Type my medicine case study

A Trial of Darbepoetin Alfa in Type 2 If your institution subscribes to this resource, and you don't have a My Access Profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus. Methods. In this study involving 4038 patients with diabetes, chronic kidney disease, and anemia, we randomly assned 2012 patients to darbepoetin alfa to achieve a.

Type 2 Diabetes Mellitus Practice Redberg, MD, MSc, Editor, University of California, San Francisco, Department of Medicine, Division of Cardiology, 505 Parnassus Ave, Ste M1180, Box 0124, San Francisco, CA 94143-0124; telephone: (415) 476-3117; fax: (866) 465-1761; email: [email protected] Clinical trial Meta-analysis Intervention study Cohort study Case-control study Epidemiologic assessment Survey with hh response rate Cost-effectiveness analysis Decision analysis Study of screening and diagnostic tests Other observational study Any research project that prospectively assns human participants to intervention or comparison s to study the cause-and-effect relationship between an intervention and a health outcome. All clinical trials must be registered at an appropriate online public registry. Interventions include but are not limited to drugs, surgical procedures, devices, behavioral treatments, process-of-care changes, and the like. 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 que for quantitatively combining the results of multiple studies that measure the same outcome into a single pooled or summary estimate. 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 Orinal Investations (see Meta-analysis). A complete systematic review of the last 5 years of published literature focusing on the latest information about management of diseases and conditions, emphasizing what is new; typiy written by senior experts in the field. These reviews should address a specific question or issue that is relevant for clinical practice. Up-to-date review for clinicians on a topic of general common interest from the perspective of internationally recognized experts in these disciplines. The focus should be an update on current understanding of the physiology of the disease or condition, diagnostic consideration, and treatment. These reviews should address a specific question or issue that is relevant for clinical practice. This journal publishes very few of these types of articles and may require a presubmission inquiry. 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. For trainees at all levels to submit articles that bring attention to the harms that can result from medical overuse and from underuse of needed medical interventions to promote appropriate medical care. Presentation of patients' and physicians' perspectives on their health care experiences, with special emphasis on examples when more care is not always better, even to the point where it is perceived as harmful. These reports typiy include randomized trials (see Clinical Trial), intervention studies, cohort studies, case-control studies, epidemiologic assessments, other observational studies, surveys with hh 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). Each manuscript should clearly state an objective or hypothesis; the desn 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; 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 orinal and should be as timely and current as possible (see Timeliness of Data). A structured abstract is required; for more information, see instructions for preparing Abstracts for Reports of Orinal 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, fures, acknowledgments, references, and online-only material) with no more than a total of 5 tables and/or fures. Back to top The ICMJE defines a clinical trial as any research project that prospectively assns human participants to intervention or comparison s 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, 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 a copy of the trial protocol including the complete statistical analysis plan (see Protocols), a CONSORT flow diagram (Fure), and a completed CONSORT checklist. All clinical trials must be registered at an appropriate online public registry (see Trial Registration requirements). For additional guidance on preparing manuscripts reporting cluster trials, noninferiority and equivalence trials, and pragmatic trials, see Extensions of the CONSORT Statement. Each manuscript should clearly state an objective or hypothesis; the desn 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 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. 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 Orinal 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, fures, acknowledgments, references, and online-only material) with no more than a total of 5 tables and/or fures. The subtitle should include the phrase "A Randomized Clinical Trial" as relevant. Back to top 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 que 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 systematiy for inclusion and critiy 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. 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: 3500 words of text (not including abstract, tables, fures, acknowledgments, references, and online-only material), with no more than a total of 4 tables and/or fures and no more than 50-75 references. The subtitle should include the phrase "A Meta-analysis." Back to top Research Letters are concise, focused reports of orinal research. 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. These should not exceed 600 words of text and 6 references and may include up to 2 tables or fures. 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, but otherwise should follow all of the guidelines in Manuscript Preparation and Submission Requirements. Letters not meeting these specifications are generally not considered. These types of Review articles differ by the scope and level of analysis of the literature searches and the titles used. Systematic Reviews require a complete systematic search of the literature using multiple databases, covering many years, and grading of the quality of the cited evidence. Advances in Diagnosis and Treatment also require a complete systematic search of the literature, but only of the last 5 years of published literature. An assessment of quality of the evidence is not required but is recommended. Narrative Reviews do not require a rorous literature search but should rely on evidence and should be written by established experts in the field. 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: 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 Orinal Investations (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. 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). Maximum length: 3500 words of text (not including abstract, tables, fures, acknowledgments, references, and online-only material), with no more than a total of 5 tables and/or fures and no more than 50-75 references. Example Question: What are the most effective medical treatments for adult chronic sinusitis? For an example of a published Systematic Review, see Key Points (75-100 words) This feature provides a quick structured synopsis of the Review, following 3 key points: Question, Findings, and Meaning. Findings: In this systematic review, symptoms of chronic sinusitis were improved with saline irration 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 irration; subsequent therapies should be based on the patient's polyp status and severity of symptoms. 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 hhest-quality evidence available receiving the greatest emphasis. 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. Back to top 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 orinal cohort). Back to top 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, Pub Med/MEDLINE, Embase, CINA, Psyc INFO). 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 hhest-quality evidence (eg, randomized clinical trials, meta-analyses, systematic reviews, and hh-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. Back to top 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. 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. 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. 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. Treatments should be based on the most recently available and hhest 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 hh-quality review or guideline. If possible, the costs for various treatments should be provided. 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. 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. Construct tables that summarize the search results. 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. Additional or lengthy tables may be published online only, if justified. 