; and Publishing Agreement. 2(pp128-133) In addition, authors are required to identify their specific contributions to the work described in the manuscript. Requests by authors to designate equal contributions or shared authorship positions (eg, co-first authorship) may be considered if justified and within reason. 6 An email with links to the Authorship Form will be sent to authors for completion after manuscripts have been submitted.

For reports of original data, authors' specific contributions will be published in the Acknowledgment section (see Manuscript Preparation and Submission Requirements , Acknowledgment section ). 2 All other persons who have made substantial contributions to the work reported in this manuscript (eg, data collection, analysis, or writing or editing assistance) but who do not fulfill the authorship criteria should be named with their specific contributions and affiliations in an Acknowledgment in the manuscript. Written permission to include the names of individuals in the Acknowledgment section must be obtained.

Nonhuman artificial intelligence, language models, machine learning, or similar technologies do not qualify for authorship. If these models or tools are used to create content or assist with writing or manuscript preparation, authors must take responsibility for the integrity of the content generated by these tools. Authors should report the use of artificial intelligence, language models, machine learning, or similar technologies to create content or assist with writing or editing of manuscripts in the Acknowledgment section or Methods section if this is part of formal research design or methods. See also Use of AI in Publication and Research , Reproduced and Re-created Material , and Image Integrity .

The authors also must certify that the manuscript represents valid work and that neither this manuscript nor one with substantially similar content under their authorship has been published or is being considered for publication elsewhere (see also About Previous Release of Information, Embargo, and Access ). 2 Authors of manuscripts reporting original data or systematic reviews must provide an access to data statement from 1 or 2 named authors, often the corresponding author (see also Data Access, Responsibility, and Analysis ). If requested, authors should be prepared to provide the data and must cooperate fully in obtaining and providing the data on which the manuscript is based for examination by the editors or their assignees.

A single corresponding author (or coauthor designee in the event that the corresponding author is unavailable) will serve on behalf of all coauthors as the primary correspondent with the editorial office during the submission and review process. If the manuscript is accepted, the corresponding author will review an edited manuscript and proof, make decisions regarding release of information in the manuscript to the news media or federal agencies, handle all postpublication communications and inquiries, and will be identified as the corresponding author in the published article.

The corresponding author also is responsible for ensuring that the Acknowledgment section of the manuscript is complete (see Acknowledgment Section ) and that the conflict of interest disclosures reported in the Acknowledgment section of the manuscript are accurate, up-to-date, and consistent with the information provided in each author's potential conflicts of interest section in the Authorship Form (see Conflicts of Interest and Financial Disclosures ).

The corresponding author also must complete the Acknowledgment statement part of the Authorship Form confirming that all persons who have contributed substantially but who are not authors are identified in the Acknowledgment section and that written permission from each person acknowledged has been obtained (see Acknowledgment Section ).

Requests for co-corresponding authors will be considered on a very limited basis if justified, but no more than 2 co-corresponding authors will be permitted. In such cases, a primary corresponding author must be designated as the point of contact responsible for all communication about the manuscript and article, manage the tasks described above, and will be listed first in the corresponding author section. 6 To read more about the role and responsibilities of corresponding authors, see the AMA Manual of Style .

Authors should determine the order of authorship among themselves and should settle any disagreements before submitting their manuscript. Changes in authorship (ie, order, addition, and deletion of authors) should be discussed and approved by all authors. Any requests for such changes in authorship after initial manuscript submission and before publication should be explained in writing to the editor in a letter or email from all authors. 2(pp128-133)

The JAMA Network recognizes that authors may change their names for personal reasons, and the editors respect authors' rights to autonomy and privacy in this regard. Authors who request confidential name changes after publication because of changes in identity, marital status, religion, or other reasons may have their names changed in articles without indication of the reason for the change and without a formal correction notice. If an author prefers this change to be public, a formal Correction notice can be issued, with or without the reason per author preference. The journal will not request the approval of coauthors, but the requesting author may wish to notify coauthors if this change will affect subsequent citations to the article. The requester may be asked to notify the corresponding author about this change to the published article; alternatively, the journal may inform the corresponding author of this change (without explaining the reason for the change). The journal will make this change to the online and PDF versions of the published article and will notify postpublication indexes and databases as a standard process but cannot guarantee when or if the change will be reflected in these indexes and databases.

If authorship is attributed to a group (either solely or in addition to 1 or more individual authors), all members of the group must meet the full criteria and requirements for authorship as described above, and all group member authors must complete Authorship Forms. 6 If all members of a group do not meet all authorship criteria, a group must designate 1 or more individuals as authors or members of a writing group who meet full authorship criteria and requirements and who will take responsibility for the group. 2 , 6 Group names should appear at the end of the byline and should not be interspersed within the list of individually named authors. Group authors may not be included for article types with limited numbers of authors (eg, opinion articles).

For articles with a large number of authors (eg, >50), a long list of authors will not fit in the byline of a print/PDF version of the article. In such cases, a group byline will be recommended with the individual names of each author listed at the end of the article. All author names would still be individually indexed, displayed, and easily searchable in bibliographic records such as PubMed. 6

Nonauthor Collaborators: Other group members who do not meet the criteria for authorship (eg, investigators, advisors, assistants) may be identified. For group author manuscripts, a Nonauthor Collaborator Template (with names, academic degrees, institution, location, role/contribution, and subgroup) must be completed during revision. The template will be available to authors with the request for revision. The collaborators will be published in an online Supplement based on this template and will be deposited to PubMed.

