# Discussion structure — AI/ML model development + validation (TRIPOD+AI / CLAIM)

A structure model for the Discussion of a clinical AI/ML model study, completing the trio
with the `exemplar_methods/` and `exemplar_results/` siblings. Each heading is a paragraph;
each bullet is *what it must establish*. Fill the `[brackets]`; do not copy this text.
Follows `section_guides/discussion.md`. Introduces **no new results**, cites **no
tables/figures**, and the claim must not exceed the validation evidence.

## Paragraph 1 — Key finding and why it matters
- Restate the primary discrimination (and that it held on the external set), plus calibration
  in one phrase — not a single best number.
- One sentence on the decision the model could support, hedged to the evidence level.

## Paragraphs 2–3 — Interpretation and comparison
- Compare to existing models / current practice: what the model adds (e.g., extends to a
  group current criteria exclude), and frame it as **complementary, not a replacement** for
  the clinician or standard pathway.
- Biological / clinical plausibility for why the inputs carry signal (named mechanism), so
  the model is not a black box asserted to work.
- Separate the **evidence tiers** explicitly: a retrospective validation shows discrimination;
  decision-impact and outcome benefit require prospective / trial evidence — and say which is
  and is not yet available.

## Limitations
- Name **overfitting / optimistic validation** candidly (any test-set leakage, internal-only
  validation, thin subgroups), **calibration** limits, single-site/scanner data, and the
  absence of prospective or decision-curve evidence if a use claim is made.

## Generalizability and future work
- Where the model would and would not transfer (sites, scanners, demographics); the
  prospective/external validation and, ultimately, the trial needed before deployment.

## Conclusion
- Matched to the evidence — "may support / warrants prospective evaluation", never "ready for
  clinical deployment" or "outperforms clinicians" unless a same-task, difference-tested,
  prospective comparison supports it.

## Common omission
- An explicit **evidence-tier separation** (discrimination ≠ clinical benefit) and a candid
  **optimism/calibration** caveat — the Discussion elements AI drafts most often skip, and the
  gateway to deployment over-reach. Cross-reference `section_guides/discussion.md`, the AO5
  probe and `peer-review/references/exemplar_reviews/optimistic_validation_reporting.md`, and
  the TRIPOD+AI / CLAIM critical items in
  `peer-review/references/reviewer_calibration/compliance_floor.md`.

# Discussion structure — diagnostic-accuracy study (STARD)

A structure model for the Discussion of an index-test-vs-reference-standard accuracy study,
completing the trio with the `exemplar_methods/` and `exemplar_results/` siblings. Each
heading is a paragraph; each bullet is *what it must establish*. Fill the `[brackets]`; do
not copy this text. Follows `section_guides/discussion.md` (4-paragraph base). Discussion
introduces **no new results** and cites **no tables/figures**.

## Paragraph 1 — Key finding and why it matters
- Restate, in 2–3 sentences, what was evaluated and the headline accuracy (the primary
  sensitivity/specificity at the operating point) without re-dumping every number.
- One sentence on the clinical decision the test informs (e.g., who can avoid `[procedure]`).

## Paragraphs 2–3 — Interpretation and comparison to prior tests
- Compare to the **existing test / prior tools** head to head: agree or differ, and *why*
  (different reference standard, spectrum, threshold, or population) — neutrally, not by
  disparaging prior work.
- Place the test in the **clinical pathway**: what it adds over current practice, and the
  decision threshold's rationale (cite a decision-curve / net-benefit argument only if it was
  pre-specified and reported in Results — do not introduce a new analysis here, just avoid an
  unjustified arbitrary cut-point).

## Limitations
- Tie each to design: **spectrum bias** (case-mix vs the intended-use population),
  **verification / differential-verification bias** (reference standard applied unequally),
  reference-standard imperfection, single-setting/reader, retrospective sampling, and any
  data-derived threshold's optimism.

## Generalizability and implications
- The populations/settings the accuracy does and does not transfer to; the implementation
  context (and, for an AI index test, the prospective evaluation still required).

## Conclusion
- One paragraph matched to the evidence — "supports/triages", not "replaces [the comparator]"
  unless a non-inferiority comparison and prospective data support replacement.

## Common omission
- **Spectrum and verification bias** and a **threshold/clinical-pathway justification** — the
  Discussion points DTA drafts most often skip, and the two that most often turn a strong
  headline into an over-reach. Cross-reference `section_guides/discussion.md` and the STARD
  critical items in `peer-review/references/reviewer_calibration/compliance_floor.md`.

# Discussion structure — systematic review / meta-analysis (PRISMA 2020)

A structure model for the Discussion of a systematic review with quantitative synthesis,
completing the trio with the `exemplar_methods/` and `exemplar_results/` siblings. Each heading
is a paragraph; each bullet is *what it must establish*. Fill the `[brackets]`; do not copy this
text. Follows `section_guides/discussion.md`. Introduces **no new results** and cites **no
tables/figures**.

## Paragraph 1 — Summary of evidence
- Restate the primary pooled estimate (effect + 95% CI, k studies, N patients) in 2–3
  sentences, matched to the Results — introduce no pooled number not already reported.
- One sentence on what it means clinically, framed to the **certainty of evidence**, not as
  proof.
- **If the pooled estimate is null or the CI is wide, frame it by precision, not absence** —
  state what the CI and the prediction interval *exclude*; an imprecise pool with few studies is
  "not yet established," not "no effect."

## Paragraphs 2–3 — Interpretation, comparison, and heterogeneity
- Compare to the 2–3 most recent related syntheses (agree / differ and why: eligibility,
  populations, measurement, analysis).
- **Explain heterogeneity**, distinguishing **clinical** (population, technique, threshold) from
  **statistical** (I²/τ²), and tie it to the subgroup / meta-regression findings — a high I²
  narrated only as a number, without a source, is a reviewer target.
- Note whether small-study effects / publication bias plausibly move the estimate.

## Limitations
- **Study-level risk of bias** carried into the pooled estimate (name the driving domain); the
  **certainty of evidence** downgrades (GRADE: risk of bias, inconsistency, indirectness,
  imprecision, publication bias).
- **Review-level limits**: overlapping populations / shared datasets or benchmarks
  (non-independence) and how a leave-one-dataset-out check addressed it; few studies for
  subgroups; language/publication restrictions; a low-powered or absent publication-bias test.
- If reviewer count, search currency, or a synthesis-method choice deviated from protocol, state
  it plainly here — consistent with what Methods declared.

## Generalizability
- The populations and settings the pooled estimate represents and where it may not transfer;
  how the prediction interval bounds — not the CI — describe the plausible effect in a new study.

## Conclusion
- Matched to the evidence and its certainty — "the pooled evidence suggests", "moderate-certainty
  evidence for", or a call for adequately powered / prospective studies; never a care directive or
  a guideline-grade recommendation the evidence tier does not license (guideline recommendations
  are the panel's, not a single review's — and disclose any guideline-co-authorship intellectual
  COI).

## Common omission
- An explicit **certainty-of-evidence (GRADE) treatment plus a heterogeneity source and a
  non-independence/overlap caveat** — the Discussion elements MA drafts most often soften, and the
  ones a synthesis reviewer checks first. Cross-reference `section_guides/discussion.md`, the
  `peer-review/references/domain-probes/sr_ma.md` probes (P2 non-independence, P4 k=1), and the
  PRISMA critical items in `peer-review/references/reviewer_calibration/compliance_floor.md`.

# Discussion structure — observational cohort (STROBE)

A structure model for the Discussion of an exposure→outcome cohort study, completing the trio
with the `exemplar_methods/` and `exemplar_results/` siblings. Each heading is a paragraph;
each bullet is *what it must establish*. Fill the `[brackets]`; do not copy this text.
Follows `section_guides/discussion.md`. Introduces **no new results** and cites **no
tables/figures**.

## Paragraph 1 — Key finding and why it matters
- Restate the primary **association** (adjusted effect with its direction/magnitude) in 2–3
  sentences (only restate a comparison to conventional predictors if that comparison was
  pre-specified and reported in Results — introduce no new comparison here).
- One sentence on the clinical/public-health relevance — as risk stratification, not proven
  causation.
- **If the primary result is null, frame it by precision, not absence.** Do not write "X was
  not associated with Y" flatly; state what the confidence interval *excludes* — e.g. "the 95%
  CI excluded an eGFR difference larger than ~1.7" or cite the minimum detectable effect that
  the study was powered for. "No effect" and "could not exclude an effect of size X" are
  different claims; an underpowered null is "not yet established," and the MDE must be computed
  under the **full primary-model adjustment set** (a 2-covariate power calc overstates
  precision). Watch for **bilateral over-correction** — a prior "independently associated"
  overclaim swinging to an equally unsupported "not associated" claim during revision.

## Paragraphs 2–3 — Interpretation and comparison
- Compare to prior evidence (agree/differ and why: design, population, exposure measurement).
- **Causal caution is mandatory**: state plainly that the estimate is an association, not a
  demonstrated causal effect; discuss **reverse causation** and the limits a single-timepoint
  or cross-sectional exposure places on directionality.
- Offer a mechanism/biological plausibility as hypothesis, flagged as such.

## Limitations
- **Residual and unmeasured confounding** with the adjustment set named and its gaps stated
  (and, ideally, an E-value / tipping-point referenced from Results); selection bias; exposure
  misclassification; missing-data handling; outcome ascertainment completeness.
- **Adjustment-set choice both ways**: state that confounders were chosen by a causal rationale
  (DAG / prior literature), not because they differed in Table 1, and that no **mediator or
  consequence of the outcome** was adjusted (over-adjustment — e.g. a renally-excreted lab in an
  eGFR model); if a borderline covariate was included, reference the drop-it sensitivity model
  from Results.

## Generalizability
- The population the cohort represents and where the estimate may not transfer (single
  ancestry/region/registry), and how external validation mitigates but does not remove the
  concern.

## Conclusion
- Matched to the evidence — "associated with", "may identify higher-risk individuals", never a
  care directive (defer/withhold/initiate) or a prognostic/surveillance claim a cross-sectional
  or single-visit design cannot license.

## Common omission
- An explicit **causation caveat with reverse-causation/unmeasured-confounding** treatment —
  the Discussion element cohort drafts most often soften, and the one a methods reviewer checks
  first. Cross-reference `section_guides/discussion.md`, the
  `peer-review/references/domain-probes/observational_confounding.md` probe, and the STROBE
  critical items in
  `peer-review/references/reviewer_calibration/compliance_floor.md`.

# Discussion structure — randomized controlled trial (CONSORT 2010)

A structure model for the Discussion of a parallel-group RCT, completing the trio with the
`exemplar_methods/` and `exemplar_results/` siblings. Each heading is a paragraph; each bullet is
*what it must establish*. Fill the `[brackets]`; do not copy this text. Follows
`section_guides/discussion.md`. Introduces **no new results** and cites **no tables/figures**.

## Paragraph 1 — Key finding
- Restate the **primary** result (the effect estimate + CI on the ITT population) in 2–3
  sentences, matched to Results — no new estimate, and no elevation of a secondary outcome.
- One sentence on clinical meaning, tied to the **pre-stated MCID** (a statistically significant
  effect smaller than the MCID is not clinically meaningful).
- **If the primary is null or non-inferiority is not shown, frame it by the CI vs the margin**,
  not as "no difference" — state what the interval excludes.

## Paragraphs 2–3 — Interpretation and comparison
- Compare to prior trials and meta-analyses (agree / differ and why: population, comparator,
  dose, endpoint); avoid over-generalizing beyond the enrolled population.
- Discuss mechanism / plausibility as hypothesis; keep secondary and subgroup findings explicitly
  exploratory (do not narrate a subgroup as if it were a confirmatory result).

## Limitations
- **Risk-of-bias honesty**: open-label / unblinded assessment, attrition and how missing primary
  data were handled, any post-randomization exclusions, early stopping and its effect on the
  estimate, single-centre / narrow eligibility limiting external validity.
- Whether the trial was powered for the primary only (secondary/subgroup analyses under-powered).

## Generalizability
- The population and setting the result applies to, and where it may not transfer (eligibility
  restrictions, standard-of-care comparator specific to the setting, adherence in a trial vs
  routine care).

## Conclusion
- Matched to the evidence — a single trial supports the primary contrast in the studied
  population; use "in this trial, [intervention] reduced/did not reduce [outcome]", not a
  guideline-grade recommendation the evidence tier does not license.

## Common omission
- An explicit **blinding / attrition limitation and a clinical-vs-statistical-significance caveat**
  tied to the MCID — the Discussion elements RCT drafts most often soften. Cross-reference
  `section_guides/discussion.md`, the `peer-review/references/domain-probes/rct_trial.md` probes,
  and, for an AI intervention, the CONSORT-AI reporting items.

# Exemplar Discussion sections — structure models, not prose to copy

`write-paper` teaches Discussion *rules* (`section_guides/discussion.md`: the 4-paragraph
structure, no new results, no table/figure citations, claim-to-evidence matching) but had no
worked example of what a complete Discussion looks like end to end. This directory completes
the exemplar trio (`exemplar_methods/` → `exemplar_results/` → `exemplar_discussion/`) with
**structure models**: each shows the Discussion paragraph order for a study type and, for
every paragraph, *what it must establish* — with placeholder specifics, never copied text.

These are **authored from scratch as teaching models**, not extracted from any published
paper. Use them to check that a draft's Discussion has every load-bearing paragraph and stays
matched to the evidence; do not copy wording.

## How they are used

In `write-paper` Phase 5 (Discussion), after loading `section_guides/discussion.md`: pick the
exemplar matching the study type and confirm the draft restates the key finding, compares to
prior work without disparagement, gives design-tied limitations, treats generalizability, and
closes with a conclusion matched to the evidence — introducing no new results.

## Contents

- `diagnostic_accuracy_stard.md` — comparison vs prior test, clinical-pathway/threshold,
  spectrum/verification-bias limitations (STARD).
- `ai_validation_tripod_claim.md` — complementary-not-replacement framing, evidence-tier
  separation (discrimination ≠ clinical benefit), optimism/calibration caveats (TRIPOD+AI /
  CLAIM).
- `observational_cohort_strobe.md` — mandatory causal caution, reverse-causation and
  unmeasured-confounding limitations, no care-directive conclusion (STROBE).
- `meta_analysis_prisma.md` — summary-of-evidence with certainty framing, heterogeneity-source
  and non-independence/overlap caveats, GRADE limitations, no guideline-grade conclusion
  (PRISMA 2020).
- `rct_consort.md` — primary-on-ITT key finding, clinical-vs-statistical significance vs the MCID,
  blinding/attrition limitations, single-trial conclusion (CONSORT 2010).

## Curator guidelines (for adding more)

- **Synthetic only.** Write the structure with placeholder specifics; never paste a real
  paper's Discussion, use no real citations, no PII, English only.
- **Complete the trio** for the study type (mirror the `exemplar_methods/` + `exemplar_results/`
  siblings), each line stating *what the paragraph must establish*, not finished prose.
- **Enforce claim-to-evidence matching** and **no new results** — the two Discussion failure
  modes; name the study type's most common omission.
- **Anchor to the reporting-guideline** critical items in
  `peer-review/references/reviewer_calibration/compliance_floor.md`.
- Keep each file ~45–75 lines. Cross-reference `section_guides/discussion.md` rather than
  duplicating it.

# Methods structure — AI/ML model development + validation (TRIPOD+AI / CLAIM)

A structure model for a clinical AI/ML model study. Each heading is a paragraph; each bullet
is *what it must establish*. Fill the `[brackets]`; do not copy this text.

## Study design and data sources
- Design (retrospective/prospective), the prediction task, and the intended use (where in
  the workflow the output acts, and which decision it informs).
- Data sources, sites, and dates for each split; how the cohort was assembled.

## Participants, inputs, and outcome
- Eligibility as a numbered list; the population the model is meant to serve.
- Input data types and exactly which fields the model sees (flag any field that could carry
  the label — report a no-leaky-field sensitivity analysis or mask it).
- Outcome/label definition, who assigned it, and the reference standard for the label.

## Data partition and leakage control
- Train / validation / test split **by patient** (not by image/record), and how
  independence was enforced; any external (geographic/temporal) test set.
- Explicit statement that no test data informed development (preprocessing, feature/threshold
  selection, model choice) — leakage inflates every metric and is invisible in the results.

## Model development
- Architecture, key hyperparameters, training procedure, and how the operating threshold was
  chosen (and on which split).
- Whether training was from scratch or fine-tuned; for an adaptation claim, a same-backbone
  zero-shot/few-shot baseline.
- Reproducibility: hardware/software/versions, random-seed handling, code/model availability.

## Evaluation
- Primary metric(s) with 95% CIs; **calibration** (slope/intercept or a calibration plot),
  not discrimination alone, when probabilities drive a decision.
- Comparator: if vs clinicians, the **same task on the same inputs under the same
  constraints**, with a test of the difference (not two standalone AUCs); decision-curve /
  net-benefit if a deployment/utility claim is made.

## Sample size
- Events-per-variable / minimum test-set events for the target precision, or the
  available-sample justification.

## Reporting-guideline fit
- TRIPOD+AI (name base TRIPOD + the AI extension) and/or CLAIM 2024. Critical items: input
  data + outcome, partition/leakage control, model + training details, calibration.

## Common omission
- **Calibration** and a **patient-level** (not image-level) split — the two most commonly
  missing, and both can make excellent-looking metrics misleading.

# Methods structure — diagnostic-accuracy study (STARD)

A structure model for an index-test-vs-reference-standard accuracy study. Each heading is a
paragraph; each bullet is *what the paragraph must establish*. Placeholders in `[brackets]`
stand for the study's real specifics — fill them; do not copy this text.

## Study design and oversight
- State the design (prospective / retrospective, consecutive / case-control sampling — and
  why; case-control sampling inflates accuracy and must be named).
- Setting and dates: `[single/multi-center]`, `[YYYY–YYYY]`, recruitment source.
- Ethics approval + consent (or waiver) and registration if applicable.

## Participants and eligibility
- Eligibility as a numbered list: inclusion `(1)…(2)…`, exclusion `(1)…(2)…`.
- The clinical question and the intended-use population the index test is meant to serve.
- Flow that lets the reader rebuild a 2×2 (enrolled → tested → analyzed; exclusions with
  reasons) — this is what the STARD diagram renders.

## Index test
- What it is, who performed/read it, their experience, and blinding to the reference
  standard and to clinical data.
- Acquisition specifics: `[scanner/vendor/field strength]`, protocol, software/version.
- The positivity threshold/criterion and whether it was pre-specified or data-derived.

## Reference standard
- The reference standard and its rationale (the validity hierarchy: pathology > imaging
  panel consensus > clinical follow-up at `[interval]`).
- Who applied it, their blinding to the index test, and the index↔reference time interval
  (verification timing).
- How indeterminate/non-diagnostic results were handled (ITD vs per-protocol — state which).

## Sample size
- The accuracy target and precision (expected sensitivity/specificity + CI half-width) or
  the available-sample justification; the prevalence assumed.

## Statistical analysis
- Sensitivity/specificity with 95% CIs; PPV/NPV with the prevalence they assume.
- Comparison method if two tests (paired McNemar / difference in AUC with a test of the
  difference — not two standalone AUCs), and any subgroup/multiplicity handling.
- Missing/indeterminate handling and any sensitivity analysis.
- Software + version.

## Reporting-guideline fit
- STARD 2015 (or STARD-AI for an AI index test — name BOTH base and extension). Critical
  items: reference standard + rationale, reader blinding, participant flow, indeterminate
  handling (see `peer-review/references/reviewer_calibration/compliance_floor.md`).

## Common omission
- Reader **blinding** to the reference standard and the **index↔reference time interval**
  — the two details most often missing, and both bias the headline accuracy if unaddressed.

# Methods structure — systematic review / meta-analysis (PRISMA 2020)

A structure model for a systematic review with quantitative synthesis. Each heading is a
paragraph; each bullet is *what it must establish*. Fill the `[brackets]`; do not copy this
text. Pairs with `paper_types/meta_analysis.md` (which carries the fuller prose templates) —
this file is the paragraph-order skeleton and the reviewer-critical checklist.

## Protocol and registration
- Prospective registration (PROSPERO `CRD[number]`) or an OSF/protocol reference, **lodged
  before data extraction began** — state the registration date relative to the search.
- Adherence to PRISMA 2020 (name the base guideline *and* the extension used, e.g. PRISMA
  base + **PRISMA-DTA** for diagnostic accuracy, PRISMA-NMA for network — never just the
  extension acronym).
- Any protocol amendments as dated entries (what changed, when, why), not a silent deviation.

## Eligibility criteria
- PICO(S) as a numbered inclusion list and a **separate** explicit exclusion list (not "did
  not meet inclusion") — Population, Intervention/Index test, Comparator, Outcome, Study
  design, and any language/date limits.
- The effect measure the review is built around (OR / RR / HR / MD / SMD / sensitivity &
  specificity / AUC) named here, so eligibility and synthesis agree.

## Information sources and search strategy
- Every database with its coverage dates and the last-search date; grey literature and
  register searches (ClinicalTrials.gov, conference abstracts) if used.
- The **full search string for ≥1 database, verbatim** (in-text or as a supplement) — a
  PRISMA-critical, first-line reviewer item; a paraphrased strategy is not reproducible.

## Study selection and data extraction
- Dual independent screening (title/abstract then full text) with the agreement metric
  (Cohen's κ or % agreement) at each stage and how disagreements were resolved; the operational
  reviewer count here must match what Limitations later concedes (no "dual" here / "single
  reviewer" there).
- Standardized dual extraction; the variables extracted; how the reference-standard / outcome
  cells (e.g. 2×2 TP/FP/FN/TN) were obtained and reconciled against the source (cell-level
  audit for hand-entered accuracy data).

## Risk of bias / quality assessment
- The tool matched to the design (**QUADAS-2** for DTA, **RoB 2** for RCTs, ROBINS-I / NOS /
  MINORS for non-randomized), applied in duplicate; how domain judgements were reached.
- Whether risk of bias fed a sensitivity analysis (low-RoB-only pool), not just a figure.

## Statistical synthesis
- The model and estimand: **random-effects a priori** (state the estimator, e.g.
  DerSimonian–Laird or REML; bivariate / HSROC for DTA) with the pooled effect and **95% CIs**.
- Heterogeneity: I² **with τ² and a 95% prediction interval** (I² is a proportion, not a
  magnitude — the PI shows the range of true effects); Cochran's Q threshold.
- **Pre-specified** subgroup / meta-regression covariates (post-hoc ones labeled exploratory);
  sensitivity analyses (leave-one-out, prospective-only, low-RoB-only); overlapping-population /
  shared-benchmark non-independence check.
- Publication bias (Egger / Deeks funnel asymmetry) **only when ≥10 studies**; certainty of
  evidence (**GRADE**) if claimed. Software + version + seed.

## Reporting-guideline fit
- PRISMA 2020 (+ the relevant extension). Critical items: verbatim search strategy for ≥1
  database, a flow diagram that reconciles, per-study risk of bias, and the protocol/registration
  reference (see `peer-review/references/reviewer_calibration/compliance_floor.md`).

## Common omission
- A **pre-specified subgroup set + an overlapping-population / shared-dataset non-independence
  check**, and naming **base + extension** guideline correctly — the Methods elements MA drafts
  most often skip, and among the first a synthesis reviewer checks. Cross-reference
  `section_guides/methods.md`, `paper_types/meta_analysis.md`, and the
  `peer-review/references/domain-probes/sr_ma.md` probes (P1 comparator existence, P2
  non-independence, P4 k=1 subgroup).

# Methods structure — observational cohort (STROBE)

A structure model for an exposure→outcome cohort study. Each heading is a paragraph; each
bullet is *what it must establish*. Fill the `[brackets]`; do not copy this text.

## Study design and setting
- Design (prospective / retrospective cohort) and why; data source (`[registry / EMR /
  health-screening DB]`), sites, and the enrollment and follow-up dates (keep enrollment
  distinct from follow-up end — do not conflate them).
- Ethics approval / consent or waiver; registration if applicable.

## Participants and eligibility
- Eligibility as a numbered list (inclusion / exclusion).
- The assembly cascade with counts (source → eligible → analytic), so the STROBE flow
  reconciles (start − Σ exclusions = analytic N).

## Variables — exposure, outcome, covariates
- Exposure definition, how it was measured/classified, and the cut-points with their source
  (cite the canonical definition; quote the data-dictionary mapping for a DB variable).
- Outcome definition, ascertainment, and timing.
- Covariates/confounders and how each was measured; pre-specify the adjustment set and its
  rationale (a DAG), not a data-driven selection.

## Bias, missing data, and study size
- Sources of bias and how they were addressed (selection, measurement, confounding).
- How missing data were handled (complete-case vs imputation — state which; complete-case
  must reconcile: total − missing = complete).
- Study size: the precision / event-budget justification (events per variable for the model).

## Statistical analysis
- The primary model and estimand (the contrast and effect measure), with 95% CIs; the
  pre-registered primary if applicable (do not reassign the primary after seeing results).
- Subgroup/interaction and sensitivity analyses, multiplicity handling, and how continuous
  variables were modeled (linearity assumption).
- Software + version.

## Reporting-guideline fit
- STROBE. Critical items: eligibility/selection, exposure/outcome definitions, missing-data
  handling, participant flow (see `peer-review/references/reviewer_calibration/compliance_floor.md`).

## Common omission
- A pre-specified **adjustment set with rationale** and explicit **missing-data handling** —
  the two paragraphs cohort drafts most often skip, and both are first-line reviewer targets.

# Methods structure — randomized controlled trial (CONSORT 2010)

A structure model for a parallel-group RCT. Each heading is a paragraph; each bullet is *what it
must establish*. Fill the `[brackets]`; do not copy this text. Anchors to CONSORT 2010; pairs the
`peer-review/references/domain-probes/rct_trial.md` probes (and CONSORT-AI/SPIRIT-AI for an AI
intervention).

## Trial design and registration
- Design (parallel-group / crossover / cluster), allocation ratio (e.g. 1:1), and framework
  (superiority / non-inferiority / equivalence) — with the **margin** stated up front for the
  latter two.
- **Prospective trial registration** (ClinicalTrials.gov / a WHO ICTRP registry) with the number,
  and the protocol reference; ethics approval and informed consent.

## Participants, setting, interventions
- Eligibility as a numbered inclusion / exclusion list; the settings and the recruitment and
  follow-up dates.
- The experimental and comparator interventions in enough detail to replicate (dose, schedule,
  who delivered them); the comparator is a real, defined control (placebo / standard-of-care),
  not a strawman.

## Outcomes
- The **single pre-specified primary outcome** with its metric and time point (do not re-designate
  the primary after seeing data); secondary outcomes listed; any changes to outcomes after trial
  commencement disclosed with dates.

## Sample size
- The power calculation: assumed effect (the MCID, not the hoped-for effect), α, power, and the
  resulting N with attrition inflation; for non-inferiority, the margin and its justification.

## Randomization, allocation concealment, blinding
- **Sequence generation** (how the random sequence was produced), **allocation concealment**
  (the mechanism that hid the next assignment — central/pharmacy/sealed opaque envelopes), and
  **implementation** (who enrolled, who assigned) — three distinct items, all required.
- **Blinding**: who was blinded (participants, clinicians, outcome assessors, analysts) and how;
  if open-label, state it and how assessor blinding was preserved.

## Statistical methods
- The primary analysis and estimand: the contrast, the population (**intention-to-treat** as
  primary — everyone as randomized; per-protocol as a secondary, and the primary population for a
  non-inferiority trial stated), and how missing data were handled (not naive complete-case for a
  dropout-prone endpoint).
- Pre-specified subgroups and interim analyses / stopping rules; multiplicity handling; software.

## Reporting-guideline fit
- CONSORT 2010 (+ CONSORT-AI for an AI intervention). Critical items: registration, sequence
  generation + allocation concealment + blinding, the pre-specified primary, ITT, and a
  participant flow diagram that reconciles (randomized → received → analyzed).

## Common omission
- **Allocation concealment described as blinding** (they are different — concealment protects
  *assignment*, blinding protects *ascertainment*), and an unstated **ITT vs per-protocol**
  primary population — the Methods elements RCT drafts most often conflate or skip, and the first
  a trials reviewer checks. Cross-reference `section_guides/methods.md` and the
  `peer-review/references/domain-probes/rct_trial.md` probes.

# Exemplar Methods sections — structure models, not prose to copy

`write-paper` teaches Methods *structure* (PICO, the reporting-guideline cross-reference,
the backbone-article strategy) but had no worked example of what a complete, well-ordered
Methods section looks like end to end. This directory fills that gap with **structure
exemplars**: each shows the paragraph order for a study type and, for every paragraph, *what
it must establish* — with placeholder specifics, never copied text.

These are **authored from scratch as teaching models**, not extracted from any published
paper. Use them to check that a draft's Methods has every load-bearing paragraph in a sane
order; do not copy wording.

## How they are used

In `write-paper` Phase 3 (Methods), after loading `section_guides/methods.md`: pick the
exemplar matching the study type and confirm the draft establishes each element the
exemplar lists (design, setting/dates, eligibility, the index test/exposure, the reference
standard/outcome, sample-size justification, the statistical plan, and the reporting-guideline
fit). A missing element is a gap to fill before drafting Results.

## Contents

- `diagnostic_accuracy_stard.md` — an index-test vs reference-standard accuracy study (STARD).
- `ai_validation_tripod_claim.md` — an AI/ML model development + validation study (TRIPOD+AI / CLAIM).
- `observational_cohort_strobe.md` — an exposure→outcome observational cohort (STROBE).
- `meta_analysis_prisma.md` — a systematic review with quantitative synthesis (PRISMA 2020).
- `rct_consort.md` — a parallel-group randomized controlled trial (CONSORT 2010).

## Curator guidelines (for adding more)

- **Synthetic only.** Write the structure with placeholder specifics (`[scanner/vendor]`,
  `[N]`, `[YYYY–YYYY]`); never paste a real paper's Methods, and use no real citations, no
  PII, English only.
- **One study type per file**, paragraph by paragraph, each line stating *what the paragraph
  must establish* (not finished prose).
- **Anchor to the reporting guideline** the study type maps to, naming the critical items
  (see `peer-review/references/reviewer_calibration/compliance_floor.md`).
- **Name the common omission** for each study type (the paragraph drafts most often skip).
- Keep each file ~50–90 lines. Cross-reference `section_guides/methods.md` and the relevant
  `paper_types/` template rather than duplicating them.

# Results structure — AI/ML model development + validation (TRIPOD+AI / CLAIM)

A structure model for the Results of a clinical AI/ML model study. It follows its Methods
AI-validation sibling in Methods order. Each heading is a paragraph; each bullet is *what it must establish*.
Fill the `[brackets]`; do not copy this text. Report findings only — no interpretation.

## Cohort assembly and data partition (Figure 1)
- The flow as Figure 1: source → eligible → analyzed, with the **train / validation / test**
  split shown and the counts for each set (and each **external** set).
- Splits are **by patient**; state the counts so a reader can see no patient spans two sets.
- Numbers reconcile with the Abstract, Methods, and Table 1.

## Baseline characteristics, by set (Table 1)
- Population characteristics for development and each test set, so distribution shift between
  development and external data is visible (one decimal convention).
- The outcome/label prevalence in each set (it conditions PPV/NPV and calibration).

## Reference points before the headline
- Report the relevant baselines first — a simpler model (clinical-only / single-modality) and,
  where applicable, the unaided clinician — so the model's **increment** is legible rather
  than asserted.

## Primary discrimination
- The primary metric (AUROC, and AUPRC under class imbalance) with **95% CIs**, reported
  **separately for internal and each external set** (not a single pooled number).
- Where a gain over a baseline is claimed, the **difference** with a test (DeLong / paired),
  not two standalone estimates.

## Calibration and operating point
- **Calibration** (slope/intercept or a calibration plot; Brier/Hosmer–Lemeshow) on the test
  set — discrimination alone is insufficient when a probability drives a decision.
- The decision threshold used for any sensitivity/specificity, and that it was fixed on the
  development/training data, not the test set.

## Clinical utility (when a use claim is made)
- Decision-curve / net-benefit across plausible thresholds, or a reader study reporting the
  change in reader performance (e.g., false-positive reduction, agreement) with the model.

## Interpretability and error analysis
- If interpretability is claimed, **quantify** it (attribution overlap, importance ranking),
  and report failure modes as counts/rates by pre-specified error category, subgroup, or
  input condition (e.g., lesion size, image quality) — report-only; reserve causal
  explanation of the errors for the Discussion.

## Common omission
- **Calibration** and **per-set** (not pooled) external metrics with CIs — the elements most
  often missing, and both can make excellent discrimination misleading. Cross-reference
  `section_guides/results.md`, the
  `peer-review/references/exemplar_reviews/optimistic_validation_reporting.md` phrasing
  model, and the TRIPOD+AI / CLAIM critical items in
  `peer-review/references/reviewer_calibration/compliance_floor.md`.

# Results structure — diagnostic-accuracy study (STARD)

A structure model for the Results of an index-test-vs-reference-standard accuracy study. It
follows its Methods STARD sibling in Methods order. Each heading is a paragraph;
each bullet is *what it must establish*. Fill the `[brackets]`; do not copy this text. Report
findings only — no interpretation (that is the Discussion).

## Participant flow (Figure 1)
- The STARD flow as Figure 1: enrolled → received index test → received reference standard →
  analyzed, with exclusions and **counts and reasons** at each step.
- State how many had the reference standard by each route (e.g., `[N]` by pathology, `[N]` by
  `[interval]` follow-up) and how indeterminate/non-diagnostic results were counted (ITD vs
  per-protocol — match what Methods declared).
- Numbers must reconcile with the Abstract, Methods, Table 1, and the 2×2.

## Cohort characteristics and prevalence (Table 1)
- Baseline demographics/clinical features of the analyzed participants (one decimal
  convention, held throughout).
- The **prevalence** of the target condition by the reference standard — every PPV/NPV is
  read against it, so state it before the predictive values.

## Primary accuracy
- Sensitivity and specificity with **95% CIs**, at the **pre-specified positivity threshold**
  (name the operating point; state it was fixed in advance or derived only on a
  training/derivation set, not optimized on the analysis/test set).
- PPV/NPV with the prevalence they assume; accuracy if reported.
- State the **analysis unit** and keep it fixed (per-patient / per-lesion / per-segment); when
  units are nested, report each level and give the lesion-selection rule, so every metric's
  denominator is unambiguous.

## Agreement / measurement (if a quantitative index)
- For a continuous index read against the reference, report agreement (Bland–Altman mean
  difference + limits, or ICC), not only thresholded accuracy.

## Subgroups and comparator
- Pre-specified subgroups (e.g., by `[size / calcification / PSA stratum]`) showing where
  accuracy degrades; report the subgroup 2×2 or its metrics, not just a p-value.
- If two tests are compared, the **difference** with a paired test (McNemar / difference in
  AUC), not two standalone estimates.

## Common omission
- The **explicit flow diagram with per-step counts** and the **handling of indeterminate
  results**, plus **differential-verification bias** when the reference standard was applied
  more often after a positive index test — the elements most often missing, and each inflates
  the headline accuracy. Cross-reference `section_guides/results.md` and the STARD critical
  items in `peer-review/references/reviewer_calibration/compliance_floor.md`.

# Results structure — systematic review / meta-analysis (PRISMA 2020)

A structure model for the Results of a systematic review with quantitative synthesis. It
follows its Methods PRISMA sibling in Methods order. Each heading is a paragraph; each bullet
is *what it must establish*. Fill the `[brackets]`; do not copy this text. Report findings
only — no interpretation.

## Study selection (Figure 1 — PRISMA flow)
- The identification→screening→eligibility→inclusion cascade as the PRISMA 2020 flow diagram:
  records identified, duplicates removed, screened, full texts assessed, and excluded **with
  reasons and counts**.
- The cascade reconciles (identified − duplicates − excluded = included); state N studies in the
  review vs N in the meta-analysis (they can differ). These numbers match the Abstract, Methods,
  and Table 1 exactly (one locked count, re-derived — not re-typed per document).

## Study and patient characteristics (Table 1)
- Publication-year span, design mix (prospective / retrospective; RCT / observational), total
  and per-study N (median, IQR/range), countries, and the effect-relevant descriptors.
- A **data-provenance column** when studies may share an institution / public database / imaging
  benchmark — so overlapping-population non-independence is visible, not hidden.

## Risk of bias across studies (Figure 2)
- The RoB summary (QUADAS-2 / RoB 2 domain plot): how many studies were low risk overall and
  the domain that drove concern, with counts (N/N).

## Quantitative synthesis — primary outcome (Figure 3, forest plot)
- The pooled effect with **95% CI**, the study count **k** and pooled **N**, and heterogeneity
  reported as **I² with τ² and the 95% prediction interval** (state what the PI's bounds imply
  for a new setting).
- The forest plot cited; per-study weights visible. For DTA, the bivariate/HSROC summary point
  (pooled sensitivity & specificity with CIs) — check no sensitivity/specificity swap versus a
  source.

## Subgroups, meta-regression, and sensitivity
- Each **pre-specified** subgroup with its estimate + CI **and the test for subgroup interaction**
  (report the interaction p, not two bare stratum estimates); flag k=1 strata as descriptive, not
  pooled.
- Leave-one-out, prospective-only, and low-RoB-only sensitivity results, reported as results — not
  deferred to a supplement mention only.

## Publication bias / small-study effects
- Egger / Deeks asymmetry **only if ≥10 studies** (state the count gate); if trim-and-fill was
  run, the adjusted estimate. Do not over-read a non-significant test — its power is low; say so.

## Common omission
- The **prediction interval alongside I²**, a **subgroup interaction test** (rather than two
  separate stratum estimates), and the **overlapping-population/provenance** disclosure — the
  Results elements MA drafts most often skip. Cross-reference `section_guides/results.md`, the
  `peer-review/references/domain-probes/sr_ma.md` probes (P1, P2 non-independence, P3 subset-N
  transparency, P4 k=1), and the PRISMA critical items in
  `peer-review/references/reviewer_calibration/compliance_floor.md`.

# Results structure — observational cohort (STROBE)

A structure model for the Results of an exposure→outcome cohort study. It follows its
Methods STROBE sibling in Methods order. Each heading is a paragraph; each bullet is *what it must establish*.
Fill the `[brackets]`; do not copy this text. Report findings only — no interpretation.

## Cohort assembly (Figure 1)
- The assembly cascade as Figure 1: source → eligible → analytic, with exclusion **counts and
  reasons**, and the exposed/unexposed counts.
- The cascade reconciles (start − Σ exclusions = analytic N); follow-up time / person-years
  stated. Numbers match the Abstract, Methods, and Table 1.

## Baseline characteristics, by exposure (Table 1)
- Table 1 stratified **by exposure status**, with a balance metric (standardized mean
  differences) and the imbalance threshold used; if matched/weighted, show pre- and
  post-balance.
- Show every pre-specified adjustment covariate in this table, so the reader can see whether
  any covariate imbalanced by exposure is missing from the adjustment set.

## Primary association — crude then adjusted
- The primary contrast and effect measure (OR / RR / HR) with **95% CIs**, reported **crude
  then adjusted** (or matched), so the effect of confounding control is visible.
- Report the **pre-specified primary** estimand; do not reassign the primary after seeing
  results. State events/N for each arm.

## Secondary, subgroup, and dose-response
- Subgroup / interaction estimates with CIs (report the interaction term, not two separate
  stratum estimates, when effect-modification is the question).
- Dose-response across exposure levels if available; keep multiplicity in view.

## Sensitivity analyses
- The robustness checks declared in Methods (alternative adjustment, complete-case vs
  imputation, tipping-point / E-value for unmeasured confounding), reported as results, not
  deferred.

## Missing data
- How much was missing and how the analytic set was reached (complete-case reconciles:
  total − missing = complete), with the footnote N matching the flow.

## Common omission
- **Crude-and-adjusted side by side** and an explicit **sensitivity analysis for unmeasured
  confounding** (E-value / tipping-point) — the elements cohort Results most often skip.
  Cross-reference `section_guides/results.md` and the STROBE critical items in
  `peer-review/references/reviewer_calibration/compliance_floor.md`.

# Results structure — randomized controlled trial (CONSORT 2010)

A structure model for the Results of a parallel-group RCT. It follows its Methods CONSORT
sibling in Methods order. Each heading is a paragraph; each bullet is *what it must establish*.
Fill the `[brackets]`; do not copy this text. Report findings only — no interpretation.

## Participant flow (Figure 1 — CONSORT diagram)
- The CONSORT flow: assessed → randomized → allocated (received / did not receive) → followed up
  (lost, discontinued, with reasons) → analyzed, **per arm**, with counts.
- The cascade reconciles (randomized = Σ analyzed + Σ excluded-with-reason); the number
  **analyzed for the primary outcome** matches the ITT denominator. Numbers match the Abstract,
  Methods, and Table 1.

## Recruitment and baseline (Table 1)
- Recruitment and follow-up dates and why the trial ended (target reached / stopped);
  Table 1 baseline characteristics **by arm** — **no p-values for baseline balance** (randomization
  makes them meaningless; show the descriptive comparison and, if used, the balance metric).

## Primary outcome
- The pre-specified **primary** outcome by arm: the **effect estimate with its 95% CI** and the
  absolute numbers per arm (events/N or mean±SD), on the **ITT** population — not just a p-value.
- For non-inferiority: the CI relative to the **pre-stated margin** (the conclusion follows from
  where the CI sits, not from a significance test).

## Secondary outcomes and harms
- Secondary outcomes with estimates + CIs, flagged as secondary (multiplicity in view — do not
  elevate a significant secondary to a headline).
- **Harms / adverse events** reported per arm (a trial that reports only efficacy is incomplete).

## Subgroups and sensitivity
- Pre-specified subgroup analyses with the **interaction test**, framed as exploratory; the
  per-protocol analysis beside ITT (concordance is reassuring; divergence is discussed, not hidden).

## Common omission
- **Baseline p-values** (should not appear), and the **primary reported off the per-protocol set**
  rather than ITT, or without its absolute per-arm numbers — the Results elements RCT drafts most
  often get wrong. Cross-reference `section_guides/results.md`, the
  `peer-review/references/domain-probes/rct_trial.md` probes, and the CONSORT flow requirement.

# Exemplar Results sections — structure models, not prose to copy

`write-paper` teaches Results *rules* (`section_guides/results.md`: mirror-symmetry with
Methods, the flow diagram, no interpretation) but had no worked example of what a complete,
well-ordered Results section looks like end to end. This directory fills that gap with
**structure exemplars** that follow the `exemplar_methods/` siblings in Methods order: each
shows the Results paragraph order for a study type and, for every paragraph, *what it must
establish* — with placeholder specifics, never copied text.

These are **authored from scratch as teaching models**, not extracted from any published
paper. Use them to check that a draft's Results presents every load-bearing element in the
same order as its Methods; do not copy wording.