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. Fures 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, elible, and included in the final review. Advances in Diagnosis and Treatment Reviews provide the latest information about management of diseases and conditions, emphasizing what is new, and are typiy written by senior experts in the field. Advances in Diagnosis and Treatment Reviews require a complete systematic review of the last 5 years of published literature. If necessary to document advances, the review can include more than the last 5 years and this should be explained. An evaluation of the quality of evidence is recommended but not required. Advances in Diagnosis and Treatment Reviews should address a specific question or issue that is relevant for clinical practice and provide an evidence-based, balanced, patient-oriented current review on a focused topic. The basic structure of manuscripts reporting Advances in Diagnosis and Treatment 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 subsections Advances in Diagnosis and Advances in Treatment); Discussion (1000 words); and Conclusions (2-3 sentences). Maximum length: 3500 words of text (not including abstract, tables, fures, acknowledgments, references, and online-only material), with no more than a total of 5 tables and/or fures and no more than 50-75 references. Example Question: What advances in diagnosis, prevention, and management of diabetes have been introduced in the last 5 years? For an example of this type of article, see Back to top Key Points (75-100 words) This feature provides a quick structured synopsis of the Advances in Diagnosis and Treatment Review, following 3 key points: Question, Findings, and Meaning. Findings: The diabetes epidemic is secondary to the hh prevalence of overweht and obesity contributing to the development of type 2 diabetes and resulting in severe morbidity and mortality; research shows that reducing the burden of microvascular and cardiovascular disease has been effective in management of diabetes. Meaning: Improved glycemic control, better management of risk factors for the complications of diabetes, and more effective treatment of cardiovascular disease and microvascular complications have resulted in a more optimistic outlook for people with diabetes. Importance: Include 1 or 2 sentences describing the clinical question or issue, and explain the reason an update of recent advances in diagnosis and treatment is needed. Objective: State the precise primary objective of the review and indicate the aspects of diagnosis and treatment that are being reviewed. Evidence Review: Describe the information sources used, including the search strategies, years searched (limit to the last 5 years, unless otherwise justified), other sources of material, such as subsequent reference searches of retrieved articles, and criteria used for inclusion of identified articles. If a quality assessment is included, explain the methods used for quality assessment of the evidence. 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 summarizing the advances in diagnosis and the advances in treatment in an evidence-based, objective, and balanced fashion, with the hhest-quality evidence receiving the greatest emphasis. Conclusions and Relevance: The conclusions should emphasize the major advances in diagnosis and treatment, be based on evidence reported in the abstract findings subsection, and mention how these advances should be applied in clinical practice. Back to top Introduction (150-250 words) The first 2-3 sentences of the Introduction should draw in readers in such that they want to continue reading the article and should establish the importance of the Review. The clinical question or issue and its importance for general medical practice, specialty practice, or public health should be clearly indicated, and the reasons for providing an update in diagnosis and treatment should be described. The first paragraph should provide a general summary of the clinical issue (eg, obesity), with a brief summary of the current epidemiology of the disease. The next paragraph should focus on the specific advances in diagnosis and treatment the article will explore (eg, advances in surgical treatments for obesity). The third paragraph should discuss what material will be covered in the Review (eg, outcomes of novel surgical treatments reported in trials with a minimum follow-up of 2 years including 80% of the orinal cohort). Back to top 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 and should be limited to the last 5 years. A search of the primary literature should be conducted, including multiple bibliographic databases (eg, Pub Med/MEDLINE, Embase, CINA, Psyc INFO). 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 search methods should be described in sufficient detail such that 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. The hhest-quality evidence (eg, randomized clinical trials, meta-analyses, systematic reviews, and hh-quality prospective cohort studies) should receive the greatest emphasis. An evaluation of the quality of evidence is recommended but not required. If a quality assessment is included, the rating system used to evaluate the evidence (see table below) should be specified 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. Clinical practice guidelines ordinarily should not be used as a primary component of the evidence base for the Advances in Diagnosis and Treatment Reviews, although relevant current guidelines should be addressed in the Discussion section of the article. Back to top 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, if the quality of evidence was assessed, provide a brief summary of the quality of the evidence. Details of this information can be included in a PRISMA-style flow diagram (in an online supplement) and table(s) as needed. The Results sections of Advances in Diagnosis and Treatment Reviews should include specific sections (Advances in Diagnosis, Advances in Treatment) summarizing the latest information in the areas related to diagnostic and therapeutic advances. Other sections, such as new information relevant to pathophysiology, clinical presentation, or prognosis, may be included, depending of the clinical topic or issue. Overall the Results section should include 1000-1250 words. Describe advances in clinical assessment, laboratory testing, imaging studies, or other diagnostic procedures, including clinical utility and application of these advances. For laboratory or imaging studies, provide the sensitivity and specificity and diagnostic accuracy of these tests and consider providing likelihood ratios. Sequences of novel diagnostic tests may be presented in a table or as an element of a proposed diagnostic algorithm. Comparison of the advances in diagnosis with previously established diagnostic approaches may be discussed. If possible, the costs of the advances in diagnostic approaches should be included. Advances in treatment should be based on the most recently available and hhest 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, if an assessment of study quality was performed. Comparison of the advances in treatment with previously established treatments may be discussed. If possible, the costs for the advances in treatment should be provided. Discussion (Approximately 1000 words) The key findings of the review, hhting the advances in diagnosis and treatment, should be summarized in the first paragraph of the Discussion section. All statements made should be supported by evidence. The Discussion should provide a critical synthesis of data and information based on the results of the review and how the advances in diagnosis and treatment can be interpreted and used to guide clinical practice. The limitations of the evidence and of the review should be discussed, gaps in evidence should be addressed, and advantages and caveats related to the advances in diagnosis and treatment, compared with established diagnostic and therapeutic approaches, may be included. A discussion of controversial or unresolved issues and topics in need of future research also should be included. In the Discussion section, also describe current clinical practice guidelines, relevant to the advances in diagnosis and therapy addressed in 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. Back to top Tables Construct tables that summarize the epidemiology, advances in diagnostic approaches, and advances in therapies available for the disease during the last 5 years. In some cases, all 3 topics may not all be relevant to the review topic and tables may be appropriately modified to fit the review. If appropriate, include a fourth table that compares the findings of the review and current clinical practice recommendations or diagnostic and therapeutic uncertainty or controversies. Table 1: Major epidemiologic and burden of disease facts Table 2: Major diagnostic tools available Table 3: Major therapies available Table 4: Current clinical practice recommendations and/or diagnostic and therapeutic uncertainty, and controversies 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. Additional or lengthy tables may be published online only, if justified. If a quality assessment of the evidence was performed, 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. Back to top Fures A PRISMA-style flow diagram should be included that summarizes the results of the literature search and the numbers of articles/records/studies and patients/participants represented in the studies identified, screened, elible, and included as an online-only supplement. Additional fures 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 Fures and