To read more about authorship, click here .

A conflict of interest may exist when an author (or the author's institution or employer) has financial or personal relationships or affiliations that could influence (or bias) the author's decisions, work, or manuscript. All authors are required to report potential conflicts of interest including specific financial interests relevant to the subject of their manuscript in the Acknowledgment section of the manuscript 2 and in the Disclosure of Potential Conflicts of Interest section of the Authorship Form. Note: These forms will be requested after a manuscript has been submitted, but authors should also include conflict of interest disclosures in the Acknowledgment section of the submitted manuscript.

Definitions and Terms of Conflicts of Interest Disclosures:

Authors are expected to provide detailed information about all relevant financial interests, activities, relationships, and affiliations (other than those affiliations listed in the title page of the manuscript) including, but not limited to, employment, affiliation, funding and grants received or pending, consultancies, honoraria or payment, speakers' bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Following the guidelines of the ICMJE, 4 the definitions and terms of such disclosures include

Any potential conflicts of interest "involving the work under consideration for publication" (during the time involving the work, from initial conception and planning to present), Any "relevant financial activities outside the submitted work" (over the 3 years prior to submission), and Any "other relationships or activities that readers could perceive to have influenced, or that give the appearance of potentially influencing" what is written in the submitted work (based on all relationships that were present during the 3 years prior to submission).

Authors without conflicts of interest, including relevant financial interests, activities, relationships, and affiliations, should indicate such in their disclosures and include a statement of no such interests in the Acknowledgment section of the manuscript. Failure to include this information in the manuscript may delay evaluation and review of the manuscript. Authors should err on the side of full disclosure and should contact the editorial office if they have questions or concerns.

Although many universities and other institutions and organizations have established policies and thresholds for reporting financial interests and other conflicts of interest, the JAMA Network requires complete disclosure of all relevant financial relationships and potential financial conflicts of interest, regardless of amount or value. For example, authors of a manuscript about hypertension should report all financial relationships they have with all manufacturers and owners of products, devices, tests, and services used in the management of hypertension, not only those relationships with entities whose specific products, devices, tests, and services are mentioned in the manuscript. If authors are uncertain about what constitutes a relevant financial interest or relationship, they should contact the editorial office.

For all accepted manuscripts, the corresponding author will have been asked to confirm that each coauthor's disclosures of conflicts of interest and relevant financial interests, activities, relationships, and affiliations and declarations of no such interests are accurate, up-to-date, and consistent with the disclosures reported in the Acknowledgment section of the manuscript because this information will be published in the Acknowledgment section of the article. Decisions about whether such information provided by authors should be published, and thereby disclosed to readers, are usually straightforward. Although editors are willing to discuss disclosure of specific conflicts of interest with authors, JAMA Network policy is one of complete disclosure of all potential conflicts of interest, including relevant financial interests, activities, relationships, and affiliations (other than those affiliations listed in the title page of the manuscript). The policy requiring disclosure of conflicts of interest applies for all manuscript submissions, including letters to the editor. If an author's disclosure of potential conflicts of interest is determined to be inaccurate or incomplete after publication, a correction will be published to rectify the original published disclosure statement, and additional action may be taken as necessary.

All authors must also complete the Disclosure of Potential Conflicts of Interest section of the Authorship Form. 7

All financial and material support for the research and the work should be clearly and completely identified in an Acknowledgment section of the manuscript. At the time of submission, information on the funding source (including grant identification) must also be completed via the online manuscript submission and review system. The specific role of the funding organization or sponsor in each of the following should be specified: "design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication." 7 To read more about reporting funding and other support, see the AMA Manual of Style .

For all reports (regardless of funding source) containing original data, at least 1 named author (eg, the principal investigator), and no more than 2 authors, must indicate that she or he "had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis." 7 This exact statement should be included in the Acknowledgment section at the end of the manuscript. Modified statements or generic statements indicating that all authors had such access are not acceptable. In addition, for all reports containing original data, the names and affiliations of all authors (or other individuals) who conducted and are responsible for the data analysis must be indicated in the Acknowledgment section of the manuscript. If the individual who conducted the analysis is not named as an author, a detailed explanation of his/her contributions and reasons for his/her involvement with the data analysis should be included.

For all reports of research, authors are required to provide a Data Sharing Statement to indicate if data will or will not be shared. Specific questions regarding the sharing of data are included in the manuscript submission system. If authors choose to share or not share data, this information will be published in a Data Sharing Statement in an online supplement linked to the published article. Authors will be asked to identify the data, including individual patient data, a data dictionary that defines each field in the data set, and supporting documentation (eg, statistical/analytic code), that will be made available to others; when, where, and how the data will be available (eg, a link to a data repository); types of analyses that are permitted; and if there will be any restrictions on the use of the data. Authors also have the option to explain why data may not be shared. A list of generalist public repositories that authors may consider using is available from the National Library of Medicine .