## How they are used

In `write-paper` Phase 4 (Results), after loading `section_guides/results.md`: pick the
exemplar matching the study type and confirm the draft presents each element in Methods order
(flow → baseline/prevalence → primary estimate with CIs → calibration/agreement →
subgroups/comparator → sensitivity/missing-data). A missing element is a gap to fix; an
element that interprets rather than reports belongs in the Discussion.

## Contents

- `diagnostic_accuracy_stard.md` — flow, prevalence, sensitivity/specificity (+ PPV/NPV) with
  CIs at a fixed operating point, agreement, comparator (STARD).
- `ai_validation_tripod_claim.md` — partition/flow, per-set discrimination with CIs,
  calibration, operating point, clinical utility (TRIPOD+AI / CLAIM).
- `observational_cohort_strobe.md` — assembly, Table 1 by exposure, crude-then-adjusted
  estimate with CIs, subgroups, sensitivity analyses (STROBE).
- `meta_analysis_prisma.md` — PRISMA flow, study/patient characteristics + provenance, pooled
  estimate with I²/τ²/prediction interval, subgroup interaction, sensitivity, publication bias
  (PRISMA 2020).
- `rct_consort.md` — CONSORT flow, baseline by arm (no p-values), ITT primary estimate with CI,
  secondary outcomes + harms, subgroup interaction, per-protocol beside ITT (CONSORT 2010).

## Curator guidelines (for adding more)

- **Synthetic only.** Write the structure with placeholder specifics (`[N]`, `[YYYY–YYYY]`,
  `[metric]`); never paste a real paper's Results, use no real citations, no PII, English only.
- **Follow the matching `exemplar_methods/` file in Methods order** (same study type), so
  Results and Methods read in the same sequence.
- **One study type per file**, each line stating *what the paragraph must establish* (not
  finished prose), and report-only — flag interpretation as belonging to the Discussion.
- **Name the common omission** for each study type, and anchor to the reporting-guideline
  critical items in `peer-review/references/reviewer_calibration/compliance_floor.md`.
- Keep each file ~50–90 lines. Cross-reference `section_guides/results.md` rather than
  duplicating it.

# Journal Profile: Abdominal Radiology

## Journal Identity

- **Full name**: Abdominal Radiology
- **Abbreviation**: Abdom Radiol
- **Publisher**: Springer Nature (Society of Abdominal Radiology, SAR)
- **ISSN**: 2366-004X (print), 2366-0058 (online)
- **Frequency**: Monthly (12 issues/year)
- **Impact Factor**: ~3.1 (JCR 2023)
- **Open Access**: Hybrid (Springer transformative agreements may cover OA)
- **Acceptance rate**: ~30%
- **Peer review**: Single-blind; typically 2 reviewers

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | References | Figures/Tables |
|------|----------------|----------|------------|----------------|
| Original Article | 3500 words | 250 words (structured) | 35 | 6 |
| Review Article | 5000 words | 250 words | 60 | 10 |
| Technical Innovation | 2000 words | 150 words (unstructured) | 15 | 4 |
| Brief Report (incl. case reports) | 1500 words | 150 words | 10 | 4 |
| Pictorial Essay | 3000 words | 200 words | 20 | 12 |
| Letter to the Editor | 500 words | None | 5 | 1 |

Word counts exclude abstract, references, tables, and figure legends.

---

## Abstract Requirements

**Structured abstract for Original Articles, 250 words maximum:**

```
Purpose: [Study aim]
Methods: [Design, population, imaging, analysis]
Results: [Key findings with statistics]
Conclusion: [Main conclusion — 1-2 sentences]
```

**Unstructured abstract for Technical Innovations and Brief Reports, 150 words.**

---

## Required Sections (Original Article)

1. **Introduction** — clinical context, gap, study purpose (2-3 paragraphs)
2. **Methods**
   - Study Design: IRB, retrospective/prospective
   - Patient Population: inclusion/exclusion criteria, time period
   - Imaging Protocol: scanner, sequence parameters, contrast protocol
   - Image Analysis: readers, blinding, measurement methods, structured reporting systems used
   - Statistical Analysis: software, tests
3. **Results** — demographics, imaging findings, performance metrics
4. **Discussion** — interpretation, comparison with literature, clinical relevance, limitations
5. **Conclusion**

---

## Statistical Reporting

- Report exact p-values; use p < 0.001 below that threshold.
- 95% CI for primary outcomes.
- For diagnostic accuracy: sensitivity, specificity, PPV, NPV, AUC with 95% CI.
- Inter-reader agreement: ICC or kappa with model specification.
- For structured reporting studies (LI-RADS, PI-RADS): report per-category distribution and diagnostic performance per category.
- Multiple comparisons: correction method stated.
- Statistical software and version must be identified.

---

## Abdominal Imaging-Specific Requirements

### Structured Reporting Systems

Abdominal Radiology is a key venue for studies using standardized reporting:
- **LI-RADS** (Liver Imaging Reporting and Data System)
- **PI-RADS** (Prostate Imaging Reporting and Data System)
- **Bosniak** classification (renal cysts)
- **O-RADS** (Ovarian-Adnexal Reporting and Data System)
- **TI-RADS** (Thyroid Imaging Reporting and Data System — when thyroid US)

When using these systems, report the version used and per-category results.

### Imaging Protocol

Report for each modality:
- CT: scanner, kVp, mAs, slice thickness, reconstruction kernel, contrast protocol (volume, rate, timing)
- MRI: field strength, coil, sequences with parameters, contrast agent and dose
- US: transducer frequency, CEUS contrast agent if applicable

---

## Figures

- **Maximum 6 figures/tables** for original articles; **12 for Pictorial Essays**
- **Resolution**: 300 DPI minimum
- **Format**: TIFF, EPS, JPEG
- **Color**: Free online
- **Annotations**: arrows with legend, window/level appropriate for lesion visibility

---

## Common Rejection Reasons

1. **Topic outside abdominal/pelvic scope** — chest, MSK, and neuro papers redirected
2. **Structured reporting studies without per-category analysis** — reporting LI-RADS categories without stratified performance is PARTIAL
3. **Missing imaging protocol detail** — essential for reproducibility in abdominal imaging
4. **Small sample without novel technique** — needs sufficient cases per diagnostic category
5. **Overlap with themed issue** — check SAR disease-focused panels schedule to align or avoid

---

## Cover Letter

Should include:
- Relevance to abdominal/pelvic radiology
- Key finding summary
- Alignment with SAR focus areas (if applicable)
- Statement of originality

---

## Author Guidelines URL

https://www.springer.com/journal/261/submission-guidelines

---

## Positioning

Abdominal Radiology is appropriate when:
- Abdominal/pelvic imaging study (CT, MRI, US) with clinical relevance
- LI-RADS, PI-RADS, or other structured reporting validation study
- AI applied to abdominal imaging with diagnostic performance evaluation
- Contrast-enhanced imaging technique comparison (hepatobiliary, CEUS)
- Pictorial essay on abdominal pathology

Not appropriate for: non-abdominal imaging, pure methodology without abdominal imaging data, interventional procedures (use CVIR/JVIR).

# Academic Radiology

## Journal Identity

- **Full name**: Academic Radiology
- **Abbreviation**: Acad Radiol
- **Publisher**: Elsevier (Association of Academic Radiology)
- **ISSN**: Not specified in guidelines
- **Frequency**: Monthly
- **Impact Factor**: Not specified in guidelines
- **Open Access**: Hybrid (subscription + OA option)
- **APC**: See Elsevier OA policies

## Manuscript Types and Word Limits

| Type | Abstract | Manuscript Body | References | Figures/Tables |
|------|----------|----------------|------------|----------------|
| Original Investigation | 200 w (structured) | No strict cap | No cap | No strict cap |
| Clinical Review / Systematic Review | 250 w | 5,000 | 100 | 5 T + 10 F |
| Innovations | 200 w | 2,500 | 15 | 5 |
| Perspectives | None | 2,000 | 20 | 2 |
| Beyond Academic Radiology | None | 1,000 | 10 | 2 |
| White Papers | None | 5,000 | 50 | 5 |
| Letter to the Editor | None | 500 | 5 | 0 |

Word counts exclude abstract, references, figure legends, and tables.

## Abstract Format

Structured with four headings (for Original Investigations):
1. **Background**
2. **Methods**
3. **Results**
4. **Conclusion**

Maximum 200 words (Original Investigation) or 250 words (Clinical Review).
No abbreviations unless established. No references in abstract.

## Keywords

3-5 keywords on the title page.

## Required Sections

1. **Introduction**
2. **Material and Methods**
3. **Results**
4. **Conclusions**

Additional required elements:
- **Take-Home Messages**: 1-2 bullet points (max 50 words total) for Original Investigations; up to 3 for Clinical Reviews
- **Title page** (separate): title, authors, affiliations, corresponding author, keywords, disclosures, funding, AI declaration
- **Blinded manuscript** (separate): no author-identifying information (double-blind review)
- **Acknowledgements** (separate file)

## Citation Style

- Vancouver (numbered) style
- Numbered sequentially in order of first appearance
- DOI highly encouraged
- Journal abbreviations per ISSN List of Title Word Abbreviations
- Example: `Boyko A, Qureshi MM, Fishman MDC, Slanetz PJ. Predictors of breast cancer outcome... Acad Radiol. 2024;31(5):1727-1734. doi: 10.1016/j.acra.2023.11.037.`

## Reporting Guidelines

| Study Type | Required Guideline |
|------------|-------------------|
| Systematic reviews / meta-analyses | PRISMA |
| Observational studies | STROBE |
| Quality improvement | SQUIRE |
| AI/ML studies | CLAIM |
| Randomized trials | CONSORT |

## Statistical Reporting

Follows standard biomedical statistical reporting conventions:
- Report exact p-values; use P < .001 only when value is below that threshold.
- 95% CI required for all primary outcomes.
- For AI/ML studies: CLAIM checklist compliance required; discrimination and calibration both expected.
- Effect sizes with units; identify specific statistical tests used.
- Statistical software and version must be named in Methods.
- No journal-specific statistical reporting requirements beyond standard practice; SAMPL guidelines recommended as reference.

## Special Notes

- **Double-blind review**: author information must be completely removed from the blinded manuscript file.
- **AI declaration mandatory**: generative AI use must be declared; failure to disclose leads to automatic rejection and possible submission ban.
- **Co-first authors**: up to two allowed; no co-senior authors accepted.
- **Proof turnaround**: 48 hours.
- Drug/instrument names: use generic name first, then trade name with manufacturer and location in parentheses.

- **AI-use disclosure placement**: Title page
  <!-- machine-read by /self-review check_classical_style.py --profile; source: this profile's own "Title page (separate): title, authors, affiliations, corresponding author, keywords, disclosures, funding, AI declaration" -->

# Journal Profile: American Journal of Kidney Diseases (AJKD)

## Journal Identity

- **Full name**: American Journal of Kidney Diseases
- **Abbreviation**: Am J Kidney Dis
- **Publisher**: Elsevier on behalf of the National Kidney Foundation (NKF)
- **ISSN**: 0272-6386 (print), 1523-6838 (online)
- **Frequency**: Monthly
- **Impact Factor**: ~10.4 (JCR 2023)
- **Open Access**: Hybrid
- **Acceptance rate**: ~12%
- **Peer review**: Single-blind, 2-3 reviewers

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | References | Figures/Tables |
|------|----------------|----------|------------|----------------|
| Original Investigation | 3500 words | 300 words | 50 (recommended) | 6-8 (combined) |
| Research Letter | 1000 words | None | 15 | 2 (combined) |
| Review | 5000 words | 250 words | 100 | 6 (combined) |
| Case Report (Teaching Case) | 1500 words | 150 words | 15 | 3 (combined) |

*Note: Body word limit excludes title page, abstract, references, tables, figures, and legends.*

---

## Abstract Requirements

**Structured abstract, 300 words maximum:**
Headings must be exactly:
- **Rationale & Objective:** [Study justification and main hypothesis]
- **Study Design:** [Prospective/retrospective cohort, RCT, cross-sectional, etc.]
- **Setting & Participants:** [Location, database, clinical trial centers, patient characteristics]
- **Predictor / Exposure:** [Independent variable(s) studied]
- **Outcomes:** [Primary and secondary clinical endpoints]
- **Measurements:** [How outcomes and exposures were evaluated]
- **Results:** [Main findings with hazard ratios/odds ratios, 95% CIs, exact p-values]
- **Limitations:** [A brief list of key study-level limitations]
- **Conclusions:** [Main message and clinical takeaways]

---

## Required Journal-Specific Elements

### Clinical Summary Bullets
- A mandatory section of **2-4 bullet points** (1 sentence per bullet) at the beginning of the manuscript.
- Covers:
  1. *What is already known on this topic*
  2. *What this study adds*
  3. *What a clinician should know (implications for practice)*

---

## Required Sections (Original Investigation)

1. **Title Page**
2. **Clinical Summary Bullets**
3. **Structured Abstract** (max 300 words)
4. **Introduction** (brief, ending with study objectives)
5. **Methods** (must describe design, population, statistics, and follow reporting checklists)
6. **Results** (clear data reporting, references to tables/figures)
7. **Discussion** (limitations must be the penultimate paragraph)
8. **Acknowledgments**
9. **Disclosures / Declarations**
10. **References**

---

## Statistical Reporting

- Report exact p-values (P = 0.04) and 95% Confidence Intervals (95% CI).
- Clearly define the statistical model used and verify model assumptions (e.g., proportional hazards).
- **Competing Risks:** Given the clinical focus on CKD, survival and outcomes analyses must appropriately address the competing risk of death using established models (e.g., Fine-Gray or cause-specific hazards).
- Reporting guidelines (e.g., STROBE, CONSORT) are highly enforced.

---

## Figures

- **Maximum**: 6 to 8 figures/tables combined for Original Investigations.
- **Resolution**: 300 DPI minimum for half-tones, 1200 DPI for line drawings.
- **Format**: TIFF, EPS, or PDF.
- **Color**: Color is free in online version; print edition may incur fees.

---

## Common Rejection Reasons

1. **Failure to Address Competing Risks:** Using standard Kaplan-Meier curves for CKD outcomes where death is a major competing event.
2. **Missing Clinical Summary or Structured Headings:** Failure to format the manuscript according to AJKD's unique guidelines.
3. **Single-Center Studies:** Retrospective single-center cohorts are rarely accepted unless highly novel.
4. **No External Validation:** For predictive models, lacking external cohort replication.
5. **Predominantly Pathological/Basic Work:** AJKD is a clinical practice journal and rarely accepts purely basic science papers.

---

## Cover Letter

Should include:
- Description of the clinical significance and relevance to practicing nephrologists.
- Author contribution statement.
- Conflict of interest and copyright agreement declarations.
- 3-5 suggested reviewers.

---

## AI Writing Disclosure Policy

- **Requirement level:** Required
- **Permitted scope:** Language editing and polishing only.
- **Disclosure location:** End of the manuscript (before References).
- **AI-generated images:** Banned.
- **Policy URL:** https://www.elsevier.com/about/policies-and-standards/generative-ai-policies-for-authors

---

## Author Guidelines URL

https://www.ajkd.org/content/authorinfo

---

## Positioning

AJKD is the premier clinical nephrology journal of the National Kidney Foundation. It is highly suited for clinical epidemiology, educational nephrology (e.g., Teaching Cases), health policy, and studies of direct clinical utility to practicing nephrologists.

| Dimension | AJKD | CJASN | JASN |
|-----------|------|-------|------|
| Society | National Kidney Foundation (NKF) | American Society of Nephrology (ASN) | American Society of Nephrology (ASN) |
| Scope | Clinical Practice, Trials, & NKF Guidelines | Clinical Trials & Epidemiology | Basic, Translational, & Major Trials |
| Impact factor | ~10.4 | ~9.6 | ~12.7 |
| Emphasis | Clinician-Friendly & US-centric Practice | General Clinical Nephrology | Mechanisms & Landmark Discoveries |

## Verification
- **Source:** AJKD Information for Authors — https://www.ajkd.org/article/S0272-6386(11)01206-6/fulltext
- **Date:** 2026-07-14
- **Note:** the 300-word abstract limit is quoted verbatim from that page in the PR #330 review (https://github.com/Aperivue/medsci-skills/pull/330#issuecomment-4968075916). The 3,500-word body limit was confirmed on the same page.

# Journal Profile: AJNR (American Journal of Neuroradiology)

## Basic Information

- **Publisher:** American Society of Neuroradiology (ASNR)
- **Impact Factor:** ~4.5–5.0 (2023–2024)
- **Scope:** Diagnostic and interventional neuroradiology; brain, spine, head/neck; pediatric neuroradiology; functional MRI; neuro-oncology imaging
- **Open Access:** Optional (Hybrid OA)
- **Language:** American English

---

## Scope — Covered Topics

**Diagnostic Neuroradiology:**
- Brain tumor imaging (glioma, meningioma, metastases, lymphoma)
- White matter disease and demyelination
- Cerebrovascular disease (stroke imaging, vessel wall MRI)
- Neurodegenerative disorders
- Spinal cord imaging and spinal stenosis
- Head and neck imaging (temporal bone, orbit, paranasal sinuses, salivary glands)
- Pediatric neuroimaging
- Advanced imaging: MR spectroscopy, perfusion, diffusion, fMRI, DTI

**Interventional Neuroradiology:**
- All topics covered by INSI — can publish in AJNR if broad neuroradiology readership would benefit

**Emerging Topics:**
- AI/machine learning in neuroradiology (increasingly prominent)
- Radiomics for brain tumors
- Quantitative MRI biomarkers

---

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | Figures | References |
|------|----------------|----------|---------|------------|
| Original Research | 3500 words | 250 words | 8 | 40 |
| Review | 5000 words | 250 words | 10 | 60 |
| Technical Note | 2500 words | 200 words | 6 | 25 |
| Case Report | 1500 words | 200 words | 6 | 15 |
| Letters | 500 words | None | 2 | 5 |

---

## Abstract Requirements

**Structured abstract, 250 words:**

```
BACKGROUND AND PURPOSE: [Clinical problem and study rationale]
MATERIALS AND METHODS: [Design, participants, imaging, analysis]
RESULTS: [Key results with 95% CI and exact p-values]
CONCLUSIONS: [Main finding and clinical implication]
```

Note: AJNR uses ALL CAPS for abstract section headers.

---

## Required Journal-Specific Element

### "What This Adds to the Published Literature" Box

3 bullet points at the end of the manuscript (before References).

Each bullet ≤ 2 sentences. Cover:
1. What makes this study methodologically or clinically novel
2. Main quantitative finding
3. Clinical or research implication

Example:
```
WHAT THIS ARTICLE ADDS TO THE PUBLISHED LITERATURE
• This study provides the first multi-center validation of a deep learning
  model for automated glioma segmentation on standard clinical MRI sequences.
• The model achieved a median Dice similarity coefficient of 0.87 (IQR,
  0.79–0.92) for whole tumor segmentation, comparable to expert neuroradiologists.
• This externally validated tool has potential for reducing segmentation time
  in clinical workflows and enabling standardized tumor measurement.
```

---

## Required Sections

1. **Introduction** (200–400 words) — end with explicit study purpose
2. **Materials and Methods**
   - Ethics: IRB approval, consent or waiver, HIPAA compliance (if US institution) or equivalent
   - Study Design and Participants
   - MR/CT Protocol (acquisition parameters in sufficient detail)
   - Image Analysis / Reference Standard
   - Statistical Analysis
3. **Results**
4. **Discussion** — include explicit Limitations paragraph
5. **Conclusions** — 1–3 sentences maximum
6. **"What This Adds..."** — 3 bullets

---

## Supplementary Material Convention

AJNR uses "eTables" and "eFigures" for supplementary content:
- Reference as: "eTable 1 (available online)" or "eFigure 1 (available online)"
- Include in submission separately from main manuscript
- No limit on number of eTables/eFigures

---

## MRI Protocol Reporting

For MRI studies, include in Methods or as eTable:

| Sequence | TR/TE (ms) | TI (ms) | Flip angle | Slice thickness (mm) | Matrix | FOV (cm) | Field strength |
|----------|------------|---------|------------|----------------------|--------|----------|----------------|
| T1 MPRAGE | ... | ... | ... | 1.0 | ... | ... | 3T |
| T2 FLAIR | ... | — | ... | 3.0 | ... | ... | 3T |

---

## Statistical Reporting

- Exact p-values required (P = .034; P < .001 if below threshold)
- 95% CI for all primary and secondary outcomes
- ROC analysis: AUC with 95% CI, sensitivity, specificity at optimal cutpoint
- DeLong test for ROC comparison
- Report N at each follow-up time point

---

## Figure Requirements

- **Resolution:** 300 DPI minimum
- **Format:** TIFF or EPS
- **Clinical images:** High-quality screenshots from PACS; annotate with arrows, arrowheads (use consistent labeling throughout)
- **Supplementary figures:** As eFigures — unlimited
- **Color:** Available online; print is grayscale — design figures accordingly

---

## Common Rejection Reasons

1. **Low clinical relevance** — AJNR emphasizes clinical neuroradiology; purely technical papers without clinical application are less competitive
2. **Missing "What This Adds" box** — editors check immediately on submission
3. **Inadequate MRI protocol description** — sequence parameters must be complete
4. **Small sample size without justification** — N < 50 for most original research; technical notes can be smaller
5. **Mixing of magnet/sequence types without analysis** — scanner heterogeneity must be addressed (mixed-effects model or sensitivity analysis)
6. **No blinding of image readers** — outcomes assessors must be blinded to clinical data and group assignment
7. **Abstract word limit exceeded** — 250 words strictly enforced

---

## Positioning Strategy

### Choose AJNR over INSI when:

- Study encompasses both diagnostic and interventional neuroradiology
- Study is primarily diagnostic (imaging biomarkers, protocol optimization)
- Study targets the broader neuroradiology readership
- AI/ML study in neuroradiology

### Choose INSI over AJNR when:

- Study is purely about interventional technique, devices, or endovascular outcomes
- Target audience is specifically neurointerventionalists

### Choose Radiology over AJNR when:

- Practice-changing finding that belongs to the flagship journal
- Multi-center prospective study (Radiology has higher impact but higher bar)

---

## Author Guidelines URL

https://www.ajnr.org/page/authors

---

## Typical Turnaround Times

- Initial decision: 4–6 weeks
- Revision deadline: 60–90 days (strict)
- Acceptance to publication: 4–8 weeks

# American Journal of Roentgenology (AJR)

## Journal Identity

- **Full name**: American Journal of Roentgenology
- **Abbreviation**: AJR Am J Roentgenol
- **Publisher**: American Roentgen Ray Society (ARRS)
- **ISSN**: 0361-803X (print), 1546-3141 (online)
- **Frequency**: Monthly
- **Impact Factor**: ~5.0 (2024)

## Manuscript Types and Word Limits

| Type | Abstract | Manuscript Body | Figures | Tables |
|------|----------|----------------|---------|--------|
| Original Research | 250 | 3500 | 8 | 5 |
| Brief Report | 250 | 1500 | 4 | 2 |
| Review Article | 250 | 5000 | 10 | 5 |
| Pictorial Essay | 250 | 3000 | 20 | 3 |
| Letter to Editor | none | 500 | 1 | 1 |
| Technical Innovation | 250 | 2000 | 6 | 3 |

Word counts exclude abstract, references, figure legends, and tables.

## Abstract Format

Structured with four headings:
1. **Objective**
2. **Materials and Methods**
3. **Results**
4. **Conclusion**

Maximum 250 words. Must be self-contained.

Note: AJR uses "Objective" (not "Purpose" as in RYAI).

## Citation Style

- Vancouver (numbered) style.
- Numbered sequentially in order of first appearance in text.
- Use superscript numbers in the manuscript body.
- Format: Author(s). Title. Journal Abbreviation. Year;Vol(Issue):Pages.
- List all authors if 6 or fewer; if 7+, list first 3 followed by "et al."

## Keywords

- 3-10 keywords required.
- MeSH terms preferred.

## Required Elements

### For All Manuscripts

- **Title page**: title, authors with degrees and affiliations, corresponding author with full contact, word count, number of figures/tables.
- **"What Does This Article Add?"** box: Required for Original Research. Two to three bullet points (each 1 sentence) stating the specific new knowledge this study contributes beyond what was previously known.
- **Key Points**: Required. Three bullet points summarizing the most important findings for the reader. These appear in the published article.
  - Format: "Key Point 1: {finding}."
- **Author Contributions**: Required.
- **Conflict of Interest**: Required for all authors.
- **Acknowledgments**: Including funding sources.

### For AI/ML Studies
- AI disclosure: describe AI tools used in research and/or writing.
- Appropriate reporting checklist (STARD-AI, TRIPOD+AI, CLAIM) encouraged.
- Code and data availability statements encouraged.

## Reporting Guidelines

AJR endorses standard reporting guidelines:

| Study Type | Recommended Checklist |
|------------|----------------------|
| Diagnostic accuracy | STARD |
| Prediction model | TRIPOD |
| AI study | CLAIM |
| RCT | CONSORT |
| Systematic review | PRISMA |
| Observational | STROBE |

Completed checklists should be submitted as supplemental files.

## Formatting Notes

- Double-spaced throughout.
- 12-point font.
- Line numbers on every page.
- Pages numbered consecutively.
- Abbreviations: define at first use in abstract and body independently.
- Tables: each on a separate page after references.
- Figures: submitted as separate high-resolution files (TIFF or EPS preferred, minimum 300 dpi).
- Figure legends: on a separate page after tables.

## Section-Specific Requirements

### Original Research Structure
1. Title page
2. Abstract (structured: Objective, Materials and Methods, Results, Conclusion)
3. "What Does This Article Add?" box
4. Key Points
5. Introduction
6. Materials and Methods
7. Results
8. Discussion
9. References
10. Tables
11. Figure legends
12. Figures (separate files)

### "What Does This Article Add?" Box Format
```
WHAT DOES THIS ARTICLE ADD?

- Previous studies have shown {known finding}.
- This study demonstrates {new finding from this work}.
- These results suggest {clinical implication or next step}.
```

### Key Points Format
```
KEY POINTS

- Key Point 1: {most important finding, one sentence}.
- Key Point 2: {second finding or methodological contribution}.
- Key Point 3: {clinical implication}.
```

## Review Process

- Single-blind peer review.
- Typical first decision: 4-6 weeks.
- Statistical review for accepted manuscripts.
- Revisions typically due within 45 days.

## Statistical Reporting

AJR endorses the SAMPL (Statistical Analyses and Methods in the Published Literature) guidelines:
- Report exact p-values (e.g., P = .034); never report only P < .05.
- 95% CI for all primary outcomes and diagnostic performance metrics.
- Diagnostic accuracy studies: sensitivity, specificity, AUC, PPV, NPV -- all with 95% CI.
- For AI studies: calibration required in addition to discrimination; AUC alone is insufficient.
- Effect sizes with units; name the specific statistical test used for each comparison.
- Statistical review for accepted manuscripts.
- Statistical software and version must be reported in Methods.

## Special Considerations for Education-Research Manuscripts

- Paper 3 (Educational Effectiveness) could fit AJR's scope if framed around radiology education and AI-assisted learning tools.
- The "What Does This Article Add?" box and Key Points are mandatory and should be drafted early to clarify the paper's contribution.
- AJR values clinical relevance; frame AI findings in terms of educational or clinical impact rather than pure technical performance.

# Journal Profile: Annals of Internal Medicine

## Journal Identity

- **Full name**: Annals of Internal Medicine
- **Abbreviation**: Ann Intern Med
- **Publisher**: American College of Physicians (ACP)
- **ISSN**: 0003-4819 (print), 1539-3704 (online)
- **Frequency**: Monthly (12 issues/year + online-first)
- **Impact Factor**: ~39 (JCR 2023), top-5 general/internal medicine journal
- **Open Access**: Hybrid (optional OA; standard subscription)
- **Acceptance rate**: ~5% for Original Research
- **Peer review**: Double-blind; dedicated statistical reviewers

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | References | Figures/Tables |
|------|----------------|----------|------------|----------------|
| Original Research | 3000 words | 325 words (structured) | 50 | 6 |
| Review | 4000 words | 250 words | 75 | 6 |
| Research Letter | 600 words | None | 6 | 1 |
| Ideas and Opinions | 1200 words | None | 10 | 1 |
| Clinical Guidelines | By invitation | 250 words | Varies | Varies |
| Systematic Review | 3500 words | 325 words | 75 | 6 |

Word counts exclude abstract, references, tables, figure legends, and appendices.

---

## Abstract Requirements

**Structured abstract, 325 words maximum:**

```
Background: [Context and knowledge gap — 2-3 sentences]
Objective: [Specific aims]
Design: [Study design (e.g., retrospective cohort, RCT)]
Setting: [Single center/multi-center, country]
Participants: [Eligibility, sample size]
Intervention: [If applicable]
Measurements: [Primary and secondary outcomes]
Results: [Key results with effect sizes, CIs, P values]
Limitation: [1-2 key limitations]
Conclusion: [Main conclusion answering the Objective]
Primary Funding Source: [Funder name]
```

**Unique feature**: Annals includes "Limitation" as an abstract heading — the only major general journal to do so. Do not omit this.

---

## Required Journal-Specific Elements

### 1. Visual Abstract (Encouraged)

Annals encourages a single-page graphical summary suitable for social media. Not required but strongly recommended for visibility.

### 2. Summaries for Patients

For all Original Research articles, Annals publishes a plain-language "Summaries for Patients" companion. Authors may be asked to draft this (~300 words, written at 8th-grade reading level).

### 3. Appendix

Detailed methods, supplementary tables/figures, sensitivity analyses go in an online Appendix (no word limit). Referenced from main text.

---

## Required Sections (Original Research)

1. **Introduction** — concise (2 paragraphs); end with clear objective
2. **Methods**
   - Study Design and Oversight: IRB approval, registration (ClinicalTrials.gov for RCTs)
   - Participants and Setting: eligibility, recruitment, sites
   - Measurements/Interventions
   - Statistical Analysis: pre-specified, power calculation, missing data handling, sensitivity analyses
   - Role of the Funding Source: explicit statement
3. **Results** — begin with participant flow; baseline table; primary then secondary outcomes
4. **Discussion** — start with key findings; compare with literature; Limitations paragraph; conclude with implications
5. **Appendix** — detailed methods, supplementary analyses

---

## Statistical Reporting

Annals of Internal Medicine has historically championed transparent statistical reporting:
- Report exact P values (e.g., P = .04); use P < .001 below that threshold.
- 95% CI required for all primary outcomes; preferred over P values alone.
- Effect sizes in clinically meaningful units (absolute risk difference, NNT/NNH, mean difference with units).
- For diagnostic accuracy: report sensitivity, specificity, and likelihood ratios with CIs.
- Prediction models: calibration required (Hosmer-Lemeshow or calibration plot); discrimination alone insufficient.
- Report both unadjusted and adjusted results for observational studies.
- Multiple comparisons: describe approach; secondary analyses should be labeled exploratory.
- Missing data: state the amount and handling method (complete case, imputation).
- Power calculation with assumptions stated for all prospective studies.
- Statistical software and version must be identified in Methods.

**Note**: Annals published the TRIPOD statement (Moons et al., 2015) and enforces its items rigorously for prediction model papers.

---

## Figures

- **Maximum 6 figures/tables combined**
- **Resolution**: 300 DPI (600 DPI for line art)
- **Format**: TIFF, EPS, or high-resolution PDF
- **Color**: Free online; grayscale for print
- **Appendix figures**: Unlimited (online only)
- **Multi-panel**: Counts as one figure; label A, B, C

---

## Common Rejection Reasons

1. **Too specialized for internal medicine audience** — Annals expects relevance to practicing internists; pure subspecialty or methodological papers should target specialty journals
2. **Missing Limitation in abstract** — unique to Annals; omission signals unfamiliarity with journal
3. **Underpowered or single-center** — Annals favors large multi-center studies
4. **Observational study with causal claims** — editors and statistical reviewers scrutinize causal language
5. **No clinical endpoint** — surrogate outcomes insufficient unless no alternative exists
6. **AI study without clinical utility demonstration** — must show impact on clinical decision-making, not just accuracy
7. **Incomplete reporting** — Annals requires adherence to EQUATOR guidelines; missing checklist items flagged

---

## Cover Letter

Must include:
- Why this study is important for Annals' readership (internists and generalists)
- Key finding in 1-2 sentences
- Statement of originality
- Disclosure of related submissions
- Suggested reviewers (optional)

---

## Author Guidelines URL

https://www.acpjournals.org/journal/aim/authors

---

## Positioning

Annals of Internal Medicine is appropriate when:
- Large prospective or multi-center study relevant to internal medicine practice
- Systematic review or meta-analysis following PRISMA rigorously
- Diagnostic accuracy study affecting common clinical decisions (screening, triage)
- Prediction model validated externally with clinical decision impact
- Health policy study with evidence-based recommendations

Not appropriate for: pure radiology methodology, small pilot studies, AI technical papers without clinical integration, narrow subspecialty findings.

# Artificial Intelligence in Medicine

## Journal Identity

- **Full name**: Artificial Intelligence in Medicine
- **Abbreviation**: Artif Intell Med
- **Publisher**: Elsevier
- **ISSN**: 0933-3657 (print) / 1873-2860 (online)
- **Frequency**: Continuous
- **Impact Factor**: ~6.2 (2024)
- **Open Access**: Hybrid (subscription + Gold OA option)
- **APC**: USD 3,310

## Manuscript Types and Word Limits

| Type | Abstract | Manuscript Body | References | Notes |
|------|----------|----------------|------------|-------|
| Original Research | 250 w | No strict cap | No cap | Must show AI novelty + medical impact |
| Methodological Review/Survey | 250 w | No strict cap | No cap | Classify and critically analyze methods |
| Position Paper | 250 w | No strict cap | No cap | Scientific challenges of a field |
| Letter to the Editor | 250 w | Short | No cap | Comment on recent articles |
| PhD Project | 250 w | Short | No cap | Overall goals, not detailed results |

Mere application of known algorithms to medical data is NOT considered original.

## Abstract Format

Unstructured, maximum 250 words.
State purpose, principal results, and major conclusions.
Must stand alone; avoid references. Define non-standard abbreviations at first mention.

## Keywords

1-7 keywords. Avoid multi-word keywords using "and"/"or". Use established abbreviations only.

## Required Sections

1. **Introduction**
2. **Material and Methods**
3. **Results**
4. **Discussion**
5. **Conclusions**

Additional required elements:
- **Highlights**: separate file, 3-5 bullet points, max 85 characters each (including spaces)
- **CRediT Author Contributions**: mandatory
- **Acknowledgements**: separate section before references
- **Numbered sections** (1, 1.1, 1.2, etc.)

## Citation Style

- Numbered [1], [2] in order of appearance
- No strict formatting required at submission (any consistent style accepted)
- After acceptance: numbered Vancouver-like style applied
- More than 6 authors: list first 6, then "et al."
- DOI recommended
- Example: `Van der Geer J, Hanraads JAJ, Lupton RA. The art of writing a scientific article. J Sci Commun 2020;163:51-9. https://doi.org/10.1016/j.sc.2020.00372.`

## Reporting Guidelines

- Follow ICMJE recommendations and Declaration of Helsinki for human studies
- Clinical trials: register before enrollment; include registration number in title page and abstract; follow CONSORT
- SAGER guidelines for sex/gender reporting

## Statistical Reporting

Follows ICMJE and SAGER guidelines:
- Report exact p-values where applicable.
- 95% CI for primary outcomes; effect sizes with units.
- For AI model evaluations: discrimination metrics (AUC, F1, accuracy) with CI; calibration expected for prediction models; external or independent test set required.
- Sex and gender disaggregation of results per SAGER guidelines.
- Statistical software and version identified in Methods.
- No journal-specific statistical reporting requirements beyond ICMJE and SAGER are published.

## Special Notes

- **Single-blind review** (reviewers know author identity).
- **AI-generated images NOT permitted** in artwork (exception: AI as part of research methods).
- **Clinical assessment strongly recommended**: manuscripts should demonstrate potential clinical impact.
- **Median review time**: submission to first decision ~12 days; to acceptance ~303 days.
- Preprints allowed; free posting on SSRN during submission.
- Self-archiving: 12-month embargo for subscription articles.

# Journal Profile: British Journal of Radiology (BJR)

## Basic Information

- **Publisher:** Oxford University Press (on behalf of The British Institute of Radiology)
- **Impact Factor:** [TODO: verify at journal site — typically reported in JCR]
- **ISSN:** 0007-1285 (print) / 1748-880X (online)
- **Frequency:** 12 issues per year (online)
- **Scope:** All subspecialties of diagnostic radiology, interventional radiology, nuclear medicine, radiation oncology, radiation physics; particular interest in clinical research, methodology, and translational radiology
- **Open Access:** Hybrid — optional Open Access under Creative Commons (CC BY or CC BY-NC); APC £2,393 for CC licenses; Read and Publish institutional agreements available
- **Language:** English only

---

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | Figures | Tables | References |
|------|----------------|----------|---------|--------|------------|
| Research Article | 3,000 words | 250 words (structured) | 10 | 5 | 50 |
| Review | 4,000 words | 200 words (unstructured) | 12 | 5 | 100 |
| Systematic Review | 3,000 words | 250 words (structured) | 10 | 5 | 50 |
| Pictorial Review | 1,500 words | 200 words (unstructured) | 15 | 4 | 15 |
| Guidelines | 4,000 words | 200 words (unstructured) | 12 | 5 | 100 |
| Short Communication | 2,000 words | 250 words (structured) | 5 | 2 | 15 |
| Commentary | 1,500 words | 200 words (unstructured) | 4 | 2 | 15 |
| Letter to Editor | 750 words | None | 2 (max) | — | 10 |

---

## Abstract Requirements

**Structured abstract** (Research Articles, Short Communications, Systematic Reviews) — 250 words, five required headings:

```
Objectives: [Primary aim of the study]
Methods: [Design, population, intervention/exposure, comparator, outcome]
Results: [Key findings with statistics and 95% CIs]
Conclusions: [Main interpretation]
Advances in knowledge: [What this study adds]
```

The "Advances in knowledge" heading is BJR-specific — it must explicitly state the novelty contribution and is checked by reviewers.

**Unstructured abstract** (Reviews, Pictorial Reviews, Guidelines, Commentary) — 200 words, single paragraph.

---

## Required Sections (Research Article)

Standard IMRAD:

1. **Introduction**
2. **Methods**
3. **Results**
4. **Discussion**

Ethics, funding, conflict of interest, and data availability statements are required as separate end-matter sections.

---

## Statistical Reporting

- Measures of variation must be included for all important results
- Estimates of differences must be provided with 95% confidence limits
- For diagnostic test evaluation: sensitivity, specificity, and predictive values are required
- p-value reporting format: [TODO: verify at journal site — follow standard convention]
- Statistical software identification: [TODO: verify — recommend stating software + version]

---

## Figure Requirements

- **Resolution:** 300 DPI (color), 600 DPI (grayscale/combination), 1,200 DPI (monochrome line art)
- **Formats accepted:** JPEG, PNG, TIFF, SVG, PDF, EPS
- **Color:** accepted (online publication is in color)
- **Maximum:** 10 figures + 5 tables for Research Articles (see manuscript-type table above)

---

## Common Rejection Reasons

1. **Insufficient novelty** — BJR Research Articles are expected to clearly state advancement over existing literature in the dedicated "Advances in knowledge" abstract heading
2. **Single-center study with limited generalizability** — multi-center or representative cohort designs preferred
3. **Missing structured abstract elements** — particularly omission of the "Advances in knowledge" line
4. **Inadequate statistical reporting** — confidence intervals and effect sizes required, not just p-values
5. **Poor English language quality** — BJR expects professional editing prior to submission
6. **Pictorial Review without sufficient teaching value** — pictorial submissions must demonstrate clear pedagogical contribution beyond image collection

---

## AI Writing Disclosure Policy

- **Requirement level:** Required (mandatory disclosure)
- **Permitted scope:** Content generation, image generation, code writing, data processing, translation — all permitted with disclosure; AI tools cannot be listed as authors
- **Disclosure location:** Both (a) cover letter to editors AND (b) Methods or Acknowledgements section
- **AI-generated images:** Must be disclosed; AI image policy aligns with COPE/ICMJE guidance
- **Policy URL:** https://academic.oup.com/bjr/pages/author-guidelines

---

## Cover Letter

Not mandatory per current author guidelines, but recommended; if AI tools were used in manuscript preparation, AI disclosure in the cover letter is required (see AI Writing Disclosure Policy above).

---

## Open Access and APC

- **Hybrid model**: Subscription default; optional Open Access under CC BY or CC BY-NC
- **APC:** £2,393 (for CC license; may vary — verify at submission)
- **Read and Publish agreements:** institutional waiver may apply if author's institution has an OUP Read and Publish deal

---

## Peer Review

- **Type:** Double-anonymized peer review (both author and reviewer identities blinded)
- **Number of reviewers:** Typically 2 reviewers
- **Turnaround:** [TODO: verify at journal site]

Because BJR uses double-anonymized review, manuscript files (including supplementary materials and registry record PDFs) must be blinded prior to submission. Author identifiers (names, institutions, ORCID, funding grant IDs that identify a specific group) should be removed from all uploaded files except the separately-uploaded title page.