Video. Narrative Reviews on clinical topics provide an up-to-date review for clinicians on a topic of general common interest from the perspective of internationally recognized experts in these disciplines. The focus of Narrative Reviews will be an update on current understanding of the physiology of the disease or condition, diagnostic consideration, and treatment. These reviews should address a specific question or issue that is relevant for clinical practice. Narrative Reviews do not require (but may include) a systematic review of the literature search. Recommendations should be supported with evidence and should rely on recent systematic reviews and guidelines, if available, emphasizing factors such as cause, diagnosis, prognosis, therapy, or prevention. The basic structure of manuscripts reporting Narrative Reviews should include the following: Abstract (structured abstract of no more than 300 words); Introduction (150-250 words); Methods, if included (150-250 words); Discussion/Observations (1000-1250 words, with the following subsections, if appropriate: Pathophysiology, Clinical Presentation, Assessment and Diagnosis, Treatment, and Prognosis); and Conclusions (2-3 sentences). Typical length: 2000-3500 words (maximum), with no more than a total of 5 tables and/or fures, and no more than 50-75 references. For an example of this type of article, see 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 cliniy relevant should be specifiy stated. Back to top Introduction (150-250 words) The first 2 to 3 sentences of the Introduction should draw in readers in 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). This information should include disease prevalence and incidence and perhaps discussion of the presence and frequency of any relevant subpopulations and any geographic or seasonal variations of the disease if these are relevant. The third paragraph should discuss exactly what material will be covered in the Review (eg, obesity treatments). Back to top Methods (150-250 words) A Methods section is not required for Narrative Reviews, but may be included to summarize a literature search that was conducted for this Review. If included, briefly describe the characteristics of the literature searched and included in the review, including the bibliographic databases and other sources searched, search terms used, dates included in the search, date the literature search was conducted, and any process used to evaluate the literature. Discussion/Observations (1000-1250 words) The principal observations of the Narrative Review generally should include the subsections listed below, although each section may not be necessary for some topics. The word counts following each subsection are suggested to assist with keeping the overall Observations section limited to 1000-1250 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. 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 physician to evaluate or treat it. 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. Treatments should be based on the most recently available and hhest 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 or a hh-quality guideline. If possible, the costs for various treatments should be provided. A section outlining the overall prognosis for the condition, once treated, should be included. Tables For most Narrative Reviews, tables should be included that summarize the epidemiology, diagnostic tools, and therapies available for the disease. In some cases, these 3 topics may not all be relevant to the review topic and tables may be appropriately modified to fit the review. Include a fourth table that compares the findings of the review and current clinical practice recommendations or diagnostic and therapeutic uncertainty or controversies. Table 1: Major epidemiologic and burden of disease facts Table 2: Major diagnostic tools available Table 3: Major therapies available Table 4: Current clinical practice recommendations and/or diagnostic and therapeutic uncertainty, and controversies Tables summarizing treatments should have information organized by category of treatment and then by individual treatments. Columns may include the treatment, strength of evidence supporting the treatment, the effect of the treatment (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 explanatory comments, if necessary. Additional or lengthy tables may be published online only, if justified. Follow additional instructions for preparation and submission of Tables. Fures that illustrate pathophysiology or clinical presentation may be included. We encourage videos, if appropriate, to illustrate a point made or process described in the Review. Follow additional instructions for preparation and submission of Fures and Video. 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. Depending on the content, either a structured abstract or unstructured abstract is required. Maximum length: 3000 words of text (not including tables, fures, or references) with no more than a total of 4 tables and/or fures and no more than 50 references. For a recently published example, see Back to top These peer-reviewed articles demonstrate challenges and pitfalls in electrocardiography (ECG) interpretation for practitioners in the office, hospital, and prehospital setting. Examples include misinterpreted ECG findings, artifacts, limitations of computer interpretations, and controversies. The goal is educational, and the focus is on presentations and findings that represent a risk of potential misdiagnosis or treatment. Each submission should include a brief text introduction, 1 ECG image, 1 or 2 pertinent questions, and an anonymized case discussion and patient course, if applicable. Maximum specifications: 1000 words, consisting of no more than 200 words for the case presentation and no more than 800 words for the case discussion and patient course, if applicable; 5 bulleted summary points; no more than 10 references; no more than 3 authors. Labels should be added to electronic images only on a separate layer or by importing into applications such as Word, Power Point, or Illustrator; however, orinal image files must also be submitted. (For additional information, see Fures.) Back to top These articles, which require a presubmission inquiry, aim to make hh-quality evidence reports accessible to clinicians and to describe the impact of the findings on clinical care. Evidence to Practice manuscripts should be focused, brief, and organized under the following headings: Source of Review, Background, Summary of Findings, Limitations on the Evidence, Conclusions, References. Maximum specifications: 3 authors; 1000 words of text with no more than 1 table and/or fure; 1200 words of text if no table or fure; and no more than 7 references. In general, inclusion of 1 table or fure is preferred. Back to top The Teachable Moment series is desned to encourage trainees at all levels to submit articles that bring attention to the harms that can result from medical overuse and from underuse of needed medical interventions. Teachable Moment manuscripts should present an illustrative case of inappropriate underuse or overuse of medical care that resulted in harm. Our series aims to educate clinicians about the harms of over and underuse of care in everyday practice. Given this, we prefer more common cases rather than "case reports" of very rare conditions. Each Teachable Moment manuscript should include a clinical vnette headed "Story From the Front Lines" (an engaging story with enough clinical information for readers to understand the clinical issues) and a summary of the clinical issues headed "Teachable Moment" (a succinct summary of the clinical issues, stating the evidence for over-testing or under-testing or treatment and suggesting an alternative approach). The manuscript should be given a title that reflects the specific focus. The first author must be a trainee (professional student, intern, resident, fellow, masters or doctoral student, or postdoctoral student). Please describe the level of training of the first author at the time the manuscript was prepared and the role of the trainee in preparing, drafting, and revising the article. Manuscripts should not exceed 800 words and 5 references, and should have a maximum of 3 authors. A sned Patient Permission form must be included at the time of initial submission. A sned statement of informed consent to publish (in print and online) patient descriptions, photographs, video, and pedrees should be obtained from all persons (parents or legal guardians for minors) who can be identified (including by the patients themselves) in such written descriptions, photographs, video, or pedrees and should be submitted with the manuscript and indicated in the Acknowledgment section. Such persons should be offered the opportunity to see the manuscript before submission. Omitting data or making data less specific to deidentify patients is acceptable, but changing any such data or names 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 cliniy or scientifiy relevant and important. 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 may not appear in an image. These papers may address virtually any important topic in 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. 