The Acknowledgment section is the general term for the list of contributions, disclosures, credits, and other information included at the end of the text of a manuscript but before the references. The Acknowledgment section includes authors' contributions; information on author access to data; disclosure of potential conflicts of interest, including financial interests, activities, relationships, and affiliations; sources of funding and support; an explanation of the role of funder(s)/sponsor(s); names, degrees, and affiliations of participants in a large study or other group (ie, collaborators); any important disclaimers; information on previous presentation of the information reported in the manuscript; and the contributions, names, degrees, affiliations, and indication if compensation has been received for all persons who have made substantial contributions to the work but who are not authors. 2

All other persons who have made substantial contributions to the work reported in the manuscript (eg, data collection, analysis, and writing or editing assistance) but who do not fulfill the authorship criteria should be named with their specific contributions in an Acknowledgment in the manuscript.

Authors must obtain written permission to include the names of all individuals included in the Acknowledgment section, and the corresponding author must confirm that such permission has been obtained in the Authorship Form.

Authors should report the use of artificial intelligence, language models, machine learning, or similar technologies to create content or assist with writing or editing of manuscripts in the Acknowledgment section or the Methods section if this is part of formal research design or methods. This should include a description of the content that was created or edited and the name of the language model or tool, version and extension numbers, manufacturer, date(s) of use, and confirmation that the authors take responsibility for the integrity of the content generated. (Note: this does not include basic tools for checking grammar, spelling, references, etc.) See also Use of AI in Publication and Research and Statistical Analysis Subsection .

Requirements for Reporting

Authors of research articles should follow the EQUATOR Reporting Guidelines . See specific Study Types for detailed guidance on reporting.

Guidance on Reporting Research Statistics and Methods

See the JAMA Surgery Guide to Statistics and Methods series for practical guidance on statistics and research methods.

Causal language (including use of terms such as effect and efficacy) should be used only for randomized clinical trials. For all other study designs (including meta-analyses of randomized clinical trials), methods and results should be described in terms of association or correlation and should avoid cause-and-effect wording. To read more about use of causal language, see the AMA Manual of Style .

Research reports should be timely and current and should be based on data collected as recently as possible. Manuscripts based on data from randomized clinical trials should be reported as soon as possible after the trial has ended, ideally within 1 year after follow-up has been completed.

For cohort studies, the date of final follow-up should be no more than 5 years before manuscript submission. Likewise, data used in case-control or cross-sectional studies should have been collected as recently as possible, but no more than 5 years before manuscript submission. Manuscripts in which the most recent data have been collected more than 5 years ago ordinarily will receive lower priority for publication; thus, authors of such manuscripts should provide a detailed explanation of the relevance of the information in light of current knowledge and medical practice as well as the most recent date(s) of analysis of the study.

General Considerations

Authors are encouraged to consult "Reporting Statistical Information in Medical Journal Articles." 1 In the Methods section, describe statistical methods with enough detail to enable a knowledgeable reader with access to the original data to reproduce the reported results. Such description should include appropriate references to the original literature, particularly for uncommon statistical methods. For more advanced or novel methods, provide a brief explanation of the methods and appropriate use in the text and consider providing a detailed description in an online supplement.

In the reporting of results, when possible, quantify findings and present them with appropriate indicators of measurement error or uncertainty, such as confidence intervals (see Reporting Standards and Data Presentation ). Avoid relying solely on statistical hypothesis testing, such as the use of P values, which fails to convey important quantitative information. For observational studies, provide the numbers of observations. For randomized trials, provide the numbers randomized. Report losses to observation or follow up (see Missing Data ). For multivariable models, report all variables included in models, and report model diagnostics and overall fit of the model when available (see Statistical Procedures ).

Define statistical terms, abbreviations, and symbols, if included. Avoid nontechnical uses of technical terms in statistics, such as correlation, normal, predictor, random, sample, significant, trend. Do not use inappropriate hedge terms such as marginal significance or trend toward significance for results that are not statistically significant. Causal language (including use of terms such as effect and efficacy) should be used only for randomized clinical trials. For all other study designs (including meta-analyses of randomized clinical trials), methods and results should be described in terms of association or correlation and should avoid cause-and-effect wording.

Sample Size Calculations

For randomized trials, a statement of the power or sample size calculation is required (see the EQUATOR Network CONSORT Guidelines ). For observational studies that use an established population, a power calculation is not generally required when the sample size is fixed. However, if the sample size was determined by the researchers, through any type of sampling or matching, then there should be some justification for the number sampled. In any case, describe power and sample size calculations at the beginning of the Statistical Methods section, following the general description of the study population.

Descriptive Statistics

It is generally not necessary to provide a detailed description of the methods used to generate summary statistics, but the tests should be briefly noted in the Methods section (eg, ANOVA or Fisher exact test).

Statistical Procedures

Identify regression models with more than 1 independent variable as multivariable and regression models with more than 1 dependent variable as multivariate. Report all variables included in models, as well as any mathematical transformations of those variables. Provide the scientific rationale (clinical, statistical, or otherwise) for including variables in regression models.

For regression models fit to dependent data (eg, clustered or longitudinal data), the models should account for the correlations that arise from clustering and/or repeated measures. Failure to account for such correlation will result in incorrect estimates of uncertainty (eg, confidence intervals). Describe how the model accounted for correlation. For example, for an analysis based on generalized estimating equations, identify the assumed correlation structure and whether robust (or, sandwich) variance estimators were used. Or, for an analysis based on mixed-effects models, identify the assumed structure for the random effects, such as the level of random intercepts and whether any random slopes were included. Fixed-effects estimation should be described as conditional likelihood. Avoid the term fixed effects for describing covariates.