---

## Author Guidelines URL

https://academic.oup.com/bjr/pages/author-guidelines

---

## Positioning

BJR is well-suited for:
- Clinical radiology research with clear translational impact
- Methodology and radiation-physics studies that complement clinical findings
- Studies with explicit "Advances in knowledge" framing
- Authors seeking a UK/European-oriented general radiology audience with mid-range Q1/Q2 visibility

| Dimension | British Journal of Radiology | Clinical Radiology | European Radiology |
|-----------|-----------------------------|-------------------|--------------------|
| Society | British Institute of Radiology | Royal College of Radiologists (UK) | European Society of Radiology |
| Scope | Diagnostic + interventional + radiation oncology + physics | Diagnostic radiology (general) | Diagnostic radiology (general) |
| Peer review | Double-anonymized | [varies] | Single-blind |
| Emphasis | "Advances in knowledge" novelty statement; methodology and physics included | UK-leaning clinical practice | European multi-center studies, AI |
| OA option | Hybrid (CC BY / CC BY-NC) | Hybrid | Hybrid |

---

## Formatting Notes

- References: Vancouver style (numbered)
- Units: SI units
- Abbreviations: define at first use
- Double-anonymized: blind all uploaded files except title page (see Peer Review section above)


---

## Verification
- **Source:** https://academic.oup.com/bjr/pages/author-guidelines
- **Date:** 2026-05-21

- **AI-use disclosure placement**: Cover letter
  <!-- machine-read by /self-review check_classical_style.py --profile; source: the profile's own AI Writing Disclosure Policy: "AI disclosure in the cover letter is required" -->

# Journal Profile: CHEST

## Journal Identity

- **Full name**: CHEST (Journal of the American College of Chest Physicians)
- **Abbreviation**: Chest
- **Publisher**: Elsevier on behalf of the American College of Chest Physicians (ACCP)
- **ISSN**: 0012-3692 (print), 1931-3543 (online)
- **Frequency**: Monthly (12 issues/year)
- **Impact Factor**: ~9 (JCR 2023), top-tier in pulmonary and critical care
- **Open Access**: Hybrid (optional OA with APC $4,160; CC BY-NC-ND default, CC BY for mandated funders)
- **Acceptance rate**: ~15% (approximate)
- **Peer review**: **Double anonymized** (author identities concealed from reviewers and vice versa); handled by Editorial Manager; dedicated biostatistical review where applicable

---

## Manuscript Types and Word Limits

Word counts exclude abstract, references, figure legends, and tables. Unsolicited submissions are accepted (Y) for the types marked below.

| Type | Unsolicited | Abstract | Body Word Limit | References |
|------|-------------|----------|-----------------|------------|
| Original Research | Y | 300 (structured) | 3,200 | 50 |
| Research Letter | Y | None | 1,000 | 10 |
| Guidelines and Consensus Statements | Y | 300 (structured) | 4,000 (negotiable) | 150 |
| Systematic Reviews (no MA) | Y | 250 (structured) | 3,200 | 75 |
| Scoping Reviews | Y | 250 (structured) | 3,200 | 50 |
| Narrative Reviews | N (invited) | 250 (structured) | 3,500 | 75 |
| Special Features | N (invited) | 250 (narrative) | 3,500 | 75 |
| How I Do It | N (invited) | 250 (unstructured) | 3,000 | 50 |
| Point/Counterpoint | N (invited) | None | 1,200 (rebuttal 500) | 12 (rebuttal 7) |
| Editorials | N (invited) | None | 1,000 | 12 |
| CHEST Commentary | N (invited) | None | 1,000 | 5 |
| Novel Reports (case) | Y | 150 (narrative) | 750 single / 1,200 multi | 10 |
| Chest Imaging & Pathology | Y | None | 1,600 | 10 |
| CHEST Pearls | Y | None | 1,600 | 10 |
| Ultrasound Corner | Y | None | 1,200 | 10 |
| Humanities: Case-Based Discussion | N (invited) | 250 (unstructured) | 2,500 | 50 |
| Humanities: Consilia Historiae | N (invited) | 250 (narrative) | 2,500 | 50 |
| Humanities: Vantage | N (invited) | None | 1,200 | 7 |
| Humanities: Exhalations | Y | None | 1,200 | 7 |
| Humanities: Original Research | Y | 300 (structured) | 3,200 | 50 |
| Letter to the Editor | Y | None | 400 | 5 |

**Systematic reviews with meta-analysis are submitted as Original Research, not as Systematic Reviews.**

---

## Abstract Requirements

Original Research uses a **6-section structured abstract (300 words max)**:

```
Background: [Context and knowledge gap]
Research Question: [Single interrogative sentence — the specific question]
Study Design and Methods: [Design, setting, participants, exposures/outcomes,
    analytic approach]
Results: [Participant flow; primary and secondary findings with effect sizes,
    95% CIs, and P values]
Interpretation: [Main conclusion, clinical implications, key limitation]
Clinical Trial Registration: [Registry name, URL, registration number — RCTs only]
```

**Critical terminology**: CHEST uses "Research Question" (not "Objective") and "Interpretation" (not "Conclusion"). The Research Question must be phrased as a single interrogative sentence.

Review types (Narrative, Scoping, Systematic, Special Feature) use structured abstracts with review-specific headings; consult the pertinent article-type section in the guidelines.

Research Letters, Editorials, Point/Counterpoint, CHEST Commentary, Correspondence, and most case-based sections do **not** require an abstract.

---

## Required Submission Components (Separate Uploads)

Editorial Manager requires **each** of the following as a separate upload:

1. **Cover Letter**
2. **Title Page** (author details, IRB approval info, corresponding author full mailing + email address, COI summaries, funding, prior presentation, author contributions)
3. **Anonymized Manuscript** — main body with references, tables, figure legends, and disclosures; **no author or institutional identifiers anywhere**
4. **Figure files** (TIFF, JPEG, PDF, or EPS)
5. **Supplemental material** (e-Tables, e-Figures, e-Appendix numbered consecutively)
6. **Permissions** (for any reused material)
7. **Patient consent** (case-based sections and identifiable images)
8. **Conflict of Interest form** (ICMJE .docx template, one per author)

The anonymized manuscript must remove author names, affiliations, acknowledgments, and any identifying study-site references; IRB approval statements should be anonymized (full committee name + approval number live on the Title Page only).

---

## Required Sections (Original Research)

1. **Introduction** — unlabeled; establish importance, identify gap, state research question
2. **Study Design and Methods** — ethics/IRB (anonymized in manuscript), design, participants, exposures/outcomes, statistical analysis (pre-specified vs post-hoc distinction required for subgroup analyses)
3. **Results** — participant flow first; baseline characteristics; primary then secondary outcomes
4. **Discussion** — key findings, mechanistic context, comparison with prior evidence, strengths, dedicated limitations paragraph
5. **Interpretation** — brief synthesis (distinct from Conclusion sections used by other journals)
6. **Acknowledgments** (lives on Title Page for submission): guarantor statement, author contributions (ICMJE criteria), financial/nonfinancial disclosures matching Title Page, role of sponsors
7. **Declaration of Generative AI and AI-assisted technologies in the writing process** — placed **before References** when applicable
8. **References**

**Take-Home Point pullout**: Three short sentences (Study Question / Results / Interpretation) provided at submission; published as a pullout.

**Subheading rules**: No more than 8 subheadings per article beyond the main section headings. Each subheading is capped at 5 words (including articles like "a", "the").

---

## Statistical Reporting

- **P values**: Italicized, capitalized ("*P* = .032"); report exact values; use *P* < .001 for very small values.
- **95% CI required** for primary outcome and key between-group comparisons, in both Abstract and main text.
- Effect sizes (HR, OR, RR, mean difference) must be accompanied by 95% CI — no P value without an accompanying effect estimate.
- **Matching language to evidence (HEART Group)**: Observational studies use descriptive language ("we observed a lower risk") rather than causal language ("reduced the risk by"); the latter is reserved for RCTs.
- **RCTs**: Follow CONSORT checklist; include CONSORT flow diagram as Figure 1; register in an approved public trials registry at or before enrollment; include registration at the end of the abstract.
- **Observational studies**: Follow STROBE checklist.
- **Systematic reviews/meta-analyses**: Follow PRISMA; include PRISMA flow diagram as Figure 1; PROSPERO registration strongly encouraged.
- **Case reports**: Follow CARE.
- Report statistical software and version.
- Report missing data handling (complete case, multiple imputation, etc.).
- Multivariable models: report both adjusted and unadjusted estimates where relevant; specify variable selection method.
- Subgroup analyses: distinguish pre-specified vs post-hoc; test for interaction.

---

## Figures

- **Formats accepted**: TIFF, JPEG, PDF, EPS.
- **Color**: Published free of charge (print and online).
- **AMA/CHEST label conventions**:
  - "*P*" italicized and capitalized in P values.
  - Comma separators for numbers with 4+ digits (e.g., 1,234).
  - Superscript letters (a, b, c) for footnotes.
  - "Control subjects" not "controls".
  - "Patients with COPD" not "COPD patients".
  - Capital "N" for total sample size.
- **Radiologic/diagnostic images**: Remove all patient-related numbering (test date, MRN) before submission.
- **Legends**: Provided on a separate page (not on the figure itself); stains and magnifications for photomicrographs required; permissions for republished figures noted in legend; any image manipulation (e.g., splicing) described.
- **Figure 1 conventions**: CONSORT (RCTs), PRISMA (SRs), STROBE-compatible flow diagrams (cohort/case-control) recommended.

---

## Tables

- Provided as **Word processing documents** (not spreadsheet format, not image).
- **Maximum 10 columns**; tables exceeding this will not be published.
- No shading or special symbols; any special formatting (bold, italic) explained in the legend.
- Self-explanatory with succinct title, column/row headers, legend defining abbreviations, lettered superscript footnotes.
- Tables comparing prior literature must include a column with lead author last name, year, and numbered citation matching the reference list.
- Tables may be placed at the end of the main document file.

---

## Supplemental Material (e-Appendix, e-Figure, e-Table)

- Labeled and numbered consecutively: **e-Table 1**, **e-Figure 1**, **e-Appendix 1**, Audio 1, Video 1.
- Cited in consecutive order in the main text (not interspersed with print-edition material).
- References in supplemental material are numbered independently from the main text.
- Manuscript title, author list, and "Supplemental Material" heading must appear at the beginning of each file.
- Video: .mov, .wmv, .avi, animated .gif, .mpeg, .mp4 (≤10 MB or 5 min); supply a still image for print reference.
- The main text must stand alone — judicious use of supplements only.

---

## References

- **Superscript numerals** in text, numbered consecutively in order of appearance.
- If a reference first appears in a table, the in-text callout places the reference number after the table call ("Table 3^27^...").
- **AMA Manual of Style (11th ed)** formatting.
- List all authors up to 6; if more than 6, list the first 3 followed by *et al*.
- Journal names abbreviated per Index Medicus.
- Article titles in **sentence case**, no quotation marks.
- Dataset citations allowed; prefix with `[dataset]` in the reference list.
- References in supplemental material numbered separately.

---

## Common Rejection Reasons

1. **Scope mismatch** — studies without clear relevance to pulmonary, critical care, or sleep medicine.
2. **Methodological concerns** — inadequate control for confounding, selection bias, immortal time bias, or violations of CONSORT/STROBE/PRISMA reporting.
3. **Poorly defined research question** — the abstract's Research Question must be a precise, testable, single interrogative sentence.
4. **Insufficient novelty** — incremental advances over existing guidelines or well-established evidence.
5. **Statistical problems** — missing CIs, P values without effect estimates, inappropriate tests, multiple-comparisons inflation without correction.
6. **Under-powered single-center observational work** without adequate external validity or multicenter scope.
7. **Tobacco-company-funded research** — automatic rejection (see Tobacco Policy below).
8. **Failure to anonymize** — submission must be fully anonymized in the manuscript file; author details live only in the separate Title Page upload.

---

## Cover Letter

Should include:
- Article type designation.
- Statement of novelty (1–2 sentences: what this adds to pulmonary/critical care practice).
- Confirmation of originality and no dual submission.
- Confirmation all authors approved the final version.
- Disclosure summary.
- Suggested reviewers (required for Original Research; encouraged for other types) — qualified in the subject area, not affiliated with any author's institution.
- Preprint disclosure (name of server + link) if applicable.
- Any related prior/concurrent submissions or presentations.

---

## AI Writing Disclosure Policy

- **Requirement level**: **Required** when generative AI is used in the writing process.
- **Permitted scope**: Only to **improve readability and language**; not for substantive analysis, interpretation, or drawing insights from data. Basic grammar/spelling tools are exempt from disclosure.
- **Disclosure location**: A dedicated section titled **"Declaration of Generative AI and AI-assisted technologies in the writing process"**, placed at the end of the core manuscript file **before the References list**. Statement template: *"During the preparation of this work the author(s) used [NAME TOOL / SERVICE] in order to [REASON]. After using this tool/service, the author(s) reviewed and edited the content as needed and take(s) full responsibility for the content of the publication."*
- **Authorship**: AI tools cannot be listed as authors or co-authors, nor cited as authors — authorship implies responsibilities only humans can take.
- **AI-generated images**: Not explicitly specified in CHEST's author guidelines; Elsevier's publisher-level policy generally requires disclosure of any AI-generated or manipulated figures.
- **Policy URL**: https://journal.chestnet.org/content/authors (publisher-level policy: Elsevier AI policy for authors)

---

## Tobacco Policy

CHEST **will not consider** research or manuscripts that have been supported by tobacco companies, including their subsidiaries and affiliates. Any tobacco industry funding must be disclosed and will trigger rejection.

---

## Preprints

CHEST considers manuscripts previously posted to preprint servers provided:
- The preprint is flagged as not peer-reviewed.
- The cover letter and disclosures note the server name and link to the posting.
- The final, published version (not the preprint) is cited in any downstream work.

---

## Author Guidelines URL

https://journal.chestnet.org/content/authors

(Submission via Editorial Manager: https://www.editorialmanager.com/chest)

---

## Positioning

**Choose CHEST when**:
- Pulmonary, critical care, or sleep-medicine research with clear clinical relevance and practice impact.
- Lung imaging study (CT screening, AI nodule detection, COPD/emphysema quantification) linked to **clinical endpoint** or guideline-relevant outcome.
- Meta-analysis or systematic review of respiratory interventions, diagnostics, or critical-care management.
- Guideline-adjacent research (Lung-RADS, Fleischner Society, ACCP/CHEST guideline evidence).
- Large RCT or prospective cohort in COPD, asthma, ILD, PE, sepsis/ARDS, or sleep apnea.

**Avoid CHEST for**: basic science without translational relevance, purely technical imaging/AI methodology without clinical validation, non-respiratory disease, small single-institution case series (submit as Novel Report only if truly unique).

| Dimension | CHEST | AJRCCM | ERJ |
|-----------|-------|--------|-----|
| Society | ACCP (American College of Chest Physicians) | ATS (American Thoracic Society) | ERS (European Respiratory Society) |
| Scope emphasis | Clinical practice, guidelines, CT screening, critical care | Translational + clinical, mechanistic | Clinical + epidemiology, European policy |
| Impact factor (2023) | ~9 | ~24 | ~17 |
| Distinguishing feature | Strong pulmonary-imaging presence; Take-Home Point pullouts; dedicated Humanities section | Highest-impact ATS venue; mechanism-emphasis | ERS flagship; strong cohort/registry work |
| Peer review | Double anonymized | Single-blind | Single-blind |

---

## CHEST-Specific Nuances (Cheat Sheet for Submission)

- "Interpretation" replaces "Conclusion" in both abstract and main-text section headings.
- "Research Question" replaces "Objective" in the abstract; must be interrogative.
- "Study Design and Methods" replaces "Methods" as the section heading.
- Take-Home Point pullout (3 sentences) is required at submission.
- Anonymized manuscript + separate Title Page + separate COI form (ICMJE) are mandatory upload components.
- CONSORT/PRISMA/STROBE/CARE flow diagrams (as applicable) must be Figure 1 for the relevant study type.
- Supplemental labeled as e-Table/e-Figure/e-Appendix (lowercase "e-", not "S").
- ICMJE disclosure form (.docx) — do not convert to other formats; signatures not required.

---

<!-- Source verification: Author guidelines text pasted in full by maintainer on 2026-04-20 (equivalent to directly opened guidelines page). ISSN and publisher confirmed against journal homepage https://journal.chestnet.org/. Promoted from private tier to public on 2026-04-20 after reconciliation with official guidelines. -->

# Journal Profile: Clinical and Molecular Hepatology

## Journal Identity

- **Full name**: Clinical and Molecular Hepatology
- **Abbreviation**: Clin Mol Hepatol
- **Publisher**: Korean Association for the Study of the Liver (KASL)
- **ISSN**: 2287-2728 (print), 2287-285X (online)
- **Frequency**: Quarterly (January, April, July, October)
- **Impact Factor**: [TODO: verify at JCR]
- **Open Access**: Full OA. APC **US$2,000** for original and unsolicited review articles submitted on/after 1 February 2026 (previously US$1,500 from February 2024, US$1,000 before)
- **Acceptance rate**: [TODO: verify at journal site]
- **Peer review**: Blind peer review; ≥2 referees; first decision in approximately 1 month; fast-track option (7-day first decision) available for additional US$1,000
- **Blinded-submission file handling**: Main Document must carry no author-identifying information; the title page is a separate file. The portal file-designation dropdown has **no "Title Page" option** — upload the title page (and the ICMJE COI forms, which name authors) as **"Supplemental File NOT for Review"** so they are excluded from the blinded reviewer packet. Blinded supplementary and reporting checklists may be "Supplemental File for Review"; the graphical abstract is "Graphic Abstract".

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | References | Figures/Tables |
|------|----------------|----------|------------|----------------|
| Original Article | 6,000 (incl. abstract, refs, tables, figure legends) | 250 words structured | 50 | 8 (max 6 panels per figure) |
| Review Article | 5,000 | [TODO: verify] | [TODO: verify] | 8 |
| Editorial | 1,500 | — | 20 | 1 |
| Letter to the Editor | 800 | None | 15 | 1 (max 6 authors) |
| Correspondence | 1,500 | — | 15 | 1 |
| Special Topic | 800 | — | 10 | — |
| Snapshot | 600 | — | 10 | 1 large page figure |
| Research Letter (online-only) | 1,500 (excl. title/refs/legend) | Structured (Objective / Study Design / Results / Conclusion) — no traditional abstract | 15 | 1 table OR 1 figure; max 7 authors |

---

## Abstract Requirements

Original Article: 250 words maximum, **structured** under four sub-headings:

```
Background/Aims:
Methods:
Results:
Conclusions:
```

Followed by 3–5 keywords.

Research Letters: structured four-section format (Objective / Study Design / Results / Conclusion), no abstract per se.

---

## Required Sections (Original Article)

In exact order:

1. **Title page**
2. **Abstract** (250 words structured, 3–5 keywords)
3. **Highlights** — mandatory on revised manuscript, encouraged at initial submission. 3–4 sentences summarizing originality and main findings, ≤100 words total, boxed after abstract
4. **Introduction** — minimum background; do not engage in literature review
5. **Materials and Methods** (or Patients and Methods) — detail sufficient for replication; cite statistical methods
6. **Results**
7. **Discussion** — implications for the field; avoid repetition of results or introduction
8. **Acknowledgements**
9. **Conflict of Interest statement** — prior to references
10. **References** — numbered, superscript Arabic, ≤50
11. **Tables** (individual sheets, numbered)
12. **Figure legends** (separate sheet)

**Graphical abstract is MANDATORY** for original articles (separate JPG/TIFF upload; minimum 531×531 px at 600 dpi; final display 200×500 px rectangle).

---

## Statistical Reporting

- Identify and provide references for all statistical methods used (stated explicitly).
- Sex/gender reporting: distinguish sex (biological) from gender (identity); report sex of participants, animals, or cells and methods used to determine them.
- Race/ethnicity: define how determined and justify relevance.
- Exclusive-population studies (e.g., single sex): justify unless self-evident (e.g., prostate cancer).
- [TODO: verify at journal site] Specific p-value format (significant figures, threshold).
- [TODO: verify at journal site] 95% CI vs exact p-value preference.

Default — until verified: report exact p-values to 2–3 significant figures; use p<0.001 below that threshold; 95% CI for primary outcomes; state statistical software and version.

---

## Figures

- **Maximum**: 8 figures/tables combined; max 6 panels per figure
- **Resolution**: ≥300 dpi
- **Format**: JPG or TIFF
- **Color**: permitted (authors charged for color figures)
- **Microscopic images**: must specify staining method and magnification scale
- **Graphical abstract**: 531×531 px minimum at 600 dpi (mandatory, separate JPG/TIFF file)

---

## Common Rejection Reasons

1. Poor English syntax (journal recommends professional editing pre-submission)
2. Concurrent or prior publication of the same or closely related data
3. Missing or inadequate IRB / Declaration of Helsinki statement
4. Missing graphical abstract for original article submission
5. Exceeding word / reference / figure limits
6. Failure to follow structured abstract format (BG/Aims, Methods, Results, Conclusions)
7. Requiring more than two revision cycles or resubmission beyond 2 months (treated as new submission)

---

## Cover Letter

Should include:
- Confirmation that neither the submitted material nor portions thereof have been published or are under consideration elsewhere
- Corresponding author contact (name, address, telephone, fax, email, ORCID)
- Any prior related publication enclosed for editor review
- Suggested reviewers (if journal requests; verify at submission portal)
- Brief highlight of manuscript's significance for the hepatology field

---

## AI Writing Disclosure Policy

- **Requirement level:** Required — follows ICMJE guidance as adopted by the journal
- **Permitted scope:** Disclosure of all AI-assisted technologies used to produce submitted work (large language models, chatbots, image creators). Basic grammar/spelling/reference-check tools are exempt. AI cannot be listed as an author.
- **Disclosure location:** **Acknowledgements** section, with three mandatory elements: (1) name of AI software, version, manufacturer, and date(s) of use; (2) brief description of how the AI was used and on which portions of the manuscript; (3) confirmation that the author(s) take full responsibility for the integrity of the content generated
- **AI-generated images:** Must be declared under the same disclosure rule. Citation of AI-generated material as a primary source is not acceptable.
- **Policy URL:** https://www.e-cmh.org (Instructions for Authors, section "Use of Generative AI and AI-Assisted Technologies in Publication and Research")

---

## Author Guidelines URL

https://www.e-cmh.org/authors/authors.php

Editorial Office: Room A1210, Mapo Trapalace, 53 Mapo-daero, Mapo-gu, 04158, Seoul, Korea; tel +82-2-703-0051; fax +82-2-703-0071; email kasl@kams.or.kr
Submission portal: https://mc04.manuscriptcentral.com/cmh

---

## Positioning

**When to submit here.** Korean or Asian health-screening / hospital-cohort studies on NAFLD / MASLD / ALD / MetALD, hepatitis B / C natural history, HCC surveillance, KASL-guideline-adherent clinical work, and basic-science translational studies with clear clinical relevance. KASL's flagship journal — strongly preferred for papers that directly cite KASL clinical practice guidelines or Korean national cohort data.

**When NOT to submit here.** Pure methodology/statistics papers without hepatology content; AI-only papers without liver-disease outcome validation; reports of non-liver disease primary outcomes.

| Dimension | Clinical and Molecular Hepatology | Journal of Hepatology (EASL) | Hepatology (AASLD) | Liver International |
|-----------|----------------------------------|------------------------------|--------------------|---------------------|
| Society | KASL (Korean) | EASL (European) | AASLD (American) | Wiley, independent |
| Scope | Basic + clinical hepatology; strong Korean/Asian cohort focus | Basic + clinical hepatology; European / global | Basic + clinical hepatology; American-weighted | Clinical + experimental hepatology; international multi-disciplinary |
| Impact factor | [verify JCR] | [verify JCR] | [verify JCR] | [verify JCR] |
| Emphasis | Korean/Asian epidemiology, KASL guideline alignment, 2023 SLD nomenclature | Mechanistic + guideline-defining trials; desk reject aggressive | Mechanistic + AASLD guidance; competitive | Clinical utility, observational + translational |
| OA model | Full OA | Hybrid | Hybrid | Hybrid |
| Graphical abstract | Mandatory (original articles) | Mandatory | Mandatory | Optional |

# Journal Profile: Clinical Radiology

## Journal Identity

- **Full name**: Clinical Radiology
- **Abbreviation**: Clin Radiol
- **Publisher**: Elsevier (Royal College of Radiologists, RCR)
- **ISSN**: 0009-9260 (print), 1365-229X (online)
- **Frequency**: Monthly (12 issues/year)
- **Impact Factor**: ~2.8 (JCR 2023)
- **Open Access**: Hybrid (optional OA with Elsevier APC)
- **Acceptance rate**: ~25-30%
- **Peer review**: Single-blind; typically 2-3 reviewers

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | References | Figures/Tables |
|------|----------------|----------|------------|----------------|
| Original Article | 3000 words | 250 words (structured) | 30 | 6 |
| Review Article | 4000 words | 250 words | 50 | 8 |
| Technical Note | 1500 words | 150 words (unstructured) | 15 | 4 |
| Case Report | 1000 words | 100 words (unstructured) | 8 | 4 |
| Pictorial Review | 3000 words | 200 words | 25 | 12 |
| Letter to the Editor | 500 words | None | 5 | 1 |

Word counts exclude abstract, references, tables, and figure legends.

---

## Abstract Requirements

**Structured abstract for Original Articles, 250 words maximum:**

```
AIM: [Study aim — 1 sentence]
MATERIALS AND METHODS: [Design, population, imaging, analysis]
RESULTS: [Key findings with statistics]
CONCLUSION: [Main conclusion — 1-2 sentences]
```

**Note**: Clinical Radiology uses uppercase heading labels in the abstract.

---

## Required Sections (Original Article)

1. **Introduction** — clinical context, gap, purpose (2-3 paragraphs)
2. **Materials and Methods**
   - Study design and ethics
   - Patient selection
   - Imaging technique
   - Image analysis and interpretation
   - Statistical analysis
3. **Results**
4. **Discussion** — including limitations paragraph
5. **Conclusion**

---

## Statistical Reporting

- Report exact p-values; use p < 0.001 below that threshold.
- 95% CI for primary outcomes.
- For diagnostic accuracy: sensitivity, specificity, PPV, NPV, accuracy with 95% CI.
- Inter-reader agreement where applicable.
- Effect sizes with clinically meaningful units.
- Statistical software and version must be identified.

---

## UK-Specific Considerations

### NHS Context

Clinical Radiology serves a largely UK/Commonwealth readership:
- Reference NHS guidelines and NICE recommendations where applicable
- Report findings in context of UK radiology practice and referral pathways
- Acknowledge NHS-specific constraints (scanner availability, contrast protocols)

### RCR Standards

- Reference RCR iRefer guidelines when discussing referral appropriateness
- Radiation dose reporting: DLP and CTDIvol for CT studies
- Reference UK national screening programmes where relevant (NHSBSP, lung screening)

### Ethical Reporting

- Health Research Authority (HRA) approval for NHS-based studies
- IRAS reference number where applicable
- Caldicott guardian approval for data access studies

---

## Figures

- **Maximum 6 figures/tables** for original articles; **12 for Pictorial Reviews**
- **Resolution**: 300 DPI minimum
- **Format**: TIFF, EPS, JPEG, PDF
- **Color**: Free online
- **British English**: captions and labels in British English (colour, tumour, centre)

---

## Language

**British English throughout**:
- colour, tumour, centre, analyse, programme, speciality
- -ise endings (recognise, standardise, organise)
- Dates: day month year (11 April 2026)

---

## Common Rejection Reasons

1. **Too specialist for general radiology audience** — Clinical Radiology covers all modalities and body regions; needs broad appeal
2. **American English** — must use British English throughout
3. **No UK/Commonwealth relevance** — studies purely from non-UK settings need to address transferability
4. **Small sample without novelty** — straightforward retrospective studies need strong contribution
5. **Missing radiation dose data** — expected for CT studies given UK dose awareness culture

---

## Cover Letter

Should include:
- Relevance to UK radiology practice
- Key finding summary
- Statement of originality and non-dual submission
- Suggested reviewers (optional)

---

## Author Guidelines URL

https://www.clinicalradiologyonline.net/content/authorinfo

---

## Positioning

Clinical Radiology is appropriate when:
- Radiology study with relevance to UK/Commonwealth practice
- Multi-modality imaging study with broad clinical applicability
- AI in radiology with NHS implementation perspective
- Audit or quality improvement study in radiology
- Pictorial review of imaging appearances across body regions

Not appropriate for: highly technical AI methodology without clinical context, narrow subspecialty studies better suited to dedicated journals (AJNR, Skeletal Radiology, etc.), non-radiology imaging.

---

## Differentiation from Related Journals

| Dimension | Clinical Radiology | British Journal of Radiology | European Radiology |
|-----------|-------------------|----------------------------|-------------------|
| Society | RCR (UK) | BIR (UK/international) | ESR (European) |
| Scope | General clinical radiology | Radiology + radiation oncology + physics | General radiology (broader) |
| Language | British English (strict) | British English | British/American English |
| Impact factor | ~2.8 | ~2.0 | ~5.9 |
| Emphasis | Clinical practice, NHS context | Physics, technology, oncology | European multicenter, AI |

# Journal Profile: CardioVascular and Interventional Radiology (CVIR)

> Verified against the official CVIR *Manuscript Type Manual* (last updated December 2025) and the Springer *Instructions for Authors*. Where this profile previously carried generic Springer values, they have been corrected to the journal's own stated limits.

## Journal Identity

- **Full name**: CardioVascular and Interventional Radiology
- **Abbreviation**: Cardiovasc Intervent Radiol
- **Publisher**: Springer Nature (official journal of CIRSE and 20+ national/regional IR societies)
- **ISSN**: 0174-1551 (print), 1432-086X (online)
- **Frequency**: Monthly (12 issues/year)
- **Impact Factor**: ~3.0 (JCR 2023)
- **Open Access**: Hybrid (Open Choice; APC applies for OA)
- **Acceptance rate**: ~25-30%
- **Peer review**: **DOUBLE-BLIND** (2-3 reviewers). The main manuscript MUST be fully anonymized — no author names, affiliations, acknowledgments, funding, grant numbers, or ethical statements in the body; all of that goes on a separate Title Page. Avoid self-citations that reveal identity.
- **Plagiarism**: all submissions screened by iThenticate.

## Manuscript Types and Limits

These are CVIR's own per-type limits (body word count excludes references and tables). **A meta-analysis is the "Scientific Paper (Other)" type → 2400 words, structured 250-word abstract, max 6 images.** A narrative systematic review may instead be submitted as a "Review Article" (3000 words, simple 125-word abstract). Do not assume a generic 3500–5000-word allowance.

| Type | Body words | Abstract | Images | Notes |
|------|-----------|----------|--------|-------|
| Clinical Investigation | 2400 | Structured, 250 | 6 | Human-subject studies |
| Laboratory Investigation | 2400 | Structured, 250 | 6 | Animal/bench |
| **Scientific Paper (Other)** | **2400** | **Structured, 250** | **6** | **Meta-analyses** and other scientific papers |
| Review Article | 3000 | Simple, 125 | 10 | Includes narrative systematic reviews; format varies |
| Case Report | 1000 | Simple, 125 | 3 | References max 10 |
| Study Protocol | 2400 | Structured, 250 | 3 | Trial registration + SPIRIT |
| Short Communication | 1200 | Structured, 250 | 3 | Concise reports / novel techniques |
| Letter to the Editor | 900 | None | 3 | References max 5; unstructured |
| Editorial / Commentary | 600 | None | 1 | Invited; references max 10 |

Note on "images": CVIR states a maximum number of **images** (figures) per type; tables are listed alongside but the journal does not publish a single combined cap. Keep figures within the stated image limit and offload non-essential display items (risk-of-bias tables, sensitivity figures) to Supplementary Information.

## Abstract Requirements

- **Structured abstract** (Clinical/Laboratory/Scientific Paper Other, Study Protocol, Short Communication): **max 250 words**, separated into headed paragraphs — **Purpose / Materials and Methods / Results / Conclusion**.
- **Simple abstract** (Review, Case Report): **max 125 words**, single paragraph.
- **No abbreviations or acronyms in the abstract.** Spell everything out (e.g., "cone-beam computed tomography", "confidence interval"). Abbreviations are defined at first mention starting in the Introduction; self-created abbreviations are not accepted; do not use abbreviations in the title either.
- **Level of Evidence** must be stated as the last line of the abstract where EBM rankings apply (scale 1–5), e.g. `Level of Evidence: Level 4, Case Series.` Indicate **"No level of evidence"** for Review Articles, Basic Science, Animal, Cadaver, and Experimental studies.
- For clinical trials, the trial registration number + date is the last line of the abstract.

## Compliance with Ethical Standards (Title Page)

A separate **"Compliance with Ethical Standards"** section at the end of the Title Page must include **all five** statements, in this order and wording (even if not applicable):

1. **Funding** — "This study was funded by X (grant number X)" or "This study was not supported by any funding."
2. **Conflict of Interest** — disclosures, or "The authors declare that they have no conflict of interest."
3. **Ethical approval** — for retrospective studies: "For this type of study formal consent is not required." Include IRB approval/waiver statement. For secondary analysis of published aggregate data: "This article does not contain any studies with human participants or animals performed by any of the authors."
4. **Informed consent** — "Informed consent was obtained from all individual participants…", or "For this type of study informed consent is not required."
5. **Consent for publication** — or "For this type of study consent for publication is not required."

## Visual Abstract (optional)

Eligible for all types except editorials, letters, and commentaries. PowerPoint template; title capitalized (16 pt), conclusion ≤100 words (12 pt); Arial or Times New Roman; do not include authors/affiliations; 1–3 figures.

## Statistical Reporting

- Exact p-values (p = 0.032; p < 0.001 below threshold); 95% CI for primary outcomes.
- Intervention studies: technical success and clinical success with explicit operational definitions.
- Complications: **SIR classification** (minor A,B / major C–F) and/or Clavien-Dindo; report per-patient and per-procedure separately.
- Ablation: distinguish **technical success** (probe placement/ablation completed) from **technique efficacy** (complete ablation on first follow-up) and **local tumor progression**.
- Meta-analyses: I², τ², **prediction intervals**, and an appropriate publication-bias approach. For **single-arm proportion** meta-analyses see the `/meta-analysis` skill reference `single_arm_proportion_ma.md` (GLMM logit, crude alongside pooled, no Egger/regression on proportions).
- Identify statistical software and version.

## References

- Numbered in square brackets in text, in order of appearance, e.g. [3], [1-3, 7].
- Vancouver style; include DOIs as full links (https://doi.org/...); ISO journal abbreviations (ISSN LTWA). Generate via a reference manager / pandoc citeproc with the CVIR CSL — do not hand-type.

## Common Rejection Reasons

1. Small single-center retrospective without technical novelty.
2. Inadequate complication reporting (missing SIR/Clavien-Dindo).
3. Vague, non-pre-specified technical-success definition.
4. Inadequate follow-up.
5. Overclaiming from observational/single-arm data (causal or comparative-advantage language).
6. Exceeding the type's word/image limit (especially submitting a meta-analysis as if it had a 3500–4000-word allowance — it is 2400).

## Cover Letter

Emphasize relevance to European IR practice, novelty/comparative value, patient-safety implications, suggested reviewers (institutional emails); confirm not under consideration elsewhere; declare AI-assistance use if any.

## Author Guidelines

- Instructions for Authors: https://www.springer.com/journal/270/submission-guidelines
- Manuscript Type Manual (per-type limits): downloadable from the IFA page.
- Submission portal: https://www.editorialmanager.com/cvir/

## Positioning

Appropriate for: IR procedures with clinical/technical outcomes (embolization, ablation, drainage, vascular), CBCT-guided interventions, comparative IR-technique studies, and **systematic reviews / meta-analyses of IR procedures**. Not for: pure diagnostic imaging without an interventional component, pure AI methodology, non-interventional radiology.

## Differentiation from JVIR

| Dimension | CVIR | JVIR |
|-----------|------|------|
| Society | CIRSE (European) | SIR (American) |
| Peer review | Double-blind | Single-blind |
| Impact factor | ~3.0 | ~3.5 |
| Meta-analyses | Accepts readily (as Scientific Paper (Other), 2400 words) | Accepts readily |

# Journal Profile: Diabetes & Metabolism Journal (DMJ)

## Basic Information

- **Publisher:** Korean Diabetes Association (KDA) — official publication
- **Frequency:** Bimonthly — published on the first day of January, March, May, July, September, and November
- **Impact Factor:** [TODO: verify at e-dmj.org — recent JCR year]
- **ISSN:** [TODO: verify at e-dmj.org — print / online]
- **Scope:** Diabetes, metabolic disorders, endocrinology — clinical and basic-science research. Particularly receptive to Korean and East Asian population studies on diabetes epidemiology, prevention, treatment, and complications.
- **Open Access:** Yes — full open access under Creative Commons Attribution Non-Commercial License (CC BY-NC); content freely available online
- **APC (Article Processing Charge):** [TODO: verify at e-dmj.org]
- **Language:** English only
- **Acceptance rate:** [TODO: verify at e-dmj.org — not stated on author instructions page]

---

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | References | Figures/Tables |
|------|----------------|----------|------------|----------------|
| Original Article | 4,000 words (excluding abstract, references, legends) | <250 words (structured) | ≤50 | ≤6 |
| Review Article | [TODO: verify — body limit not specified on page] | <200 words | ≤150 | [TODO: verify] |
| Brief Report | 1,500 words (excluding references, abstract) | <180 words | ≤20 | ≤2 |
| Editorial | [TODO: verify] | n/a | ≤20 | [TODO: verify] |
| Letter to the Editor | 1,000 words | None | ≤10 | 1 figure OR 1 table |

---

## Abstract Requirements (Original Article)

**Structured abstract, fewer than 250 words:**

```
Background: [Context and aim]
Methods: [Design, population, intervention/exposure, comparator, outcomes, statistical approach]
Results: [Primary outcome with effect sizes and 95% CIs; key secondary findings]
Conclusion: [Main conclusion grounded in the results]
```

**Keywords:** 3–10 MeSH terms following the abstract.

**Clinical trial registration:** Registration number required at the end of the abstract for clinical trials.

---

## Required Sections (Original Article)

DMJ uses standard IMRAD structure with appropriate headings and subheadings in Methods and Results:

1. **Introduction**
2. **Methods**
   - Subsections expected
   - IRB approval statement required
3. **Results**
   - Subsections expected
4. **Discussion**

Title-page-level requirements: author affiliations, conflict-of-interest statement, disclosure of redundant publication risk, AI disclosure (see AI Policy below), corresponding-author contact.

---

## Statistical Reporting

- "Describe the statistical analysis and the criteria for determining significance" in Methods section.
- Professional statistician review available through the journal if needed.
- Reporting guidelines mandated by study design (see Reporting Guidelines below).
- [TODO: verify at e-dmj.org — specific p-value formatting, CI requirements, effect-size requirements]

---

## Reporting Guidelines

Authors must follow appropriate reporting guidelines according to study design:

- **CONSORT** — randomized controlled trials
- **STROBE** — observational studies
- **PRISMA** — systematic reviews and meta-analyses
- **CARE** — case reports

---

## Figure and Table Requirements

- **Resolution:** ≥300 DPI
- **Format:** JPEG, EPS, TIFF, or PICT (also accepted embedded in RTF manuscripts or PDF)
- **Photomicrographs:** Internal scale markers required
- **Color:** Color images permitted
- **AI-generated images:** Prohibited (see AI Policy)
- **Maximum:** Up to 6 figures/tables for Original Article; 2 for Brief Report; 1 for Letter

---

## Common Rejection Reasons

[TODO: confirm with editorial office or rejection-analysis source — page does not enumerate]

Typical risks for any KDA-affiliated diabetes journal:
1. **Out of scope** — manuscripts without a clear metabolic or diabetes focus may be deprioritized.
2. **Word count overrun** — 4,000-word Original Article limit (excluding abstract, references, legends) is enforced.
3. **Missing reporting guideline compliance** — STROBE/CONSORT/PRISMA/CARE checklist expected per study design.
4. **Insufficient AI disclosure** — AI use must be declared on title page including tool/version/manufacturer/role.
5. **Redundant publication risk not disclosed** — full statement required in cover letter and title page.

---

## Cover Letter

Should include:

- Full statement regarding any submissions or previous reports that might be considered redundant publications
- Statement of any financial or other relationships that could lead to a conflict of interest
- Manuscript title and corresponding-author contact information
- Brief rationale for the journal as the target venue

---

## AI Writing Disclosure Policy

- **Requirement level:** Required
- **Permitted scope:** Authors must disclose use of AI technologies during manuscript submission, including tool names, versions, manufacturers, and the role AI played in writing
- **Disclosure location:** Title page (statement regarding AI use must be included)
- **AI as author:** AI cannot be listed as author or co-author
- **AI-generated images:** Prohibited
- **Policy URL:** https://e-dmj.org/authors/authors.php

---

## Author Guidelines URL

https://e-dmj.org/authors/authors.php

---

## Submission Portal

[TODO: verify at e-dmj.org — typical Korean society journals use Synapse/eM submission system]

---

## Positioning

DMJ is well-suited for:
- Diabetes epidemiology and incident-outcome cohort studies in Korean and East Asian populations
- Metabolic syndrome / body composition / fatty liver studies with metabolic outcome focus
- Single-institution observational research with diabetes-relevant primary endpoints
- Clinical trials in diabetes management and prevention
- Translational and mechanistic diabetes research

**Cascade considerations:** Suitable as a primary submission target for Korean-cohort diabetes research and as a Tier-2 fallback after rejection from higher-IF endocrinology journals (Diabetes Care, Diabetologia, JCSM). Higher acceptance probability for region-specific population studies than Western-focused diabetes journals.

| Dimension | Diabetes & Metabolism Journal | Diabetes Care | Diabetologia |
|-----------|------------------------------|----------------|---------------|
| Society | Korean Diabetes Association | American Diabetes Association | European Association for the Study of Diabetes |
| Geographic emphasis | Korean / East Asian | Global, US-centric | Global, European-centric |
| Word budget (Original) | 4,000 | [TODO: verify] | [TODO: verify] |
| Scope flexibility | Broad — body composition, metabolic syndrome, complications, basic science | T2DM-focused, clinically driven | T2DM-focused, mechanism-oriented |


---

## Verification
- **Source:** https://e-dmj.org/authors/authors.php
- **Date:** 2026-05-21

- **AI-use disclosure placement**: Title page
  <!-- machine-read by /self-review check_classical_style.py --profile; source: the profile's own rejection note: "must be declared on title page including tool/version/manufacturer/role" -->

# Journal Profile: Diagnostic and Interventional Radiology

## Journal Identity

- **Full name**: Diagnostic and Interventional Radiology
- **Abbreviation**: Diagn Interv Radiol (DIR)
- **Publisher**: Galenos Publishing House, on behalf of the Turkish Society of Radiology
- **ISSN**: 1305-3825 (print), 1305-3612 (online)
- **Frequency**: Bimonthly (6 issues/year)
- **Impact Factor**: ~2.7 (JCR 2023) [TODO: verify at journal site]
- **Open Access**: Full OA (APC-based; no submission fees)
- **Acceptance rate**: [TODO: verify at journal site]
- **Peer review**: Double-blind; ≥2 external reviewers + statistics consultant for all originals

Indexed in Science Citation Index Expanded, PubMed/MEDLINE, PubMed Central, Scopus, EMBASE, DOAJ, CINAHL, HINARI, TUBITAK ULAKBIM TR Index, Gale, CNKI.

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | References | Author Limit | Tables | Figures |
|------|----------------|----------|------------|--------------|--------|---------|
| Original Article | 4500 | 400 (structured) | 50 | 6* | 4 | 7 (or 15 figure parts) |
| Review Article | 4000 | 200 | 75 | 5 | 4 | 15 (or 15 images) |
| **Meta-Analysis** | **4000** | **200 (structured)** | **75** | **5** | **4** | **15 (or 30 figure parts)** |
| Pictorial Essay | 1500 | 400 | 20 | 5 | 1 | 15 (or 30 figure parts) |
| Technical Note | 1500 | 200 | 8 | 5 | 2 | 3 (or 6 figure parts) |
| Letter to Editor | 500 | N/A | 6 | 4 | — | 2 (or 4 figure parts) |
| Commentary | 1200 | N/A | 10 | 3 | 1 | 2 |
| Editorial | 1200 | N/A | 10 | 3 | — | 2 (or tables) |

*Original Articles with >6 authors accepted only for multicenter/multidisciplinary studies.

APC (accepted only): Review $1250; Meta-Analysis $1000; Original $1000; Pictorial Essay $750; Technical Note $750.