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 fure—and no more than 7 references. Viewpoints not meeting these guidelines will not be considered. " articles present patients' and physicians' perspectives on their health care experiences, with special emphasis on examples when more care is not always better, even to the point where it is perceived as harmful. Maximum specifications: up to 1200 words of text-or 1000 words with 1 small table and/or fure (excluding title, byline, and references); no more than 7 references; up to 3 authors. For more information on patient identifiability, see Teachable Moments. Back to top The journal welcomes the submission of images from members of the health care community that have special snificance to them and that would be of interest and relevance to our readers. Each image should carry with it a short, descriptive caption. We limit submissions to 8 per calendar year and no more than 4 in any one month. Each submission requires a completed Permission to Reproduce Copyrht-Protected Photographs for Publication. 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. 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 orinal 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. 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 sample Authorship Form). See other details in these instructions for additional requirements. Back to top 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 or submitted any related papers from the same study (see Previous Release of Information, Embargo, and Access). Back to top Include in the manuscript file a title page, abstract, text, references, and as appropriate, fure legends and tables. Start each of these sections on a new page, numbered consecutively, beginning with the title page. Fures should be submitted as separate files (1 file per fure) and not included in the manuscript text. Back to top For submission and review, please submit the manuscript as a Word document. Use 10-, 11-, or 12-point font size, double-space text, and leave rht margins unjustified (ragged). Back to top The title page should be the first page of your manuscript file. It should include a manuscript title; the full names, hhest 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 fure legends). Please limit the length of titles to 150 characters for reports of research and other major articles and 100 characters for Editorials, Viewpoints, Commentaries, and Letters. 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). Report basic numbers only but state if results are statistiy snificant or not snificant; do not include results of statistical tests or measures of variance (see example below). Meaning: Key conclusion and implication based on the primary finding(s). Example of Research Article Question: What is the immunogenicity of an inactivated influenza A vaccine with and without adjuvant? For reports of other types of research, do not include study type or desn in the title or subtitle. Include the desn (eg, clinical trial, cohort study, case-control study, meta-analysis). 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 snificant difference. 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. Question: Focused question based on the study hypothesis or goal/purpose. Meaning: In an influenza pandemic the use of an adjuvant with inactivated influenza A vaccine may be warranted. 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 irration 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 irration; subsequent therapies should be based on the patient's polyp status and severity of symptoms. Back to top Include a structured abstract for reports of orinal 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. Reports of orinal 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. Desn: Describe the basic desn 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 ings, 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 elibility criteria, and key sociodemographic features of patients (or other study participants). The numbers of elible 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 elible 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 s, 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 "Desn, 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) 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. 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 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. Back to top 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 desns. 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 (such as criteria for causal inference and whether data were pooled using a fixed-effect or random-effects model). The method by which the guidelines were applied should be stated (for example, independent extraction by multiple observers). 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. 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 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. 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 hhest-quality evidence available receiving the greatest emphasis. 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. 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 cliniy relevant should be specifiy stated. Back to top 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 fures, 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 Back to top 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 Gen Bank, and a complete accession number (and version number if appropriate) must be provided in the Methods section or Acknowledgment of the manuscript. Please verify that all information and materials in the manuscript are orinal. The journal generally does not republish text, tables, fures, 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 Copyrht-Protected Material Form. Back to top 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 Pub Med. 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: In the Methods section, describe statistical methods with enough detail to enable a knowledgeable reader with access to the orinal data to reproduce the reported results. Such description should include appropriate references to the orinal 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 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 noncal uses of cal terms in statistics, such as correlation, normal, predictor, random, sample, snificant, trend. Do not use inappropriate hedge terms such as marginal snificance or trend toward snificance for results that are not statistiy snificant. For observational studies, methods and results should be described in terms of association or correlation and should avoid cause-and-effect wording. Randomized trials may use terms such as effect and causal relationship. Back to top 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. Back to top 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). Back to top 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). 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. Back to top 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. Back to top Both randomized and observational studies should identify the primary outcome(s) before the study began, as well as any prespecified secondary, sub, 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 (see Reporting Clinical Trials). 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. Back to top At the end of the Methods section, briefly describe the statistical tests used for the analysis. State the level of snificance 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. Back to top 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. 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 ). 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 sub 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 snificance 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- desn, there is no validity in conducting hypothesis tests regarding the distribution of baseline covariates between s; by definition, these differences are due to chance. Because of this, tables of baseline participant characteristics should not include values or statements of statistical comparisons among randomized s. Instead, report cliniy meaningful imbalances between s, along with potential adjustments for those imbalances in multivariable models. Back to top Restrict tables and fures 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 fure and provide a descriptive title for each. Every table and fure should have an in-text citation. (%)," not as percentages alone (exception, sample sizes exceeding ~10,000). Verify that data are consistently reported across text, tables, fures, and supplementary material. 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. 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 graphiy in fures. Provide the unadjusted and adjusted results for the primary exposure(s) or comparison(s) of interest. Pie charts and 3-D graphs should not be used and should be revised to alternative graph types. If a more detailed description of the model is required, consider providing the additional unadjusted and adjusted results in supplementary tables. 