Missing Data

Report losses to observation, such as dropouts from a clinical trial or those lost to follow-up or unavailable in an observational study. If some participants are excluded from analyses because of missing or incomplete data, provide a supplementary table that compares the observed characteristics between participants with complete and incomplete data. Consider multiple imputation methods to impute missing data and include an assessment of whether data were missing at random. Approaches based on "last observation carried forward" should not be used.

Primary Outcomes, Multiple Comparisons, and Post Hoc Comparisons

Both randomized and observational studies should identify the primary outcome(s) before the study began, as well as any prespecified secondary, subgroup, and/or sensitivity analyses. Comparisons arrived at during the course of the analysis or after the study was completed should be identified as post hoc. For analyses of more than 1 primary outcome, corrections for multiple testing should generally be used. For secondary outcomes, address multiple comparisons or consider such analyses as exploratory and interpret them as hypothesis-generating. The reporting of all outcomes should match that included in study protocols. For randomized clinical trials, protocols with complete statistical analysis plans should be cited in the Methods section and submitted as online supplementary content. Randomized clinical trials should be primarily analyzed according to the intention-to-treat approach. Deviations from strict intention-to-treat analysis should be described as "modified intention-to-treat," with the modifications clearly described.

Statistical Analysis Subsection

At the end of the Methods section, briefly describe the statistical tests used for the analysis. State any a priori levels of significance and whether hypothesis tests were 1- or 2-sided. Also include the statistical software used to perform the analysis, including the version and manufacturer, along with any extension packages (eg, the svy suite of commands in Stata or the survival package in R). Do not describe software commands (eg, SAS proc mixed was used to fit a linear mixed-effects model). If analysis code is included, it should be placed in the online supplementary content.

Reporting Standards and Data Presentation

Analyses should follow EQUATOR Reporting Guidelines and be consistent with the protocol and statistical analysis plan, or described as post hoc.

When possible, present numerical results (eg, absolute numbers and/or rates) with appropriate indicators of uncertainty, such as confidence intervals. Include absolute numbers and/or rates with any ratio measures and avoid redundant reporting of relative data (eg, % increase or decrease). Use means and standard deviations (SDs) for normally distributed data and medians and ranges or interquartile ranges (IQRs) for data that are not normally distributed. Avoid solely reporting the results of statistical hypothesis testing, such as P values, which fail to convey important quantitative information. For most studies, P values should follow the reporting of comparisons of absolute numbers or rates and measures of uncertainty (eg, 0.8%, 95% CI −0.2% to 1.8%; P  = .13). P values should never be presented alone without the data that are being compared. If P values are reported, follow standard conventions for decimal places: for P values less than .001, report as " P <.001"; for P values between .001 and .01, report the value to the nearest thousandth; for P values greater than or equal to .01, report the value to the nearest hundredth; and for P values greater than .99, report as " P >.99." For studies with exponentially small P values (eg, genetic association studies), P values may be reported with exponents (eg, P  = 1×10 −5 ). In general, there is no need to present the values of test statistics (eg, F statistics or χ² results) and degrees of freedom when reporting results.

For secondary and subgroup analyses, there should be a description of how the potential for type I error due to multiple comparisons was handled, for example, by adjustment of the significance threshold. In the absence of some approach, these analyses should generally be described and interpreted as exploratory, as should all post hoc analyses.

For randomized trials using parallel-group design, there is no validity in conducting hypothesis tests regarding the distribution of baseline covariates between groups; by definition, these differences are due to chance. Because of this, tables of baseline participant characteristics should not include P values or statements of statistical comparisons among randomized groups. Instead, report clinically meaningful imbalances between groups, along with potential adjustments for those imbalances in multivariable models. To read more about statistical tests and data presentation, see the AMA Manual of Style .

Researchers are encouraged to report studies that include diverse and representative participants and to indicate participant inclusion and exclusion criteria and how the findings generalize to the population(s) that are the focus of or are compatible with the research question. Aggregate, deidentified demographic information (eg, age, sex, race and ethnicity, and socioeconomic indicators) should be reported for all research reports along all prespecified outcomes. Demographic variables collected for a specific study should be reported in the Methods section. Demographic information assessed should be reported in the Results section, either in the main article or in an online supplement or both. If any demographic characteristics that were collected are not reported, the reason should be stated. Summary demographic information (eg, baseline characteristics of study participants) should be reported in the first line of the Results section of Abstracts.

Reporting Age

Study inclusion or exclusion criteria by age or age group should be defined in the Methods section. Stratification by age groups should be based on relevance to disease, condition, or population (eg, <5 or >65 years). The ages for study participants should be reported in aggregate (ie, mean and SD or median and IQR or range) in the Results section.