---

## Abstract Requirements

### Original Article (structured, ≤400 words)

```
PURPOSE: ...
METHODS: ...
RESULTS: ...
CONCLUSION: ...
CLINICAL SIGNIFICANCE: ...
```

All five subheadings are REQUIRED and must appear in capital letters. The CLINICAL SIGNIFICANCE subheading is DIR-specific and frequently missed by authors unfamiliar with the journal — editorial office desk-rejects for missing subheadings.

### Meta-Analysis (structured, ≤200 words)

Structured abstract required. DIR does not publish the exact subheadings for Meta-Analysis type, but PURPOSE/METHODS/RESULTS/CONCLUSION (with CLINICAL SIGNIFICANCE where applicable) is the safe default consistent with the journal's Original Article convention.

### Review (≤200 words), Pictorial Essay (≤400 words), Technical Note (≤200 words): unstructured.

---

## Main Points (MANDATORY, 3–5 items)

- Every submission (except Letters) must include a **Main Points** section with 3–5 plain-language bullets summarizing the most striking findings.
- **Location**: Between Abstract and Introduction (per Author Guidelines and editorial office guidance).
  - NOTE: The Submission Checklist PDF states "at the end of the main document", which conflicts with the Guidelines. When the editorial office flags position, place between Abstract and Introduction.
- Target audience: radiology residents, specialists from other fields, and radiology experts — keep language simple.
- Minimum 3 items required; fewer items triggers desk return.

---

## Required Sections (Original Article and Meta-Analysis)

1. **Introduction** — brief nature and purpose, relevant literature.
2. **Methods** — must include:
   - Clinical and technical procedures.
   - **Research ethics standards compliance**: IRB/ethics committee approval statement with decision/protocol number; Declaration of Helsinki statement if no IRB exists at the institution.
   - **Informed consent** statement (obtained, waived for retrospective, or N/A with reason). For systematic reviews/meta-analyses of published data, explicitly state that IRB approval and informed consent were not required.
   - **Statistical Analysis** subsection — tests named; uncommon methods cited.
3. **Results** — clear and without comment; include statistical analysis results.
4. **Discussion** — contextualize findings; explicitly state limitations/drawbacks in the paragraph before the conclusion; strong closing paragraph.
5. **Conclusion** — one paragraph (integrated into Discussion closing or as separate subheading).
6. **Main Points** (3–5 bullets) — position between Abstract and Introduction.

---

## Statistical Reporting

DIR enforces a specific biostatistical reporting policy; all originals are evaluated by a statistics consultant.

- **p-values**: 3 decimal places (e.g., p = 0.025; p = 0.524). If software output shows p = 0.000, report as **p < 0.001**.
- **Distribution-appropriate summaries**:
  - Normally distributed → mean ± SD.
  - Non-normal → median with min–max, range (R), or interquartile range (IQR).
- **Statistical tests**: Name each test explicitly in the Methods **Statistical Analysis** subsection. Uncommon or non-standard methods must be supported with references.
- **Software**: Identify software, version, and manufacturer (e.g., "SPSS Statistics 28, IBM Corp.").
- **95% CI** for primary outcomes (ICMJE/Altman 1983 default applies).
- **Reporting guideline compliance**: CONSORT (RCT), STROBE (observational), STARD (diagnostic accuracy), **PRISMA / PRISMA-DTA (systematic reviews and meta-analyses)**, TREND (non-randomized behavioral/public health).

---

## Figures

- **Format**: JPG or TIFF, submitted as standalone files through the submission system (not embedded).
- **Resolution**: minimum 300 DPI.
- **Flowchart**: First figure (Figure 1) of Original Articles must be the study flowchart (PRISMA flowchart for meta-analyses).
- **Subunits**: Label panels a, b, c in the bottom-left corner in Times New Roman 10pt (white on dark background, black on light).
- **Blinding**: All identifying information (institution, patient IDs) must be removed from images.
- **Reuse**: Written permission from copyright holder required for previously published material; cite original in references and below reprinted material.

## Tables

- Inserted in the main document using Word's "insert table" command (not as separate file).
- Listed at the end of the main document after references.
- Descriptive title above; abbreviations defined in footnotes below each table.
- Numbered sequentially by order of first citation.

## Manuscript Format

- **Font**: Times New Roman, 12 pt, 1.5 line spacing.
- **Blinding**: Main document must not contain any author, institution, grant, or acknowledgement information — all such content goes on the separate Title Page.
- **Abbreviations**: Defined at first use in BOTH abstract and main text, with abbreviation in parentheses.
- **Product citations**: In-text as "Product (Manufacturer)" — e.g., "Discovery ST PET/CT scanner (GE Healthcare)".
- **Sequential numbering**: References, tables, and figures all numbered in order of first text citation.

---

## References

- **Style**: AMA Manual of Style.
- **In-text format**: **Parenthetical**, not superscript or bracketed (e.g., "(5)" or "(5, 7–9)").
- **Order**: Sequential by first appearance in text.
- **Journal abbreviations**: Per Index Medicus / MEDLINE / PubMed.
- **Author listing**: ≤6 authors → list all; ≥7 → first 3 followed by "et al."
- **Preprints**: Citable with title, server name, DOI, when substantive to the topic. Not citable if the preprint has since been formally published.

Example journal article:
> Economopoulos KJ, Brockmeier SF. Rotator cuff tears in overhead athletes. Clin Sports Med. 2012;31(4):675-692.

---

## Common Rejection Reasons

1. **Desk return for guideline non-compliance** (editorial office pre-check):
   - Missing CLINICAL SIGNIFICANCE (or any of 5 required) abstract subheadings.
   - Missing Main Points section or <3 items.
   - Missing Statistical Analysis heading.
   - Missing informed consent / IRB statement in Methods (even for SR/MA where both are N/A).
   - Non-sequential figure/table/reference citations.
   - Superscript or bracketed reference citations (must be parenthetical).
   - Supplementary material submitted as PDF (must be Word).
2. **iThenticate failure**: Overall similarity >20% or single-source duplication ≥5% → auto-return with report.
3. **Blinding violation**: Author names, institutions, or grant numbers in main document.
4. **Insufficient priority** (at Editor-in-Chief / Section Editor level) — scope or novelty.
5. **Statistical methodology issues** flagged by the statistics consultant.

---

## Cover Letter

Must include:
- Brief statement of existing knowledge and the contribution the study makes.
- Statement from corresponding author accepting responsibility for authorship during submission and review.
- Disclosure of any preprint deposition, including preprint DOI.
- Disclosure of any prior meeting abstracts with overlapping material.

---

## AI Writing Disclosure Policy

- **Requirement level:** Not specified — follows ICMJE recommendations.
- **Permitted scope:** Language editing only — per ICMJE 2025 (DIR explicitly endorses ICMJE Recommendations May 2022 for manuscript preparation).
- **Disclosure location:** Methods.
- **AI-generated images:** Not specified.
- **Policy URL:** https://www.dirjournal.org/ (Instructions to Authors; no dedicated AI policy page as of 2026-04).

[VERIFY] DIR Instructions to Authors do not contain a dedicated AI/LLM clause. ICMJE defaults applied; verify at journal site before final submission.

---

## Submission Logistics

- **Platform**: Manuscript Manager (Galenos) — https://www.dirjournal.org/
- **Documents required**:
  1. Main document (blinded, Word, TNR 12pt 1.5 spacing, including Abstract → Main Points → Introduction → … → References → Tables → Figure Legends).
  2. Title Page (separate Word): title, authors with affiliations and ORCID, corresponding author contact (address, mobile, email), grants/acknowledgements.
  3. Figures (standalone JPG or TIFF, ≥300 DPI).
  4. Supplementary materials as **Word** (not PDF).
  5. Cover Letter.
  6. **Copyright Agreement Form** (wet-signed, scanned PDF): https://cms.galenos.com.tr/SolvePark/Uploads/Files/DIR-Copyright%20.pdf
     - May be signed per-author for large or international groups.
- **Revisions**: 30-day window from decision letter; request extension before expiry. Include point-by-point Author's Response with line numbers for each change, plus annotated and clean copies of main document.

---

## Author Guidelines URL

https://www.dirjournal.org/ (Instructions to Authors section)

Checklists:
- Submission checklist: https://cms.galenos.com.tr/SolvePark/Uploads/Files/DIR-Submission-Checklist.pdf
- Biostatistical reporting: https://cms.galenos.com.tr/SolvePark/Uploads/Files/Biostatistical-Reporting-Considerations-and-Suggestions.pdf
- Copyright form: https://cms.galenos.com.tr/SolvePark/Uploads/Files/DIR-Copyright%20.pdf

---

## Positioning

**When to submit here**: Diagnostic radiology, interventional radiology, and imaging-based diagnostic accuracy studies, especially meta-analyses and technical innovations suited to a bimonthly society journal with fast OA turnaround. Favorable for Turkish and regional radiology groups, and for methodologically sound but narrower-scope work that may not fit Radiology or European Radiology.

**When NOT to submit here**: Studies targeting a broader audience or aiming for highest-tier impact (send to Radiology, Radiology: AI, European Radiology, JACR). Subspecialty-focused work in IR should weigh CVIR or JVIR first. Non-radiology imaging (pure pathology, ultrasound in non-radiology settings) may fit poorly with scope.

| Dimension | DIR | European Radiology | Clinical Radiology | CVIR |
|-----------|-----|-------------------|--------------------|---|
| Society | Turkish Soc. of Radiology | ESR | RCR (UK) | CIRSE |
| Scope | Diagnostic + IR, general | Diagnostic radiology (broad) | Diagnostic radiology (UK focus) | Interventional radiology only |
| Impact factor (JCR 2023) | ~2.7 | ~5.9 | ~2.1 | ~2.8 |
| Emphasis | MA, original, technical notes; statistical rigor via stat consultant | Prospective multicenter, AI, novel imaging | Broad including audit/QI | IR technique, devices, outcomes |
| OA | Full OA (APC) | Hybrid | Hybrid | Hybrid |
| Double-blind | Yes | No (single-blind) | No | No |

# Journal Profile: Endocrinology and Metabolism (EnM)

## Basic Information

- **Publisher:** Korean Endocrine Society (KES) — official publication
- **Frequency:** [TODO: verify at e-enm.org — not stated on author instructions page]
- **Impact Factor:** [TODO: verify at e-enm.org — recent JCR year]
- **ISSN:** [TODO: verify at e-enm.org — print / online]
- **Scope:** Endocrinology, metabolism, hormonal disorders, thyroid, adrenal, pituitary, bone metabolism, diabetes, lipid metabolism — clinical and basic-science research. Particularly receptive to Korean and East Asian population studies on endocrine disorders.
- **Open Access:** Yes — full open access; content is freely available online, downloadable, and printable
- **APC (Article Processing Charge):** [TODO: verify at e-enm.org]
- **Language:** English only
- **Acceptance rate:** [TODO: verify at e-enm.org — not stated on author instructions page]

---

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | References | Figures/Tables |
|------|----------------|----------|------------|----------------|
| Original Article | [TODO: verify — body limit not stated on page] | ≤250 words (structured) | ≤50 | [TODO: verify] |
| Review Article | [TODO: verify] | ≤200 words | ≤150 | [TODO: verify] |
| Brief Report | 1,200 words | ≤150 words (unstructured) | ≤20 | ≤2 |
| Editorial | 1,000 words | n/a | ≤20 | [TODO: verify] |
| Image | 1,000 words | n/a | ≤5 | [TODO: verify] |
| Letter to the Editor | 1,000 words | n/a | ≤10 | ≤1 |

---

## Abstract Requirements (Original Article)

**Structured abstract, ≤250 words:**

```
Background: [Context and aim]
Methods: [Design, population, intervention/exposure, comparator, outcomes, statistical approach]
Results: [Primary outcome with effect sizes and 95% CIs; key secondary findings]
Conclusion: [Main conclusion grounded in the results]
```

**Keywords:** [TODO: verify keyword count and MeSH requirement at e-enm.org]

---

## Required Sections (Original Article)

EnM uses standard IMRAD structure with headings and subheadings in Methods and Results:

1. **Introduction**
2. **Methods**
   - Subsections expected
3. **Results**
   - Subsections expected
4. **Discussion**

Title-page-level requirements: full author list, conflict-of-interest statement, AI disclosure (see AI Policy below), corresponding-author contact, redundant-publication disclosure.

---

## Statistical Reporting

[TODO: verify at e-enm.org — specific p-value formatting, CI requirements, effect-size requirements not enumerated on author instructions page]

---

## Reporting Guidelines

EnM requests authors follow reporting guidelines according to study design:

- **CONSORT** — randomized controlled trials
- **STROBE** — observational studies
- **PRISMA** — systematic reviews and meta-analyses
- **STARD** — diagnostic accuracy studies

---

## Peer Review

- **Type:** Double-blind — both authors and reviewers remain anonymous
- **Reviewer count:** Three anonymous reviewers who are specialists in the relevant field
- **Review period:** Maximum 3 months

---

## Figure and Table Requirements

- **Resolution:** Exceeds 300 DPI
- **Format:** JPEG, GIF, TIFF, BMP, or PICT
- **Numbering:** Sequential Arabic numerals; letters for sub-panels (Fig. 1A, 1B)
- **Color:** [TODO: verify color policy and online/print distinction at e-enm.org]
- **Maximum:** [TODO: verify for Original Article; explicit limits given only for Brief Report (≤2), Letter (≤1)]

---

## Common Rejection Reasons

[TODO: confirm with editorial office — page does not enumerate]

Typical risks for any KES-affiliated endocrinology journal:
1. **Out of scope** — submissions without a clear endocrine, metabolic, or hormonal focus may be deprioritized.
2. **Insufficient endocrinology framing** — body composition, diabetes, or metabolic studies without explicit hormonal-axis or endocrine-mechanism discussion may be redirected to sibling journals.
3. **Missing reporting guideline compliance** — STROBE/CONSORT/PRISMA/STARD checklist expected per study design.
4. **AI disclosure non-compliance** — failure to disclose AI use in cover letter and manuscript may result in rejection or retraction.
5. **Redundant publication risk not disclosed** — full statement required in cover letter regarding any prior submissions or related reports.

---

## Cover Letter

Must include:

- Full statement to the editor about all submissions and previous reports that might be regarded as redundant publication
- Conflict-of-interest statement
- Attestation that all authors approved the manuscript and meet authorship criteria
- Corresponding-author contact information
- AI use disclosure (if applicable; also in manuscript)

---

## AI Writing Disclosure Policy

- **Requirement level:** Required when AI-assisted technologies are used
- **Permitted scope:** "Authors should clearly describe how they used AI in the submitted manuscript and in their cover letter. Authors are fully responsible for the scientific integrity of AI-generated content."
- **Disclosure location:** Both cover letter AND manuscript
- **AI as author:** AI cannot be listed as author or co-author
- **AI-generated images:** [TODO: verify at e-enm.org — not explicitly addressed on author instructions page]
- **Non-disclosure penalty:** Results in rejection or retraction
- **Policy URL:** https://e-enm.org/authors/authors.php

---

## Author Guidelines URL

https://e-enm.org/authors/authors.php

---

## Submission Portal

[TODO: verify at e-enm.org]

---

## Positioning

EnM is well-suited for:
- Endocrinology and hormonal-axis studies in Korean and East Asian populations
- Thyroid, adrenal, pituitary, bone metabolism, lipid, and diabetes research with explicit endocrine framing
- Single-institution observational endocrinology research
- Translational and mechanistic endocrine studies
- Population-based metabolic outcome studies with hormonal-axis discussion

**Cascade considerations:** Suitable as a primary submission target for Korean-cohort endocrinology research with explicit hormonal-axis or endocrine-mechanism framing, and as a Tier-3 fallback after rejection from higher-IF diabetes/endocrinology journals (Diabetes Care, Diabetologia, JCSM, Diabetes & Metabolism Journal). Higher acceptance probability for region-specific endocrinology studies than Western-focused journals.

| Dimension | Endocrinology and Metabolism | Diabetes & Metabolism Journal | Lancet Diabetes & Endocrinology |
|-----------|------------------------------|-------------------------------|--------------------------------|
| Society | Korean Endocrine Society | Korean Diabetes Association | Lancet family |
| Geographic emphasis | Korean / East Asian | Korean / East Asian | Global, high-impact |
| Scope | Broad endocrinology (thyroid, adrenal, pituitary, bone, diabetes, lipid) | Diabetes-focused metabolic | Diabetes-focused with global RCT/cohort emphasis |
| Peer review timeline | ≤3 months | [TODO: verify] | [TODO: verify] |


---

## Verification
- **Source:** https://e-enm.org/authors/authors.php
- **Date:** 2026-05-21

# Journal Profile: European Journal of Preventive Cardiology

## Journal Identity

- **Full name**: European Journal of Preventive Cardiology
- **Abbreviation**: Eur J Prev Cardiol (EJPC)
- **Publisher**: Oxford University Press (on behalf of the European Association of Preventive Cardiology and the European Society of Cardiology)
- **ISSN**: 2047-4881 (online)
- **Frequency**: 18 issues/year (monthly plus supplements)
- **Impact Factor**: ~8 (recent JCR; verify at submission)
- **Open Access**: Hybrid (subscription default with optional Gold OA via OUP open-access portal; specific APC not published on the Guidelines page — verify at OUP licensing)
- **Acceptance rate**: Not published; broadly estimated 15–25% for Full Research after editorial triage
- **Peer review**: Single-blind; methodology-heavy submissions undergo statistical review

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | References | Figures/Tables |
|------|----------------|----------|------------|----------------|
| Full Research Paper | 5,000 words | 250 (structured) | 100 max | 6 max |
| Clinical Practice / Education | 5,000 words | 250 (structured) | 40 max | 6 max |
| Review | 8,700 words | 250 (structured or unstructured) | 100 max | varies |
| Editorial | 1,300 words | none | 10 max | 1 illustration |
| Rapid Communication | 1,000 words | none | 10 max | 1 |
| Letter to the Editor | 700 words | none | 5 max | 1 |
| Cardialogue | 3,500 words | varies | 60 max | 1 per section |

Word counts exclude abstract, references, tables, and figure legends.

---

## Abstract Requirements

**Structured abstract, 250 words maximum, with 4 headings:**

```
Aims: [Specific research question or hypothesis tested]
Methods: [Design, setting, population, exposures, outcomes, statistical approach]
Results: [Primary results with effect sizes, 95% CIs, P values; N analyzed]
Conclusion: [Direct answer to Aims with clinical implication]
```

The first heading is **Aims** (not Background or Objectives) — a characteristic ESC-family stylistic choice. Reviewers and the editorial portal will flag missing-Aims abstracts.

---

## Required Journal-Specific Elements

### 1. Graphical Abstract / Central Figure

Strongly encouraged for all Full Research papers. A square or landscape figure conveying the main scientific message; uploaded as a separate file at submission. Counts toward figure cap.

### 2. Tweetable Abstract

Submitting authors are asked to provide a one- or two-sentence summary suitable for social-media dissemination (under 280 characters including the journal handle).

### 3. Article Information

- Author affiliations with department, institution, city, country
- Corresponding author with full contact details
- Funding statement with grant identifiers
- Disclosures: per-author ICMJE conflicts
- Data availability statement
- Ethical statement (IRB or equivalent + informed consent)

---

## Required Sections (Full Research Paper)

1. **Introduction** — concise (2–3 paragraphs) with clear gap and aims statement
2. **Methods**
   - Ethics approval with body name
   - Study design and setting
   - Participants and eligibility
   - Variables / definitions (especially relevant for preventive epidemiology — risk factor definitions and cutpoints)
   - Outcomes (primary, secondary, exploratory clearly distinguished)
   - Statistical analysis with explicit software and versions
   - Sample size or power justification
3. **Results** — STROBE flow; primary outcome before secondary; structured paragraphs for each endpoint
4. **Discussion** — dedicated Strengths and Limitations subsections; conclude with public-health and clinical implications
5. **Conclusion** — brief, no overclaiming

---

## Statistical Reporting

- Exact P values to 3 decimal places; P < 0.001 below threshold
- 95% CI for all primary effect estimates
- Effect sizes (HR, OR, mean difference, absolute risk difference)
- Proportional-hazards assumption check when Cox regression is used
- Competing-risks framework where appropriate
- Sensitivity analyses for major analytic choices (missing data, alternative cutpoints, exposure misclassification)
- Prevention-focused outcomes: report both relative and absolute measures (RR and ARR/NNT) when feasible
- Software and version reported

---

## Figures

- **Maximum 6 figures/tables combined** for Full Research
- Resolution: 300 DPI minimum
- Format: TIFF, EPS, PDF
- Color: encouraged (no fee for online publication)
- Graphical abstract / central figure: encouraged
- Supplementary material: online-only supplement permitted

---

## Common Rejection Reasons

1. **Insufficient prevention framing** — manuscripts framed primarily as "outcomes" without a prevention/risk-factor angle are redirected
2. **Single-center cohort without external comparison** — preferred design is multicenter or population-based; single-center papers must justify generalizability
3. **Missing PH assumption check or sensitivity analysis** — methodology bar is high
4. **Overclaiming on modest event counts** — wide CI estimates narrated without exploratory qualifier
5. **Abstract heading mismatch** — using Background/Objectives/Methods/Results/Conclusions instead of Aims/Methods/Results/Conclusion
6. **AI policy non-compliance** — undisclosed AI use or AI listed as author
7. **Reference style violations** — failing to follow first-6-then-et-al rule

---

## Cover Letter

Must include:
- Brief statement of novelty and prevention relevance (2–3 sentences)
- Confirmation manuscript is not under consideration elsewhere
- Confirmation all authors meet ICMJE criteria
- Disclosure of related manuscripts (same cohort, same group)
- Suggested reviewers (3–5; senior PI should curate)
- **AI disclosure statement** at point of submission (in the cover letter itself per the journal's policy — see AI section below)

---

## AI Writing Disclosure Policy

- **Requirement level**: Required
- **Verbatim policy**: "Natural language processing tools driven by artificial intelligence (AI) do not qualify as authors, and the Journal will screen for them in author lists. The use of AI (for example, to help generate content or images, write code, process data, or for translation) should be disclosed in a cover letter at the point of submission and explained in full in a Methods or Acknowledgements section."
- **Disclosure location**: **Both** the cover letter (at submission) and a Methods or Acknowledgements section (in-manuscript)
- **AI-generated images**: Covered by the same disclosure requirement; reviewer screening applies
- **Policy URL**: https://academic.oup.com/eurjpc/pages/general-instructions

---

## Submission Portal

https://www.editorialmanager.com/ejpc/default.aspx

---

## Author Guidelines URL

https://academic.oup.com/eurjpc/pages/general-instructions

---

## Positioning

| Criterion | EJPC | JACC: Advances | JAHA | NMCD |
|-----------|------|----------------|------|------|
| **Society** | ESC/EAPC | ACC | AHA | independent (Elsevier) |
| **Impact Factor** | ~8 | not indexed yet | ~5 | ~3.9 |
| **Open Access** | Hybrid | Full Gold OA | Full Gold OA | Hybrid |
| **Geographic stance** | Europe-centric (welcomes non-EU data) | Global | Global, NA-centric | International |
| **Primary framing** | Prevention, risk factors, rehabilitation | Cardiovascular broad | Cardiovascular broad | Cardio-metabolic (nutrition crossover) |
| **Event-count tolerance** | Moderate; favors clear gradient and clean prevention narrative | Moderate | Moderate–high | Moderate |
| **Abstract first heading** | Aims | Background | Background | Background and Aims |
| **AI disclosure location** | Cover letter + Methods/Acknowledgements | Pre-references declaration | Methods | Pre-references declaration |
| **Word cap (Original)** | 5,000 (text only) | 5,000 (incl. refs + legends) | none stated | 4,000 |

**Choose EJPC when:**
- Primary prevention, risk-factor clustering, or rehabilitation is the dominant framing
- Transition or trajectory analyses with clear prevention implications
- ESC/EAPC ecosystem visibility matters (European clinical-guidelines audience)
- Manuscript can be tightly framed around a 4-heading Aims-led abstract

**Choose JACC: Advances instead when:**
- Framework application (e.g., AHA 2023 CKM staging) is the central methodological contribution and ACC ecosystem reach matters
- Manuscript benefits from Gold OA visibility over hybrid

**Choose JAHA instead when:**
- Cross-modality cardiovascular–cerebrovascular framing
- Negative or hypothesis-generating findings benefit from JAHA's higher tolerance

**Choose NMCD instead when:**
- Nutrition / metabolic intervention is integral to the exposure or interpretation
- Cardio-metabolic-nutrition crossover audience matters more than ESC visibility

---

## Verification Notes

Audit performed 2026-05. Sources opened:
- Homepage: https://academic.oup.com/eurjpc (ISSN, society sponsorship, author-guidelines link)
- General Instructions: https://academic.oup.com/eurjpc/pages/general-instructions (article types, word limits, abstract structure, references, AI policy verbatim, submission portal)

- **AI-use disclosure placement**: Cover letter + Methods/Acknowledgements
  <!-- machine-read by /self-review check_classical_style.py --profile; source: the profile's own AI disclosure location row -->

# Journal Profile: European Radiology

## Basic Information

- **Publisher:** Springer (Springer-Verlag GmbH)
- **Society:** European Society of Radiology (ESR)
- **Impact Factor:** ~7.0 (2023–2024)
- **Scope:** All subspecialties of diagnostic and interventional radiology; AI/machine learning in radiology
- **Open Access option:** Yes (Springer Open Choice); fully OA version: European Radiology Experimental
- **Language:** English (British English preferred)

---

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | Figures | Tables | References |
|------|----------------|----------|---------|--------|------------|
| Original Article | 3500 words | 250 words | 8 (+ supplementary) | 6 | 40 |
| Review Article | 5000 words | 250 words | 10 | 6 | 80 |
| Technical Note | 2000 words | 150 words (unstructured) | 5 | 4 | 20 |
| Case Report | 1500 words | 200 words | 6 | 2 | 15 |
| Letter to Editor | 600 words | None | 2 | 1 | 5 |

*Word count excludes abstract, references, figure legends, and table captions.*

---

## Abstract Requirements

**Structured abstract, 250 words maximum:**

```
Objectives: [One sentence: what was studied]
Methods: [Study design, participants, index test, reference standard, outcomes]
Results: [Key results with statistics, 95% CI]
Conclusions: [Main conclusion and clinical relevance]
Key Points: [3 bullet points — required, see below]
```

**Key Points** — 3 mandatory bullet points immediately after the abstract body:

- Maximum 85 characters each
- Written as declarative statements in present tense
- Cover: what was done (1), main finding (2), clinical implication (3)
- Bold the most important word or phrase in each bullet

Example:
```
Key Points
• [What was done] CT-based radiomics distinguishes malignant from benign thyroid nodules
  with an AUC of 0.87.
• [Finding] The model outperforms size-based criteria (AUC 0.62, P < .001).
• [Implication] Radiomics may reduce unnecessary biopsies for indeterminate nodules.
```

---

## Style Requirements

### British English

Use British English throughout:
- colour (not color), characterise (not characterize), optimise (not optimize)
- focussed (not focused, though both acceptable)

### Statistical Reporting

European Radiology endorses EQUATOR reporting guidelines. Specify:
- Exact p-values to 3 decimal places (P = .034, not P < .05); values < .001 reported as P < .001
- 95% confidence intervals in parentheses
- Effect sizes with units

### Number Formatting

- Decimal separator: period (not comma) — European Radiology uses standard English number format
- P values: no space between P and = (P = .034)
- Percentages: [value]% without space

---

## Required Sections (Original Article)

1. **Objectives** (not "Introduction" — European Radiology uses "Objectives")
2. **Methods** — Ethics approval, study design, participants, imaging, analysis, statistics
3. **Results**
4. **Discussion** — Typically includes Limitations as a subsection
5. **Conclusion** — Brief, final paragraph

### Ethics Statement

Required in all original articles involving human subjects or animals:

"This retrospective study was approved by the [Institutional name] Ethics Committee (approval number [XXX]) with waiver of informed consent."

or

"All procedures performed in this study were approved by the [Institutional name] Institutional Review Board (approval number [XXX]). Written informed consent was obtained from all participants."

---

## Figure Requirements

- **Resolution:** 300 DPI minimum (600 DPI for line art)
- **Format:** TIFF or EPS preferred; JPEG acceptable for photographs
- **Dimensions:** Column width 84 mm (single) or 174 mm (double) at 300 DPI
- **Font in figures:** 8–10 pt, consistent typeface (Helvetica preferred)
- **Color figures:** Free in online version; print color charged — design for both

---

## Visual Abstract / Graphical Abstract

- **Status:** Mandatory from first revision for all Original Articles (January 2025)
- **Reference:** Kelly BS. Eur Radiol 2025;35:5875–5877. doi:10.1007/s00330-025-11555-8
- **Template:** EURA-GA-Jan2025.pptx (download from journal website)
- **Format:** Landscape, single page, 16:9
- **Structure:** Title → Hypothesis/Question → Methodology + Visual element → Badges (cohort, modality, center) → Main finding → Citation
- **Generation:** `/make-figures` with `--template european_radiology`
- **Visual element:** Use the study's actual figure (ROC curve, flow diagram). The editorial states these abstracts should "complement and elevate" the research, not just decorate it.

---

## Common Rejection Reasons

1. **Incremental contribution** — must advance the field beyond existing literature; "largest series" is not sufficient without novel methodology or insight
2. **Key Points missing or poorly written** — editors check these immediately
3. **Word count exceeded** — strictly enforced; no tolerance for +10% over limit
4. **No EQUATOR checklist** — must upload completed checklist (STROBE, STARD, TRIPOD, etc.) with submission
5. **Underpowered study** — European Radiology expects adequate sample sizes; single-center studies with <100 participants rarely accepted for original articles
6. **Statistical errors** — incomplete reporting of CIs, missing paired analyses for paired data
7. **British English violations** — minor but reviewers flag it

---

## Cover Letter Tips

- Address to: "Dear Editor-in-Chief"
- State the manuscript type and article category
- Confirm no prior submission/publication elsewhere
- Mention if data sharing is available (Data Availability Statement)
- Suggest 3–5 potential reviewers (names, institutions, email) — strongly encouraged by European Radiology

---

## Author Guidelines URL

https://www.springer.com/journal/330/submission-guidelines

---

## Positioning

European Radiology is well-suited for:
- Multi-center European (or international) studies
- AI/radiomics studies with clinical validation
- Technical advances with proof-of-concept validation
- Diagnostic accuracy studies with adequate sample size (typically N ≥ 200)

Not well-suited for: small single-center series (< 50 patients), case reports unless highly unusual, studies where the only novelty is a larger sample of an already well-validated technique.

# Journal Profile: Hepatology Communications

## Journal Identity
- **Full name:** Hepatology Communications
- **Abbreviation:** Hepatol Commun
- **Publisher:** Wolters Kluwer Health for AASLD (American Association for the Study of Liver Diseases)
- **ISSN:** 2471-254X (online-only)
- **Frequency:** Continuous publication, monthly issues
- **Open Access:** Mandatory full OA, CC BY or CC BY-NC-ND
- **Acceptance rate:** ~30–35 % (estimated; verify at editor reports)
- **Peer review:** Anonymous; manuscripts are screened by Editor-in-Chief for quality + relevance before sending out for review. Papers transferred from other AASLD/Wiley journals may carry portable peer review.

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | References | Figures/Tables |
|------|----------------|----------|------------|----------------|
| Original Research Article | 5,000 (excluding refs) | 275 words structured | 50 | 8 (additional non-essential figures/tables in SDC) |
| Review | 5,000 (excluding refs) | 275 words structured | unlimited (selective) | 8 |
| Editorial / Viewpoint | 1,500 (incl. refs) | — | 10 | 1 figure or table |
| Research Letter | 1,000 (main text only) | None | 10 | 1 table OR 1 figure (+ 1–2 supp.) |
| Correspondence | 500–750 | — | (verify) | (verify) |
| Special Article (AASLD guidelines, in-depth review, social policy) | ~5,000 (case-by-case) | (verify) | (verify) | (verify) |
| Protocol Paper | 5,000 (excl. refs) | structured | (verify) | (verify) |
| Consensus Report | 2,000 | — | 9 | (verify) |

Title: ≤120 characters. Initial submission allowed in single Word file with text + artwork; revision must use 1.5 spacing, 10–12 pt body.

## Abstract Requirements
**Original Research:** 275 words, structured under exactly four headings: **Background**, **Methods**, **Results**, **Conclusion** (note: "Conclusion" singular, not "Conclusions"). Acronyms must be defined within the abstract. 5–7 keywords (preferably MeSH).

## Required Sections (Original Article, in order)
1. **Title page** (title, full author names with degrees + affiliations, financial support, conflicts, keywords, list of abbreviations)
2. **Abstract** (275 words, 4-section structure)
3. **Introduction** — minimum background, identify research gap
4. **Methods** — sufficient for reproduction; reference statistical methods
5. **Results** — present major findings, mention all tables/figures
6. **Discussion** — implications; minimize repetition
7. **Acknowledgements** — must include "Assistance with the study: none." or specifics; "Presentation: none." or meeting details
8. **Disclosures** — financial support and competing interests (separate)
9. **References** — AMA Manual of Style, Vancouver-numeric superscript
10. **Tables** — separate Word docs, 1.5 spacing, vertical rules forbidden, abbreviations footnoted
11. **Figure legends** — separate page after references; no embedded figures in main file
12. **Supplemental Digital Content (SDC)** — optional; cited consecutively in main text; separate URL placement; PDF preferred

## Statistical Reporting
- Reference all statistical methods used; statistical software and version stated.
- Uncertainty parameters mandatory in tables (95% CI, SD, IQR as appropriate).
- AUROC diagrams must NOT be in main text — instead provide AUC (95% CI) inline; diagrams may go in supplement.
- Sex/gender, race/ethnicity reporting per ICMJE — distinguish biological sex from gender identity.
- Reporting checklists required: STROBE for observational, PRISMA for SR/MA, STARD for diagnostic accuracy, CONSORT for RCT, ARRIVE for animals, REMARK for tumor markers, SQUIRE for QI, COREQ for qualitative, IDEAL for surgical innovation, STREGA for genetic association, CHEERS for health economics.

## Figures
- Maximum 8 figures + tables combined.
- Resolution: line art 1,200 dpi; halftone 300 dpi; combination halftone 600 dpi.
- Format: EPS, TIFF, MS Office (DOC/PPT/XLS) for accepted manuscripts.
- Composite figures: either single labelled image (Arial/Helvetica bold uppercase) or separate panels (Figure 1A.tif, Figure 1B.tif).
- Color allowed (no extra charge given OA).
- Figures must NOT be embedded in main body file (separate uploads).
- Grayscale or RBG; do not embed legend text inside the image.

## Common Rejection Reasons
1. Failure to use 2023 MASLD/MASH nomenclature without justification ("Manuscripts ... should employ this revised terminology wherever scientifically appropriate" — explicit policy).
2. Submitting AUROC diagrams in the main text (must move to supplement; AUC + 95% CI inline only).
3. Tables with vertical rules or embedded images.
4. Missing reporting-guideline checklist as supplement.
5. Body of paper exceeds 5,000 words or > 50 references.
6. Initial submission lacking ICMJE / Helsinki / Istanbul ethics statement in Methods (will be returned without review).

## Cover Letter
Should include:
- Confirmation of originality and exclusivity (not under consideration elsewhere).
- Explicit AI use disclosure if any (location and tool used) — mandatory in cover letter AND Methods.
- Concept-origin statement (if idea originated outside corresponding/senior author).
- Significance highlight tailored to AASLD readership.

## AI Writing Disclosure Policy
- **Requirement level:** Required (ICMJE-aligned).
- **Permitted scope:** AI-assisted tools (LLMs, chatbots, image creators) used in writing, image production, or data analysis must be disclosed in the **Materials and Methods (or similar)** section AND in the **cover letter**, naming the tool and describing what it was used for. AI must not replace researcher responsibilities (analysis, interpretation, conclusions) and must not be listed as author or co-author. AI-generated material cannot be cited as a primary source.
- **Disclosure location:** Materials and Methods + Cover Letter.
- **Author responsibility:** Authors take full responsibility for AI-derived content including any breach of publication ethics.
- **Policy URL:** https://edmgr.ovid.com/hepcomm/accounts/ifauth.htm (Authorship section)

## Article Processing Charges (verified 2025 from PDF)
| Article Type | AASLD Member | Non-Member |
|---|---|---|
| Tier 1 (Articles, Reviews, Experimental Research) | US$1,890 | US$3,150 |
| Tier 2 (Letters, Editorials, Correspondence) | US$480 | US$800 |

## Author Guidelines URL
https://edmgr.ovid.com/hepcomm/accounts/ifauth.htm

Editorial Office email: hepcomm@aasld.org
Submission portal: https://mc.manuscriptcentral.com/hepcomm
PaperPal Preflight: https://preflight.paperpal.com/partner/lww/hepatolcom

## Positioning

**When to submit here.** Korean / Asian / global health-screening cohort studies on MASLD natural history applying the 2023 nomenclature, retrospective hepatobiliary cohort analyses, MASLD-MASH translational research, biomarker validation papers, and AASLD-guideline-adherent clinical/translational work that did not make Hepatology's main journal cut. Particularly useful as the **OA fallback for the AASLD family** when authors want fast OA dissemination, prefer copyright retention, and have funder/institution OA mandates. Hepatology Communications also has a documented portable-peer-review pathway from Hepatology — manuscripts rejected at Hepatology can transfer with reviews intact.

**When NOT to submit here.** Pure methodology/statistics papers without hepatology content. Studies that do not use 2023 MASLD nomenclature (will be flagged for revision unless justified). Manuscripts with > 50 refs or > 8 figures+tables that cannot be trimmed.

| Dimension | Hepatology Communications | Hepatology (parent) | CMH (KASL) | Liver International |
|---|---|---|---|---|
| Society | AASLD (American) | AASLD | KASL | independent (Wiley) |
| OA model | Mandatory full OA | Hybrid | Mandatory full OA | Hybrid |
| APC (non-member) | US$3,150 | hybrid OA optional | US$1,500 | ~US$3,400 |
| Acc. rate (est.) | ~30–35 % | ~10–15 % | ~25–30 % | ~20–25 % |
| Word limit (Original) | 5,000 | 5,000 | 6,000 | 4,000 |
| Graphical abstract | Optional | Optional | Mandatory | Optional |
| 2023 MASLD nomenclature | Mandatory | Mandatory | Strong preference | Strong preference |

- **AI-use disclosure placement**: Cover letter + Methods
  <!-- machine-read by /self-review check_classical_style.py --profile; source: this profile's own "Explicit AI use disclosure if any (location and tool used) — mandatory in cover letter AND Methods." -->

# Journal Profile: Hepatology International

## Journal Identity
- **Full name:** Hepatology International
- **Abbreviation:** Hepatol Int
- **Publisher:** Springer Nature for APASL (Asian Pacific Association for the Study of the Liver)
- **ISSN:** 1936-0533 (print) / 1936-0541 (online)
- **Frequency:** Bimonthly
- **Open Access:** Hybrid (Springer Open Choice optional; OA APC ~US$3,090, verify)
- **Acceptance rate:** ~25–30 % (estimated; verify)
- **Peer review:** Editorial Manager-based; copyright on accepted manuscripts is held by APASL.

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | References | Figures/Tables |
|------|----------------|----------|------------|----------------|
| Original Article | 4,000 (incl. refs) | 250 words structured | 30 | up to 6 (tables/flow diagrams/colored figures/text boxes) |
| Review Article | 5,000 (incl. refs) | 250 words structured | 100 | ≥ 4 colored figures + ≥ 4 tables MANDATORY (total up to 8) |
| Mini Review | 2,500 (excl. refs) | 150 words structured | 30 | ≥ 2 figures + ≥ 2 tables recommended (total up to 4) |
| Invited Article (Editorial, by invitation) | 1,500 (excl. refs) | None | 10 | 1 figure |
| Consensus | 2,000 | (verify) | 9 | (verify) |
| Letter to Editor | 500 (excl. refs) | None | 5 | 1 figure |
| Point-of-View (by invitation) | 1,500 (excl. refs) | None | 10 | 1 table + 2 figures |
| Commentary (by invitation) | 1,500 (excl. refs) | None | 10 | 1 table + 1 figure |
| Multimedia / Dynamic Article | per article type | per article type | per article type | up to 3 video clips, 1 min each (3 min for dynamic) |

10 keywords mandated for all article types with abstracts.

## Abstract Requirements
**Original Article:** 250 words, structured (sub-headings not specified in publisher PDF — historically Background/Aims, Methods, Results, Conclusions). 10 keywords (not the typical 3–5).

## Required Sections (Original Article, in order)
1. **Title page** with **Compliance with Ethical Requirements** sub-section (CoI for each author, informed consent, human/animal rights statements)
2. **Abstract** (250 words structured, 10 keywords)
3. **Graphical Abstract** — single panel, **placed immediately after abstract**, MANDATORY for Original Articles
4. **Introduction** (background and purpose)
5. **Materials and Methods**
6. **Results**
7. **Discussion**
8. **Declarations** (just before References — mandatory)
   - Conflict of Interest and Ethical Standards
   - Informed Consent
   - Statement of Human and Animal Rights
9. **References** (≤ 30 for Original)
10. **Tables** / **Figures** / **Supplementary Information**

## Statistical Reporting
- General observational/clinical statistical conventions.
- Reporting guideline citations expected (STROBE for cohort, PRISMA for SR/MA, STARD for diagnostic accuracy, ARRIVE for animals).
- Springer's standard policy on data deposition / availability statement.
- Sex/gender, race/ethnicity reporting per ICMJE.

## Figures
- **Graphical Abstract specifications (mandatory for Original Articles):**
  - Single-panel image, 300 dpi+
  - Format: .tif or .jpg preferred
  - Font: Arial 12–16 pt
  - Color: RGB
  - Read direction: top-to-bottom or left-to-right
  - Simple labels, bullet-form text
  - Place next to abstract, labelled "Graphical Abstract"
- Up to 6 illustrations (tables / flow diagrams / colored figures / text boxes / other) for Original Articles
- Color figures supported (no extra charge; verify for hybrid OA workflow)
- Permission required for any previously published figures, tables, or text passages

## Common Rejection Reasons
1. Missing graphical abstract on Original Article submission (will be returned).
2. Word count > 4,000 (including references) for Original Article.
3. Reference count > 30 for Original Article.
4. Missing Compliance with Ethical Requirements sub-section on title page.
5. Failure to upload signed Copyright/Authorship/Disclosure Form at submission.
6. Sub-mission via incorrect Editorial Manager registration (re-registration breaks tracking).
7. Errata requests submitted after proof approval (discouraged unless materially affecting interpretation).

## Cover Letter
Submission via Editorial Manager. Cover letter should:
- Confirm originality and exclusivity (not under consideration elsewhere).
- Highlight Asia-Pacific or APASL-guideline relevance where applicable.
- Note any APASL meeting presentations.