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 included in the analysis at intervals along the x-axis scale. For any fures 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 fure legend. Units of measure must be provided for continuous data. Note: All fures are re-created by journal graphics experts according to reporting standards using The JAMA Network style guide and color palette. Back to top 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. Each piece of data needs to be contained in its own cell. Do not try to aln cells with hard returns or tabs; alnment will be imposed in the production system if the paper is accepted. Although individual empty cells are acceptable in a table, be sure there are no empty columns. 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: 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 If a table must be continued, repeat the title and column headings on the second page, followed by "(continued)." Back to top 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 totals or percentages do not add to 100%. For more detail on the components and recommended structure of tables, see the Number all fures (graphs, charts, photographs, and illustrations) in the order of their citation in the text. Avoid complex composite or multipart fures unless justified. See Categories of Articles for limits on the number of fures and/or tables according to article type. For initial manuscript submissions, fures 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 fures that meet the requirements described in Fure File Requirements for Publication. Graphs, charts, some illustrations, titles, legends, keys, and other elements related to fures in accepted manuscripts will be re-created and edited according to JAMA Network style and standards prior to publication. Online-only fures will not be edited or re-created (see Online-Only Supplements and Multimedia). Back to top Preparation of scientific images (clinical images, radiographic images, micrographs, gels, etc) for publication must preserve the integrity of the image data. Dital adjustments of brhtness, contrast, or color applied uniformly to an entire image are permissible as long as these adjustments do not selectively hht, misrepresent, obscure, or eliminate specific elements in the orinal fure, 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. When inappropriate image adjustments are detected by the journal staff, authors will be asked for an explanation and will be requested to submit the image as orinally captured prior to any adjustment, cropping, or labeling. Authors may be asked to resubmit the image prepared in accordance with the above standards. Back to top Each fure for the main article may be uploaded as a separate file or appended to the end of the manuscript with the fure titles and legends. Online-only fures 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 fure for the main article as a separate file and follow the instructions in Fure File Requirements for Publication. See the Table of Fure Requirements for additional guidance for specific types of fures for suggested resolution and file formats. In general each fure should be no larger than 1 MB. Back to top Each fure for the main article must be uploaded as a separate file. Online-only fures must be combined into the PDF of the online-only supplement (see Online-Only Supplements and Multimedia). See the Table of Fure Requirements for additional guidance and file formats for specific types of fures. Files created by vector programs are best for accurately plotting and maintaining data points. The JAMA Network journals are unable to use file formats native to statistical software applications to prepare fures for publication; most statistical software programs allow users to save or export files in dital vector formats. Images created ditally (by dital camera or electroniy created illustrations) must meet the minimum resolution requirements at the time of creation. Electroniy 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 s 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. Back to top At the end of the manuscript, include a title for each fure. The fure title should be a brief descriptive phrase, preferably no longer than 10 to 15 words. A fure legend (caption) can be used for a brief explanation of the fure or markers if needed and expansion of abbreviations. For photomicrographs, include the type of specimen, orinal magnification or a scale bar, and stain in the legend. For gross pathology specimens, label any rulers with unit of measure. Ditally enhanced images must be clearly identified in the fure legends as enhanced or manipulated, eg, computed tomographic scans, magnetic resonance images, photographs, photomicrographs, x-ray films. Back to top 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 fure legend. The Fure field in the File Description tab of the manuscript submission system allows for uploading of 2 versions of the same fure. 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). To present frequency data (numbers or percentages). Bar graphs are typiy 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, Acceptable File Formats for Revision and Publication: .ai, .emf, .eps, .pdf, .wmf, 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. Acceptable File Formats for Initial Submission: .ai, .bmp, .docx, .emf, .eps, .jpg, .pdf, .ppt, .psd, .tif, .wmf, Acceptable File Formats for Revision and Publication: .ai, .emf, .eps, .pdf, .wmf, To show participant recruitment and follow-up or inclusions and exclusions (such as in a systematic review). Follow EQUATOR Reporting Guidelines Acceptable File Formats for Initial Submission: .ai, .docx, .emf, .eps, .jpg, .pdf, Acceptable File Formats for Revision and Publication: .ai, .docx, .emf, .eps, 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. Acceptable File Formats for Initial Submission: .ai, .bmp, .docx, .emf, .eps, .jpg, .pdf, .ppt, .psd, .tif, .wmf, Acceptable File Formats for Revision and Publication: .ai, .emf, .eps, .pdf, .wmf, To show data distribution from 1 or more s, particularly aggregate/summary data. Each element should be described (the ends of the boxes, the middle line, and the whiskers). Outlier data are typiy shown as circles plotted beyond the whiskers. Acceptable File Formats for Initial Submission: .ai, .bmp, .docx, .emf, .eps, .jpg, .pdf, .ppt, .psd, .tif, .wmf, Acceptable File Formats for Revision and Publication: .ai, .emf, .eps, .pdf, .wmf, To illustrate summary data, particularly in meta-analyses and systematic reviews. The data are presented both tabularly and graphiy. 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). Typiy, proportionally sized boxes represent the weht of each study and a diamond shows the overall effect at the bottom of the plot. Acceptable File Formats for Initial Submission: .ai, .bmp, .docx, .emf, .eps, .jpg, .pdf, .ppt, .psd, .tif, .wmf, Acceptable File Formats for Revision and Publication: .ai, .emf, .eps, .pdf, .wmf, 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 desnate variability. Acceptable File Formats for Initial Submission: .ai, .bmp, .docx, .emf, .eps, .jpg, .pdf, .ppt, .psd, .tif, .wmf, Acceptable File Formats for Revision and Publication: .ai, .emf, .eps, .pdf, .wmf, To show individual data points plotted according to coordinate values with continuous, quantitative x- and y-axis scales. A curve that is generated mathematiy may be fitted to the data to summarize the relationship among the variables. Acceptable File Formats for Initial Submission: .ai, .bmp, .docx, .emf, .eps, .jpg, .pdf, .ppt, .psd, .tif, .wmf, Acceptable File Formats for Revision and Publication: .ai, .emf, .eps, .pdf, .wmf, To explain physiological mechanisms, describe clinical maneuvers and surgical ques, 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, , tif Acceptable File Formats for Revision and Publication: .ai, .eps, .jpg, .pdf, .psd, 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. Required minimum resolution for publication: ≥350 ppi Acceptable File Formats for Initial Submission: .eps, .jpg, .pdf, .ppt, .psd, Acceptable File Formats for Revision and Publication: .eps, .jpg, .psd, To illustrate anatomy or procedures. Required minimum resolution for publication: ≥600 ppi Acceptable File Formats for Initial Submission: .docx, .jpg, .pdf, .ppt, .psd, Acceptable File Formats for Revision and Publication: .jpg, .psd, 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 orinal 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, e Table in the Supplement) and numbered in order of citation in the text (eg, e Table 1, e Table 2, e Fure 1, e Fure 2, e Methods). The first page of the online-only document should list the number and title of each element included in the document. Back to top 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. 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. Back to top Online-only tables should be inserted in the document and numbered consecutively according to the order of citation as e Table 1, e Table 2, etc. 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. 