Reporting Sex and Gender

The term sex should be used when reporting biological factors and gender should be used when reporting gender identity or psychosocial/cultural factors. The methods used to obtain information on sex, gender, or both (eg, self-reported, investigator observed or classified, or laboratory test) should be explained in the Methods section. 12 The distribution of study participants or samples should be reported in the Results section, including for studies of humans, tissues, cells, or animals. All participants should be reported, not just the category that represents the majority of the sample. Studies that address pregnancy should follow these recommendations, and if the gender identity of participants was not assessed, use the terms pregnant participants , pregnant individuals , pregnant patients , etc, as appropriate.

In research articles, follow recommendations to include all representative populations in study design, data analyses, results, and interpretation of findings. Report sex or gender of study participants, including how sex or gender was defined and assessed. Whenever possible, all main outcomes should be reported by sex or gender (or both if appropriate). In nonresearch reports, choose gender-neutral and sex-neutral terms that avoid bias, suit the material under discussion, and are not confusing to readers. See the Sex and Gender Equity in Research (SAGER) guidelines for additional guidance.

Reporting Race and Ethnicity

The Methods section should include an explanation of who identified participant race and ethnicity and the source of the classifications used (eg, self-report or selection, investigator observed, database, electronic health record, survey instrument).

If race and ethnicity categories were collected for a study, the reasons that these were assessed also should be described in the Methods section. If collection of data on race and ethnicity was required by the funding agency, that should be noted.

Specific racial and ethnic categories are preferred over collective terms, when possible. Authors should report the specific categories used in their studies and recognize that these categories will differ based on the databases or surveys used, the requirements of funders, and the geographic location of data collection or study participants. Categories included in groups labeled as "other" should be defined.

Categories should be listed in alphabetical order in text and tables.

Race and ethnicity of the study population should be reported in the Results section.

For additional information, see " Updated Guidance on Reporting Race and Ethnicity in Medical and Science Journals " and the Summary Guide for Preferred Terms When Reporting Race and Ethnicity .

For all manuscripts reporting data from studies involving human participants or animals, formal review and approval, or formal review and waiver, by an appropriate institutional review board or ethics committee is required and should be described in the Methods section. 2(p226) For those investigators who do not have formal ethics review committees, the principles outlined in the Declaration of Helsinki should be followed. 13 For investigations of humans, state in the Methods section the manner in which informed consent was obtained from the study participants (ie, oral or written) and whether participants received a stipend. Authors of research studies involving humans should not make independent determinations of exemption or exclusion of IRB or ethical review; they should cite the institutional or regulatory policy for that determination and indicate if the data are deidentified and publicly available or protected by prior consent or privacy safeguards. Editors may request that authors provide documentation of the formal review and recommendation from the institutional review board or ethics committee responsible for oversight of the study.

A signed statement of informed consent to publish patient descriptions, photographs, video, and pedigrees should be obtained from all persons (parents or legal guardians for minors) who can be identified (including by the patients themselves) i/n such written descriptions, photographs, or pedigrees and should be submitted with the manuscript and indicated in the Acknowledgment section of the manuscript. Such persons should be offered the opportunity to see the manuscript before its submission. 2(pp229-232)

Omitting data or making data less specific to deidentify patients is acceptable, but changing any such data is not acceptable. Only those details essential for understanding and interpreting a specific case report or case series should be provided. Although the degree of specificity needed will depend on the context of what is being reported, specific ages, race/ethnicity, and other sociodemographic details should be presented only if clinically or scientifically relevant and important. 2 Cropping of photographs to remove identifiable personal features that are not essential to the clinical message may be permitted as long as the photographs are not otherwise altered. Please do not submit masked photographs of patients. Patients' initials or other personal identifiers must not appear in an image.

Patient Permission Form:

The Patient Permission form for publication of identifying material is available here . Translated versions in Arabic, Chinese, French, German, Hindi, Italian, Japanese, Portuguese, and Spanish are available on request.

AI Used in Manuscript Preparation

When traditional and generative AI technologies are used to create, review, revise, or edit any of the content in a manuscript, authors should report in the Acknowledgment section the following:

• Name of the AI software platform, program, or tool
• Version and extension numbers
• Manufacturer
• Date(s) of use
• A brief description of how the AI was used and on what portions of the manuscript or content
• Confirmation that the author(s) take responsibility for the integrity of the content generated

Note this guidance does not apply to basic tools for checking grammar, spelling, references, and similar.

AI Used in Research

When AI (eg, large language model [LLM] or natural language processing [NLP], supervised or unsupervised machine learning [ML] for predictive/prescriptive or clustering tasks, chatbots, or similar other technologies) is used as part of a scientific study, authors should:

• Follow relevant reporting guidelines for specific study designs when they exist and report each recommended guideline element with sufficient detail to enable reproducibility.
• Avoid inclusion of identifiable patient information in text, tables, and figures.
• Be aware of copyright and intellectual property concerns.
• If content protected by copyright was entered into the AI model by authors, include a copy of the permission or license from the copyright owner and describe this permission/license in the Methods section.
• If content (text, images, multimedia) generated by AI is included in a submitted manuscript or supplemental material, indicate rights or permissions to publish that content as determined by the AI service or owner in the Methods section or in the legend(s) of any AI-generated figures or multimedia.