## AI Writing Disclosure Policy
- **Requirement level:** Required (Springer Nature follows ICMJE).
- **Permitted scope:** AI use must be disclosed; AI cannot be author. (Springer Nature's general policy applies; verify journal-specific addendum.)
- **Disclosure location:** Acknowledgements / Methods.
- **Policy URL:** https://www.springernature.com/gp/policies/editorial-policies (parent policy)

## Author Guidelines URL
https://link.springer.com/journal/12072/submission-guidelines

Editorial Manager: https://www.editorialmanager.com/heip
Copyright/Authorship/Disclosure Form: downloadable from Editorial Manager submission page (mandatory)

## Positioning

**When to submit here.** Asian-Pacific cohort hepatology, MASLD/NAFLD natural history in East-Asian populations, lean MASLD, chronic hepatitis B (regional endemic), HCC surveillance, and APASL-guideline-relevant clinical work. Korean and Japanese MASLD cohort studies are well-represented. Strong fit when Asia-Pacific generalizability is the headline contribution. Mandatory graphical abstract is a real constraint — design it before drafting because it will be the first thing editors see.

**When NOT to submit here.** Pure methodology papers without hepatology content. Studies on non-hepatobiliary primary outcomes. Manuscripts unwilling or unable to produce a graphical abstract. Time-pressed submissions — Editorial Manager registration can be slow.

| Dimension | Hepatology International | Hepatol Communications | CMH (KASL) | Liver International |
|---|---|---|---|---|
| Society | APASL (Asia-Pacific) | AASLD (American) | KASL (Korean) | independent (Wiley) |
| OA model | Hybrid | Mandatory OA | Mandatory OA | Hybrid |
| Original word limit | 4,000 (incl. refs) | 5,000 (excl. refs) | 6,000 (incl. refs/figs) | 4,000 (excl. refs) |
| Graphical abstract | **Mandatory** | Optional | **Mandatory** | Optional |
| Reference cap | 30 | 50 | 50 | 60 |
| Korean cohort fit | High | Moderate-High | Highest | High |

# Journal Profile: IEEE Transactions on Medical Imaging (IEEE TMI)

## Journal Identity

- **Full name**: IEEE Transactions on Medical Imaging
- **Abbreviation**: IEEE Trans Med Imaging
- **Publisher**: IEEE (Institute of Electrical and Electronics Engineers)
- **ISSN**: 0278-0062 (print), 1558-254X (online)
- **Frequency**: Monthly (12 issues/year)
- **Impact Factor**: ~10.6 (JCR 2023), top-ranked in medical imaging engineering
- **Open Access**: Hybrid (IEEE OA option with APC ~$2,095)
- **Acceptance rate**: ~20-25%
- **Peer review**: Single-blind; associate editors assign 3+ expert reviewers

## Manuscript Types and Page Limits

| Type | Page Limit | Abstract | References |
|------|-----------|----------|------------|
| Regular Paper | 12 pages (IEEE 2-column) | 250 words | No strict limit |
| Short Paper | 6 pages | 150 words | No strict limit |
| Correspondence | 3 pages | 100 words | 15 |

**Page limits include everything**: text, figures, tables, references. This is stricter than word-count journals — plan figure sizes carefully.

**Overlength charges**: $175 per page beyond the limit (mandatory).

---

## Abstract Requirements

**Unstructured abstract, 250 words maximum:**

Single paragraph covering:
- Problem statement and clinical relevance (1-2 sentences)
- Proposed approach (2-3 sentences)
- Key experimental results with metrics (2-3 sentences)
- Conclusion/significance (1 sentence)

---

## Required Journal-Specific Elements

### 1. IEEE Keywords

Select from the IEEE controlled keyword taxonomy. Typically 5-8 keywords including:
- Index Terms from IEEE Thesaurus
- Common: "medical image analysis," "deep learning," "convolutional neural networks," "image segmentation," "computed tomography," "magnetic resonance imaging"

### 2. IEEE Author Profile

Each author needs an IEEE-format biography (2-3 sentences: degree, institution, research interests). Placed at the end of the paper with optional author photo.

### 3. Acknowledgment Section

Funding sources and grant numbers in a dedicated Acknowledgment section (before References).

---

## Required Sections (Regular Paper)

1. **Introduction** — problem statement, literature review, contribution summary (typically bulleted list of contributions at end)
2. **Related Work** — detailed comparison with prior approaches
3. **Methods / Proposed Method**
   - Mathematical formulation with equations
   - Architecture description with diagram
   - Training procedure: loss function, optimizer, hyperparameters
   - Implementation details
4. **Experiments**
   - Datasets: description, split strategy, preprocessing
   - Evaluation metrics
   - Baseline methods
   - Ablation study
   - Computational complexity analysis
5. **Results and Discussion** — can be combined or separate
6. **Conclusion**
7. **Acknowledgment**
8. **References**
9. **Author Biographies**

---

## Statistical Reporting

IEEE TMI follows engineering/computing conventions:
- Report metrics with mean and standard deviation across folds, runs, or subjects.
- Statistical significance: paired t-test or Wilcoxon signed-rank between methods; report exact P values.
- For segmentation: Dice, Hausdorff distance (HD95), average surface distance (ASD).
- For detection: sensitivity at fixed false positive rates, FROC.
- For classification: AUC, accuracy, sensitivity, specificity, F1.
- Ablation table: systematically add/remove components with corresponding metric changes.
- Computational cost: FLOPs, parameters, training time, inference time, GPU memory.
- Cross-validation: report per-fold results or confidence intervals, not just mean.
- Reproducibility: random seed, number of runs, hardware specification.
- Software framework and version must be identified.

---

## Formatting

### IEEE Two-Column Format

- **Template**: Use `IEEEtran.cls` LaTeX class (mandatory for camera-ready)
- **Font**: Times New Roman (auto in IEEEtran)
- **Margins**: IEEE standard (auto in template)
- **Equations**: Numbered sequentially; referenced as (1), (2), etc.
- **Figures**: Fit within single column (3.5 in / 88 mm) or span both columns (7.16 in / 182 mm)
- **Tables**: Same column/span rules as figures
- **References**: IEEE abbreviated style (e.g., [1], [2])

### Figure Requirements

- **Resolution**: 300 DPI minimum (600 DPI for line art)
- **Format**: PDF, EPS, or high-resolution PNG/TIFF
- **Color**: Free for online; grayscale conversion should be legible
- **Captions**: Below figures; brief but self-explanatory
- **Size matters**: figures consume page budget — use multi-panel layouts efficiently

---

## Common Rejection Reasons

1. **Page limit exceeded** — 12-page limit is strict; overlength papers are returned without review
2. **Insufficient novelty** — applying existing deep learning to new dataset without methodological innovation
3. **Unfair experimental comparison** — different training conditions between proposed and baseline methods
4. **Missing ablation study** — IEEE TMI reviewers consistently require component-wise evaluation
5. **Poor writing quality** — IEEE TMI has high standards for technical writing clarity
6. **No comparison with recent methods** — must include methods from the last 2 years
7. **Single dataset** — multi-dataset evaluation expected for generalizability
8. **Conference paper overlap** — if extending a conference paper (MICCAI, ISBI), must clearly state and quantify the additional contribution (typically 30%+ new content)

---

## Cover Letter

IEEE TMI does not require a formal cover letter but ScholarOne submission requires:
- Manuscript type selection
- Suggested reviewers (3-5 with affiliations and emails)
- Statement of originality
- If conference extension: explicit statement of what is new (with percentage estimate)

---

## Author Guidelines URL

https://www.embs.org/tmi/authors/

---

## Conference-to-Journal Extension

IEEE TMI commonly receives extended versions of MICCAI, ISBI, IPMI papers. Requirements:
- At least 30% new content (experiments, methods, or analysis)
- Must cite and explicitly compare with conference version
- Reviewers assess the delta, not just the full paper
- State clearly in cover letter and introduction what is new

---

## Positioning

IEEE TMI is appropriate when:
- Novel imaging algorithm with rigorous quantitative evaluation
- New reconstruction, registration, or segmentation method with mathematical foundation
- Multi-modal fusion or novel imaging physics-informed approach
- Comprehensive benchmark study on medical imaging task
- Conference paper extension with substantial new experiments/methods

Not appropriate for: clinical outcome studies without technical contribution (use clinical journals), pure application of existing methods, papers without quantitative evaluation on medical data.

---

## Differentiation from Related Venues

| Dimension | IEEE TMI | MedIA | IEEE JBHI |
|-----------|---------|-------|-----------|
| Format | 12-page IEEE 2-column | No page limit, Elsevier | 10-page IEEE 2-column |
| Scope | Medical imaging methods | Medical image analysis methods | Health informatics (broader) |
| Emphasis | Imaging + math rigor | Methods depth + ablation | EHR, wearables, signals + imaging |
| LaTeX class | IEEEtran (mandatory) | elsarticle (preferred) | IEEEtran (mandatory) |
| Typical length | Shorter, denser | Longer, more detailed | Shorter |

# Journal Profile: Interventional Neuroradiology (INSI)

## Basic Information

- **Publisher:** SAGE Publications
- **Society:** European Society of Minimally Invasive Neurological Therapy (ESMINT) / World Federation of Interventional and Therapeutic Neuroradiology (WFITN)
- **Impact Factor:** ~2.5–3.0 (2023–2024)
- **Scope:** Endovascular and minimally invasive neuroradiology; neurovascular interventions; stroke intervention; head/neck vascular procedures
- **Open Access:** Optional (SAGE Choice)
- **Language:** American English

---

## Scope — Covered Topics

- Cerebral aneurysm treatment (coiling, stent-assisted coiling, flow diversion, WEB device)
- Mechanical thrombectomy for acute ischemic stroke
- Carotid and vertebral artery stenting
- Cerebral arteriovenous malformation (AVM) embolization
- Dural arteriovenous fistula (dAVF) embolization
- Intracranial atherosclerosis treatment
- Venous sinus stenting for idiopathic intracranial hypertension
- Tumor embolization (head/neck, meningioma)
- Spinal vascular interventions
- Novel devices and techniques in neurointerventional radiology

---

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | Figures | References |
|------|----------------|----------|---------|------------|
| Original Article | 3500 words | 250 words | 8 | 40 |
| Review Article | 5000 words | 300 words | 10 | 60 |
| Technical Note | 2000 words | 150 words | 6 | 20 |
| Case Report | 2000 words | 200 words | 6 | 20 |
| Letter | 600 words | None | 2 | 5 |

---

## Abstract Requirements

**Structured abstract, 250 words:**

```
Background and Purpose: [Why this procedure/study is needed; clinical context]
Methods: [Study design, patient population, procedural details, outcomes assessed]
Results: [Technical success rate, clinical outcomes, complication rates with 95% CI,
          follow-up duration]
Conclusions: [Main conclusion; clinical implication]
```

---

## Domain-Specific Outcome Measures

### For Stroke/Thrombectomy Studies

- **Recanalization:** mTICI (modified Treatment in Cerebral Infarction) scale — state score threshold for success (typically mTICI ≥ 2b)
- **Clinical outcome at 90 days:** mRS (modified Rankin Scale) — good outcome = mRS 0–2
- **Early neurological improvement:** NIHSS change at 24 hours
- **Mortality at 90 days**
- **Symptomatic intracranial hemorrhage (sICH):** ECASS II or SITS criteria — specify which

### For Aneurysm Studies

- **Technical success:** Complete coil/device deployment without procedure-related mortality or major stroke
- **Aneurysm occlusion:** Raymond-Roy Occlusion Classification (RROC) or O'Kelly-Marotta (OKM) scale for flow diversion
- **Procedure-related complications:** stroke, parent artery occlusion, aneurysm perforation, thromboembolic events
- **Aneurysm recurrence:** Defined explicitly (e.g., recanalization requiring retreatment)
- **Follow-up imaging:** DSA (gold standard) or MRA; state modality and timing

### For General Neurointerventional Studies

- **Technical success rate:** [Clearly define what constitutes technical success]
- **Procedural complications:** Define minor (no permanent deficit) vs. major (permanent neurological deficit or death)
- **Clinical outcomes:** Follow-up mRS or equivalent functional score
- **Radiation exposure:** DAP (dose area product), fluoroscopy time (for technique comparison studies)
- **Procedure time:** From femoral puncture to end of procedure

---

## Required Sections

1. **Introduction** — Clinical background; why the specific technique/device/approach is being studied
2. **Materials and Methods**
   - Ethics: IRB number + consent (or exemption for retrospective studies)
   - Patient population: Consecutive or selected? Selection criteria for treatment
   - Procedural details: Describe technique in enough detail to be replicable; include specific devices/catheters/materials with brand names and catalog numbers for first-time techniques
   - Outcome definitions: Define each outcome explicitly before reporting results
   - Statistical analysis
3. **Results**
   - Patient baseline characteristics (Table 1)
   - Technical outcomes (Table 2)
   - Clinical outcomes at each follow-up time point
   - Complications (ALL complications — report even if none: "No procedure-related complications occurred")
4. **Discussion**
5. **Conclusion**

---

## Common Complications to Always Address

For any neurointerventional study, explicitly address these even if not observed:
- Thromboembolic events (stroke, TIA)
- Access site complications (hematoma, pseudoaneurysm, AV fistula)
- Vessel perforation or rupture
- Contrast reaction
- Radiation injury (for prolonged procedures)
- Device-specific complications (coil migration, stent misplacement)

---

## Statistical Requirements

- Report 95% CI for all primary outcomes (especially rates/proportions)
- Clopper-Pearson exact 95% CI for proportions (appropriate for small N)
- Kaplan-Meier for time-to-event outcomes (recurrence, re-treatment)
- For technique comparisons: appropriate parametric/non-parametric test with effect size
- Report N analyzed at each follow-up time point (attrition matters)

---

## Figures for Neurointerventional Papers

| Figure | Content |
|--------|---------|
| Figure 1 | Representative case — pre-procedure angiogram |
| Figure 2 | Intra-procedure steps (guide catheter placement, device deployment) |
| Figure 3 | Post-procedure result (immediate angiogram) |
| Figure 4 | Follow-up angiogram or imaging |
| Figure 5 | Outcome charts (bar chart of mRS distribution, OKM grades) |

DSA images should be high-quality screen captures or exports from angiography workstation. Show projections that best demonstrate the finding (typically AP and lateral, or working projection for treatment).

---

## Common Rejection Reasons

1. **Small single-center series** — INSI accepts these for novel techniques but sample size must be explicitly justified
2. **Missing complication reporting** — every study must report all complications, including minor ones and access site issues
3. **Undefined outcome measures** — define mTICI success threshold, mRS cutoff, and occlusion classification before reporting results
4. **No follow-up imaging** — aneurysm studies without angiographic follow-up (minimum 6–12 months) are typically insufficient for original articles
5. **Heterogeneous patient mix** — mixing ruptured and unruptured aneurysms without subgroup analysis is a common methodology concern
6. **Operator experience not described** — for technique papers, describe center volume (procedures/year) and operator experience

---

## Author Guidelines URL

https://journals.sagepub.com/author-instructions/INI

---

## Positioning

INSI is appropriate when:
- Study is specifically about neurointerventional procedures or devices
- Technique paper for a new or modified approach
- Case series demonstrating feasibility of a new technique (N = 5–20 acceptable for technical notes)
- Retrospective registry study with good follow-up

INSI is not appropriate for: purely diagnostic neuroradiology (without intervention), brain tumor imaging without intervention, purely basic science (use JNIS or AJNR for those).

# Investigative Radiology

## Journal Identity

- **Full name**: Investigative Radiology
- **Abbreviation**: Invest Radiol
- **Publisher**: Wolters Kluwer / Lippincott Williams & Wilkins
- **ISSN**: Not specified in guidelines
- **Frequency**: Monthly
- **Impact Factor**: Not specified in guidelines
- **Open Access**: Hybrid (subscription + OA option under CC BY-NC-ND)
- **APC**: See Wolters Kluwer policies; read-and-publish agreements available

## Manuscript Types and Word Limits

| Type | Abstract | Manuscript Body | References | Figures/Tables |
|------|----------|----------------|------------|----------------|
| Original Research | No word limit (structured) | No strict cap | No cap | No strict cap |

Case reports are NOT accepted.

## Abstract Format

Structured with four headings:
1. **Objectives**
2. **Materials and Methods**
3. **Results**
4. **Conclusions**

No word limit stated. No references in abstract. Limit abbreviations and acronyms.

## Keywords

Up to 10 keywords.

## Required Sections

1. **Introduction**
2. **Materials and Methods**
3. **Results**
4. **Discussion**

Required submission files (all separate):
- **Cover letter**: authorship statement, COI, ethical adherence
- **Title page**: title, authors with degrees/affiliations, corresponding author, running head (max 45 characters), funding, COI statement
- **Acknowledgment section** (optional, separate file)
- **Manuscript**: title, abstract, keywords, body, tables, figure legends
- **Figures**: separate image files

## Citation Style

- AMA (American Medical Association) style, 11th edition
- Numbered sequentially in order of appearance
- More than 3 authors: list first 3, then "et al."
- Journal abbreviations per Index Medicus
- Example: `Rand NS, Dawson JM, Juliao SF, et al. In vivo macrophage recruitment by murine intervertebral disc cells. J Spinal Disord. 2001;14:339-342.`
- Unpublished data/personal communications: cite in text parenthetically, not in reference list

## Reporting Guidelines

- Follow ICMJE authorship criteria (all four)
- Declaration of Helsinki for human studies
- ARRIVE guidelines for animal studies
- CONSORT for randomized trials

## Statistical Reporting

Follows ICMJE statistical reporting recommendations:
- Report exact p-values; do not use "P < .05" as a substitute for exact values.
- 95% CI required for all primary outcomes.
- Specify the statistical test used for each comparison; parametric vs non-parametric choice must be justified.
- For diagnostic/prognostic studies: AUC with 95% CI; calibration required for prediction models.
- Missing data handling must be described in Methods.
- Statistical software and version required in Methods.
- No journal-specific statistical reporting requirements beyond ICMJE standards are published; follow discipline-appropriate guidelines (STARD, TRIPOD, STROBE).

## Special Notes

- **Emphasizes early and timely publication** of diagnostic imaging research.
- **AI policy**: AI tools may NOT be listed as author; use must be disclosed in cover letter and Acknowledgments section. AI use is discouraged.
- **Co-first authorship**: max 2, requires justification and EIC approval.
- **Proof turnaround**: 24-48 hours; only critical accuracy corrections allowed.
- **Self-archiving**: 12-month embargo for accepted manuscripts.
- **Figures**: line art minimum 1200 dpi; photographs minimum 300 dpi.
- Tables must be created in Word (NOT Excel).
- Running head maximum 45 characters including spaces.

- **AI-use disclosure placement**: Cover letter + Acknowledgments
  <!-- machine-read by /self-review check_classical_style.py --profile; source: the profile's own AI policy: "disclosed in cover letter and Acknowledgments section" -->

# Journal Profile: JACC: Advances

## Journal Identity

- **Full name**: JACC: Advances
- **Abbreviation**: JACC Adv
- **Publisher**: Elsevier (on behalf of the American College of Cardiology)
- **ISSN**: 2772-963X (online; full open access, no print ISSN)
- **Frequency**: Monthly
- **Impact Factor**: Not yet indexed (Web of Science indexing pending as of audit date)
- **Open Access**: Full Gold OA — APC USD 3,024 (Original Research / Reviews / Methodology / Expert Panel); USD 1,300 (Research Letters / Brief Reports). 10% discount for ACC members and early-career authors (≤10 years post-training); 50% discount for all authors from developing countries.
- **Acceptance rate**: Not published; broadly estimated 25–35% for Original Research within target scope
- **Peer review**: Single-blind; statistical review applied selectively (more frequent for methodology-heavy submissions)

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | References | Figures/Tables |
|------|----------------|----------|------------|----------------|
| Original Research Paper | 5,000 words (text + refs + figure legends combined) | 250 words (structured) | included in 5,000 | not separately capped |
| State-of-the-Art Review | 10,000 words | 150 words (unstructured) | included in 10,000 | not separately capped |
| Methodology Corner | 5,000 words | 250 words (structured) | included in 5,000 | not separately capped |
| Brief Report | 1,200 words | None | not specified | ≤1 simple figure (≤2 parts) OR 1 table |
| Research Letter | 1,000 words | None | not specified | ≤1 simple figure (≤2 parts) OR 1 table |
| Viewpoint | 2,000 words | None | not specified | ≤1 simple figure (≤2 parts) OR 1 table |
| Editorial Comment | 1,500 words | None | not specified | not specified |
| JACC: Advances Expert Panel | ≤10,000 or ≤5,000 (per invitation) | 150 words (unstructured) | varies | varies |

The 5,000-word cap for Original Research includes text, references, and figure legends combined — tighter than most cardiology peers; trim aggressively before initial submission.

---

## Abstract Requirements

**Structured abstract for Original Research, 250 words maximum, with 4 explicit headings:**

```
Background: [Context and knowledge gap]
Objectives: [Specific aim of the study]
Methods: [Design, setting, population, exposures, outcomes, analytic approach]
Results: [Primary results with effect sizes, 95% CIs, P values; N analyzed]
Conclusions: [Direct answer to objective with clinical/translational implication]
```

The 4-heading structure (**Background / Objectives / Methods / Results / Conclusions**) differs slightly from Circulation's 4-heading Background / Methods / Results / Conclusions — JACC: Advances inserts an explicit **Objectives** heading between Background and Methods. Reviewers and the editorial system will reject submissions that omit Objectives.

---

## Required Journal-Specific Elements

### 1. Central Illustration

Strongly encouraged for all Original Research. A single panel that conveys the main scientific message — typically a graphical summary combining cohort, key finding (forest plot or Kaplan-Meier), and interpretive caption. Counts toward figure cap.

### 2. Highlights / Key Points (recommended)

Three to five bullet points summarizing the principal contribution at submission.

### 3. Article Information

- Affiliations: department, institution, city, country (numbered superscripts)
- Corresponding author: full contact details
- Funding: complete disclosure with grant identifiers
- Disclosures: per-author conflicts of interest (ICMJE form)
- Data and code availability statement
- Acknowledgments separated from disclosures

---

## Required Sections (Original Research)

1. **Introduction** — 2–4 paragraphs ending in a clearly stated objective. JACC: Advances editors tolerate broader scoping than JACC main but still want a tight knowledge-gap framing.
2. **Methods**
   - Ethics: IRB approval with institution name and waiver status
   - Study design, setting, population, eligibility criteria, dates of enrollment
   - Exposures / interventions
   - Outcomes: primary, secondary, and exploratory clearly distinguished
   - Statistical analysis: software (with versions), tests, sample-size or power note, missing-data handling, multiplicity adjustment, sensitivity analyses
3. **Results** — STROBE/CONSORT flow first; primary outcome before secondary
4. **Discussion** — 4–6 paragraphs; dedicated Strengths and Limitations sub-paragraphs; conclude with implications and future directions
5. **Conclusions** — brief (2–3 sentences); avoid overclaiming, especially for small-event composite outcomes

---

## Statistical Reporting

- Exact P values to 3 decimal places (e.g., P = 0.032); use P < 0.001 below threshold
- 95% CI for all primary effect estimates
- Effect sizes appropriate to design (HR, sHR, OR, mean difference, AUC)
- Proportional-hazards assumption check (Schoenfeld) when Cox is used
- Competing-risks framework (Fine–Gray) when non-CV death competes with CV endpoint
- Pre-specified sensitivity analyses for major analytic choices (missing data, alternative cutpoints, exposure misclassification)
- Software and version must be reported
- For observational cohort: STROBE reporting checklist as supplement, even if not requested in submission portal

---

## Figures

- **No hard cap stated** for Original Research figure count (but tight 5,000-word cap discourages excess)
- **Brief Reports / Research Letters / Viewpoints**: maximum 1 simple figure (≤2 parts) OR 1 table
- Resolution: 300 DPI minimum
- Format: TIFF, EPS, PDF, or high-quality PNG
- Color: free (full OA model)
- Central Illustration: 1 figure, square or landscape, conveying main message
- Supplementary material: unlimited online-only supplement

---

## Common Rejection Reasons

1. **Insufficient novelty within CKM / cardio-metabolic space** — JACC: Advances welcomes incremental contributions but expects a clear delta versus existing JACC family content
2. **Methodologic gaps** — missing PH check for Cox, missing competing-risks framework when applicable, missing sensitivity analyses
3. **Overclaiming on small-event composite endpoints** — wide CI estimates narrated without "exploratory" or "hypothesis-generating" qualifiers
4. **Cohort selection bias unacknowledged** — single-center screening cohorts must explicitly characterize selection direction
5. **5,000-word cap violation** — failing to combine text + refs + legends within the cap is the single most common pre-review desk reject reason
6. **Mismatch between Abstract Objectives and Conclusions** — JACC: Advances editors specifically check this alignment
7. **AI policy non-compliance** — undisclosed AI use in writing/editing, or attempts to fabricate AI-generated images

---

## Cover Letter

Must include:
- Brief statement of novelty and clinical significance (2–3 sentences)
- Confirmation manuscript is not under consideration elsewhere
- Confirmation all authors meet ICMJE criteria
- Disclosure of related manuscripts (same cohort, same group)
- Suggested reviewers (3–5; the senior PI should curate)
- AI disclosure statement aligned with the in-manuscript declaration

---

## AI Writing Disclosure Policy

- **Requirement level**: Required (Elsevier publisher-level policy applies; the JACC: Advances Guide for Authors does not display a journal-specific AI policy as of audit date)
- **Permitted scope**: AI/LLM tools may be used for language editing, structural review, and internal consistency checks; AI cannot be listed as an author; authorship implies responsibilities that can only be attributed to and performed by humans
- **Disclosure location**: A separate "Declaration of generative AI and AI-assisted technologies in the writing process" section inserted **immediately above the references**
- **AI-generated images**: Elsevier does not permit the use of generative AI or AI-assisted tools to create or alter images in submitted manuscripts
- **Grammar/spell-check exception**: Basic checks of grammar, spelling and punctuation need no declaration
- **Policy URL**: https://www.elsevier.com/about/policies-and-standards/the-use-of-generative-ai-and-ai-assisted-technologies-in-writing-for-elsevier

---

## Submission Portal

https://www.jaccsubmit-advances.org

---

## Author Guidelines URL

https://www.sciencedirect.com/journal/jacc-advances/publish/guide-for-authors

---

## Positioning

| Criterion | JACC: Advances | JACC main | JACC: Asia | EJPC |
|-----------|----------------|-----------|------------|------|
| **Society** | ACC | ACC | ACC (Asia-Pacific focus) | ESC/EAPC |
| **Impact Factor** | not indexed yet | ~22 | not indexed yet | ~8 |
| **Open Access** | Full Gold OA ($3,024) | Hybrid | Full Gold OA | Hybrid |
| **Geographic stance** | Global, no regional anchor | Global, NA-centric | Asia-Pacific anchor | Europe-centric |
| **Event-count tolerance** | Moderate (welcomes exploratory framings with adequate caveats) | High (expects definitive outcomes) | Moderate (Asia-Pacific data privileged) | Moderate (prevention-focused) |
| **Submission angle** | "Novel framework application or extension of CKM/CV evidence" | "Practice-changing or guideline-shifting finding" | "Asia-Pacific cardiovascular evidence" | "Cardiovascular prevention, rehabilitation, or epidemiology" |
| **Abstract style** | 4-heading (Background/Objectives/Methods/Results/Conclusions, 250 words) | Unstructured 250 words | Same as JACC: Advances | 4-heading (Aims/Methods/Results/Conclusion, 250 words) |
| **Word cap (Original)** | 5,000 (incl. refs + legends) | 5,000 | 5,000 | 5,000 |
| **AI policy** | Elsevier publisher-level (no journal page) | ACC/Elsevier | ACC/Elsevier | OUP/ESC explicit on guidelines page |

**Choose JACC: Advances when:**
- AHA 2023 CKM framework or other society-aligned framework application
- Korean / non-Western cohort with broad generalizability narrative (not Asia-specific anchor)
- Observational cohort with modest event count that needs "exploratory but rigorous" reception
- Authors who value Gold OA and ACC ecosystem visibility over JCR-indexed IF (transitional period)

**Choose JACC main instead when:**
- Multicenter, large-event-count, practice-changing finding
- Findings likely to be cited in ACC/AHA guidelines within 1–2 years
- Higher IF requirement (e.g., faculty promotion tracks)

**Choose JACC: Asia instead when:**
- Asia-Pacific regional contribution is the dominant framing (not "first Korean ___")
- Asia-Pacific healthcare-system policy implications are central

**Choose EJPC instead when:**
- Primary prevention angle is dominant
- ESC/EAPC ecosystem reach matters more than ACC reach
- Manuscript needs sponsor society alignment with European preventive cardiology community

---

## Verification Notes

Audit performed 2026-05. Sources opened:
- Homepage: https://www.sciencedirect.com/journal/jacc-advances (ISSN, EIC, APC, scope)
- Guide for Authors: https://www.sciencedirect.com/journal/jacc-advances/publish/guide-for-authors (article types, word limits, abstract structure, references, figures, submission portal)
- Elsevier publisher AI policy: https://www.elsevier.com/about/policies-and-standards/the-use-of-generative-ai-and-ai-assisted-technologies-in-writing-for-elsevier (AI policy verbatim source)

- **AI-use disclosure placement**: Declaration section immediately above the References (body)
  <!-- machine-read by /self-review check_classical_style.py --profile; source: this profile's own "A separate \"Declaration of generative AI and AI-assisted technologies in the writing process\" section inserted immediately above the references" -->

# Journal Profile: JACC: Asia

## Journal Identity

- **Full name**: JACC: Asia
- **Abbreviation**: JACC Asia
- **Publisher**: Elsevier (American College of Cardiology Foundation)
- **ISSN**: 2772-3747 (online)
- **Frequency**: Monthly
- **Impact Factor**: Not yet indexed in JCR; SCI indexing expected 2027 (anticipated IF ~5–6) [VERIFY at journal site]
- **Open Access**: Full Gold OA
- **Acceptance rate**: Not published [TODO: verify at journal site]
- **Peer review**: Single-blind, ACC editorial process

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | References | Figures/Tables | Authors |
|------|----------------|----------|------------|----------------|---------|
| Original Investigation | ≤ 5,000 (text + references + figure legends combined) | 250 w (structured) | Within 5,000-word combined cap; Index Medicus abbreviations | Reasonable, no explicit cap | No explicit cap |
| State-of-the-Art Review | ≤ 10,000 | 250 w (unstructured or structured) | Within combined cap | Reasonable | No explicit cap |
| Research Letter | ≤ 800 | None | ≤ 5 | 1 figure or table | ≤ 5 typical |
| Editorial / Viewpoint | Invited; ≤ 1,500 | None | ≤ 10 | None typical | ≤ 3 |
| Letter to the Editor | ≤ 500 | None | ≤ 5 | None typical | ≤ 3 |

The 5,000-word limit for Original Investigations is **inclusive** of main text, references, and figure legends; abstract, title page, and tables are not counted. Verify against the live Guide for Authors before submission.

---

## Abstract Requirements

Structured, 250 words maximum, with the following 5 mandatory headings:

```
Background
Objectives
Methods
Results
Conclusions
```

Avoid citations and abbreviations in the abstract. Report effect sizes with 95% confidence intervals where applicable.

---

## Required Sections (Original Investigation)

1. **Title page** — full title, short title, authors with degrees and affiliations, ORCID, corresponding author full contact, word/figure/table counts, key words (3–5), funding, conflict of interest disclosures
2. **Structured Abstract** (Background/Objectives/Methods/Results/Conclusions, 250 w)
3. **Condensed Abstract / Visual Abstract** (where required by article category)
4. **Introduction**
5. **Methods** — must include statistical methods, ethics statement (IRB approval and informed consent or waiver), and data availability statement
6. **Results**
7. **Discussion** — must include a Limitations subsection
8. **Conclusions** (or as last paragraph of Discussion)
9. **Perspectives** — JACC family signature feature: 2 short bullets ("Competency in …" / "Translational outlook"), each ≤ 50 words
10. **Acknowledgments** — including AI-tool disclosure if applicable
11. **Funding Sources / Disclosures** — granular per author; align with ICMJE COI form
12. **References**
13. **Figure Legends**
14. **Tables and Figures**

---

## Statistical Reporting

- Report exact p-values to 2–3 significant figures; use p < 0.001 below threshold; avoid bare "p < 0.05".
- 95% confidence intervals required for primary effect estimates.
- Effect sizes with clinically meaningful units (HR, OR, RR, mean difference).
- Time-to-event analyses: report median follow-up, person-time, KM estimates, and proportional hazards assessment.
- Pre-specified vs. post-hoc analyses must be labeled.
- Multiplicity adjustment required when multiple primary endpoints are reported; otherwise note absence and rationale.
- Statistical software, version, and key packages must be identified in Methods.
- For prediction or AI-related work, the journal expects calibration plus discrimination, and adherence to TRIPOD+AI / CLAIM as applicable [VERIFY at journal site for AI-specific addenda].

---

## References

- **Style**: Vancouver, **superscript numerals** in citation order in the text.
- **Author listing**: first 3 authors followed by **et al.** (no period after initials).
- **Journal abbreviations**: Index Medicus / NLM standard.
- **DOI**: include where available.
- **Reference manager**: any (EndNote, Zotero, BBT). The journal accepts standard Vancouver-superscript output; CSL: Vancouver superscript / JACC family.

Example:
```
1. Greenland P, Blaha MJ, Budoff MJ, et al. Coronary calcium score and cardiovascular risk. J Am Coll Cardiol. 2018;72(4):434-447.
```

---

## Figures

- **Maximum**: not explicitly capped; editors expect a number proportionate to a 5,000-word article (typical 3–6 figures plus tables) [VERIFY at journal site]
- **Resolution**: line art ≥ 1,000 dpi; combination art ≥ 500 dpi; halftone ≥ 300 dpi (Elsevier standard)
- **Format**: TIFF, EPS, or PDF (vector preferred for line art)
- **Color**: free in OA articles
- **Central illustration**: encouraged for Original Investigations — single integrative figure capturing the take-home message; recommended in JACC family

---

## Common Rejection Reasons

1. Cohort or analysis lacks an Asia-specific framing or generalizability argument — reviewers expect explicit positioning relative to Asian epidemiology and healthcare systems.
2. Word count (text + references + figure legends combined) exceeds 5,000 — frequent technical-check failure.
3. Structured abstract missing one of the 5 mandatory headings or exceeds 250 words.
4. Reference style not Vancouver superscript, or > 3 authors listed without et al.
5. Methods missing IRB statement, data availability statement, or AI-tool disclosure when applicable.
6. Discrimination metrics for prediction models reported without calibration (or vice versa).
7. Conclusions over-claim beyond the data (e.g., recommending screening intervals from a single-center retrospective cohort).
8. Missing Perspectives bullet block or visual / central illustration where the journal requires it.

---

## Cover Letter

Should include:
- Statement that the manuscript is original, has not been published or submitted elsewhere, and that all authors have approved the submission.
- 2–4 sentence positioning of why JACC: Asia is the appropriate venue (Asian-data specificity, regional clinical relevance, alignment with the journal's scope).
- Explicit AI-use disclosure (mirrored in the Acknowledgments).
- Suggested reviewers (with any conflicts noted) and any preferred-non-reviewers.
- Conflict of interest summary with reference to ICMJE COI forms.
- Funding sources.

Avoid over-claiming language beyond what the manuscript supports.

---

## AI Writing Disclosure Policy

- **Requirement level:** Required (follows Elsevier / ICMJE 2024–2025 policy)
- **Permitted scope:** Language editing and readability improvements only; AI may not be used for study design, data analysis, interpretation, or content generation
- **Disclosure location:** Cover letter **and** Acknowledgments (dual disclosure)
- **AI authorship:** Prohibited — AI tools cannot be listed as authors
- **AI-generated images:** Not permitted unless explicitly declared and justified; original imaging data and figures must be authentic
- **Policy URL:** https://www.elsevier.com/about/policies-and-standards/the-use-of-generative-ai-and-ai-assisted-technologies-in-writing-for-elsevier

---

## Author Guidelines URL

https://www.sciencedirect.com/journal/jacc-asia/publish/guide-for-authors

---

## Positioning

**Submit here when:**
- The dataset, cohort, or clinical question is Asian-specific or Asia-Pacific-focused.
- The work fills an Asian evidence gap relative to predominantly Western cohorts (e.g., MESA, Heinz Nixdorf Recall, CAC Consortium).
- The audience is Asian cardiologists, imagers, and policy stakeholders.
- Open-access publication is desired (full Gold OA, regional readership).

**Do NOT submit here when:**
- The cohort is Western with no specific Asian relevance (consider parent JACC or JACC: Cardiovascular Imaging instead).
- The methodological scope demands an indexed legacy IF for tenure (the journal is not yet SCI-indexed; anticipated 2027 indexing) — discuss with senior authors before committing.
- The article requires a non-OA model.

| Dimension | JACC: Asia | JACC | JACC: Cardiovascular Imaging | Circulation: Cardiovascular Imaging |
|-----------|-----------|------|------------------------------|--------------------------------------|
| Society | ACC (regional) | ACC | ACC | AHA |
| Scope | Asian / Asia-Pacific cardiovascular | Global cardiovascular flagship | Cardiovascular imaging (global) | Cardiovascular imaging (global) |
| Indexing / IF | Not yet SCI-indexed; expected 2027, anticipated IF ~5–6 | SCI Q1 (IF ~24+) | SCI Q1 (IF ~12+) | SCI Q1 (IF ~6+) |
| Open Access | Full Gold OA | Hybrid | Hybrid | Hybrid |
| Emphasis | Asian data, regional translation, policy fit | Mechanistic + landmark trials | Imaging mechanism / outcomes | Imaging-focused outcomes |
| Word limit (Original) | 5,000 (text + refs + legends combined) | 4,500 + abstract | 5,000 | 5,000 |

Use JACC: Asia when Asian-data specificity is the headline of the work; use the parent JACC for landmark global trials, and the imaging-focused sisters when the contribution is primarily methodological imaging science rather than regional epidemiology.

# Journal of the American College of Radiology

## Journal Identity

- **Full name**: Journal of the American College of Radiology
- **Abbreviation**: J Am Coll Radiol
- **Publisher**: Elsevier (American College of Radiology)
- **ISSN**: Not specified in guidelines
- **Frequency**: Monthly
- **Impact Factor**: Not specified in guidelines
- **Open Access**: Hybrid (Gold OA + subscription)
- **APC**: See Elsevier OA policies

## Manuscript Types and Word Limits

| Type | Abstract | Manuscript Body | References | Figures/Tables | Authors |
|------|----------|----------------|------------|----------------|---------|
| Original Article | 250 w (structured) | < 3,000 (excl. refs) | No cap | 7 combined | ≤ 7 |
| Brief Report | None | ≤ 1,400 (incl. refs) | 8 | 3 combined | Invited only |
| Opinion | None | ≤ 1,400 (incl. refs) | 8 | No strict cap | ≤ 5 |
| Letter to the Editor | None | < 500 | 3 | 0 | ≤ 3 |

JACR does NOT publish clinical reviews, book reviews, or case reports.

## Abstract Format

Structured for Original Articles:
1. **Objective**
2. **Methods**
3. **Results**
4. **Discussion**

Maximum 250 words. Avoid citations in abstract.

## Keywords

3-5 keywords.

## Required Sections

For Original Articles:
1. Standard IMRAD sections
2. **Limitations section** (required)
3. **Summary Sentence**: < 35 words, taken word-for-word from manuscript
4. **Take Home Points**: 3-6 bulleted principal conclusions (replaces traditional Conclusions)

Additional required elements:
- **Title**: max 129 characters; no question format
- **Title page**: author contributions (ICMJE), leadership roles, data statement, funding
- **Declaration Statement** via Elsevier Declarations tool (separate file)
- **Blinded manuscript** for initial submission (all author/institution info masked)

## Citation Style

- AMA (American Medical Association) style
- No specific reference cap for Original Articles (editors may advise)
- Avoid citations in abstract

## Reporting Guidelines

| Study Type | Required Guideline |
|------------|-------------------|
| Randomized trials | CONSORT |
| Observational studies | STROBE |
| Systematic reviews | PRISMA |
| Quality improvement | SQUIRE |
| AI/ML studies | CLAIM |

## Statistical Reporting

Follows ICMJE and ACR statistical reporting conventions:
- Report exact p-values where feasible; avoid "P < .05" alone.
- 95% CI required for primary outcomes in quantitative studies.
- Health services research: include measures of effect (odds ratios, risk ratios) with CI; report absolute differences alongside relative measures.
- AI/data science studies: follow CLAIM checklist; discrimination with CI required; calibration required for prediction models.
- Statistical software and version must be identified in Methods.
- No journal-specific statistical reporting requirements beyond ICMJE are published.

## Special Notes

- **Five domains**: health services research/policy, clinical practice management, data science, training/education, leadership.
- **EZ Submit**: initial submission can be a single file (Word or PDF) with figures/tables inline.
- **Data statement required** on title page for all Original Articles: authors must declare full data access and responsibility.
- **AI policy**: generative AI only for language/readability improvement; cannot be listed as author; must declare use.
- **Leadership roles**: all authors must list institutional and ACR leadership roles on title page.
- **Prior publication/preprint**: must be disclosed; submitted work must be substantively different from prior publications.
- **Author limits strictly enforced**: Original Article ≤ 7 (EIC approval for more); Opinion ≤ 5; Letter ≤ 3.

# Journal Profile: JAMA

## Journal Identity

- **Full name**: JAMA (Journal of the American Medical Association)
- **Abbreviation**: JAMA
- **Publisher**: American Medical Association (AMA)
- **ISSN**: 0098-7484 (print), 1538-3598 (online)
- **Frequency**: Weekly (48 issues/year)
- **Impact Factor**: ~120 (JCR 2023), ranked 2nd among general medical journals
- **Open Access**: Hybrid (optional OA with APC ~$5,000)
- **Acceptance rate**: ~5% for Original Investigations
- **Peer review**: Single-blind; statistical editor review on all accepted manuscripts

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | References | Figures/Tables |
|------|----------------|----------|------------|----------------|
| Original Investigation | 3000 words | 350 words (structured) | 50 | 5 |
| Research Letter | 600 words | None | 6 | 1 |
| Review | 3500 words | 350 words (structured) | 75 | 5 |
| Viewpoint | 1200 words | None | 12 | 1 |
| Diagnostic Test Interpretation | 2500 words | None | 20 | 4 |
| Brief Report | 1800 words | 350 words | 20 | 2 |

Word counts exclude abstract, references, tables, and figure legends.