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. Back to top Online-only fures should be inserted in the document and numbered consecutively according to the order of citation as e Fure 1, e Fure 2, etc. Fure titles should be set in Arial font, 12 point, bold, and single-spaced. Text within fures should be set as Arial font, 10 point. Fure 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 are generally not suitable for graphs. Photographs, including all radiological images, should be prepared as (hhest option) or (uncompressed) files at a resolution of 300 dpi and width of 3-5 inches, but the resolution of photographic files with an orinal resolution Verify that the videos are viewable in Quick Time 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 desnated 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 sned by each patient. If the author does not hold copyrht 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 the JAMA Network video production will re-create all text using our house style. 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, the JAMA Network video production staff may contact you to request an orinal uncompressed audio file in or format. There is no maximum file size requirement for publication at this stage. Back to top 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 orinal 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 elibility 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-blind 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. Information from submitted manuscripts may be systematiy collected and analyzed as part of research to improve the quality of the editorial or peer review process. Final decisions regarding manuscript publication are made by an editor who does not have any relevant conflicts of interest. and returned to the corresponding author (or her/his desnee) 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. Back to top 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 Presentation or Release of Information and Embargo Policy. Back to top 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 elible 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 fures 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. 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. 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, Preprint Server Posting, and Related Manuscripts and Reports. Back to top 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 dital form or be released by the news media until the specified embargo release date. Back to top 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. Elibility: Available only for authors of manuscripts reporting research funded by a not-for-profit foundation or agency that requires immediate open access of published research articles in exchange for payment of article processing charges. Reviewers and editors will be unaware of the request for open access until after a final decision is made. 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 assn copyrht on my behalf. Author-Pay Open Access Options All elible research articles that are accepted for publication will be made immediate free access on the journal website following payment of article processing charges (APC) and will be deposited on your behalf in Pub Med Central for immediate free access following deposit. All authors will be required to complete the Publishing Agreement that will indicate the Open Access Option before any manuscript can be accepted for publication. Note: if the open access funding source is commercial, only the JN-OA License is available. For detailed information on public access, open access, copyrht, and licensing, please see below. Free Public Access Option and Copyrht Transfer All research articles, regardless of funding, that are accepted for publication will be made free access online 12 months after publication on the journal website and will be deposited on your behalf in Pub Med Central. 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 Copyrht Act, and copyrht ownership cannot be transferred. Author requirements: Payment of 00 and transfer of a publication license to the journal. Elibility: Available for authors of manuscripts reporting research, regardless of funding source, that desire immediate open access of published research articles in exchange for payment of article processing charges. If you choose this option, there are no fees and you will select A, B, or C for copyrht transfer in the Publishing Agreement. In consideration of the action of the American Medical Association (AMA) in reviewing and editing this submission (manuscript, tables, fures, video, audio, and other supplemental files for publication), I hereby transfer, assn, or otherwise convey all copyrht ownership, including any and all rhts incidental thereto, exclusively to the AMA, in the event that such work is published by the AMA. License rhts: Immediate open access on journal website on the day of publication, access to a PDF copy of the published article, retention of copyrht, 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 orinal authors and journal. Author requirements: Payment of 00 and transfer of copyrht to the journal. All authors will be required to complete the Publishing Agreement that will indicate this Public Access Option before any manuscript can be accepted for publication. License rhts: Immediate open access on journal website on the day of publication, access to PDF copy of the published article, and a JN-OA license permitting authors to display a copy on a password-protected website hosted by their institution, share a copy with colleagues for their personal/educational/research noncommercial use, share a copy with students in an academic class or course they are teaching, include a copy in a thesis or dissertation (provided that it is not to be published commercially), and incorporate it in other noncommercial uses on request—provided that credit is given to the orinal authors and journal. All research articles published after April 2017 will be deposited into Pub Med Central (PMC) immediately after publication and are publicly available 12 months after publication. If you have purchased an open access license, the article will be made immediate free access following deposit in PMC. A few weeks after publication, you may obtain your PMCID on the PMC site at https://gov/pmc/pmctopmid/. Authors of research articles published before April 2017 may deposit copies of the published article into PMC provided that the article not be made public access until 12 months after publication. Non–research articles may not be deposited into PMC. Editorial Policies for Authors Back to top 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), 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 desnated 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. In addition, authors are required to identify their contributions to the work described in the manuscript. An email with links to the Authorship Form will be sent to authors for completion after manuscripts have been submitted (see sample Authorship Form). For reports of orinal data and systematic reviews, authors' specific contributions will be published in the Acknowledgment section (see Manuscript Preparation and Submission Requirements, Acknowledgment Section). 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. 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 Previous Release of Information, Embargo, and Access). Authors of manuscripts reporting orinal data or systematic reviews must provide an access to data statement from at least 1 named author, 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 assnees. Back to top A single corresponding author (or coauthor desnee 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, respond to letters to the editor, and will be the only author identified as the corresponding author in the published article. The corresponding author 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 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 sample Authorship Form and Acknowledgment Section). Back to top 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. Back to top If authorship is attributed to a (either solely or in addition to 1 or more individual authors), all members of the must meet the full criteria and requirements for authorship as described above, and all member authors must complete Authorship Forms (see sample Authorship Form). If all members of a do not meet all authorship criteria, a must desnate 1 or more individuals as authors or members of a writing who meet full authorship criteria and requirements and who will take responsibility for the . Both authors and collaborators will be noted in published articles and in Pub Med records. 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 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 Pub Med. Back to top 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, and to declare whether they have or do not have any conflicts of interest in 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. Back to top 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, 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). 