Also address the following:

Methods Section

• Include the study design and, if a relevant reporting guideline exists, indicate how it was followed, with sufficient detail to enable reproducibility.
• Describe how AI was used for specific aspects of the study (eg, to generate or refine study hypotheses, assist in the generation of a list of adjustment variables, create graphs to show visual relationships).
• For studies using LLMs, provide the name of the platform or program, tool, version, and manufacturer; specify dates and prompt(s) used and their sequence and any revisions to prompts in response to initial outputs.
• For studies reporting ML and algorithm development, include details about data sets used for development, training, and validation. Clearly state if algorithms were trained and tested only on previously collected or existing data sets or if the study includes prospective deployment. Include the ML model and describe the variables and outcome(s) and selection of the fine-tuning parameters. Describe any assumptions involved (eg, log linearity, proportionality) and how these assumptions were tested.
• Indicate the metric used to evaluate the performance of the algorithms, including bias, discrimination, calibration, reclassification, and others as appropriate.
• Indicate the methods used to address missing data.
• Indicate institutional review board/ethics review, approval, waiver, or exemption.
• Describe methods or analyses included to address and manage AI-related methodologic bias and inaccuracy of AI-generated content.
• Indicate, when appropriate, if sensitivity analyses were performed to explore the performance of the AI model in vulnerable or underrepresented subgroups.
• Provide a data sharing statement, including if code will be shared.

Results Section

• When reporting comparisons, provide performance assessments (eg, against standard of care), include effect sizes and measures of uncertainty (eg, 95% CIs) and other measurements such as likelihood ratios, and include information about performance errors, inaccurate or missing data, and sufficient detail for others to reproduce the findings.
• Report the results of analyses to address methodologic bias and population representation.
• If examples of generated text or content are included in tables or figures, be sure to indicate the source and licensing information, as noted above.

Discussion Section

• Discuss the potential for AI-related bias and what was done to identify and mitigate such bias.
• Discuss the potential for inaccuracy of AI-generated content and what was done to identify and manage this.
• Discuss generalizability of findings across populations and results of analyses performed to explore the performance of the AI model in vulnerable or underrepresented subgroups.

A signed statement of permission should be included from each individual identified as a source of information in a personal communication or as a source for unpublished data, and the date of communication and whether the communication was written or oral should be specified. 2(p199) Personal communications should not be included in the list of references but added to the text parenthetically.

Authors and reviewers are expected to notify editors if a manuscript could be considered to report dual use research of concern (ie, research that could be misused by others to pose a threat to public health and safety, agriculture, plants, animals, the environment, or material). 14 The editor in chief will evaluate manuscripts that report potential dual use research of concern and, if necessary, consult additional reviewers.

Journal Policies

Final decisions regarding manuscript publication are made by the editor in chief or a designated editor who does not have any relevant conflicts of interest. The journal has a formal recusal process in place to help manage potential conflicts of interest of editors. In the event that an editor has a conflict of interest with a submitted manuscript or with the authors, the manuscript, review, and editorial decisions are managed by another designated editor without a conflict of interest related to the manuscript.

All authors are required to complete and submit a Publishing Agreement that is part of the journal's electronic Authorship Form. In this agreement, authors will transfer copyright or a publication license; or indicate that they are employed by a federal government; or indicate that they are an employee of an institution that considers the work in the manuscript a work for hire, in which case an authorized representative of that institution will assign copyright or a publication license on the author's behalf.

Published articles become the permanent property of the American Medical Association (AMA) and may not be published elsewhere without written permission. Unauthorized use of the journal's name, logo, or any content for commercial purposes or to promote commercial goods and services (in any format, including print, video, audio, and digital) is not permitted by the JAMA Network or the AMA.

1. Cummings P, Rivara FP. Reporting statistical information in medical journal articles. Arch Pediatr Adolesc Med . 2003;157(4):321-324. doi:10.1001/archpedi.157.4.321

2. Iverson C, Christiansen S, Flanagin A, et al. AMA Manual of Style: A Guide for Authors and Editors . 11th ed. Oxford University Press; 2020. http://www.amamanualofstyle.com

3. Golub RM. Correspondence course: tips for getting a letter published in JAMA . JAMA . 2008;300(1):98-99. doi:10.1001/jama.300.1.98

4. International Committee of Medical Journal Editors. Recommendations for the conduct, reporting, editing, and publication of scholarly work in medical journals. Updated May 2023. Accessed May 18, 2023. http://www.icmje.org/recommendations/

5. Fontanarosa PB, Flanagin A, DeAngelis CD. Update on JAMA 's policy on release of information to the public. JAMA . 2008;300(13):1585-1587. doi:10.1001/jama.300.13.1585

6. Fontanarosa P, Bauchner H, Flanagin A. Authorship and team science. JAMA . 2017;318(24):2433-2437. doi:10.1001/jama.2017.19341

7. Fontanarosa PB, Flanagin A, DeAngelis CD. Reporting conflicts of interest, financial aspects of research, and role of sponsors in funded studies. JAMA . 2005;294(1):110-111. doi:10.1001/jama.294.1.110

8. DeAngelis CD, Drazen JM, Frizelle FA, et al; International Committee of Medical Journal Editors. Clinical trial registration: a statement from the International Committee of Medical Journal Editors. JAMA . 2004;292(11):1363-1364. doi:10.1001/jamainternmed.2014.6933