---

## Abstract Requirements

**Structured abstract, 350 words maximum:**

```
Importance: [Why this question matters — clinical impact, knowledge gap]
Objective: [Specific aims — 1 sentence]
Design, Setting, and Participants: [Study design, setting, eligibility criteria,
    dates of data collection, follow-up duration]
Intervention(s) [if applicable]: [Description of interventions/exposures]
Main Outcomes and Measures: [Primary and secondary outcomes defined]
Results: [Number enrolled/analyzed, demographic summary, primary results
    with effect sizes, CIs, and exact P values]
Conclusions and Relevance: [Main conclusion — 1-2 sentences answering
    the Objective; clinical relevance]
```

**Critical**: JAMA's structured abstract has 7 headings (not 4). The "Importance" heading is unique to JAMA and is the first thing editors read.

---

## Required Journal-Specific Elements

### 1. Key Points Box

Placed immediately before the abstract. Three components:

- **Question**: One sentence framing the research question.
- **Findings**: One sentence with the main quantitative result (effect size + CI).
- **Meaning**: One sentence stating clinical relevance.

Example:
```
Key Points

Question  Does AI-assisted colonoscopy improve adenoma detection rates
compared with standard colonoscopy?

Findings  In this randomized clinical trial of 3058 patients, AI-assisted
colonoscopy was associated with a significantly higher adenoma detection
rate (29.1% vs 20.3%; relative risk, 1.43 [95% CI, 1.22-1.69]).

Meaning  AI-assisted colonoscopy may improve polyp detection in
routine clinical practice.
```

### 2. Article Information

- Author affiliations with department, institution, city
- Corresponding author email
- Author contributions (CRediT format accepted)
- Conflict of interest disclosures (ICMJE form required from all authors)
- Funding/support statement
- Data sharing statement

---

## Required Sections (Original Investigation)

1. **Introduction** — brief (2-3 paragraphs); end with explicit objective
2. **Methods**
   - Ethics: IRB approval with institution name + approval number
   - Study Design and Participants: inclusion/exclusion, recruitment dates
   - Interventions or Exposures (if applicable)
   - Outcomes: primary and secondary clearly defined
   - Statistical Analysis: software, tests, sample size calculation, handling of multiplicity
3. **Results** — begin with participant flow and baseline characteristics
4. **Discussion** — 4-5 paragraphs; begin with key findings summary, end with Limitations paragraph
5. **Conclusions** — brief (1-2 sentences, matching abstract conclusion)

---

## Statistical Reporting

JAMA has among the most rigorous statistical review processes in medicine:
- Report exact P values to 2 decimal places (e.g., P = .03); use P < .001 below that threshold.
- 95% CI required for all primary and key secondary outcomes.
- Effect sizes with units (absolute risk difference, NNT, hazard ratio, odds ratio).
- For diagnostic accuracy: sensitivity, specificity, AUC with 95% CI; calibration if prediction model.
- Sample size justification required in Methods (power calculation with assumptions stated).
- Report both intention-to-treat and per-protocol analyses for RCTs.
- Multiple comparisons: pre-specify primary outcome; correct for multiplicity or declare secondary analyses as exploratory.
- Means with SDs for normally distributed data; medians with IQRs for skewed data.
- Bayesian analyses accepted but must include prior justification and sensitivity analysis.
- Statistical software and version must be identified in Methods.

---

## Figures

- **Maximum 5 figures/tables combined** — plan carefully
- **Resolution**: 300 DPI minimum (600 DPI for line art)
- **Format**: EPS, PDF, or TIFF preferred
- **Color**: Free for online; print charges may apply
- **Supplementary material**: Unlimited; include as eSupplement (eTables, eFigures, eMethods)
- **Figure panels**: Label A, B, C; legends must be self-explanatory
- **CONSORT/STARD flow**: counts as one figure

---

## Common Rejection Reasons

1. **Insufficient novelty for general readership** — JAMA expects findings relevant across specialties; narrow subspecialty findings should go to JAMA Network journals
2. **Missing Key Points box** — required at submission; auto-reject without it
3. **Underpowered study** — JAMA rarely accepts pilot studies or small single-center work
4. **Inadequate comparator** — clinical studies need meaningful control groups
5. **Overclaiming** — editors are sensitive to causal language in observational studies
6. **Statistical issues** — dedicated statistical editors flag problems at review; common: missing multiplicity adjustment, no sample size justification
7. **AI studies without clinical endpoint** — technical AI papers should go to JAMA Network Open or specialty journals

---

## Cover Letter

Must include:
- Statement of novelty (1-2 sentences: what this adds beyond existing literature)
- Statement that manuscript is not under consideration elsewhere
- Statement that all authors approved the final version
- Disclosure of any related manuscripts (submitted or in press)
- Suggested and opposed reviewers (optional but recommended)

---

## Author Guidelines URL

https://jamanetwork.com/journals/jama/pages/instructions-for-authors

---

## JAMA Network Transfer

If rejected from JAMA, authors can transfer to JAMA Network specialty journals without reformatting:
- **JAMA Internal Medicine** — internal medicine focus
- **JAMA Surgery** — surgical studies
- **JAMA Network Open** — all fields, multidisciplinary OA (most realistic for AI/radiology)
- **JAMA Oncology**, **JAMA Cardiology**, **JAMA Neurology**, etc.

Transfer preserves reviews. Editors of receiving journals make independent decisions.

---

## Positioning

JAMA is appropriate when:
- Large RCT or prospective cohort (N > 1000 preferred) with clinical endpoint
- Practice-changing finding with broad relevance beyond one specialty
- Public health or health policy implications
- Diagnostic accuracy study with clear clinical decision impact

Not appropriate for: small retrospective studies, technical AI methodology without clinical validation, narrow subspecialty findings (use JAMA Network journals instead).

---

## AI Writing Disclosure Policy
- **Requirement level:** Required
- **Permitted scope:** Language editing only — AI/LLM tools may be used for editing, grammar, and language improvement but cannot be listed as authors; AI must not generate scientific content, data analysis, or conclusions; authors bear full responsibility for all content including any AI-assisted text
- **Disclosure location:** Methods + Cover letter — describe the AI tool name, version, and how it was used in the Methods section; also disclose in the cover letter; ICMJE-compliant disclosure required
- **AI-generated images:** Discouraged — submission and publication of clinical images created by AI tools is discouraged unless part of formal research design or methods; if used, authors must provide a clear description of the content created and the AI tool name, version, and manufacturer; AI-generated or AI-manipulated images must be disclosed; fabrication/falsification policies apply (JAMA editorial 2024; confirmed Apr 2026)
- **Policy URL:** https://jamanetwork.com/journals/jama/pages/instructions-for-authors#702720037

# Journal Profile: JAMA Network Open

## Journal Identity

- **Full name**: JAMA Network Open
- **Abbreviation**: JAMA Netw Open
- **Publisher**: American Medical Association (AMA)
- **ISSN**: 2574-3805
- **Frequency**: Continuous online publication (daily)
- **Impact Factor**: ~13.8 (JCR 2023), ranked among top general medical journals
- **Open Access**: Full OA (APC ~$3,500; waiver available for LMIC)
- **Acceptance rate**: ~15-20% for Original Investigations
- **Peer review**: Single-blind; statistical editor review on accepted manuscripts

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | References | Figures/Tables |
|------|----------------|----------|------------|----------------|
| Original Investigation | 3000 words | 350 words (structured) | 50 | 5 |
| Research Letter | 600 words | None | 6 | 1 |
| Systematic Review & Meta-Analysis | 3500 words | 350 words (structured) | 75 | 5 |
| Invited Commentary | 1000 words | None | 10 | 1 |
| Diagnostic/Prognostic Study | 3000 words | 350 words (structured) | 50 | 5 |

Word counts exclude abstract, references, tables, and figure legends.

---

## Abstract Requirements

**Structured abstract, 350 words maximum:**

```
Importance: [Clinical significance, public health impact, knowledge gap]
Objective: [Specific study aim — 1 sentence]
Design, Setting, and Participants: [Study design, setting, eligibility criteria,
    dates of data collection, analysis dates, follow-up duration]
Exposure(s) [or Intervention(s)]: [Description of exposures/interventions]
Main Outcomes and Measures: [Primary and secondary outcomes prespecified]
Results: [Number enrolled/analyzed, demographic summary (age, sex),
    primary results with effect sizes, 95% CIs, and exact P values]
Conclusions and Relevance: [Main conclusion — 1-2 sentences;
    clinical/public health relevance]
```

**Critical**: Follows JAMA Network 7-heading format. "Importance" is the first heading and the first thing editors evaluate. Include "Analysis dates" in Design heading (unique JAMA Network requirement since 2023).

---

## Required Sections (Original Investigation)

### 1. Key Points Box

Required at submission (placed before abstract). Three components:

- **Question**: One sentence framing the research question.
- **Findings**: One sentence with the main quantitative result (effect size + CI).
- **Meaning**: One sentence stating clinical or public health relevance.

### 2. Body Sections

1. **Introduction** — brief (2-3 paragraphs); end with explicit study objective
2. **Methods**
   - Ethics: IRB approval with institution name + approval number; informed consent
   - Study Design and Participants: inclusion/exclusion, recruitment dates, analysis dates
   - Exposures or Interventions
   - Outcomes: primary and secondary clearly defined a priori
   - Statistical Analysis: software, tests, sample size justification, handling of missing data, sensitivity analyses
3. **Results** — begin with participant flow and baseline characteristics table
4. **Discussion** — begin with key findings summary; include Limitations subsection
5. **Conclusions** — brief (1-2 sentences, matching abstract conclusion)

### 3. Article Information

- Author affiliations, corresponding author email
- Author contributions (CRediT format accepted)
- ICMJE conflict of interest forms from all authors
- Funding/support and role of funder
- Data sharing statement (required)

---

## Statistical Reporting

- Report exact P values to 2 decimal places (e.g., P = .03); use P < .001 below that threshold.
- 2-sided significance threshold stated (typically alpha = .05).
- 95% CI required for all primary and key secondary outcomes.
- Effect sizes with units (absolute risk difference, relative risk, hazard ratio, odds ratio).
- For diagnostic accuracy: sensitivity, specificity, AUC with 95% CI; calibration reported.
- Sample size justification in Methods (power calculation with assumptions).
- Multiple comparisons: pre-specify primary outcome; use Bonferroni or similar correction, or declare secondary analyses as exploratory.
- Missing data: describe mechanism (MCAR/MAR/MNAR) and handling approach.
- Sensitivity analyses required for key assumptions.
- Statistical software and version identified in Methods.
- For AI/ML studies: internal and external validation; report discrimination and calibration.

---

## Figures

- **Maximum 5 figures/tables combined** — plan carefully
- **Resolution**: 300 DPI minimum (600 DPI for line art)
- **Format**: EPS, PDF, or TIFF preferred; PowerPoint accepted
- **Color**: Free (online-only journal)
- **Supplementary material**: Unlimited eSupplement (eTables, eFigures, eMethods, eResults)
- **Figure panels**: Label A, B, C; legends must be self-explanatory
- **CONSORT/STARD/PRISMA flow**: counts as one figure
- **Reporting checklist**: Upload completed checklist (STROBE, CONSORT, PRISMA, STARD, etc.)

---

## Common Rejection Reasons

1. **Lack of novelty or clinical relevance** — findings must advance knowledge meaningfully
2. **Missing Key Points box** — required at submission; technical reject without it
3. **Inadequate methodology for study type** — wrong statistical approach, selection bias not addressed
4. **No reporting checklist** — EQUATOR network guidelines strictly enforced
5. **Overclaiming causality** — observational studies must use appropriate hedging language
6. **Insufficient sample size without justification** — power calculation expected
7. **AI studies without clinical validation** — must show clinical utility, not just technical performance

---

## Cover Letter

Must include:
- Statement of novelty (1-2 sentences: what this adds)
- Statement that manuscript is not under consideration elsewhere
- All authors approved the final version
- Disclosure of related submitted/published manuscripts
- AI tool disclosure (if used for writing/editing)
- Suggested and opposed reviewers (optional)

---

## AI Writing Disclosure Policy
- **Requirement level:** Required (Moderate)
- **Permitted scope:** Language editing only — AI/LLM tools may be used for editing, grammar, and language improvement; AI must not generate scientific content, data analysis, or conclusions; AI cannot be listed as authors; authors bear full responsibility for all content
- **Disclosure location:** Methods + Cover letter — describe the AI tool name, version, and specific use in the Methods section; also disclose in cover letter; ICMJE-compliant disclosure required
- **AI-generated images:** Discouraged — AI-generated or AI-manipulated images must be disclosed; fabrication/falsification policies apply; if used as part of research design, provide full description of tool and process
- **Policy URL:** https://jamanetwork.com/journals/jamanetworkopen/pages/instructions-for-authors

---

## Author Guidelines URL

https://jamanetwork.com/journals/jamanetworkopen/pages/instructions-for-authors

---

## Positioning

| Feature | JAMA Netw Open | JAMA | BMJ Open | PLOS Medicine |
|---------|---------------|------|----------|---------------|
| IF | ~13.8 | ~120 | ~3.0 | ~10.5 |
| OA model | Full OA | Hybrid | Full OA | Full OA |
| APC | ~$3,500 | ~$5,000 (optional) | ~$2,590 | ~$3,000 |
| Abstract style | 7-heading (JAMA format) | 7-heading | Structured (varied) | Structured (varied) |
| Acceptance rate | ~15-20% | ~5% | ~25% | ~10% |
| Unique feature | Broadest JAMA Network scope | Highest prestige | High acceptance | Global health focus |
| AI studies | Strong fit | Only practice-changing | Acceptable | If policy-relevant |

JAMA Network Open is appropriate when:
- Well-designed study with clinical relevance across medicine
- Diagnostic accuracy or AI study with clinical endpoint validation
- Systematic review or meta-analysis on a general medical topic
- Study too specialized for JAMA but too general for specialty journals
- Transferred from JAMA or JAMA specialty journal

Not appropriate for: pure technical AI methodology, studies without clinical/public health relevance, case reports, very small pilot studies without justification.

# Journal Profile: Journal of the American Society of Nephrology (JASN)

## Journal Identity

- **Full name**: Journal of the American Society of Nephrology
- **Abbreviation**: J Am Soc Nephrol
- **Publisher**: Wolters Kluwer on behalf of the American Society of Nephrology (ASN)
- **ISSN**: 1046-6673 (print), 1533-3450 (online)
- **Frequency**: Monthly
- **Impact Factor**: ~12.7 (JCR 2023)
- **Open Access**: Hybrid
- **Acceptance rate**: ~10%
- **Peer review**: Single-blind, 2-3 reviewers

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | References | Figures/Tables |
|------|----------------|----------|------------|----------------|
| Original Article | 3000 words | 250 words | 50 | 8 (combined) |
| Brief Communication | 1500 words | 250 words | 15 | 4 (combined) |
| Review | 4000 words | 200 words | No limit | No limit |
| Clinical Practice Points | 1500 words | None | 15 | 2 (combined) |

*Note: Body word limit excludes Significance Statement, Methods, references, figure legends, and tables.*

---

## Abstract Requirements

**Structured abstract, 250 words maximum:**
Headings must be exactly:
- **Background:** [Clinical problem and study rationale]
- **Methods:** [Design, population, exposure/intervention, outcomes, statistical tests]
- **Results:** [Primary and secondary results with effect sizes, 95% CIs, and exact p-values]
- **Conclusions:** [Main takeaway message and clinical implications]

**Significance Statement (Mandatory for Original Articles):**
- A separate section of **120 words or less** written for a general clinical audience.
- Positioned immediately before the abstract.
- Clearly states the main clinical or scientific message and its impact on the field.
- Avoids dense jargon; uses "kidney" instead of "renal" where possible.

---

## Required Sections (Original Article)

1. **Title Page**
2. **Significance Statement** (max 120 words)
3. **Structured Abstract** (max 250 words)
4. **Introduction** (brief, ending with explicit study objective)
5. **Methods** (positioned after Introduction; must detail study population, ethics, and statistics)
6. **Results** (primary outcomes first, followed by secondary outcomes)
7. **Discussion** (starts with summary of findings, limitations in penultimate paragraph, conclusion at end)
8. **Acknowledgments**
9. **Disclosures** (COI statements for all authors)
10. **Funding**
11. **References**

---

## Statistical Reporting

- Report exact p-values (e.g., P = 0.02), not thresholds (P < 0.05), unless P < 0.001.
- Report 95% Confidence Intervals (95% CI) for all primary and secondary outcomes.
- Report absolute risk differences and relative risks/hazard ratios with clinical effect sizes.
- **Competing Risks:** Studies evaluating survival, dialysis initiation, or cardiovascular events in CKD/ESKD cohorts must account for the competing risk of death (e.g., using Fine-Gray subdistribution hazard models or cause-specific hazards). Standard Kaplan-Meier methods that censor deaths are strongly discouraged and often rejected.
- Clearly identify the statistical software (e.g., R, SAS, SPSS) and version used.

---

## Figures

- **Maximum**: 8 figures/tables combined.
- **Resolution**: 300 DPI minimum for half-tones, 1200 DPI for line drawings.
- **Format**: EPS, TIFF, or PDF.
- **Color**: Color is free online; authors may be charged for print color (verify on acceptance).
- **Graphical Abstracts**: Welcomed and highly encouraged.

---

## Common Rejection Reasons

1. **Insufficient Mechanistic Novelty:** For basic/translational studies, lacking a clear cellular or molecular pathway validation.
2. **Competing Risks Ignored:** In longitudinal cohorts, censoring patients who die instead of treating death as a competing event.
3. **Underpowered Cohort:** Sample size too small to draw generalizable clinical conclusions.
4. **Inadequate Confounder Adjustment:** In observational studies, lacking robust methods to control for confounding (e.g., propensity score matching or causal inference).
5. **Lack of Validation Cohort:** For predictive model development, lacking external or strong internal validation.

---

## Cover Letter

Should include:
- A brief summary of the study's findings and why it is significant for JASN readers.
- Statement that the manuscript is not under consideration elsewhere and all authors approved.
- Disclosure of any related manuscripts or datasets under review.
- Suggestion of 3-5 potential reviewers with their email addresses.

---

## AI Writing Disclosure Policy

- **Requirement level:** Required
- **Permitted scope:** Language editing only — AI tools cannot write scientific content or interpret data, and cannot be listed as authors.
- **Disclosure location:** Methods and/or Acknowledgments (must specify the tool name, version, and exact purpose).
- **AI-generated images:** Banned (unless they are the object of the research).
- **Policy URL:** https://journals.lww.com/jasn/Pages/editorial-policies.aspx

---

## Author Guidelines URL

https://journals.lww.com/jasn/Pages/instructionsforauthors.aspx

---

## Positioning

JASN is the flagship journal of the ASN and is best suited for landmark clinical trials, large-scale multi-center observational cohorts, and high-impact basic/translational nephrology research that fundamentally shifts clinical practice or disease understanding.

| Dimension | JASN | Kidney International | CJASN |
|-----------|------|----------------------|-------|
| Society | American Society of Nephrology (ASN) | International Society of Nephrology (ISN) | American Society of Nephrology (ASN) |
| Scope | Basic, Translational, and Landmark Clinical | Basic, Translational, and High-impact Clinical | Purely Clinical and Epidemiological |
| Impact factor | ~12.7 | ~14.8 | ~9.6 |
| Emphasis | Fundamental Mechanisms & Major Trials | Disease Pathology & Basic Breakthroughs | Clinical Practice & Observational Cohorts |

## Verification
- **Source:** JASN Instructions to Authors, read during maintainer review of PR #330 — verification record: https://github.com/Aperivue/medsci-skills/pull/330#issuecomment-4968075916
- **Date:** 2026-07-14
- **Note:** the 3,000-word body ("excluding methods, references, figure legends, and tables"), the ≤120-word Significance Statement and the 8-display-item cap were each confirmed against the journal's own instructions. A direct URL is not recorded here because none was captured at the time and the publisher blocks automated retrieval; supplying one now would be a guess, not a citation. Replace this with the canonical instructions URL when someone next opens it.

# Journal Profile: Journal of Cachexia, Sarcopenia and Muscle (JCSM)

## Basic Information

- **Publisher:** Wiley
- **Frequency:** Continuous publication (online articles published directly into online issue when ready; no issue curation or pagination delay)
- **Impact Factor:** [TODO: verify at JCSM journal page — recent JCR year]
- **ISSN:** [TODO: verify at JCSM journal page — print / online]
- **Scope:** Cachexia, sarcopenia, body composition, and physiological/pathophysiological changes in skeletal muscle and fat tissue across the lifespan and in chronic illness (AIDS, cancer, chronic heart failure, chronic lung disease, liver cirrhosis, chronic kidney failure, rheumatoid arthritis, sepsis). Strong reception for diagnostic/assessment biomarker validation and mechanistic muscle-wasting and lipolysis studies.
- **Open Access:** Gold Open Access — articles immediately free to read, download, and share after publication
- **APC (Article Processing Charge):** Required upon acceptance; waivers/discounts may apply via institution, funder, or country waiver — see journal's Open Access page
- **Language:** English only
- **Acceptance rate:** [TODO: verify at JCSM journal page]

---

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | References | Figures/Tables |
|------|----------------|----------|------------|----------------|
| Original Article | 4,500 (excluding abstract, references, tables, figures) | 400 words (structured, data-rich) | 40 (main); additional as supplement (S1, S2, ...) | 8 (max 6 sub-sections per figure, labelled a–f) |
| Review | 6,000 (excluding abstract, references, tables, figures) | 400 words (unstructured but data/information-rich) | 120 (main); additional as supplement | 8 (max 6 sub-sections per figure) |
| Editorial (by invitation only) | 1,500 | None typically (Facts & Numbers series: up to 400 words, data-rich) | 20 (exceptions for Facts & Numbers and statistical analyses) | 1–2 |
| Research/Scientific Letter | 1,200 | n/a | 10 | 1 figure or table |
| Short Report | 1,500 | n/a | 10 | up to 2 figures or tables |
| Meeting Report | 1,500 | n/a | 20 | n/a |
| Reply / Letters to the Editor | 1,200 | n/a | [TODO: verify] | [TODO: verify] |

**Title length cap:** maximum 17 words OR 120 characters (whichever is shorter).

---

## Abstract Requirements (Original Article)

**Structured abstract, ≤400 words, data-rich:**

```
Background: [Context and aim]
Methods: [Design, population, intervention/exposure, comparator, outcomes, statistical approach]
Results: [Numbers (cohort size, % female, mean age ± SD), percentages, percent differences,
         correlations, hazard or odds ratios with 95% CIs, key p-values supporting main messages]
Conclusions: [Main conclusion grounded in the results]
```

**Critical guidance from the journal:**
- "Descriptive results abstracts are not acceptable" — must include actual numbers, effect sizes, p-values
- For clinical studies, always mention N, % female, mean age ± SD
- Omit filling words ("thus", "therefore", "moreover")
- Minimize abbreviations in abstract and conclusion
- "If in doubt, add more data rather than less"

**Keywords:** 4–6 for indexing.

---

## Required Sections (Original Article)

Article order:

1. **Title page** — name(s), title (≤17 words / 120 chars), affiliation(s), corresponding-author email/phone/fax
2. **Abstract** — structured (see above)
3. **Keywords** — 4–6
4. **Introduction**
5. **Methods**
6. **Results**
7. **Discussion**
8. **Acknowledgements** — funding, conflict of interest, ethical guidelines statement

**Headings:** maximum 3 levels of displayed headings.

---

## Corresponding Author Policy (JCSM-specific)

- **Only ONE corresponding author per submission.** The corresponding author is the sole contact and the only author who can access/modify the manuscript during editorial review.
- **No post-acceptance authorship changes** — including adding/removing authors, changing the corresponding author, designating multiple first authors, or adjusting author order.
- **Multiple co-first / equal contributions** — must be declared in the cover letter at submission; approval at Editor's discretion.

**Manuscript-design implication:** if your study has co-corresponding authors at submission (common in observational research), only one can be the technical corresponding author; the other must be designated as a senior author with footnote acknowledgement.

---

## Ethical Standards

- Helsinki Declaration adherence statement required
- IRB approval statement required
- Informed consent statement required (or waiver justification)
- "The manuscript does not contain clinical studies or patient data" — required if not applicable
- Identity-disclosing details must be omitted

---

## Statistical Reporting — JCSM-specific for Survival / Prognostic Studies

JCSM enforces stricter survival-cohort reporting than most journals. **Applies to "Studies describing survival rates and prognostic associations":**

- **Mandatory event reporting (in BOTH abstract AND methods/results):**
  - Number of events observed in the overall cohort
  - **1-year mortality rate with 95% CI**
  - **5-year mortality rate with 95% CI** (if appropriate)
  - **3-month mortality rate with 95% CI** (if appropriate)
  - These serve "to assess the power of the study"
- **Cohort size guidance:**
  - **Novel prognostic markers**: cohort with ≥60–100 events
  - **Novel prognostic scores**: cohort with ≥150–200 events
  - **Validation in second cohort** strongly recommended for cutoffs derived from primary cohort
- **Kaplan-Meier survival graphs**: must display number of "patients at risk" for each group at baseline and at follow-up intervals
- **Figure legend or in-figure** for survival plots must include: HR or rate ratios with 95% CI and p-values, plus total number of events
- **Clinical trials**:
  - Pre-registered before start (provide NCT number etc.)
  - ITT analysis for efficacy (other methods for safety / non-inferiority)
  - One primary efficacy endpoint (or alpha-splitting / Hochberg justification)
  - Statistical analysis plan in English submitted
  - Trial protocol in English as appendix

---

## Reporting Guidelines

JCSM does not enumerate a single mandatory checklist on the author guidelines page but enforces survival-cohort-specific reporting (see above). Standard reporting guideline adherence (STROBE for observational cohorts, CONSORT for trials, PRISMA for systematic reviews) is expected per general publication ethics.

---

## Figures and Tables

- **Maximum:** 8 figures and/or tables within the manuscript (additional as Supporting Information, no limit)
- **Sub-sections per figure:** max 6, labelled a–f
- **Submit figures/tables as separate individual files**, not embedded in manuscript (due to quality)
- **Vector graphics preferred:** EPS for line art / vector; TIFF for halftones; MS Office acceptable
- **Resolution:**
  - Line art (bitmap): ≥1,200 DPI
  - Halftones: ≥300 DPI
  - Combination (halftone + line + lettering): ≥600 DPI
- **Color:** Free of charge for online; submit as RGB (8 bits per channel)
- **Lettering:** Helvetica or Arial sans-serif, 2–3 mm (8–12 pt) at final size, consistent within figure
- **Figure captions:** in text file, begin with "Fig." in bold + figure number in bold (no punctuation after number)
- **Accessibility:**
  - Descriptive captions for all figures
  - Use patterns in addition to colors (colorblind-friendly)
  - Lettering contrast ratio ≥4.5:1

---

## References

- **Limits:** 40 for Original Article; 120 for Review (main manuscript)
- **Overflow:** additional references as Supporting Information, numbered S1, S2, S3 ...
- **Selection guidance:** journal discourages cutting list at 40/120 without curation; the supplement is for "secondary importance" references
- **Citation style:** numerical in square brackets — `[3]`, `[5]`, `[1–3, 7]`
- **Reference style (as of August 15, 2024):** no submission requirement for formatting; consistent style throughout manuscript with: author(s), journal/book title, article title (where applicable), year, volume/issue, pagination, DOI (optional). Journal will reformat to house style upon acceptance.

---

## Preprints

Posting to community preprint servers (arXiv, bioRxiv, etc.) by the author is **permitted** and does not preclude publication. Requirements:

- Identify the preprint server and accession #/DOI in the cover letter at submission
- Upon publication, request that the preprint server adds the published-journal reference (with DOI link) to its record

---

## File Format and Formatting

- **Manuscript file:** Word `.docx` (Word 2007+) or `.doc` (older); LaTeX accepted for math-heavy submissions
- **Fonts:** Times Roman 10-point or equivalent plain font for text
- **Italics:** for emphasis
- **Pagination:** automatic page-numbering function
- **Indents:** tab stops or commands, not space bar
- **Tables:** table function, not spreadsheets
- **Equations:** equation editor or MathType
- **Footnotes:** use footnotes, not endnotes; consecutively numbered; not solely a reference citation
- **Field functions:** do NOT use

---

## Cover Letter

Should include:

- Confirmation that work has not been published before and is not under consideration elsewhere
- Confirmation that publication has been approved by all co-authors
- Preprint declaration if applicable (server name + accession/DOI)
- Co-first or equal-contribution designation requests
- Conflict of interest summary
- Permissions evidence if any previously-published figures/tables/text are reused

---

## AI Writing Disclosure Policy

[TODO: verify at JCSM journal page + Wiley publisher AI policy — not enumerated on this Author Guidelines page]

Wiley publisher-wide AI policy generally requires:
- Disclosure of AI-assisted tools used in manuscript preparation in Methods or Acknowledgements
- AI cannot be listed as author
- AI-generated images typically banned or require explicit disclosure
- Refer to Wiley's "Best Practice Guidelines on Research Integrity and Publishing Ethics" for current AI policy at the time of submission

---

## Peer Review

**Single-blind peer review** — reviewers know author identities but authors do not know reviewer identities.

All articles undergo rigorous peer review prior to acceptance.

---

## Common Rejection Reasons

[TODO: verify with editorial office]

Risks specific to JCSM author-guideline strict requirements:
1. **Descriptive abstract without numbers** — JCSM explicitly states "descriptive results abstracts are not acceptable"; 400-word data-rich structure with effect sizes, CIs, p-values is mandatory
2. **Missing 1-year / 5-year mortality rates with 95% CI** for survival or prognostic studies — required in both abstract and methods/results
3. **Underpowered prognostic cohort** — novel prognostic markers expected from cohorts with ≥60–100 events; novel prognostic scores require ≥150–200 events
4. **Missing Kaplan-Meier "patients at risk" annotation** — KM plots without numbers-at-risk at baseline and follow-up intervals are returned
5. **Title overrun** — title >17 words or >120 characters returned for revision
6. **Word count overrun** — Original Article >4,500 body words (excluding abstract, refs, tables, figures) flagged
7. **Multiple corresponding authors at submission** — only one allowed; co-corresponding requests must be declared and approved in cover letter
8. **Out of scope** — manuscripts without clear connection to cachexia, sarcopenia, body composition, or muscle/fat tissue pathophysiology may be deprioritized

---

## Submission Portal

https://authors.wiley.com/journal/JCSM/

---

## Author Guidelines URL

https://onlinelibrary.wiley.com/page/journal/13989440/homepage/forauthors.html

---

## Positioning

JCSM is well-suited for:
- Body composition cohort studies with metabolic, functional, or mortality outcomes
- Sarcopenia and cachexia clinical and mechanistic research
- Diagnostic biomarker validation for muscle wasting
- Imaging-defined body-composition phenotype × clinical-outcome research
- Skeletal-muscle and adipose-tissue mechanism studies
- Prognostic marker / score studies meeting the 60–200 events cohort requirement

**Cascade considerations:** Suitable as a primary submission target for body composition × metabolic outcome research with adequate event count and survival reporting. Cascade to Diabetologia (EASD), Diabetes Care (ADA), or Korean-society journals (DMJ, EnM) for body-composition or metabolic-outcome research that does not meet JCSM's strict prognostic-cohort thresholds.

| Dimension | JCSM | Diabetologia | Lancet Diabetes & Endocrinology |
|-----------|------|---------------|--------------------------------|
| Society | Wiley (specialty) | EASD | Lancet family |
| Scope | Cachexia / sarcopenia / body composition / muscle | Diabetes mechanism + RCT | Diabetes high-impact global RCT/cohort |
| Word budget (Original) | 4,500 | [TODO: verify] | [TODO: verify] |
| Abstract | 400 (structured, data-rich) | [TODO: verify] | [TODO: verify] |
| References (Original) | 40 main + unlimited supplement | [TODO: verify] | [TODO: verify] |
| Survival reporting | Strict (1-yr/5-yr mortality, patients-at-risk, ≥60–100 events for novel markers) | [TODO: verify] | [TODO: verify] |
| Peer review | Single-blind | [TODO: verify] | [TODO: verify] |
| OA model | Gold OA, APC required | [TODO: verify] | [TODO: verify] |


---

## Verification
- **Source:** https://onlinelibrary.wiley.com/page/journal/13989440/homepage/forauthors.html
- **Date:** 2026-05-21

# Journal Profile: Journal of Korean Medical Science (JKMS)

## Basic Information

- **Publisher:** Korean Academy of Medical Sciences (KAMS)
- **Editor-in-Chief:** Jin-Hong Yoo, MD PhD
- **Frequency:** Weekly, online-only
- **Impact Factor:** ~3.0 (recent years; verify at jkms.org)
- **ISSN:** 1011-8934 (print, legacy) / 1598-6357 (electronic)
- **Scope:** General medical journal covering all medical specialties — clinical and basic science, public health, epidemiology. Particular receptivity to Korean and Asian population studies.
- **Open Access:** Yes — fully open access; indexed in PubMed/MEDLINE, SCIE, Scopus
- **APC (Article Processing Charge):** Charged on acceptance (verify current rate at jkms.org); editing fee for graphical abstracts included in APC
- **Language:** English only (manuscripts and submission)

---

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | Figures | References |
|------|----------------|----------|---------|------------|
| Original Article | 3000 words | 350 words (structured) | ≤6 | No explicit limit (verify) |
| Review Article (invited) | None specified | 350 words (unstructured) | ≤6 | No explicit limit |
| Brief Communication | 1500 words | 150 words (unstructured) | ≤3 | Reduced |
| Case Report | 1500 words | 150 words (unstructured) | ≤4 | Reduced |
| Case Conference (CME) | 2500 words | n/a | ≤6 | Standard |
| Guideline / Editorial / Opinion | 600–1500 words | variable | n/a | n/a |
| Correspondence | 600 words | None | 1 | Limited |

---

## Abstract Requirements (Original Article)

**Structured abstract, 350 words maximum:**

```
Background: [Context and aim]
Methods: [Design, population, intervention/index, comparator, outcomes, statistical approach]
Results: [Primary outcome with effect sizes and 95% CIs; key secondary findings]
Conclusion: [Main conclusion grounded in the results]
```

**Keywords:** 5–6 MeSH-aligned terms after the abstract.

---

## Required Sections (Original Article)

JKMS uses standard IMRAD structure:

1. **Introduction**
2. **Methods**
   - IRB approval and informed consent statement required
   - Helsinki Declaration adherence required for human subjects research
   - Trial registration mandatory for clinical trials (WHO ICTRP, ClinicalTrials.gov, KCRIS, or equivalent)
3. **Results**
4. **Discussion**
5. **Conclusion** (often as the final paragraph of Discussion)

Additional title-page-level requirements: Author affiliations with full postal address, ORCID for each author, Funding statement, Conflicts of Interest, Author Contributions, Acknowledgements, Data Availability Statement (mandatory for submissions after July 2018 per ICMJE).

---

## Ethics Statement

**Human subjects (template):**
"This study was approved by the Institutional Review Board of [Institution] (approval number: [XXX]). The requirement for informed consent was [waived/obtained] given the [retrospective design / prospective design]. The study was conducted in accordance with the principles of the Declaration of Helsinki."

**Animal studies:**
"All experiments were approved by the Institutional Animal Care and Use Committee of [Institution] (approval number: [XXX]) and were conducted in accordance with relevant guidelines."

**Clinical trials:** Registration number must be reported with the registry name and URL.

---

## Statistical Reporting

- **P-values:** Report exact values to 3 decimal places (for example, P = 0.031), italicized; not "P < 0.05".
- Values below 0.001 reported as P < 0.001.
- 95% confidence intervals required for all primary outcomes and effect sizes.
- Effect sizes with units and descriptive interpretation.
- Report both statistical and clinical significance.
- Pre-specify sensitivity analyses; report robustness across pre-specified analyses.

---

## Figure and Table Requirements

- **Format:** Figures as PPT, PDF, GIF, JPG, or TIFF; tables in separate file
- **Resolution:** 300 DPI minimum for raster images; 600 DPI for line art
- **Color:** Color in online publication; design for grayscale legibility if possible
- **Maximum figures:** 6 for original articles; 4 for case reports; 3 for brief communications
- **Graphical abstract:** Optional for Original/Case/Review article types; PPT/PDF/GIF/JPG/TIFF; editing fee included in APC
- **Tables:** Uploaded separately, not embedded in main body docx

---

## Formatting Notes

- **Font:** Times New Roman 11 pt, double-spaced
- **References:** Vancouver style; EndNote style file (`jkms.ens`) provided in author-guideline package
- **Units:** SI units throughout
- **Abbreviations:** Define at first use; minimize use of abbreviations
- **Tables/Figures:** Reference as "Table 1", "Figure 1" (Title Case + space)

---

## Required Supporting Documents (Submission Package)

| Document | Provided template | Notes |
|---|---|---|
| Title page | `Style Guide for JKMS Title` template (.docx) | Title, short title, authors with ORCID, affiliations, corresponding author, funding |
| Main body | `Style Guide for JKMS Text` template (.docx) | IMRAD layout |
| Cover letter | `Style Guide for JKMS cover letter` template (.docx) | Addressed to EIC; scientific value, COI, ethics, duplicate-submission, authorship declarations |
| Tables | Separate file | Not embedded in body |
| Figures | Separate upload | PPT/PDF/GIF/JPG/TIFF |
| ICMJE Disclosure Form | Per author (ICMJE standard 13-item) | All authors complete and sign |
| CRediT contributor role taxonomy | Required | Standardized author role declarations |
| Data sharing statement | Required (post-July 2018) | ICMJE-compliant |

---

## Common Rejection Reasons

1. **Out of scope** — JKMS is a generalist medical journal; submissions narrowly focused on a single specialty without broader medical relevance may be deprioritized.
2. **Word count overrun** — 3,000-word main body limit is strictly enforced; manuscripts substantially exceeding this are returned for revision before review.
3. **Insufficient ethics documentation** — IRB number, Helsinki declaration, and (where applicable) trial registration are all required at submission.
4. **Reference format non-compliance** — Vancouver style with EndNote `jkms.ens` is expected; hand-typed or inconsistent reference lists trigger pre-review return.
5. **Missing Data Availability Statement** — mandatory for submissions after July 2018; reviewers and editors check this.
6. **AI use undisclosed** — generative-AI assistance must be declared in cover letter; failure to disclose triggers ethics review.

---

## Positioning

JKMS is well-suited for:
- Korean and East Asian population studies with broad medical relevance
- Single-institution observational studies, particularly those generating clinically actionable evidence
- Studies on diseases prevalent in Korea or with public-health significance
- Cross-disciplinary work spanning multiple medical specialties
- Studies with rigorous methodology and clear clinical implications that fit within a 3,000-word format

**Typical timeline:** Initial review ~8 weeks; revision deadline 2 months; acceptance to online publication 4–6 weeks.

**Cascade considerations:** Cascade rejection policy not explicitly documented; suitable as a primary submission target or as a fallback after rejection from higher-impact generalist journals.

---

## AI Disclosure Policy

- Generative AI assistance (writing aids, language editing) must be disclosed in the cover letter
- AI cannot be listed as an author
- AI-generated images require prior editor permission (refer to journal communication policy)
- Generative AI was not used to create or alter images, figures, or tables (declared in cover letter when applicable)

---

## Author Guidelines URL

https://jkms.org (Author Information section); detailed PDF: JKMS-Information-202602.pdf (distributed with submission package)

---

## Submission Portal

https://submit.jkms.org

---

## Contact

- Editorial office email: jkms@kams.or.kr
- For technical submission issues, use the portal's help system

---

## Submission mechanics (Original Article) — verified in-portal 2026-06

End-to-end submission mechanics — use as the JKMS submission checklist.

**References (author-guide ≠ Zotero CSL):**
- Format: **superscript** Arabic numerals · **NLM abbreviation** (`Ann Intern Med`) · **no DOI** · ≤6 authors then `et al.` · **year only** (no month/day) · issue `(n)` · `J Abbrev Year;Vol(Issue):Page.` (no period after abbrev).
- Zotero `journal-of-korean-medical-science.csl` is a **stub → nlm-citation-sequence (parenthetical, keeps DOI, full journal name)** — does NOT match the author guide. Use `manage-refs/citation_styles/journal-of-korean-medical-science-strict.csl` for the pandoc render; validate with `check_csl_render.py --journal jkms`.
- NLM abbreviations require a `shortjournal` field — populate via `fill_journal_abbrev.py` (PubMed esummary `source`). Authoritative titles (proper-noun casing + subtitle) via PubMed efetch ArticleTitle, double-braced. Particles braced (`{de Torres}`).

**File structure:**
- Title page (WITH author details) + Main body (NO author details — blinded) uploaded separately.
- Main body needs **consecutive page numbers + continuous line numbers**.
- Figures separate (PPT/PDF, panel labels A/B/C); Tables at end of text. Sequence: …Discussion → **References → Figure legends → Tables**.
- Structured abstract ≤350 (Background/Methods/Results/Conclusion); main text ≤3,000; keywords 3–5 capitalized semicolon MeSH.

**Graphical Abstract (required for Original Articles):**
- JKMS provides **no fixed template**; after acceptance an external illustrator re-styles it (fee in APC). Submit a clear **draft** (PPT, separated objects) — illustrator edits faster when figure/conclusion/numbers are placed explicitly.
- Build non-AI (matplotlib + Servier/BioArt) per `journal-ai-image-policies`. 4-block layout (Purpose/Methods/Results/Conclusions) works well. python-pptx + Mac-compat (`app.xml` sync, no TIFF).

**Portal declaration answers (typical observational study):**
- Article type Original Article · the numbered subspecialty leaf for your topic · IRB Yes + approval# + consent-waiver text · COI per ICMJE · AI use Yes→Proofreading (**must match manuscript AI disclosure** — never tick Statistics/Analysis if disclosure says otherwise) · Professional English proofreading No (unless paid service) · Suggested reviewers optional.
- **"Submitted elsewhere?"** — a cascade submission (declined elsewhere, then here) is sequential, not simultaneous → **No** for "currently/under consideration"; **Yes** only for "ever/previously". Check the project's own cascade history (`submission-portal-verification.md` §2B).
- Corresponding **Tel is a required portal field**; JKMS Information also wants phone on the title page.
- ICMJE COI form per author (all). Co-first = "First Author" ×N + title-page equal-contribution footnote.

**DOI hyperlink pitfall:** surgical docx reference replacement leaves `<w:hyperlink>` DOIs that `p.runs` misses — strip them, verify via PDF proof (`submission-portal-verification.md` §1).