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 strahtforward. Although editors are willing to discuss disclosure of specific conflicts of interest with authors, The 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 orinal published disclosure statement, and additional action may be taken as necessary. All authors must also complete a summary statement confirming the reporting of conflicts of interest and funding that is part of the Authorship Form. Back to top 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: "desn 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." Back to top For all reports (regardless of funding source) containing orinal data, at least 1 named author (eg, the principal investator), 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." 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 orinal 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. Back to top 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 (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. 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. Back to top Manuscripts are considered with the understanding that they have not been published previously in print or electronic format and are not under consideration by another publication or electronic medium. Copies of all related or similar manuscripts and reports (ie, those containing substantially similar content or using the same or similar data) that have been previously published or posted, or are under consideration elsewhere must be provided at the time of manuscript submission. Public dissemination of manuscripts prior to, simultaneous with, or following submission to this journal, such as posting the manuscript on preprint servers or other repositories, is discouraged, and will be considered in the evaluation of manuscripts submitted for possible publication in this journal. The evaluation will involve making a determination of whether publication of the submitted manuscript will add meaningful new information to the medical literature or will be redundant with information already disseminated with the posting of the preprint. Authors should provide information about any preprint postings, including copies of the posted manuscript and a link to it, at the time of submission of the manuscript to this journal. See also Previous or Planned Meeting Presentation or Release of Information and Depositing Research Articles in Approved Public Repositories. The ICMJE defines a clinical trial as any research project that prospectively assns human participants to intervention or comparison s 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, 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 a copy of the trial protocol including the complete statistical analysis plan (see Protocols), a CONSORT flow diagram (see Fure), and a completed trial checklist (see Checklist). All clinical trials must be registered at an appropriate online public registry (see Trial Registration requirements). These and other requirements for manuscript preparation are detailed in Categories of Articles, Clinical Trial. For additional guidance on reporting cluster trials, noninferiority and equivalence trials, pragmatic trials, and trials with patient-reported outcomes, see Extensions of the CONSORT Statement. Back to top In concert with the ICMJE, The 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). All clinical trials, regardless of when they were completed, and secondary analyses of orinal 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. Back to top 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 orinal approved protocol and statistical analysis plan, and all subsequent amendments to either document. If the manuscript is accepted, the protocol and statistical analysis plan will be published as an online supplement. Back to top 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. Back to top 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. All articles or data sources should be searched for and selected systematiy for inclusion and critiy 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 a flow diagram and the MOOSE checklist. Back to top Manuscripts reporting survey data, such as studies involving patients, clinicians, the public, or others, should report data collected as recently as possible, ideally within the past 2 years. Survey studies should have sufficient response rates (generally at least 60%) and appropriate characterization of nonresponders to ensure that nonresponse bias does not threaten the validity of the findings. For most surveys, such as those conducted by telephone, personal interviews (eg, drawn from a sample of households), mail, email, or via the web, authors are encouraged to report the survey outcome rates using standard definitions and metrics, such as those proposed by the American Association for Public Opinion Research. Back to top These manuscripts may be classified as Orinal Investations, Brief Reports, or Research Letters. For guidance on reports of diagnostic tests, see the EQUATOR Reporting Guidelines (STARD). Authors of reports of diagnostic tests are encouraged to submit the STARD flow diagram and checklist. Back to top These manuscripts may be classified as Orinal Investations, Brief Reports, or Research Letters. For guidance on reports of cost-effectiveness analyses, see the EQUATOR Reporting Guidelines (CHEERS). Authors of reports of cost-effectiveness analyses and decision analyses must submit a copy of the decision tree comprising their model. This is for editorial evaluation and review, not necessarily for publication, unless it is included in the body of the manuscript. Back to top 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 lht of current knowledge and medical practice as well as the most recent date(s) of analysis of the study. Back to top Aggregate, de-identified demographic information (eg, age, sex, race/ethnicity, and socioeconomic indicators) should be reported for all research reports and systematic reviews along with all prespecified outcomes. All demographic variables assessed should be reported in the Methods section. All demographic information collected should be reported in the Results section, either in the main article and/or in an online supplement. If any demographic characteristics that were collected are not reported, this should be explained. Summary demographic information (eg, baseline characteristics of study participants) should be reported in the first line of the Results section of Abstracts. Back to top Study inclusion or exclusion criteria by age or age should be defined in the Methods section. Stratification by age s should be based on relevance to disease, condition, or population (eg, 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, investator observed or classified, or laboratory test) should be explained in the Methods section. If only one sex is reported, or included in the study, the reason the other sex is not reported or included should be explained in the Methods section, except for studies of diseases/disorders that only affect males (eg, prostate disease) or females (eg, ovarian disease). The sex distribution of study participants or samples should be reported in the Results section, including for studies of humans, tissues, cells, or animals. Study results should disaggregate and report all outcome data by sex. Back to top An explanation of who classified individuals as to race, ethnicity, or both, the classifications used, and whether the options were defined by the investator or the participant should be included in the Methods section. The reasons that race/ethnicity was assessed in the study also should be described in the Methods section. Race/ethnicity of the study population should be reported in the Results section. 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. For investations 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. Editors may request that authors provide documentation of the formal review and recommendation from the institutional review board or ethics committee responsible for oversht of the study. Back to top A sned statement of informed consent to publish patient descriptions, photographs, video, and pedrees should be obtained from all persons (parents or legal guardians for minors) who can be identified (including by the patients themselves) in such written descriptions, photographs, or pedrees 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. 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 cliniy or scientifiy relevant and important. 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. 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. Back to top A sned 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. Back to top 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). Back to top Final decisions regarding manuscript publication are made by the editor in chief or a desnated 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 desnated editor without a conflict of interest related to the manuscript. Back to top 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 copyrht 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 assn copyrht or a publication license on the author's behalf. Back to top Published manuscripts 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 dital) is not permitted by the JAMA Network or the AMA. Type 2 diabetes mellitus consists of an array of dysfunctions characterized by hyperglycemia and resulting from the combination of resistance to insulin action.

