Preparing Your Manuscript

This guide explains how to prepare each part of your manuscript so that it can be reviewed and published efficiently. It follows practice recommended by leading open-access medical publishers, the recommendations of the ICMJE for the conduct, reporting and publication of scholarly work in medical journals, and the reporting guidelines maintained by the EQUATOR Network. Following it closely improves the clarity and integrity of your work, speeds up review and reduces the chance of your manuscript being returned before assessment.

Before you start

Confirm that your manuscript fits the journal’s Aims & Scope; that it is original and neither published nor under consideration elsewhere; that all authors meet the authorship criteria and have approved it; and that you can provide the ethics, consent and registration statements described in Ethics and Disclosures. Identify the reporting guideline that applies to your study design and prepare your manuscript, and its checklist, accordingly. Prepare the manuscript using the BJHMR template and the required citation style.

Reporting guidelines

Report your study in accordance with the guideline appropriate to its design, and upload the completed checklist with your submission:

A comprehensive list is maintained by the EQUATOR Network.

Language and writing style

Write in clear, correct and concise English, using either British or American spelling consistently throughout. Prefer plain, direct sentences; use the active voice where it aids clarity; and define every abbreviation at first use. Use person-centred, non-stigmatising and inclusive language when describing patients, participants and populations, and report participant characteristics (such as sex, gender, age and ethnicity) accurately and only where relevant. If English is not your first language, consider professional language editing before submission; language quality does not affect the editorial decision, which is based on scientific and clinical merit.

File format and general layout

Manuscript structure at a glance

Assemble the manuscript in the following order. Each element is described in detail below.

Title page

The title page should contain:

Because review is single-blind, you do not need to prepare an anonymised manuscript; author details remain in the manuscript.

Abstract

Provide a structured abstract of about 250–300 words with labelled sections — typically Background (or Objectives), Methods, Results and Conclusions — that can be read and understood on its own. Report the key numerical results with measures of uncertainty (for example confidence intervals) and, for trials, include the registration number. Do not include citations, undefined abbreviations, or figures and tables.

Keywords

Supply 4–6 keywords that describe the content for indexing and discovery. Where possible, choose terms from the U.S. National Library of Medicine’s Medical Subject Headings (MeSH) to aid indexing, avoid simply repeating words already in the title, and separate the keywords with commas.

Main text

Empirical papers should follow the IMRaD structure. Use numbered headings (for example 1, 1.1, 1.1.1) to a maximum of three levels. Reviews, case reports and other article types follow the structure of their reporting guideline (for example CARE for case reports).

Introduction

Summarise the background and rationale, drawing on the relevant literature without an exhaustive review. State what is already known and what remains uncertain, and give the specific objectives or hypotheses of the study.

Methods

Describe the study design; the setting, dates and participants, with eligibility criteria and methods of recruitment or sampling; the interventions, exposures or comparators; the outcomes, with clear definitions of primary and secondary outcomes; the data sources and measurement; the sample-size calculation; and the statistical methods, including how missing data and potential confounding were addressed. State the ethics approval and consent arrangements and, for trials, the registration details and the protocol, cross-referring to Ethics and Disclosures. Report the methods in enough detail for the study to be appraised and, where relevant, replicated.

Results

Report the flow of participants (with a flow diagram for trials and, where relevant, for reviews), the characteristics of the study population, and the findings for each outcome, giving effect estimates with confidence intervals and exact p-values rather than significance thresholds alone. Present results objectively using text supported by tables and figures, without duplicating data, and reserve interpretation for the Discussion.

Discussion

Summarise the key findings; interpret them in the context of the totality of the evidence; consider mechanisms and clinical, public-health or policy implications; and state the limitations, including potential sources of bias and the generalisability of the findings. Avoid claims that the data do not support, and do not overstate clinical applicability.

Conclusions

Provide a concise conclusion that reflects the strength of the evidence and, where appropriate, the implications for practice, policy and future research.

Units, nomenclature, drugs and statistics

Tables

Figures, images and patient privacy

References and citations

Declarations and back matter

Place the following declarations after the main text and before the references, stating “None” or “Not applicable” where appropriate but omitting none. Full guidance is given on the Ethics and Disclosures page.

Final checks before submission

Before you submit, run through the Submission Checklist to confirm that your manuscript is complete, follows the relevant reporting guideline, and is accompanied by all ethics, consent and registration statements and by every declaration, and that each table, figure and reference is cited and consistent.