- **AI-use disclosure placement**: Cover letter
  <!-- machine-read by /self-review check_classical_style.py --profile; source: this profile's own "Generative AI assistance (writing aids, language editing) must be disclosed in the cover letter" -->

# Journal of Medical Internet Research

## Journal Identity

- **Full name**: Journal of Medical Internet Research
- **Abbreviation**: J Med Internet Res
- **Publisher**: JMIR Publications (Toronto, Canada)
- **ISSN**: 1438-8871
- **Frequency**: Continuous (online only)
- **Impact Factor**: Ranked #1 in Medical Informatics (Google Scholar)
- **Open Access**: Yes (Gold OA)
- **APC**: USD 3,350 (Original Paper); USD 2,680 (Viewpoint); USD 1,675 (Research Letter)

## Manuscript Types and Word Limits

| Type | Abstract | Manuscript Body | References | Figures/Tables |
|------|----------|----------------|------------|----------------|
| Original Paper | Structured | IMRD format | No cap | No strict cap |
| Digital Health Review | Structured | No strict cap | No cap | No strict cap |
| Viewpoint/Perspective | Varies | No strict cap | No cap | No strict cap |
| Research Letter | Structured | 1,000 | 10 | 2 |
| Letter to the Editor | None | Short | No cap | None |
| Policy Paper | Varies | No strict cap | No cap | No strict cap |

## Abstract Format

Structured, following JMIR abstract guidelines (for original research).

## Keywords

Required after abstract.

## Required Sections

1. **Introduction**
2. **Methods** (subheadings: Study Design, Recruitment, Analysis, Ethical Considerations)
3. **Results** (subheadings mirror Methods)
4. **Discussion** (subheadings: Principal Results, Limitations, Comparison with Prior Work, Conclusions)
5. **Acknowledgements**
6. **Funding Statement**
7. **Conflicts of Interest**
8. **Data Availability**
9. **Authors' Contributions**
10. **Abbreviations**
11. **Multimedia Appendices** (optional)
12. **References**

## Citation Style

- AMA (American Medical Association) style, 11th edition
- No bare URLs in body text; all URLs cited as references
- Use JMIR/AMA journal style in reference managers

## Reporting Guidelines

| Study Type | Required Checklist |
|------------|-------------------|
| Randomized trials | CONSORT |
| Systematic reviews | PRISMA / QUORUM |
| Scoping reviews | Applicable checklist |
| Machine learning studies | ML reporting guidelines |

Upload completed checklists as Multimedia Appendix.

## Statistical Reporting

Follows ICMJE statistical reporting recommendations:
- Report exact p-values; use P < .001 for values below that threshold.
- 95% CI required for primary outcomes.
- For ML studies: independent validation dataset required; performance metrics (AUC, sensitivity, specificity) with 95% CI.
- Effect sizes and confidence intervals preferred over p-values alone for clinical meaningfulness.
- Statistical software and version must be identified in Methods.
- No journal-specific statistical reporting requirements beyond ICMJE and study-type guidelines (CONSORT, PRISMA) are published.

## Special Notes

- **Highly selective flagship journal** of JMIR Publications.
- **Scope**: digital health, health informatics, emerging technologies. ML papers accepted only if showing direct clinical impact with independent validation dataset.
- **ORCID required** for all authors at time of publication.
- **File format**: Microsoft Word only (.doc/.docx).
- **Figures/tables**: placed within text, not at end.
- **No URLs in body text**: all must be cited as references.
- **Cascading peer review**: rejected papers may transfer to JMIR sister journals (with reviews).
- **Fast-track option**: 4-week turnaround from submission to initial decision.
- **Topical routing**: clinical informatics must connect to consumer/patient empowerment; pure clinical informatics goes to JMIR sister journals.
- **10% content overlap** may be flagged as duplicative.
- **Preprints accepted**: disclose in cover letter.
- Standard review time: less than 2 months.

# JMIR Medical Education

## Journal Identity

- **Full name**: JMIR Medical Education
- **Abbreviation**: JMIR Med Educ
- **Publisher**: JMIR Publications
- **ISSN**: 2369-3762
- **Frequency**: Continuous (online only)
- **Impact Factor**: ~12.6 (2024)
- **Open Access**: Yes (CC BY 4.0)
- **APC**: See JMIR fee schedule (varies by article type)

## Manuscript Types and Word Limits

| Type | Abstract | Manuscript Body | References | Notes |
|------|----------|----------------|------------|-------|
| Original Paper | Structured | IMRD format | No cap | Primary research |
| Review | Structured | No strict cap | No cap | Systematic, scoping reviews |
| Viewpoint | Varies | No strict cap | No cap | Opinion/perspective |
| Policy Paper | Varies | No strict cap | No cap | Policy issues in med ed |
| Students' Corner | Varies | Short | No cap | By students/trainees |

## Abstract Format

Structured, following JMIR abstract guidelines.
For original papers, must align with IMRD structure.

## Keywords

Required after abstract. Follow JMIR keyword guidelines.

## Required Sections

1. **Introduction**
2. **Methods** (subheadings: Study Design, Recruitment, Analysis, Ethical Considerations)
3. **Results** (subheadings should mirror Methods)
4. **Discussion** (subheadings: Principal Results, Limitations, Comparison with Prior Work, Conclusions)
5. **Acknowledgments**
6. **Funding Statement** (separate from Acknowledgments)
7. **Conflicts of Interest** (mandatory; "None declared" if none)
8. **Data Availability**
9. **Author Contributions**
10. **Abbreviations**
11. **Multimedia Appendix** (optional)
12. **References**

## Citation Style

- AMA (American Medical Association) style, 11th edition
- No bare URLs in body text; all URLs cited as references
- Use JMIR/AMA journal style in reference managers (e.g., EndNote)

## Reporting Guidelines

| Study Type | Required Checklist |
|------------|-------------------|
| Randomized trials | CONSORT |
| Systematic reviews | PRISMA |
| Scoping reviews | Applicable checklist |

Upload completed checklists as Multimedia Appendix.

## Statistical Reporting

Follows ICMJE statistical reporting conventions:
- Report exact p-values; avoid reporting only P < .05.
- 95% CI required for primary outcomes in quantitative studies.
- For educational effectiveness studies: effect sizes (Cohen's d or equivalent) required alongside p-values; distinguish clinical/educational significance from statistical significance.
- For qualitative studies: no quantitative reporting requirements; follow COREQ or SRQR.
- Statistical software and version must be named in Methods.
- No journal-specific statistical reporting requirements beyond ICMJE are published.

## Special Notes

- **Single-blind review** with named reviewers (reviewer names published with accepted articles).
- **ORCID required** for all authors at time of publication.
- **File format**: Microsoft Word only (.doc/.docx).
- **Figures/tables**: placed within text (not at end), portrait orientation only.
- **No URLs in body text**: all must be cited as references.
- **Cascading peer review**: rejected papers may be transferred to JMIR sister journals.
- **Fast-track option**: editorial decision within 20 working days (additional fee).
- **Ethical Considerations** subsection mandatory in Methods for studies involving human subjects.
- **10% content overlap** with prior work may be flagged as duplicative.
- **Generative AI use** must be disclosed per JMIR AI policy.
- Style emphasis: use *italics* for emphasis, not bold or underline.

# Journal Profile: Journal of NeuroInterventional Surgery (JNIS)

## Basic Information

- **Publisher:** BMJ Publishing Group
- **Society:** Society of NeuroInterventional Surgery (SNIS)
- **Frequency:** Monthly (12 issues/year)
- **Scope:** Endovascular and surgical neurointervention — acute ischemic stroke thrombectomy, intracranial aneurysm treatment, AVM/dAVF embolization, carotid and intracranial stenting, spine intervention, neurointerventional devices
- **Open Access:** Hybrid (optional Gold OA with APC; subscription route free to authors)
- **Language:** British English
- **Peer Review:** Double-anonymised (author identifiers must be removed from the manuscript file)
- **ORCID:** Mandatory for submitting author
- **Acceptance / Timing (BMJ metrics — verify at submission):** approximately 18% acceptance; median first decision approximately 24 days

---

## Scope — Covered Topics

- Acute ischemic stroke — mechanical thrombectomy, stentriever/aspiration, imaging selection
- Intracranial aneurysm — coiling, stent-assisted coiling, flow diversion, intrasaccular devices
- Arteriovenous malformation and dural arteriovenous fistula embolization
- Carotid artery stenting, intracranial atherosclerotic disease stenting
- Spine interventions (vertebroplasty, kyphoplasty, spinal angiography, embolization)
- Neurointerventional device evaluation (first-in-human, post-market, registry)
- Clot and plaque histology from endovascular retrieval
- Socioeconomics, workforce, and systems of neurointerventional care

---

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | Figures/Tables | References |
|------|----------------|----------|----------------|------------|
| Original Research | 3,500 | 250 (structured) | 4 | ≤30 |
| Review | 4,000 | 250 (unstructured) | 4 | ≤60 |
| Case Series | 2,500 | 250 (structured) | 4 | ≤20 |
| Brief / Short Report | 2,000 | 200 (structured) | 2 | ≤15 |
| Case Report | 800 | 150 (brief) | 2 | ≤10 |
| Technical Note / New Device | 2,000 | 200 | 3 | ≤15 |
| Editorial (invited) | 1,500 | None | 2 | ≤15 |
| Letter / e-Letter | 600 | None | 1 | ≤5 |
| Video Report | 500 + video | 150 | n/a | ≤10 |

*Verify exact current limits on the author guidelines page before submission — BMJ periodically revises its limits.*

---

## Abstract Requirements

**Structured 250-word abstract for Original Research:**

```
Background: [Clinical question; rationale]
Methods: [Study design, population, interventions, outcomes, statistical approach]
Results: [Key numerical results with effect sizes and 95% CI]
Conclusions: [Main conclusion; clinical implication]
```

---

## Key Messages Box (Mandatory for Original Research)

A three-bullet summary box is required:

```
WHAT IS ALREADY KNOWN ON THIS TOPIC
• [1–2 sentences on current knowledge]

WHAT THIS STUDY ADDS
• [1–2 sentences on the novel contribution]

HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY
• [1–2 sentences on implications]
```

---

## Domain-Specific Outcome Measures

### For Acute Ischemic Stroke Thrombectomy

- **Recanalization:** mTICI (modified Treatment in Cerebral Infarction) — report rates of mTICI 2b/2c/3 (successful reperfusion = 2b–3; excellent = 2c–3)
- **Functional outcome at 90 days:** mRS (modified Rankin Scale); good outcome commonly mRS 0–2
- **Symptomatic intracranial hemorrhage (sICH):** state definition used (ECASS II, ECASS III, SITS-MOST, NINDS, or Heidelberg)
- **Procedure time:** puncture-to-reperfusion; onset-to-reperfusion when available
- **Mortality at 90 days**
- **First-pass effect (FPE):** mTICI 2c–3 after a single pass

### For Aneurysm Treatment

- **Angiographic occlusion:** Raymond-Roy Occlusion Classification (RROC) for coiling; O'Kelly–Marotta (OKM) scale for flow diverters
- **Retreatment rate** with follow-up interval explicit
- **Procedural complications:** thromboembolic events, intraprocedural rupture, access-site complications — pre-specify definitions
- **Delayed ischemic events and delayed aneurysm rupture**

### For AVM / dAVF Embolization

- **Complete obliteration rate** on follow-up DSA
- **Spetzler-Martin grade (AVM)** and **Cognard/Borden classification (dAVF)** for risk stratification
- **Rehemorrhage rate** with follow-up interval explicit

### Imaging / Device Studies

- **Diagnostic accuracy:** sensitivity, specificity, AUC with 95% CI
- **Inter-rater agreement:** Cohen's kappa or ICC
- **Report reference standard** (DSA, surgical confirmation, multidisciplinary adjudication)

---

## Required Sections

1. **Introduction** — Background; knowledge gap; specific aim
2. **Methods**
   - Ethics: IRB/ethics committee approval + informed consent statement (or waiver rationale)
   - Study design, setting, participants, timeframe
   - Exposures, interventions, and outcomes with explicit definitions
   - Statistical analysis
   - Reporting-guideline citation (STROBE/CONSORT/PRISMA/STARD/ARRIVE/TRIPOD)
   - **Data Availability Statement — mandatory (BMJ Tier 3 policy)**
3. **Results**
   - Participant flow / baseline characteristics
   - Primary and secondary outcomes with effect sizes and 95% CI
   - Subgroup and sensitivity analyses
4. **Discussion** — include Limitations subsection
5. **Conclusion**

---

## Data Sharing Statement (BMJ Tier 3 — Mandatory)

Every Original Research article must include a Data Availability Statement. Acceptable forms include (examples):
- "Data are available in a public, open access repository at [URL/DOI]."
- "Data are available upon reasonable request to the corresponding author."
- "No data are available." (only when legally or ethically restricted — must justify)

---

## Reference Style

- **Vancouver numbered system**
- Superscript reference numbers in the text
- List first 6 authors followed by "et al." when there are more than 6 authors (verify on BMJ reference style page)
- Journal abbreviations per Index Medicus / NLM
- Include DOI or PMID when available

---

## Statistical Reporting Expectations

- Effect sizes with 95% CI — not p-values alone
- State statistical software (name, version, key packages)
- Time-to-event: Kaplan-Meier with log-rank; Cox regression with PH assumption check
- Diagnostic accuracy: AUC with 95% CI (DeLong); sensitivity/specificity with Clopper-Pearson CI
- Missing data: describe amount and handling (complete-case, multiple imputation, IPW)
- Propensity-score and IPW methods: report covariates, balance diagnostics (standardized mean difference)

---

## Figures

- High-resolution TIFF, EPS, or PDF (≥300 dpi for halftone; ≥600 dpi for line art)
- Label panels with capital letters (A, B, C, ...)
- Scale bars for radiographs/histology; anatomical orientation labels for angiograms
- Figure legends separate from figures in the manuscript file
- Video files supported for endovascular case material

---

## Peer Review Model — Double-Anonymised

Authors must prepare the main manuscript file without:
- Author names, affiliations, emails on the title page (submitted separately)
- Acknowledgments, funding statements, or any wording that identifies the institution
- Self-citations that reveal the group ("as we previously reported in reference X")

Submit a separate title-page file with full authorship metadata.

---

## Common Rejection Reasons

1. **Scope mismatch** — non-neurointerventional work; stroke medical therapy without endovascular component belongs in a stroke journal
2. **Low sample size for single-center retrospective series** without external validation
3. **Missing reporting-guideline checklist**
4. **Vague outcome definitions** — mTICI, mRS cutoff, sICH, RROC/OKM all must be pre-specified and cited
5. **Failure to strip identifying information** — returned for double-anonymization non-compliance
6. **Missing or inadequate Data Availability Statement** (BMJ Tier 3 non-compliance)
7. **Weak comparison to prior literature** — incremental reports of well-established techniques need a clear reason for publication

---

## Author Guidelines URL

https://jnis.bmj.com/pages/authors/

---

## AI Writing Disclosure Policy

JNIS follows BMJ's generative-AI policy and ICMJE recommendations:

1. **AI cannot be an author** (ICMJE) — AI tools cannot take responsibility for the work.
2. **Disclose substantive AI use** in Methods (when used in research design, analysis, or drafting specific text) and in the Acknowledgments.
3. **AI-generated references are prohibited** — the corresponding author is responsible for all citation accuracy.
4. **Basic grammar / spell-check tools** (e.g., Grammarly, word-processor spell-check) do not require disclosure.
5. **Generative-AI image creation or manipulation is prohibited** in scientific figures (angiograms, histology, MRI, CT).
6. **Prompt transparency:** when AI is used in data analysis or figure generation, provide sufficient detail (prompts, tool version) for reproducibility.

Always re-check the BMJ and JNIS author pages at submission for updates.

---

## Positioning

JNIS is appropriate when:
- The study is primarily endovascular or surgical neurointerventional in nature
- The endpoint includes procedural success (mTICI, RROC, OKM), device performance, or technical complication rates
- Target audience includes interventional neuroradiologists, endovascular neurosurgeons, and interventional neurologists
- First-in-human device studies, registry reports, and technical notes are welcome

JNIS is less appropriate for: medical (non-endovascular) stroke management (consider Stroke or Journal of Stroke), purely imaging-diagnostic work without intervention (consider AJNR, Neuroradiology), or basic cerebrovascular biology (consider Stroke basic/translational track or ATVB).

---

## Verification note

Profile built 2026-04-19 from the JNIS author guidelines PDF (https://jnis.bmj.com/pages/authors/). BMJ Tier 3 data-sharing policy, double-anonymised review model, ORCID mandate, and Key Messages box requirement are transcribed from the same source. Acceptance-rate and first-decision timing figures are the BMJ-reported values on the authors page; re-verify at submission.

- **AI-use disclosure placement**: Methods
  <!-- machine-read by /self-review check_classical_style.py --profile; source: this profile's own "Disclose substantive AI use in Methods (when used in research design, analysis, or drafting)" -->

# Journal Profile: The Journal of Clinical Endocrinology & Metabolism (JCEM)

## Journal Identity

- **Full name**: The Journal of Clinical Endocrinology & Metabolism
- **Abbreviation**: J Clin Endocrinol Metab
- **Publisher**: Oxford University Press (on behalf of the Endocrine Society)
- **ISSN**: 0021-972X (print) / 1945-7197 (online)
- **Frequency**: Monthly
- **Impact Factor**: ~5.8 (recent JCR; verify at submission)
- **Open Access**: Hybrid — page-charge model (USD 99–119 per PDF page, member vs non-member; color figure surcharge USD 235–735); separate Gold OA option via OUP open-access portal
- **Peer review**: Single-blind; methodology-heavy submissions may receive statistical or sub-specialty review

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | References | Figures/Tables |
|------|----------------|----------|------------|----------------|
| Clinical Research Article (Original) | not stated as a hard cap | 250 (structured, complete sentences) | not stated | not stated |
| Approach to the Patient | 2,000–5,000 words | 150–250 | varies | varies |
| Mini-review | 2,000–5,000 words | 150–250 | varies | varies |
| Meta-analysis | as Original | as Original | as Original | as Original |
| Editorial | 1,500 words | none | 15 max | 1 max |
| Commentary | 1,500 words | none | 15 max | 1 max |
| Letter to the Editor | 500 words | none | 5 max | 1 max |
| Report and Recommendation | per society/consensus | varies | varies | varies |

JCEM does not enforce a numeric upper word limit on Original (Clinical Research Article) submissions; tight scientific writing is expected, and editors will request trimming at the revision stage if the manuscript runs long.

---

## Abstract Requirements

**Structured abstract, 250 words maximum, in complete sentences:**

```
Purpose / Context: [Specific scientific question and clinical relevance]
Methods: [Design, setting, population, exposures, outcomes, statistical approach]
Results: [Primary results with effect sizes, 95% CIs, P values; N analyzed]
Main Conclusion: [Direct answer to Purpose with clinical implication]
```

JCEM requires the abstract to be written in **complete sentences without direct text references** (no "(Figure 1)" or "(Table 2)" pointers). The four sections (Purpose, Methods, Results, Main Conclusion) are the canonical structure.

---

## Required Journal-Specific Elements

### 1. Précis (Key Message)

One-sentence summary (≤30 words) of the principal finding, requested at submission. Used by editors and the Endocrine Society newsroom; do not skip.

### 2. Article Information

- Author affiliations with department, institution, city, country
- Corresponding author full contact details
- Funding statement with grant identifiers
- Disclosures: per-author ICMJE conflicts
- Data availability statement
- Ethical statement (IRB or equivalent + informed consent)

### 3. Submission File Requirements

JCEM asks authors to **list all authors at the initial submission** (no first-N-then-et-al truncation in references at submission stage). The Endocrine Society uses the full author list for editorial workflow and indexing decisions.

---

## Required Sections (Original Article)

1. **Introduction** — concise (2–3 paragraphs) ending with clear purpose
2. **Materials and Methods** (JCEM convention)
   - Ethics approval with body name
   - Study design and setting
   - Participants and eligibility
   - Variables / definitions with assay details (intra-/inter-assay CV for hormone measurements)
   - Outcomes (primary, secondary, exploratory clearly distinguished)
   - Statistical analysis with software and versions
3. **Results** — flow diagram for cohort selection; primary outcome before secondary
4. **Discussion** — Strengths and Limitations sub-paragraphs; conclude with endocrine-mechanism implications and clinical translation
5. **Main Conclusion** — brief; avoid overclaiming

---

## Statistical Reporting

- Exact P values to 3 decimal places (P < 0.001 below threshold)
- 95% CI for all primary effect estimates
- Effect sizes appropriate to design (HR, OR, mean difference, beta coefficient)
- For hormonal axes: report assay platform, reference range, and within-subject coefficient of variation
- Proportional-hazards assumption check (Schoenfeld) when Cox is used
- Sensitivity analyses for major analytic choices
- Software and version reported

---

## Figures

- Color figure surcharge: USD 235–735 per figure (verify current schedule)
- Resolution: 300 DPI minimum
- Format: TIFF, EPS, PDF
- Supplementary material: online-only supplement permitted

---

## Common Rejection Reasons

1. **Insufficient endocrine-mechanism contribution** — clinical observations without hormonal-axis or metabolic-mechanism framing are redirected
2. **Single-center cohort without external comparison** — population-based or multicenter preferred
3. **Missing assay validation** — methodology bar is high for hormonal and metabolic biomarkers
4. **Overclaiming on observational data** — wide-CI estimates without exploratory qualifier
5. **Abstract style violation** — not using complete sentences or including direct text references
6. **AI policy non-compliance** — undisclosed AI use or AI listed as author
7. **Reference list incomplete at submission** — submitting with truncated author lists or missing references

---

## Cover Letter

Must include:
- Brief statement of novelty and clinical-endocrine relevance
- Précis (≤30 words) of principal finding
- Confirmation manuscript is not under consideration elsewhere
- Confirmation all authors meet ICMJE criteria
- Disclosure of related manuscripts (same cohort, same group)
- Suggested reviewers (3–5; senior PI curates)
- AI disclosure aligned with in-manuscript declaration

---

## AI Writing Disclosure Policy

- **Requirement level**: Required
- **Verbatim policy**: "The use of artificial intelligence (AI) tools must be disclosed during the submission process and also described in the Methods or Acknowledgments sections of the text."
- **Disclosure location**: Both the submission portal disclosure step AND the Methods or Acknowledgments section
- **Reviewer restriction**: Reviewers are explicitly prohibited from uploading any part of a manuscript into LLM tools during review (confidentiality)
- **AI-generated images**: Covered by the general disclosure; not separately permitted
- **Policy URL**: https://academic.oup.com/jcem/pages/Author_Guidelines

---

## Submission Portal

https://www.editorialmanager.com/jcem/

---

## Author Guidelines URL

https://academic.oup.com/jcem/pages/Author_Guidelines

---

## Positioning

| Criterion | JCEM | Endocrinology and Metabolism (EnM) | Diabetes & Metabolism Journal (DMJ) | Diabetes Care |
|-----------|------|------------------------------------|-------------------------------------|---------------|
| **Society** | Endocrine Society (global) | Korean Endocrine Society | Korean Diabetes Association | American Diabetes Association |
| **Impact Factor** | ~5.8 | ~3.5 | ~5.5 | ~16 |
| **Open Access** | Hybrid (page-charge default) | Full OA | Full OA (CC BY-NC) | Hybrid |
| **Geographic stance** | Global | Korean / East Asian | Korean / East Asian | Global, US-centric |
| **Primary framing** | Clinical endocrinology / metabolism — broad axis | Endocrinology, hormonal-axis focused | Diabetes / metabolism focused | Type 2 diabetes, clinically driven |
| **Abstract style** | 4-section (Purpose/Methods/Results/Main Conclusion), complete sentences | 4-heading (Background/Methods/Results/Conclusion) | 4-heading (Background/Methods/Results/Conclusion) | 4-heading (Objective/Research Design/Results/Conclusions) |
| **Word cap (Original)** | not stated | 4,000 | 4,000 | varies |
| **AI policy** | Submission portal + Methods/Acknowledgments | Manuscript + cover letter | Title page | Methods + Acknowledgments |

**Choose JCEM when:**
- Endocrine-mechanism framing is the primary scientific contribution
- Clinical-endocrine community visibility (Endocrine Society) matters
- Hormonal-axis or metabolic-axis pathway is the central narrative
- Manuscript can support the implicit "high methodological rigor" bar without a hard word cap

**Choose Endocrinology and Metabolism (KES) instead when:**
- Korean / East Asian population cohort with regional-relevance framing
- Lower IF threshold acceptable in exchange for faster decision (≤3 months)

**Choose DMJ instead when:**
- Diabetes-specific framing dominates over broader endocrinology
- Korean Diabetes Association ecosystem visibility matters

**Choose Diabetes Care instead when:**
- T2DM clinical-practice impact is the dominant framing
- Higher IF requirement (e.g., for promotion)
- Global, US-centric audience matters more than endocrine-society fit

---

## Verification

- **Source (compact harvest):** local profile library (2026-05 fetch from https://academic.oup.com/jcem/pages/Author_Guidelines)
- **Source (detail authored):** based on harvested compact + JCEM verbatim AI policy + OUP/Endocrine Society standard practice
- **Date (promoted to public):** 2026-05-21
- **Notes:** No upper word limit for Original at submission; editors may request trimming during revision. Verify page-charge and color-figure surcharge directly at OUP.

- **AI-use disclosure placement**: Submission portal + Methods/Acknowledgments
  <!-- machine-read by /self-review check_classical_style.py --profile; source: this profile's own its AI-policy comparison table, own-journal column: "Submission portal + Methods/Acknowledgments" -->

# Journal Profile: Journal of Stroke (J Stroke)

## Basic Information

- **Publisher:** Korean Stroke Society
- **Society:** Korean Stroke Society
- **Frequency:** 3 issues/year (January 31, May 31, September 30)
- **Scope:** Cerebrovascular disease — ischemic stroke, hemorrhagic stroke, TIA, stroke prevention, acute treatment, neurorehabilitation, stroke systems of care
- **Open Access:** Full OA (CC BY-NC 4.0); no article processing charge
- **Language:** American English
- **Editorial Office:** Asan Medical Center, Ulsan University College of Medicine (Seoul)

---

## Scope — Covered Topics

- Acute ischemic stroke (IV thrombolysis, endovascular therapy, imaging selection)
- Intracerebral hemorrhage and subarachnoid hemorrhage
- Transient ischemic attack and minor stroke
- Secondary stroke prevention (antithrombotics, risk factor management)
- Cerebral small vessel disease and vascular cognitive impairment
- Cerebrovascular imaging (CT/CTA/CTP, MRI/MRA, DSA)
- Stroke epidemiology, registries, and outcomes research
- Neurorehabilitation and recovery
- Stroke clinical guidelines (regional and international)

---

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | Figures/Tables | References |
|------|----------------|----------|----------------|------------|
| Special Review | ~8,000 words | 250 (unstructured) | 8 | unlimited |
| Review | ~6,000 words | 250 (unstructured) | 6 | unlimited |
| Original Article | 5,500 words | 250 (structured) | 6 | unlimited |
| Guideline | variable (invited) | 250 | variable | variable |
| Special Report | variable | 250 | variable | variable |
| Editorial | ~1,500 words | None | 2 | ≤20 |
| Letter to the Editor | 1,000 words | None | 2 | ≤10 |

*Verify exact current limits on the author guidelines page before submission.*

---

## Abstract Requirements

**Structured abstract, 250 words for Original Articles:**

```
Background and Purpose: [Clinical question; rationale]
Methods: [Study design, population, interventions/exposures, outcomes, statistical approach]
Results: [Key numerical results with effect sizes and 95% CI]
Conclusions: [Main conclusion; clinical implication]
```

Unstructured 250-word abstract for Reviews and Special Reviews.

---

## Domain-Specific Outcome Measures

### For Acute Stroke Studies

- **Functional outcome at 90 days:** mRS (modified Rankin Scale); good outcome commonly defined as mRS 0–2
- **Recanalization:** mTICI (modified Treatment in Cerebral Infarction) for endovascular studies; TIMI for older IV thrombolysis studies
- **Symptomatic intracranial hemorrhage (sICH):** report definition used (ECASS II, ECASS III, SITS-MOST, NINDS, or Heidelberg)
- **Early neurological improvement/deterioration:** NIHSS change (typically at 24 hours or discharge)
- **Mortality at 90 days**

### For Prevention / Epidemiology Studies

- **Recurrent stroke (ischemic / hemorrhagic / any):** state the composite definition explicitly
- **MACE (major adverse cardiovascular events):** define components
- **Time-to-event outcomes:** Kaplan-Meier curves + Cox proportional hazards (test PH assumption)

### For Imaging Studies

- **Diagnostic accuracy:** sensitivity, specificity, AUC with 95% CI
- **Inter-rater agreement:** Cohen's kappa or ICC depending on outcome type
- **Report reference standard explicitly** (follow-up imaging, clinical adjudication, or autopsy)

---

## Required Sections

1. **Introduction** — Clinical background; knowledge gap; specific aim
2. **Methods**
   - Ethics: IRB approval + informed consent statement (or exemption rationale for retrospective studies)
   - Study design, setting, and participant selection
   - Exposures and outcomes with explicit definitions
   - Statistical analysis
   - Reporting guideline citation (STROBE, CONSORT, PRISMA, STARD, TRIPOD)
3. **Results**
   - Participant flow / baseline characteristics
   - Primary and secondary outcome results with effect sizes and 95% CI
   - Subgroup and sensitivity analyses
4. **Discussion**
5. **Conclusion**

---

## Reference Style

- **Vancouver numbered system**
- Superscript reference numbers in the text
- List first 3 authors followed by "et al." when there are more than 6 authors (verify current rule on author page)
- Journal abbreviations per Index Medicus / NLM style

---

## Statistical Reporting Expectations

- Report effect sizes (HR, OR, RR, absolute risk difference) with 95% CI — not p-values alone
- State statistical software (version and package) used
- For time-to-event analysis: Kaplan-Meier with log-rank test, Cox regression with PH assumption check
- For diagnostic accuracy: AUC with 95% CI (DeLong method), sensitivity/specificity with Clopper-Pearson CI
- Missing data: describe amount and handling (complete-case, multiple imputation, IPW)

---

## Figures

- High-resolution TIFF, EPS, or PDF
- Black-and-white for line art; RGB color accepted
- Label panels with capital letters (A, B, C, ...)
- Include scale bars for radiographs/histology
- Figure legends separate from figures in the manuscript file

---

## Common Rejection Reasons

1. **Scope mismatch** — non-cerebrovascular work, or work where the stroke component is incidental
2. **Under-powered single-center retrospective series** without external validation or adequate sample-size justification
3. **Weak comparison group** — historical controls without contemporaneous matched comparator
4. **Missing reporting-guideline checklist** (STROBE/STARD/CONSORT/PRISMA as applicable)
5. **Outcome definition vagueness** — mRS cutoff, recanalization success, sICH definition must be pre-specified and cited
6. **Insufficient attention to prior regional literature** — Journal of Stroke expects engagement with Asia-Pacific stroke data where relevant

---

## Author Guidelines URL

https://j-stroke.org/authors/authors.php

---

## AI Writing Disclosure Policy

The author guidelines (last revised 2024-01-31) do not include an explicit generative-AI section. In the absence of a journal-specific policy, default to ICMJE and WAME recommendations:

1. **AI cannot be an author** (ICMJE) — AI tools cannot take responsibility for the work.
2. **Disclose substantive AI use** in the Methods (if involved in data generation, analysis, or writing of specific text) and/or Acknowledgments.
3. **Do not use AI-generated references** without verification — the corresponding author remains responsible for citation accuracy.
4. **Grammar / spell-check tools** do not require disclosure.
5. **Image manipulation by generative AI is prohibited** for scientific figures.

Authors should check the author guidelines page at submission time in case the policy has been updated.

---

## Positioning

Journal of Stroke is appropriate when:
- The study primarily concerns cerebrovascular disease (ischemic stroke, ICH, SAH, TIA, cSVD)
- Open-access publication with no APC is a priority (full OA, CC BY-NC 4.0)
- The target audience includes the Asia-Pacific stroke community
- Clinical practice guidelines or special reports with regional relevance

Journal of Stroke is less appropriate for: pure basic-science vascular biology (consider ATVB), purely interventional neuroradiology device papers (consider JNIS or INSI), or work with no cerebrovascular endpoint.

---

## Verification note

Profile built 2026-04-19 from the journal's author guidelines PDF (https://j-stroke.org/authors/authors.php). Editorial Office address and frequency transcribed from the same source.

- **AI-use disclosure placement**: Methods
  <!-- machine-read by /self-review check_classical_style.py --profile; source: this profile's own "Disclose substantive AI use in the Methods (if involved in data generation, analysis, ...)" -->

# Journal Profile: Journal of Vascular and Interventional Radiology (JVIR)

## Journal Identity

- **Full name**: Journal of Vascular and Interventional Radiology
- **Abbreviation**: J Vasc Interv Radiol
- **Publisher**: Elsevier (SIR — Society of Interventional Radiology)
- **ISSN**: 1051-0443 (print), 1535-7732 (online)
- **Frequency**: Monthly (12 issues/year)
- **Impact Factor**: ~3.5 (JCR 2023)
- **Open Access**: Hybrid (optional OA with Elsevier APC)
- **Acceptance rate**: ~25%
- **Peer review**: Single-blind; 2-3 reviewers per manuscript

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | References | Figures/Tables |
|------|----------------|----------|------------|----------------|
| Clinical Investigation | 3000 words | 250 words (structured) | 35 | 6 |
| Clinical Practice | 3000 words | 250 words | 35 | 6 |
| Technical Report | 2000 words | 150 words (unstructured) | 20 | 4 |
| Case Report | 1500 words | 100 words (unstructured) | 10 | 4 |
| Review Article | 4000 words | 250 words | 75 | 8 |
| Systematic Review / Meta-Analysis | 4000 words | 250 words (structured) | 60 | 8 |
| Letter to the Editor | 500 words | None | 5 | 1 |

Word counts exclude abstract, references, tables, and figure legends.

---

## Abstract Requirements

**Structured abstract for Clinical Investigations and SRMAs, 250 words maximum:**

```
Purpose: [Study aim]
Materials and Methods: [Design, setting, population, intervention, outcomes,
    statistical analysis]
Results: [Key findings with statistics]
Conclusions: [Main conclusion — 1-2 sentences]
```

**Unstructured abstract for Technical Reports, 150 words. Case Reports, 100 words.**

---

## Required Sections (Clinical Investigation)

1. **Introduction** — clinical context, knowledge gap, study purpose (2-3 paragraphs)
2. **Materials and Methods**
   - Study Design and Oversight: IRB, retrospective/prospective
   - Patient Selection: inclusion/exclusion, time period
   - Procedure: step-by-step technical description with device details
   - Endpoints: primary and secondary, with definitions
   - Follow-up Protocol: imaging and clinical assessment schedule
   - Statistical Analysis: software, methods, significance level
3. **Results** — demographics, procedural data, primary outcomes, secondary outcomes, complications
4. **Discussion** — findings in context, comparison with literature, limitations
5. **Conclusions**

---

## Statistical Reporting

- Report exact p-values; use p < .001 below that threshold.
- 95% CI for all primary outcomes.
- Technical and clinical success rates with exact denominators (n/N, %).
- Complication rates per SIR classification (mandatory for IR studies).
- For time-to-event: Kaplan-Meier with log-rank test; report median and 95% CI.
- Multivariate analysis: report adjusted OR/HR with 95% CI.
- For meta-analyses: heterogeneity (I-squared, Q-test), publication bias assessment.
- Report per-patient AND per-procedure rates when they differ.
- Statistical software and version must be identified.

---

## IR-Specific Requirements

### SIR Complication Classification (Mandatory)

JVIR, as the SIR journal, strictly enforces SIR complication classification:
- **Minor complications**: A (no therapy required), B (nominal therapy)
- **Major complications**: C (requires therapy, minor hospitalization), D (major therapy, escalation of care), E (permanent adverse sequelae), F (death)

### Outcome Definitions

Must explicitly define:
- **Technical success**: procedure-specific (e.g., "complete tumor coverage on immediate post-ablation imaging")
- **Clinical success**: patient-centered (e.g., "symptom resolution or improvement at 30 days")
- **Primary/assisted-primary/secondary patency** (vascular)
- **Local tumor progression-free survival** (ablation/embolization)

### Device Reporting

Manufacturer name, device model, and configuration for all devices. JVIR readership is procedurally oriented and expects reproducible technical detail.

---

## Figures

- **Maximum 6 figures/tables combined** for clinical investigations
- **Resolution**: 300 DPI minimum (600 DPI for line art)
- **Format**: TIFF, EPS, PDF
- **Color**: Free online
- **Typical figure set**: patient selection flowchart, pre-/intra-/post-procedure images, outcome graphs (Kaplan-Meier, bar charts)

---

## Common Rejection Reasons

1. **Retrospective single-center with small N and no novelty** — JVIR receives many of these
2. **Missing SIR complication classification** — mandatory for the society's journal
3. **Undefined technical/clinical success** — must be pre-specified
4. **Inadequate follow-up** — ablation studies need minimum 6-12 months imaging follow-up
5. **No comparative group** — single-arm studies need strong justification
6. **Duplicate scope with CVIR submission** — JVIR and CVIR do not share reviews; dual submission detected via reviewer overlap

---

## Cover Letter

Should include:
- Relevance to SIR members and IR practice
- Statement of novelty
- Brief summary of key finding
- Suggested reviewers (3+) with expertise in the specific IR subspecialty

---

## Author Guidelines URL

https://www.jvir.org/content/authorinfo

---

## Positioning

JVIR is appropriate when:
- Interventional radiology clinical investigation with adequate sample size
- IR technique innovation with clinical outcome data
- Systematic review or meta-analysis of IR procedures
- Quality improvement or practice pattern study in IR
- Multi-center IR study (especially US-based centers)

Not appropriate for: diagnostic imaging without intervention, non-IR procedures, pure imaging methodology.

---

## Differentiation from CVIR

| Dimension | JVIR | CVIR |
|-----------|------|------|
| Society | SIR (American) | CIRSE (European) |
| Geography emphasis | North American and international | European and international |
| Impact factor | ~3.5 | ~3.0 |
| Complication standard | SIR classification (strict) | SIR or Clavien-Dindo |
| Article types | Clinical Investigation / Practice | Original Article |
| Thematic issues | Quality improvement, standards of practice | Less common |

# Journal Profile: Kidney International (KI)

## Journal Identity

- **Full name**: Kidney International
- **Abbreviation**: Kidney Int
- **Publisher**: Elsevier on behalf of the International Society of Nephrology (ISN)
- **ISSN**: 0085-2538 (print), 1523-1755 (online)
- **Frequency**: Monthly
- **Impact Factor**: ~14.8 (JCR 2023)
- **Open Access**: Hybrid
- **Acceptance rate**: ~10-12%
- **Peer review**: Single-blind, 2-3 reviewers

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | References | Figures/Tables |
|------|----------------|----------|------------|----------------|
| Original Article | 4000 words | 300 words | 50 | 6 (combined) |
| Brief Communication | 1500 words | 150 words | 15 | 2 (combined) |
| In-Depth Review | 6000 words | 200 words | 120 | 6 (combined) |
| Case Report | Not accepted | - | - | - |

*Note: Case reports are no longer accepted. Body word limit excludes title page, abstract, references, tables, figures, and legends.*

---

## Abstract Requirements

**Structured abstract, 300 words maximum:**
Headings must be exactly:
- **Introduction:** [Context, clinical significance, and hypothesis]
- **Methods:** [Study design, population, key interventions/measurements, statistical analysis]
- **Results:** [Main outcomes, hazard ratios/odds ratios with 95% CIs, exact p-values]
- **Discussion:** [Conclusions, clinical implications, and future directions]

---

## Required Sections (Original Article)

1. **Title Page**
2. **Structured Abstract** (max 300 words)
3. **Introduction** (focused, ending with study aim)
4. **Results** (appears before Methods in some older formats, but standard IMRAD is now preferred; verify in submission portal)
5. **Methods** (detailed, including ethics approvals and checklist references like STROBE/CONSORT)
6. **Discussion** (limitations must be explicitly stated in a dedicated paragraph)
7. **Disclosures / Conflict of Interest**
8. **Funding Statement**
9. **References**

---

## Statistical Reporting

- Report exact p-values for all main findings.
- Always include 95% Confidence Intervals (95% CI) and effect sizes.
- Account for competing risks (death or transplantation) in survival analyses in chronic cohorts.
- Report all diagnostic accuracy measures (sensitivity, specificity, AUC) with 95% CIs.
- Explicitly identify the software and specific package versions used for the analysis.

---

## Figures

- **Maximum**: 6 figures/tables combined for Original Articles. Additional figures must go to Supplementary Material.
- **Resolution**: 300 DPI for photographs, 1200 DPI for line drawings.
- **Format**: TIFF, EPS, or high-resolution PDF.
- **Color**: Color figures are free in the electronic edition; print color may incur a fee.

---

## Common Rejection Reasons

1. **Lack of Novel Mechanistic Insight:** Particularly for basic science, if the study only describes an association without showing a direct mechanism.
2. **Single-Center Retrospective Design:** Lacking multi-center validation or generalizability.
3. **Competing Risk of Death Censored:** In dialysis or advanced CKD cohorts, failing to account for death as a competing event in survival models.
4. **Excessive Display Items:** Submitting more than 6 figures/tables without using supplementary channels.
5. **Lack of Pre-Registration:** Clinical trials or systematic reviews without registry numbers (ClinicalTrials.gov or PROSPERO).

---

## Cover Letter

Should include:
- Explanation of the study's clinical/translational significance and why it fits Kidney International.
- Statement that the work is original, has not been published elsewhere, and all authors approved.
- Disclosure of related submissions.
- Suggestion of 3-5 expert reviewers.

---

## AI Writing Disclosure Policy

- **Requirement level:** Required
- **Permitted scope:** Language editing only — AI tools cannot generate content, draw conclusions, or be listed as co-authors.
- **Disclosure location:** Dedicated AI declaration section placed at the end of the manuscript (before References).
- **AI-generated images:** Banned.
- **Policy URL:** https://www.elsevier.com/about/policies-and-standards/generative-ai-policies-for-authors

---

## Author Guidelines URL

https://www.kidney-international.org/content/authorinfo

---

## Positioning

Kidney International is the official journal of the ISN. It is highly suited for high-impact translational renal pathology, basic pathophysiologic mechanisms of kidney injury, and clinical trials of global relevance.

| Dimension | Kidney International | JASN | NDT |
|-----------|----------------------|------|-----|
| Society | International Society of Nephrology (ISN) | American Society of Nephrology (ASN) | European Renal Association (ERA) |
| Scope | Basic, Translational, and Key Clinical | Basic, Translational, and High-impact Clinical | Primarily Clinical, Dialysis, and Transplant |
| Impact factor | ~14.8 | ~12.7 | ~6.1 |
| Emphasis | Pathology & Basic Mechanisms | Multidisciplinary Nephrology & Trials | European Practice, Dialysis, & Transplantation |

## Verification
- **Source:** Kidney International Guide for Authors, read during maintainer review of PR #330 — verification record: https://github.com/Aperivue/medsci-skills/pull/330#issuecomment-4968075916
- **Date:** 2026-07-14
- **Note:** the 4,000-word body and the ≤300-word structured abstract were confirmed against the journal's own guide. As above, no direct URL was captured and the publisher blocks automated retrieval, so none is asserted here.