Practice Case #3 - Introduction to Evidence-Based 10 Ways to reduce the word count of your research paper What are the correct ways of including citations into the text of research papers? This article illustrates two ways of inserting citations into research papers depending on what is being emphasized---the names of authors or their findings.... Read More 10 Ways to reduce the word count of your research paper What are the correct ways of including citations into the text of research papers? This article illustrates two ways of inserting citations into research papers depending on what is being emphasized---the names of authors or their findings.... Read More 10 Ways to reduce the word count of your research paper What are the correct ways of including citations into the text of research papers? This article illustrates two ways of inserting citations into research papers depending on what is being emphasized---the names of authors or their findings.... Read More 10 Ways to reduce the word count of your research paper What are the correct ways of including citations into the text of research papers? This article illustrates two ways of inserting citations into research papers depending on what is being emphasized---the names of authors or their findings.... Read More 10 Ways to reduce the word count of your research paper What are the correct ways of including citations into the text of research papers? This article illustrates two ways of inserting citations into research papers depending on what is being emphasized---the names of authors or their findings.... Read More Can I submit a paper without informing my co-author? Read More Can I submit a paper without informing my co-author? Read More Can I submit a paper without informing my co-author? Read More Can I submit a paper without informing my co-author? Read More Can I submit a paper without informing my co-author? Read More Can I submit a paper without informing my co-author? Read More Why you should be a skeptical scientist"Don’t take my word for it, but being a scientist is about being a skeptic," says Tim van der Zee in this post. I wrote a manuscript to submit it to a journal and I cannot let my supervisor know about it because he doesn't show any interest in it. I wrote a manuscript to submit it to a journal and I cannot let my supervisor know about it because he doesn't show any interest in it. I wrote a manuscript to submit it to a journal and I cannot let my supervisor know about it because he doesn't show any interest in it. I wrote a manuscript to submit it to a journal and I cannot let my supervisor know about it because he doesn't show any interest in it. I wrote a manuscript to submit it to a journal and I cannot let my supervisor know about it because he doesn't show any interest in it. I wrote a manuscript to submit it to a journal and I cannot let my supervisor know about it because he doesn't show any interest in it. Read on to know why he thinks scientists should be skeptical of what they read and the... Read More Why you should be a skeptical scientist"Don’t take my word for it, but being a scientist is about being a skeptic," says Tim van der Zee in this post. Read on to know why he thinks scientists should be skeptical of what they read and the... Read More Why you should be a skeptical scientist"Don’t take my word for it, but being a scientist is about being a skeptic," says Tim van der Zee in this post. Read on to know why he thinks scientists should be skeptical of what they read and the... Read More Why you should be a skeptical scientist"Don’t take my word for it, but being a scientist is about being a skeptic," says Tim van der Zee in this post. Read on to know why he thinks scientists should be skeptical of what they read and the... Read More Why you should be a skeptical scientist"Don’t take my word for it, but being a scientist is about being a skeptic," says Tim van der Zee in this post. Read on to know why he thinks scientists should be skeptical of what they read and the... Read More Why you should be a skeptical scientist"Don’t take my word for it, but being a scientist is about being a skeptic," says Tim van der Zee in this post. Read on to know why he thinks scientists should be skeptical of what they read and the... Read More Why you should be a skeptical scientist"Don’t take my word for it, but being a scientist is about being a skeptic," says Tim van der Zee in this post. Read on to know why he thinks scientists should be skeptical of what they read and the... Read More Authors beware: Avoid falling prey to predatory journals and bogus conferences Here, the discussion centers on predatory publishers, journals, service providers, and conferences. Shawn talks about her experience receiving authorship invitations from predatory journals and... Practice Case 3 Nursing and the case for dry heat. for the administration of chemotherapy, antibiotics, blood products, fluids, and other medical therapies in hematologic patients with cancer. Heat type had no effect on patient anxiety. Were the study patients similar to my population of interest?

A Trial of Darbepoetin Alfa in <strong>Type</strong> 2
<b>Type</b> 2 Diabetes Mellitus Practice
Practice <b>Case</b> #3 - Introduction to Evidence-Based
<em>Case</em> <em>Study</em> Collection - National Center for <em>Case</em>

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