9. DeAngelis CD, Drazen JM, Frizelle FA, et al; International Committee of Medical Journal Editors. Is this clinical trial fully registered? a statement from the International Committee of Medical Journal Editors. JAMA . 2005;293(23):2927-2929. doi:10.1001/jama.293.23.jed50037

10. The CONSORT Group. The CONSORT statement. Updated 2014. Accessed September 23, 2016. http://www.consort-statement.org/consort-2010

11. American Association for Public Opinion Research. Best practices for survey research. Accessed March 23, 2023. https://aapor.org/standards-and-ethics/best-practices/

12. Clayton JA, Tannenbaum C. Reporting sex, gender, or both in clinical research? JAMA . 2016;316(18):1863-1864. doi:10.1001/jama.2016.16405

13. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA . 2013;310(20):2191-2194. doi:10.1001/jama.2013.281053

14. Journal Editors and Authors Group. Statement on scientific publication and security. Science . 2003;299(5610):1149. doi:10.1126/science.299.5610.1149 . Published correction appears in Science . 2003;299(5614):1845.

15. Christiansen S, Flanagin A. Correcting the medical literature: "to err is human, to correct divine." JAMA . 2017;318(9):804-805. doi:10.1001/jama.2017.11833

Last Updated: August 14, 2024

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• v.4(21); 2022 Nov 2

How to Write Your First Clinical Case Report

Do you remember when your first publication of a clinical case was? Most likely when you were a medical student or resident. Although the process for young authors is rewarding once the manuscript gets accepted, the writing and revision process can be exhausting. For some early career authors, it can be difficult to find a starting point. What is the main advice that the JACC: Case Reports editorial board can give you for publishing a clinical case? After having handled more than 9,000 submissions to the journal in the last 3 years, here is what we think.

Select the Journal of Submission and Look at the Literature

Before you submit your manuscript, carefully peruse the potential journals of submission and read the author instructions for those journals. It is important to ensure that the journal of submission is the right one for your work. Carefully considering journal selection will allow you to avoid disappointment if the journal’s audience is not the best fit for your clinical case. Journals will also vary in styles and format offerings, so the first step should always be to visit the instructions for that particular journal to ensure that one of the formats is appropriate for your case.

Furthermore, before you begin to write the case, perform a comprehensive literature search. Just because it is new to you does not mean that the findings or topics are novel in the context of the published literature. A manuscript also reflects your work as a clinician, so make sure that you submit a case that best reflects your clinical achievements.

Structure Your Report

Once you have selected the journal of submission, carefully reread the author instructions to structure your submission. The JACC: Case Reports authors instructions suggest a specific structure for a clinical case: history of presentation, physical examination, past medical history, differential diagnosis, investigations, management (medical/interventions), discussion, follow-up, conclusions, and learning objectives. For a clinical case, it is important to document the patient’s presentation and the physical examination. For example, in a patient with acute pulmonary embolism, it is important to document blood pressure, heart rate, and respiratory rate.

Another important component of the clinical case is the differential diagnosis, in which you should explain why you ended up with the final diagnosis. We do not wish to see a bullet point listing of possible diagnoses, but rather a narrative explanation of why you excluded other clinical issues. When you describe management, do not hesitate to describe any procedural complications. We learn from our mistakes, and a complication may be of great educational value for the medical community. When the JACC: Case Reports editorial board makes a call for procedural complications cases, we typically receive a decent number of malpractice cases. Therefore, make sure that you describe appropriate, guideline-directed clinical practice. Proper management can also a product of good mentorship, which I discuss later in this paper.

The Discussion section is crucial because it explains why your case merits publication. Why is it important to the medical community? Is it going to lead to further research that may eventually change clinical practice? Even if you did not follow clinical guidelines, this is important for us, because it is through clinical cases that we identify gaps in evidence that should be addressed.

Remember that there are also other formats for the journal, and you may choose a different format that better suits your case report.

Include High-Quality Imaging

The foundation of a clinical case is imaging, and this should reflect the high quality standards of the JACC family of journals. As an interactive journal with audiovisual multimedia, do not forget to upload complementary videos when relevant to the reader’s understanding of the case. Investigations such as echocardiograms and angiograms are crucial for the management of the patient and should be included. Remember to remove any patient identifying or institutional information from figures and videos, detach background noise from videos, and upload the original mp4 file from your institution’s system. Video recordings of echocardiograms and angiography from your cell phone may detract from the quality of the videos.

Request Senior Supervision as You Write and Revise Your Submission

Many submissions to the journal are rejected without review because of a lack of interest for the journal’s readership or a lack of sufficient novelty. However, rejection may often occur because the clinical case is poorly written if the junior author had not received oversight from the senior colleagues who are acknowledged in the manuscript. This is a learning process for junior authors: send it to your peers/senior coauthors with a deadline for comments, include those who have worked on the patient, and make sure that every author has read the manuscript and consented to the final version of submission. This is teamwork.

For early career authors, we are proud to have started the JACC: Case Reports Reviewer Mentoring Program, which aims to teach colleagues about the art of peer review, the publication process, and writing good cases and original research manuscripts. If you are interested, stay tuned for communications from the American College of Cardiology education team to apply to the next iteration of the program in 2023.

Be Respectful in the Communications Surrounding Your Manuscript

It is respectful (and helpful) to the journal’s editors to provide a cover letter explaining why you feel that your clinical case merits publication. The cover letter can also include information about how the case might be accepted for presentation at an upcoming scientific meeting, requests for expedited review, or details about conflicts of interest.

Be careful to correctly write the name of the Editor-in-Chief. Personally, I often see my name being written Graspa rather than Grapsa. It is the legacy of my father—Greek and the surname means “writer.” Although we never reject a manuscript because an Editor-in-Chief’s surname is wrong or misspelled, this can hold up the processing of your paper and leave an impression on the editors that the authors did not take time and care to prepare all manuscript materials.

Furthermore, even though social media is commonly used in the medical community to discuss publications, this is not the proper channel for authors to submit a presubmission query. Messaging the editors on social media is unfair to the other authors who choose to submit their work for peer review. Addressing queries from authors on social media would also be unfair to the authors, because our decisions are group-led through our weekly editorial board meetings, and those messages are unsecure because they are housed on social media platforms. All presubmission queries should be sent to the Editorial Office ( [email protected] ), and staff members will triage any questions or issues to the editors.

We always ask our editors, reviewers, editorialists, and staff to be respectful in communications surrounding your manuscript. We make every effort to provide constructive feedback, even if the manuscript is rejected. With that in mind, we request that authors are also respectful of our editors, reviewers, editorialists, and all those working in the Editorial Office.

Be Persistent: Do Not Get Disappointed or Discouraged

Even if your clinical case is rejected, it may not necessarily have been because of quality. It is possible there were reasons it did not reach priority for publication in that particular journal. For example, many other cases on that topic may already have been accepted/published. If the case has been accepted with revision after peer review, try to address the editors’ and reviewers’ comments and resubmit as soon as possible. A clinical case can easily get outdated if the authors delay submitting a revised version, particularly because of novelty concerns. If your case is rejected, do not get disappointed or discouraged. You may submit your case to another journal with a better outcome. Remember that we learn from a rejection letter, particularly if there are constructive comments included in the letter, and every positive or negative answer is an opportunity for us to grow.

Submit Your Case: The Sky Is the Limit

As a last message, to all of the young authors who are trying to get their clinical cases published, remember that the “sky is the limit”—be creative, find a good mentor, and write up an interesting case. Once your manuscript is accepted, it is just the beginning of your academic career.

At JACC: Case Reports , we are always willing to help you through the submission process. Please send any presubmission queries to the Editorial Office: [email protected] . Furthermore, you may wish to watch the video featuring JACC: Case Reports Deputy Editor, Dr Mary Walsh, and Associate Editor, Dr David, discussing tips and tricks for how to write a successful clinical case.

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There are multiple parts of a cover letter but for the purposes of this article, I am going to focus on an approach for writing the body of your cover letter. The body of your letter should typically be between one and three paragraphs. To write the body, or middle part of your letter, review the recruiters’ wish list, better known as the job qualifications and skills requirements. Now, think of yourself as being on trial and needing to provide evidence. After reviewing the required skills, explain how you have what they need. Let’s take one example.

The employer needs a candidate with excellent communication skills. Now think of yourself as being on trial and needing to provide evidence that you have excellent communication skills. Here is an example of a claim backed up by evidence:

By working with clients in one-on-one settings, training new hires, and presenting at national case competitions, I continue to strengthen my communication, interpersonal, and public speaking skills.

You may dedicate one paragraph to each required skill or weave all the skills you want to mention into one paragraph. Be sure to match paragraphs with skills the employer needs. You should not go on about your communication skills when the employer needs someone with strong analytical skills. Give your audience what it wants. That means tailoring, and tailoring messages takes time.

Employers spend time and money to advertise a position. Employers think through and communicate to potential applicants what they want and need in the candidate. You do not have to possess every skill or requirement on the employer’s wish list. Just like Santa Claus does not bring you everything on your wish list, employers rarely find a candidate that is a 100% match.

Let’s say I want to hire someone with problem solving skills. I could hire someone with a degree in math, philosophy or English. Each candidate should explain to me how they solve problems. One candidate will use numbers, another will use logic, and the other will use writing to work through problems. If I need a problem solver, the method of problem solving is less important to me than the skill of exceptional problem solving.

Cover letters highlight skills. Your resume lists what you have accomplished or your results. The cover letter is where you explain how you will use what you have already done, to transition or take on the challenge of a new role.

For example, your resume may indicate that you: “ Reduced lead time by 25% in one quarter by implementing a tactical performance scorecard for the company’s three largest suppliers. ”

What skills did you further develop or enhance during that project? Time-management? Attention-to-detail? Analytical skills? Those skills that you highlight in a cover letter distinguish the cover letter from the resume.

How much time you spend on your cover letter depends on how varied the roles are for which you are applying. It is helpful to keep all of your paragraphs in a master cover letter document so you can handpick skills to accentuate based on previous letters you have drafted.

Networking Tip

How formal the culture is at the company you are applying to will also help you determine how you write your cover letter. Networking with alumni in the company pays off when you need to learn about the company culture and work environment.

Consider who you are writing to – an HR generalist or the functional expert? If you are writing to an HR generalist, refrain from getting overly technical. If you are writing to a functional expert, show off your technical know-how.

Remember, your resume gets a recruiter’s attention. Your cover letter gets you invited to interview.