# Journal Profile: Korean Journal of Radiology (KJR)

## Basic Information

- **Publisher:** Korean Society of Radiology
- **ISSN:** 1229-6929 (Print) / 2005-8330 (Electronic)
- **Scope:** All subspecialties of diagnostic and interventional radiology; medical imaging AI. Excludes radiation oncology, dentistry, dental radiology, dental surgery, and translational/basic nuclear medicine studies.
- **Open Access:** Yes — fully open access (CC BY-NC 4.0), indexed in DOAJ, PubMed/MEDLINE, Scopus, SCIE
- **APC (Article Processing Charge):** USD 100 for accepted manuscripts. Exempt: invited articles, Uncover This Tech Term, Emerging Rad Dx, Letter to the Editor.
- **Language:** English only for manuscripts

---

## Manuscript Types and Limits

Body Text excludes title, abstract, keywords, references, tables, and figure legends.

| Type | Body | Abstract | Figures/Tables | References | Notes |
|------|------|----------|----------------|------------|-------|
| Original Article | ≤3000 words | ≤300 words (structured) | ≤7 | unspecified | Structured Introduction / Materials and Methods / Results / Discussion |
| Brief Research Report | ≤2000 words | ≤300 words (structured) | ≤4 | unspecified | Short paper reporting evaluation of unique techniques, procedures, or small case series; formal statistical analysis may not be needed |
| Review | ≤5000 words | ≤200 words (unstructured) | ≤10 | unspecified | Narrative comprehensive review; generally invited |
| Pictorial Essay | ≤2000 words | ≤200 words (unstructured) | ≤20 | unspecified | More illustrative than narrative |
| Focus | ≤2000 words | ≤200 words (unstructured) | ≤4 | unspecified | Shorter timely review/discussion; generally invited |
| Recommendation and Guideline | unspecified | ≤200 words (unstructured) | unspecified | unspecified | Authoritative recommendations; must be supported by published studies or expert panels |
| Editorial | ≤1000 words | No abstract | ≤2 | ≤20 | Generally invited |
| Uncover This Tech Term | ≤1000 words | No abstract | ≤2 | ≤20 | Title format: "Uncover This Tech Term: xxx" |
| Emerging Rad Dx | ≤1000 words | No abstract | ≤2 | ≤20 | Explains novel or emerging diseases/conditions |
| Letter to the Editor | ≤800 words | No abstract | ≤2 | ≤10 | Unstructured without section headings |

**Figure counting rule (PDF p.3 footnote):** A figure may contain multiple parts; **Fig. 1A-C and Fig. 2A-D are counted as two figures, not seven.** Use figure parts or composite figures appropriately to avoid an excessive number of figures.

---

## Abstract Requirements (Original Article and Brief Research Report)

**Structured abstract, ≤300 words:**

```
Objective: [Study aim]
Materials and Methods: [Design, population, index test, reference standard, statistics]
Results: [Key findings with absolute numbers and/or rates, with 95% CIs or P values]
Conclusion: [Main conclusion — must be consistent with Objective]
```

Notes:
- Objective and Conclusion must use the same wording and be consistent with the main text
- Results must present actual numerical data; not statistical indicators alone
- Reference citations are not allowed in the abstract
- Abbreviations should be minimized; if used, define within the abstract at first use

---

## Required Sections (Original Article)

KJR uses IMRAD structure with KJR-specific section naming:

1. **Introduction**
2. **Materials and Methods** (not "Methods")
   - Ethics approval and informed consent statement required at the start
3. **Results**
4. **Discussion**

---

## Ethics Statement

**Human subjects:**
> "This study was approved by the Institutional Review Board of [Institution] (approval number: [XXX]), and the requirement for informed consent was [waived/obtained from all participants] because of the [retrospective nature of the study / prospective design]."

**Animal studies:**
> "All animal experiments were approved by the Institutional Animal Care and Use Committee of [Institution] (approval number: [XXX])."

---

## AI Policy (KJR "Ethical and Responsible Use of Generative AI")

Source: KJR-Instructions-202603.pdf p.2; https://doi.org/10.3348/kjr.2026.0166

- AI tools must not be listed as authors or cited as a primary scholarly source
- Authors remain fully responsible and accountable for all submitted content and shall be accountable for any ethical or legal breach
- AI use beyond routine linguistic assistance must be clearly disclosed, with sufficient detail, in the relevant section of the manuscript or in the Acknowledgments
- When AI itself is the subject of investigation, its use must be explicitly described in the Materials and Methods section
- Reviewers and editors must safeguard the confidentiality of unpublished manuscripts. Uploading manuscript content or review text to AI services is prohibited unless confidentiality can be reliably assured
- Reviewers and editors may use AI tools for non-core, assistive purposes under their supervision; core human reviewer functions must not be delegated to AI
- Reviewers and editors who use AI tools beyond routine linguistic assistance must disclose such use to the journal

---

## Statistical Reporting

- Use 12-point font, double-spaced, 3-cm margins (A4 or letter)
- Report P values to three decimal places (0.xxx); P < 0.001 reported as "P < 0.001"
- Do not use more than one decimal place for percentages (x.x%, not x.xx%)
- Write large numbers with commas separating every three digits (e.g., 123,456,789)
- 95% confidence intervals required for primary outcomes
- Results must present absolute numbers and/or rates with appropriate indicators of statistical uncertainty (95% CIs or P values)

---

## Figure Requirements

- **Initial submission:** Embed images in the Word file as JPG/JPEG immediately following relevant figure legends
- **Revised submission:** Upload images as separate JPG/JPEG (high-quality) or TIF/TIFF files; PNG not accepted
- **Resolution:** At least 300 dpi; minimum 3 inches, maximum 7 inches in width and height after cropping
- **Multi-part figures:** Use English letters after numerals (Fig. 1A, 1B, 1C); match figure number with image file name (e.g., Fig_1A.jpg)
- **Figure number rule:** Composite/multi-part figures are counted by figure number, not by parts (Fig. 1A-C + Fig. 2A-D = 2 figures, not 7)
- **Anonymization:** Remove all patient names and identifiers; remove all author/institution identifiers
- **Color:** Online publication is in color; design figures interpretable in print if applicable
- Written permission required for previously published figures

---

## References

- Vancouver style; numbered consecutively in order of citation in the text
- **First six authors listed, then "et al."** (≥7 authors). When 6 or fewer, list all authors. (PDF p.4 explicit)
- Journal names abbreviated per Index Medicus
- Inclusive page numbers (e.g., 111-114)
- Unpublished data: cite parenthetically in text, not in reference list

Example (PDF):
> Park C, Kim JH, Kim PH, Kim SY, Gwon DI, Chu HH, et al. Imaging predictors of survival in patients with single small hepatocellular carcinoma treated with transarterial chemoembolization. *Korean J Radiol* 2021;22:213-224

---

## Common Rejection Reasons

1. **Single-center study with small N** — KJR increasingly prefers multi-center or larger single-center series
2. **Insufficient clinical relevance** — must explain "so what?" for Korean (or broader Asian/global) clinical practice
3. **Incomplete ethics documentation** — IRB number required; missing institutional details cause desk rejection
4. **Poor English language** — KJR provides language editing services but strongly prefers professionally edited manuscripts at submission
5. **Replication without added value** — replicating a Western study in a Korean cohort is acceptable only if the Korean context adds new knowledge

---

## Technical-Check Conventions (pre-peer-review desk check)

KJR runs a production "technical check" *before* peer review and **"unsubmits"** a manuscript that fails these deterministic items (it returns to the author's queue — not a reject — and delays review). Clear all of them before submitting:

1. **Float citation order.** Tables, Supplementary Tables, and Figures must each be **cited in ascending numerical order of first appearance** in the text (Table 1 before Table 2; Supplementary Table S1 before S2; …). This is the most-missed item: an analysis table cited in Methods before the baseline Table 1, or supplementary tables left in authoring order rather than citation order, triggers an unsubmit. Run `/self-review`'s `check_citation_order.py`. Fix by renumbering the series by first-citation order (reorder the supplement + remap every cross-reference, expanding ranges like "S12–S15" by hand and leaving non-float sensitivity labels like "S1–S6" untouched).
2. **Demographics location.** State the **number, age, and sex** of included patients in **Materials and Methods** — in both the abstract and the body — not introduced first in Results.
3. **Percentages to one decimal** (35.1%, not 35.14%); P to three decimals; commas in large numbers (see Statistical Reporting). `check_classical_style.py` flags `PERCENT_DECIMALS`.
4. **Double line spacing** throughout the Word file (12-pt, ~3-cm margins).
5. **Tables and figures at the end** of the Main Document, in order, **each table on its own page**; every figure has a title (legend). Initial submission embeds figures + tables in the Main Document.
6. **Acknowledgments, Funding, and Author Contributions on the Title Page only** — not in the (blinded) main body.
7. **Reporting checklist** (STROBE/PRISMA/CONSORT) uploaded as a supplementary file and cited in the text as **"Supplementary Material 1"**.
8. **IRB approval number in Materials and Methods even under double-blind review** — KJR requests it for transparency; keep the IRB number while blinding the institution name.
9. **ICMJE COI forms are collected only after acceptance** — do not upload them at initial submission (delete them from the portal if already uploaded).

Verify these technical-check requirements against the current journal instructions before submission.

---

## Positioning

KJR is well-suited for:
- Korean single-center or multi-center studies
- Studies on Korean patient populations (gastric cancer, hepatocellular carcinoma, thyroid cancer — prevalent in Korea)
- AI/radiomics studies with clinical validation
- Studies that may not reach the impact threshold of higher-tier journals but are methodologically sound
- Faster time to publication than European or American journals

**Typical timeline:** Minor Revision must be submitted within 30 days of decision; Major Revision within 60 days. Withdrawal not allowed after "under review" status entered.

---

## Author Guidelines URL

https://www.kjronline.org/index.php?body=Instruction

---

## Submission Files Checklist (KJR portal)

- Cover letter
- Full Title Page (separate Word file, KJR template recommended)
- Main Document (blinded, single Word file): blinded title page, structured abstract, ~5 keywords, body text, references, tables, figure legends
- Supplement (separate Word document if applicable)
- Figures: JPG/JPEG embedded for initial submission; separate JPG/JPEG/TIF/TIFF for revision
- ICMJE COI Disclosure Form (per author, requested by journal after acceptance)
- Statement of ethical approval and informed consent at start of Materials and Methods

---

## Formatting Notes

- Manuscript in Microsoft Word format (doc or docx); not PDF
- 12-point font, double-spaced on A4 or letter paper, ~3-cm margins
- Do not number pages or lines manually (auto-generated on conversion)
- SI units throughout (NCRP Report 82, JAMA 1986;255:2329-2339)
- Abbreviations: define at first use; minimize use
- Korean author names: use full author name (first, middle if exists, last); not initials
- Authors should describe sex/gender appropriately; race/ethnicity must be justified
- Geographic information (city, country) not required for commercial products

---

## Verification

- **Source:** KJR-Instructions-202603.pdf (March 2026 official author instructions)
- **Date:** 2026-05-21
- **Notes:** Previous profile spec values were corrected against the canonical PDF: body word limit reduced (4000 → 3000), abstract limit raised (250 → 300), figure cap reduced (8 → 7), and a non-existent "Key Messages" requirement was removed. Missing article types (Brief Research Report, Pictorial Essay, Focus, Recommendation and Guideline, Editorial, Uncover This Tech Term, Emerging Rad Dx) were added. This retrofit aligns with the canonical PDF.

- **AI-use disclosure placement**: Relevant manuscript section or Acknowledgments
  <!-- machine-read by /self-review check_classical_style.py --profile; source: this profile's own "AI use beyond routine linguistic assistance must be clearly disclosed, with sufficient detail, in the relevant section of the manuscript or in the Acknowledgments" -->

# Journal Profile: Korean Circulation Journal (KCJ)

## Journal Identity

- **Full name**: Korean Circulation Journal
- **Abbreviation**: Korean Circ J
- **Publisher**: The Korean Society of Cardiology / The Korean Cardiac Research Foundation
- **ISSN**: 1738-5520 (print) / 1738-5555 (online)
- **Frequency**: Monthly
- **Impact Factor**: ~2.5 (recent JCR; verify at submission)
- **Open Access**: Open Access, peer-reviewed
- **Peer review**: Single-blind; methodology review where applicable

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | References | Figures/Tables |
|------|----------------|----------|------------|----------------|
| Original Research | 5,000 words | 250 (structured) | not separately capped | ≤8 figures/tables combined |
| State of the Art Review | 10,000 words | 250 (unstructured or structured) | not separately capped | varies |
| Perspective | 2,000 words | 150 (unstructured) | varies | ≤4 figures/tables |
| Image in Cardiovascular Medicine | per portal | none | minimal | ≤2 images |
| Research Letter | 800 words | none | 10 max | 1 figure/table |
| Letter to the Editor | 500 words | none | 5 max | minimal |

Word counts exclude abstract, references, tables, and figure legends.

---

## Abstract Requirements

**Structured abstract for Original Research, 250 words maximum, with 4 headings:**

```
Background and Objectives: [Context, knowledge gap, specific aim]
Methods: [Design, setting, population, exposures, outcomes, statistical approach]
Results: [Primary results with effect sizes, 95% CIs, P values; N analyzed]
Conclusions: [Direct answer to Objectives with clinical implication]
```

The merged "Background and Objectives" heading is a KCJ-specific stylistic choice (mirrors the Korean society practice). Reviewers check this heading exactly.

---

## Required Journal-Specific Elements

### 1. Central Figure / Graphical Abstract (optional)

Encouraged for Original Research; uploaded as a separate file at submission.

### 2. Article Information

- Author affiliations with department, institution, city, country
- Corresponding author full contact details (KCJ portal asks for both email and ORCID)
- Funding statement with grant identifiers
- Disclosures: per-author ICMJE conflicts
- Data availability statement
- Ethical statement (IRB or equivalent + informed consent)
- Korean and English titles (typeset side-by-side on title page for Korean authors)

---

## Required Sections (Original Research)

1. **Introduction** — 2–3 paragraphs ending with clear objectives
2. **Methods**
   - Ethics approval with body name + Korean IRB approval number where applicable
   - Study design and setting
   - Participants and eligibility
   - Variables / definitions
   - Outcomes (primary, secondary, exploratory clearly distinguished)
   - Statistical analysis with software and versions
3. **Results** — STROBE/CONSORT flow; primary outcome before secondary
4. **Discussion** — Strengths and Limitations sub-paragraphs; conclude with implications, especially for Korean and Asia-Pacific clinical practice
5. **Conclusions** — brief; avoid overclaiming

---

## Statistical Reporting

- Exact P values to 3 decimal places (P < 0.001 below threshold)
- 95% CI for all primary effect estimates
- Effect sizes appropriate to design (HR, OR, mean difference, AUC)
- Proportional-hazards assumption check (Schoenfeld) when Cox is used
- Sensitivity analyses for major analytic choices
- Software and version reported

---

## Figures

- **Maximum 8 figures/tables combined** for Original Research
- Resolution: 300 DPI minimum
- Format: TIFF, EPS, PDF, or high-quality PNG
- Color: encouraged (no fee for online publication)
- Supplementary material: online-only supplement permitted

---

## Common Rejection Reasons

1. **Insufficient Korean / Asia-Pacific clinical relevance** — manuscripts written purely as Western-style cohort studies without local context lose competitive edge
2. **Single-center retrospective without external validation** — preferred design is multicenter or population-based
3. **Methodology gaps** — missing PH check for Cox, missing competing-risks framework when applicable
4. **Overclaiming on observational data** — wide-CI estimates without exploratory qualifier
5. **Abstract heading mismatch** — using Background/Methods/Results/Conclusions instead of Background and Objectives/Methods/Results/Conclusions
6. **Korean–English title mismatch on title page** — Korean authors expected to provide both, side-by-side
7. **AI policy unclear** — KCJ does not publish a journal-specific AI policy on the Instructions page; authors should default to ICMJE-aligned disclosure and contact the editorial office for clarification

---

## Cover Letter

Must include:
- Brief statement of novelty and Korean / Asia-Pacific clinical relevance
- Confirmation manuscript is not under consideration elsewhere
- Confirmation all authors meet ICMJE criteria
- Disclosure of related manuscripts (same cohort, same group)
- Suggested reviewers (3–5; senior PI curates)
- AI disclosure statement (defensive: include even though the journal does not enforce a specific format)

---

## AI Writing Disclosure Policy

- **Requirement level**: Not explicitly stated on the journal's Instructions for Authors page as of the audit date
- **Recommended default**: ICMJE-aligned disclosure — declare any AI use beyond routine language assistance in a Methods or Acknowledgments section; AI cannot be listed as author
- **Editorial office contact**: For author-policy clarification, refer to the journal editorial office via the submission portal contact form
- **Policy URL**: not separately published; default to ICMJE recommendations

---

## Submission Portal

https://kcj.edmgr.com

---

## Author Guidelines URL

https://e-kcj.org/index.php?body=instructions

---

## Positioning

| Criterion | KCJ | Korean Journal of Internal Medicine (KJIM) | JACC: Asia | JAHA |
|-----------|-----|--------------------------------------------|------------|------|
| **Society** | Korean Society of Cardiology | Korean Association of Internal Medicine | ACC (Asia-Pacific focus) | AHA |
| **Impact Factor** | ~2.5 | ~2.4 | not indexed yet | ~5 |
| **Open Access** | Open Access | Full OA (CC BY-NC, APC USD 1,000) | Full Gold OA | Full Gold OA |
| **Geographic stance** | Korean / Asia-Pacific | Korean / East Asian (internal medicine breadth) | Asia-Pacific anchor | Global, NA-centric |
| **Primary framing** | Cardiology — Korean society flagship | Internal medicine — Korean society flagship | Asia-Pacific cardiology | Cardiovascular broad |
| **Event-count tolerance** | Moderate; cascade-friendly target | Moderate; cascade-friendly target | Moderate (Asia-Pacific data privileged) | Moderate–high |
| **Abstract first heading** | Background and Objectives | Background/Aims | Background | Background |
| **Word cap (Original)** | 5,000 | varies (Korean-style) | 5,000 | none stated |
| **AI policy** | Not on Instructions page | Acknowledgments verbatim (KJIM-specific) | ACC/Elsevier | AHA family-wide |

**Choose KCJ when:**
- Korean cardiovascular cohort paper needs a guaranteed publication path and KSC community visibility
- Cascade safety-net target after rejection from higher-IF cardiology journals
- Korean clinical-practice relevance is the dominant framing
- Authors prefer the Korean Society of Cardiology editorial relationship

**Choose KJIM instead when:**
- The manuscript spans internal medicine subspecialties beyond pure cardiology
- KAIM ecosystem visibility matters more than KSC

**Choose JACC: Asia instead when:**
- Asia-Pacific regional contribution is the dominant framing (broader than Korea-specific)
- ACC ecosystem visibility and Full Gold OA matter

**Choose JAHA instead when:**
- Cross-modality cardiovascular–cerebrovascular framing
- Higher IF and AHA family alignment matter
- Negative or hypothesis-generating findings benefit from JAHA's tolerance

---

## Verification

- **Source (compact harvest):** local profile library (2026-05 fetch from https://e-kcj.org/index.php?body=instructions)
- **Source (detail authored):** based on harvested compact + KSC standard practice + ICMJE-aligned defensive defaults for AI policy
- **Date (promoted to public):** 2026-05-21
- **Notes:** AI policy is not published on the Instructions page; authors should default to ICMJE disclosure. Verify IF and APC directly on the journal site at submission.

- **AI-use disclosure placement**: Methods or Acknowledgments
  <!-- machine-read by /self-review check_classical_style.py --profile; source: this profile's own "declare any AI use beyond routine language assistance in a Methods or Acknowledgments section" -->

# Journal Profile: Korean Journal of Internal Medicine (KJIM)

## Basic Information

- **Publisher:** Korean Association of Internal Medicine
- **Impact Factor:** [TODO: verify at journal site — typically reported in JCR]
- **ISSN:** 1226-3303 (print) / 2005-6648 (online)
- **Frequency:** Bimonthly (January, March, May, July, September, November)
- **Scope:** All subspecialties of internal medicine — endocrinology, gastroenterology, hematology-oncology, infectious diseases, nephrology, pulmonology, rheumatology, cardiology, geriatrics — with emphasis on Korean and East Asian clinical research
- **Open Access:** Yes — CC BY-NC reuse policy; PubMed Central indexed
- **APC (Article Processing Charge):** $1,000 USD (₩1,000,000 KRW) for Original Articles; $300 USD (₩300,000 KRW) for Images of Interest; no charge for Correspondence (effective 2024-10-01)
- **Language:** English only for manuscripts

---

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | Figures/Tables | References | Authors |
|------|----------------|----------|----------------|------------|---------|
| Original Article | No specified maximum | 250 words (structured) | Not specified | Not specified | No limit |
| Review | 7,500 words (excluding refs/tables/figures) | 200 words (unstructured) | Not specified | Not specified | No limit |
| Editorial | 2,000 words (excluding refs/tables/figures) | None | Not specified | Not specified | No limit |
| Images of Interest | 300 words total | None | 2 figures max | Not specified | Max 5 |
| Correspondence | 500 words (excluding refs) | None | Not specified | 5 references max | No limit |

---

## Abstract Requirements

**Structured abstract** (Original Articles) — 250 words, four required sections:

```
Background/Aims: [Rationale and primary objective]
Methods: [Design, population, intervention/exposure, comparator, outcome]
Results: [Key findings with statistics and 95% CIs]
Conclusions: [Main interpretation]
```

**Keywords:** Up to 5 keywords; should refer to Index Medicus Medical Subject Headings (MeSH).

**Unstructured abstract** (Reviews) — 200 words, single paragraph.

---

## Required Sections (Original Article)

1. **Title page**
2. **Abstract and keywords**
3. **Introduction**
4. **Methods**
5. **Results**
6. **Discussion**
7. **Key Message** (KJIM-specific brief take-home statement)
8. **Acknowledgments**
9. **References**
10. **Tables**
11. **Figure legends**

Note: KJIM requires an explicit "Key Message" section — a brief summary of the clinical implication, similar in spirit to the Key Points format used by other journals.

---

## Ethics Statement

**Human subjects (Korean institutional template):**
"This study was approved by the Institutional Review Board of [Institution] (approval number: [XXX]); the requirement for informed consent was [waived because of the retrospective nature of the study / obtained from all participants for prospective enrollment]."

**Animal studies:** Approval from Institutional Animal Care and Use Committee (IACUC) required with approval number.

---

## Statistical Reporting

- "Methods of statistical analysis and criteria for statistical significance should be described."
- p-value format: [TODO: verify at journal site — recommend exact p-values with p < 0.001 below that threshold per ICMJE convention]
- 95% confidence intervals: [TODO: verify — strongly recommended for primary outcomes per general medical-journal convention]
- Statistical software and version: [TODO: verify — recommend stating software + version per ICMJE convention]

---

## Figure Requirements

- **Resolution:** 600 DPI (color figures); 1,200 DPI (line art and graphs)
- **Format:** EPS or TIF preferred; JPEG accepted for color figures
- **Color:** accepted
- **Maximum count:** Not specified at the article-type level — use judgment by manuscript type

---

## Common Rejection Reasons

1. **Insufficient clinical relevance for internal medicine readership** — radiology-heavy or imaging-only studies must explicitly translate findings into internal-medicine practice implications
2. **Single-center study with small N** — multi-center designs or representative national-cohort data preferred for Original Articles
3. **Missing Key Message** — reviewers check for this section; vague or missing Key Message signals a weak clinical take-home
4. **Incomplete ethics documentation** — IRB number, approval statement, and informed-consent statement all required
5. **Poor English language quality** — Korean Association of Internal Medicine expects professionally edited English at submission
6. **AI use not disclosed in Acknowledgments** — undisclosed AI use is grounds for desk rejection

---

## AI Writing Disclosure Policy

- **Requirement level:** Required (mandatory disclosure)
- **Permitted scope:** AI may assist in writing; AI cannot be listed as an author
- **Disclosure location:** Acknowledgments section — must include "specific technical details about the AI model used, including its name, version, source, and the method of application"
- **AI-generated images:** Not specified on page (recommend following ICMJE / COPE general guidance — avoid AI-generated images or disclose explicitly)
- **Policy URL:** https://www.kjim.org/authors/authors.php

---

## Cover Letter

Required. Must include:
- Statement that "neither the submitted material nor portions thereof have been published previously or are under consideration for publication elsewhere"
- Statement of any potential conflict of interest
- Brief justification of fit with KJIM scope (internal-medicine clinical relevance)

---

## Open Access and APC

- **CC BY-NC reuse policy** (non-commercial reuse permitted)
- **APC (effective 2024-10-01):**
  - Original Article: $1,000 USD (₩1,000,000 KRW)
  - Images of Interest: $300 USD (₩300,000 KRW)
  - Correspondence: free
- PubMed Central indexed (open-access full-text deposit)

---

## Peer Review

- **Type:** Single-blind (reviewer identities anonymized; author identities visible)
- **Number of reviewers:** Not specified on page
- **Initial decision turnaround:** Within 4 weeks of receipt (per journal statement)

---

## Author Guidelines URL

https://www.kjim.org/authors/authors.php

---

## Positioning

KJIM is well-suited for:
- Korean and East Asian internal-medicine clinical research
- Cross-disciplinary studies that connect imaging or laboratory findings to internal-medicine practice
- Cohort studies with explicit Korean health-screening or NHIS-based data
- Smaller single-center observational studies that may not reach radiology-specific or specialty-journal thresholds but have clear internal-medicine relevance
- Faster initial decision (4 weeks) than many Western general-medicine journals

| Dimension | Korean Journal of Internal Medicine | Yonsei Medical Journal | Journal of Korean Medical Science |
|-----------|--------------------------------------|------------------------|-----------------------------------|
| Society | Korean Association of Internal Medicine | Yonsei University College of Medicine | Korean Academy of Medical Sciences |
| Scope | Internal medicine (general) | All medical specialties | All medical specialties |
| Korean focus | Strong | Strong | Strong |
| Open Access | Full OA (CC BY-NC) | Full OA | Full OA |
| Indexing | PubMed/PMC, Scopus | PubMed/PMC, SCIE, Scopus | PubMed/PMC, SCIE, Scopus |
| Article emphasis | Internal-medicine clinical research | Cross-disciplinary medical research | Korean medical science (broad) |

---

## Formatting Notes

- References: Vancouver style (numbered, superscripted)
- Units: SI units
- Abbreviations: define at first use; avoid excessive abbreviations
- Korean author names: provide in English; affiliation addresses should include full postal address
- "Key Message" section is mandatory — do not omit


---

## Verification
- **Source:** https://www.kjim.org/authors/authors.php
- **Date:** 2026-05-21

- **AI-use disclosure placement**: Acknowledgments
  <!-- machine-read by /self-review check_classical_style.py --profile; source: this profile's own "AI use not disclosed in Acknowledgments — undisclosed AI use is grounds for desk rejection" -->

# Journal Profile: Lancet Gastroenterology & Hepatology

## Journal Identity
- **Full name:** The Lancet Gastroenterology & Hepatology
- **Abbreviation:** Lancet Gastroenterol Hepatol
- **Publisher:** Elsevier (The Lancet Group)
- **ISSN:** 2468-1253
- **Frequency:** Monthly
- **Open Access:** Hybrid (OA optional; APC ~US$5,500 for Gold OA — verify)
- **Acceptance rate:** ~5–8 % overall (Lancet specialty journals; ~60–70 % desk-rejected before peer review)
- **Peer review:** Single-blind by ≥ 2 external reviewers + Lancet Group statistical review; portable peer review available across Lancet specialty journals.

## Manuscript Types and Word Limits

Submission guidelines are a near-verbatim shared template across the Lancet Group specialty journals (this profile uses Lancet Diabetes & Endocrinology as the structural reference and adds the LGH-specific non-guideline content below).

| Type | Body Word Limit | Abstract | References | Figures/Tables |
|------|----------------|----------|------------|----------------|
| Articles (Original Research) | 3,500–4,500 | 300 words structured | 30 | 5 |
| Review | 4,000–5,000 | 200 words | 100 | 5 |
| Series | 5,000–8,000 (commissioned) | per series | per series | per series |
| Seminar | 5,000–6,000 | 200 words | 80 | 4–5 |
| Comment | 1,200–1,800 | — | 15 | 1 |
| Correspondence | 350–500 | — | 5 | — |
| Clinical Picture | 250 | — | 5 | 1 |
| Viewpoint / Personal View | 2,000–3,000 | 200 words | 30 | — |

## Abstract Requirements
**Articles (Original Research):** 300 words, structured under five sub-headings — **Background**, **Methods**, **Findings**, **Interpretation**, **Funding**. Trial registration number on the same page when applicable.

## Required Sections (Article)
1. **Title page** (≤ 30 words; complete authors + degrees + affiliations; corresponding author; word counts)
2. **Abstract** (300 words, 5-section structured)
3. **Research in Context** box (separate from abstract; mandatory at acceptance, recommended at first submission)
   - Evidence before this study (search strategy + dates)
   - Added value of this study
   - Implications of all the available evidence
4. **Introduction** (concise, no literature review)
5. **Methods** (sufficient for reproduction; cite reporting guideline + statistical methods; pre-registration / protocol cited)
6. **Results**
7. **Discussion** (limit to ~1.5 × abstract length; no separate Conclusions section)
8. **Contributors** (CRediT taxonomy)
9. **Declaration of interests**
10. **Data sharing statement** (mandatory; specifies what data, code, and protocols will be shared and how)
11. **Acknowledgements**
12. **References** (Lancet style; ≤ 30 for Articles)
13. **Tables and Figures** (separate)

## Statistical Reporting
- Pre-specified primary outcome and analysis plan must be cited (clinical-trial registration, protocol, or pre-print).
- 95% CI mandatory for primary effect estimates; exact p-values to 2–3 sig figs (p < 0.0001 below threshold).
- All clinical trials must include CONSORT flow diagram; observational studies STROBE; SR/MA PRISMA; diagnostic accuracy STARD.
- Statistical software, version, and any custom code disclosed; code must be deposited at acceptance.
- Sex/gender, race/ethnicity reporting per ICMJE.

## Figures
- ≤ 5 figures + tables combined for Articles.
- Lancet figure style enforced (sans-serif, no chartjunk, color-blind safe palette).
- Resolution ≥ 300 dpi (halftone) / ≥ 1,200 dpi (line art).
- Figure legends complete at acceptance (caption + abbreviations + statistical details).
- Forest plot / KM curve / flow diagram / funnel plot — Lancet-house style retouch routinely applied at copy-edit stage.

## Common Rejection Reasons
1. **Desk reject for scope (60–70 %)** — single-cohort or single-centre studies without explicit international generalizability paragraph.
2. Missing Research in Context box (returned at revision if not added).
3. Underpowered or sub-1,000 cohort observational studies (LGH Articles section is dominated by ≥ 10⁴ cohort or multi-centre trials).
4. Methodology-only papers without a "what changes practice" implications paragraph.
5. Failure to deposit data + code at acceptance per data-sharing policy.
6. Discussion exceeding ~1.5 × abstract length (Lancet house style demands brevity).
7. Cover letter missing data-sharing statement and statement of novelty.

## Cover Letter
Should include:
- Confirmation of originality and exclusivity.
- Explicit "this changes practice/guideline because…" paragraph (Lancet readership demands clinical or policy implication).
- Data-sharing statement (what / when / where / under what governance).
- Statement of novelty (1–2 sentences).
- Suggested 3–5 reviewers from ≥ 2 societies (AASLD / EASL / APASL / KASL recommended for hepatology submissions to ensure international perspective).

## AI Writing Disclosure Policy
- **Requirement level:** Required (Lancet Group ICMJE-aligned).
- **Permitted scope:** AI/LLM use disclosed in Methods + cover letter; AI cannot be author; AI-generated images must be declared and reviewed by a human author who takes responsibility.
- **Disclosure location:** Methods + Cover Letter.
- **Policy URL:** https://www.thelancet.com/lanchepa/information-for-authors

## Author Guidelines URL
https://www.thelancet.com/langas/information-for-authors

Submission portal: https://www.editorialmanager.com/thelancet-gh
Editor email: editor@lancet.com (used for pre-submission inquiries)

## Non-Guideline Editorial Culture (verified from prior submissions, 2024–2025)

### Pre-submission inquiry strongly advised
- ~60–70 % desk-reject rate. Pre-submission inquiry route: 1-page lay summary + abstract + cover letter + 3 key references + 3-line statement of novelty, emailed to editor@lancet.com.
- Decisions on inquiries typically arrive within 5–10 working days. Negative inquiry response saves 4–6 weeks vs full submission desk-reject.

### Reviewer pool
- Substantial overlap with Hepatology (AASLD), Journal of Hepatology (EASL), Hepatology International (APASL), Hepatology Communications, and Liver International. Suggesting reviewers from at least two of those venues is conventional.

### "Changes practice" framing
- Articles section is curated for evidence that *can change a guideline or clinical pathway*. Methodology-only papers (e.g., comparator-refinement methods) need an explicit "Implications of all the available evidence" paragraph showing how the method, if adopted, will revise existing risk estimates in the literature.

### MASLD natural history precedent
- Hagström L et al. (Lancet Gastroenterol Hepatol, 2024) is the de-facto reference natural-history systematic review post-2023 nomenclature, and the journal has subsequently been the home venue for MASLD natural-history evidence. Korean health-screening cohort papers fit the line of evidence when the international generalizability claim is explicit.

### Korean-cohort caveat
- Single-centre Korean cohort studies are accepted, but documented preference for *multi-cohort or international* validation. Cover letter and Discussion should pre-empt the "Asian-only single-centre" reviewer concern by referencing planned external validation (NHANES, UK Biobank, multi-society parallel analysis).

### Practical timing
- Articles section first decision target ~3 weeks (Lancet promise). Full peer-review cycle to first decision typically 4–6 weeks. Time to acceptance after revision: 2–4 months. Production: ~4–8 weeks to online publication.

## Positioning

**When to submit here.** Large-cohort or multi-centre MASLD natural-history evidence with explicit guideline-revision implications, evidence-synthesis (Cochrane-style or IPD meta-analysis), and methodology contributions that, if adopted, would change how published natural-history rates are interpreted (e.g., comparator-refinement methodology). The journal is a primary destination for evidence the authors believe should change KASL / EASL / AASLD guidance.

**When NOT to submit here.** Single-cohort studies whose contribution is descriptive rather than guideline-changing. Methodology papers without clinical-policy implication. Time-sensitive submissions where ~60 % desk-reject probability is unacceptable.

| Dimension | Lancet GH | Hepatology (AASLD) | J Hepatol (EASL) | Liver International |
|---|---|---|---|---|
| Society | Lancet Group / Elsevier | AASLD | EASL | independent (Wiley) |
| Tier | Q1 (top of GI+Hep specialty) | Q1 | Q1 | Q1 |
| OA model | Hybrid | Hybrid | Hybrid | Hybrid |
| Acc. rate (est.) | ~5–8 % | ~10–15 % | ~10–15 % | ~20–25 % |
| Pre-submission inquiry | Strongly advised | Optional | Optional | Not used |
| Research in Context box | Mandatory | Optional | Optional | Optional |
| Ideal cohort size (Articles) | ≥ 10⁴ or multi-centre | ≥ 10³ | ≥ 10³ | ≥ 5×10² |

- **AI-use disclosure placement**: Methods + cover letter
  <!-- machine-read by /self-review check_classical_style.py --profile; source: this profile's own "AI/LLM use disclosed in Methods + cover letter; AI cannot be author" -->

# Journal Profile: Liver International

## Journal Identity

- **Full name**: Liver International
- **Abbreviation**: Liver Int
- **Publisher**: John Wiley & Sons
- **ISSN**: 1478-3223 (print), 1478-3231 (online)
- **Frequency**: Continuous Publication (no issue pagination; articles published as ready with final citation)
- **Impact Factor**: [VERIFY at JCR — Q1 hepatology consistent]
- **Open Access**: Hybrid (standard copyright OR Creative Commons under OA fee; APC applies when OA chosen). >9 published pages = GBP 100/page (excess), unless fully OA.
- **Acceptance rate**: [VERIFY at journal site]
- **Peer review**: Single-blind; 2 independent reviewers plus Editors; early rejection without external review permitted; Peer Review Transparency pilot via Publons (opt-out during submission)
- **Verification date**: 2026-05-21 (author-guidelines PDF); submission mechanics verified in-portal 2026-06

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | References | Figures/Tables |
|------|----------------|----------|------------|----------------|
| Original Article | 5,000 (incl. title page, abstract, lay summary, main text; excl. refs/figs/tables/legends) | 250 words **structured** (Background & Aims, Methods, Results, Conclusions) | 50 | 8 (max 6 panels each) |
| Systematic Review / Meta-Analysis | 6,000 (incl. title page, abstract, key points, main text; excl. refs/figs/tables) | 250 **structured** (same headings as Original) | 50 | 4 (Key Points box mandatory, ≤5 bullets ≤100w) |
| Brief Definitive Report | 3,000 (incl. title page, abstract, main text, refs) | 150 unstructured | 20 | 2 |
| Review Article | 5,000 recommended / 6,000 upper limit (incl. title page, abstract, key points, main text; excl. refs/figs/tables) | 250 unstructured | 150 | Tables/figures encouraged; **Key Points box mandatory** (≤5 bullets ≤100w) |
| Mini-Review | 4,000 (incl. title page, unstructured abstract, key points, main text; excl. refs/fig legends/tables) | 250 unstructured | 30 | 2 (Key Points box mandatory ≤5 bullets ≤100w) |
| Research Letter | 1,500 | None | 10 | 2 (max 10 authors) |
| Editorial | 1,500 | None | 20 | 1 (highly recommended) |
| Letter to the Editor | 400 (main text only; about a paper published in Liver Int within 6 months) | None | 5 | 1 (max 4 authors; case reports auto-rejected) |
| Liver International Images | 250 (short description) | — | 5 | — (max 4 authors) |

**Lay Summary**: 2–3 sentences in plain English, mandatory on revised manuscripts (encouraged at initial submission) for Original Articles.

**Key Points box**: max 5 bullet points, ≤100 words total — mandatory for Systematic Reviews / Meta-Analyses and Review Articles.

---

## Abstract Requirements

Original Article: 250 words, **structured**:

```
Background & Aims:
Methods:
Results:
Conclusions:
```

No abbreviations, footnotes, or references in abstract. Electronic word count must be provided at the end of the abstract.

---

## Required Sections (Original Article)

Main text file order:

1. **Title** (max 130 characters, no abbreviations)
2. **Full names of all authors**
3. **Institutional affiliations** (superscript numerals, footnote for author changes)
4. **Keywords**
5. **Abstract** (structured, 250 words)
6. **Lay Summary** (2–3 sentences plain English; mandatory on revision)
7. **Introduction**
8. **Methods**
9. **Results**
10. **Discussion**
11. **Acknowledgments**
12. **Conflict of Interest Statement**
13. **Funding** (title page)
14. **References**
15. **Tables** (each with title and footnotes; max 10 columns; portrait orientation)
16. **Figure legends**
17. **Appendices** (if any, separate files)

**Reporting-guideline compliance is enforced**:
- Observational studies: STROBE
- Systematic reviews / MA: PRISMA (checklist required as supplement; failure → automatic rejection)
- Diagnostic / prognostic: STARD
- RCTs: [TODO: verify CONSORT expectation]
- Animal: ARRIVE
- Qualitative: SRQR
- Quality improvement: SQUIRE
- Economic: CHEERS
- Study protocols: SPIRIT
- Practice guidelines: AGREE

Clinical trial registration is **mandatory** — unregistered trials are not accepted. Trial register name and registration number must appear at the end of the abstract.

---

## Statistical Reporting

- Statistical measures (SD, SEM) must be identified in table headings
- Footnote symbols in tables: †, ‡, §, ¶ (in that order); *, **, *** reserved for P-values
- Descriptive research or methodology papers without clinical/translational relevance are not considered — statistical analyses must serve a clinical or mechanistic question
- P-value format not explicitly specified in AGL; default convention applies — report exact P-values to 2–3 significant figures; use P<0.001 below that threshold; 95% CI for primary outcomes; state statistical software and version

---

## Figures

- **Maximum**: 8 figures/tables combined (Original Article); max 6 panels per figure
- **Resolution**: .eps at minimum 800 dpi (graphs/charts) OR .tiff at minimum 300 dpi (photographs / mixed)
- **Orientation**: portrait, actual print size
- **Column widths**: 8.5 cm (one column) or 17.5 cm (two columns); height up to 23.5 cm
- **Color**: permitted; separate files for multi-part figures
- **Tables**: portrait orientation only; must be editable files (not JPG/TIFF); max 10 columns

---

## Common Rejection Reasons

1. Purely descriptive research or methodology papers without clinical/translational significance (explicit journal statement — grounds for auto-rejection)
2. Missing or retrospective clinical trial registration
3. Missing PRISMA checklist for systematic reviews / meta-analyses (auto-rejection)
4. Case reports (explicitly not accepted; rejected without review)
5. Poor English quality (Editors reserve right to reject on language grounds alone)
6. Authorship irregularities not meeting ICMJE 4-criteria
7. Exceeding word / reference / figure limits
8. Missing lay summary on revision

---

## Cover Letter

Cover letter is **required** with all submissions. Should include:
- Strengths of the manuscript (short positioning)
- Any commercial relationships (consultancies, patent-licensing) that might pose conflict of interest — with full details of the entity, address, and financial disclosure when applicable
- Statement that the manuscript is not published or under consideration elsewhere
- Corresponding author contact information with ORCID iD

---

## AI Writing Disclosure Policy

- **Requirement level:** Required — Liver International follows Wiley's AI policy, which implements ICMJE guidance (the Author Guidelines PDF does not contain a dedicated AI section; publisher-wide policy applies)
- **Permitted scope:** Disclosure of all generative AI and AI-assisted technologies used in manuscript preparation. AI tools cannot be listed as authors. Basic grammar/spelling/reference tools are exempt.
- **Disclosure location:** **Methods** (if AI was used in study/data-analysis pipeline) or **Acknowledgements** (if AI was used in drafting/editing). Specify software name, version, developer, and scope of use. (Wiley publisher-wide ICMJE policy applies; AGL itself silent on AI specifics.)
- **AI-generated images:** Not specified in the journal's author guidelines; Wiley publisher policy applies (treat as restricted unless explicit permission obtained).
- **Policy URL:** https://authors.wiley.com/author-resources/Journal-Authors/open-access/ethics/index.html (Wiley publisher-wide; redirected from authorservices.wiley.com per 2026-05-21 fetch)

---

## Author Guidelines URL

https://onlinelibrary.wiley.com/page/journal/14783231/homepage/forauthors.html

Submission: https://authors.wiley.com/journal/LIV (Research Exchange) or https://mc.manuscriptcentral.com/liverint (ScholarOne)
Editorial Office: LIVeditorialoffice@wiley.com

---

## Positioning

**When to submit here.** International hepatology cohort studies with clinical or translational significance, MASLD/NAFLD natural history, HCC prognostication, novel biomarkers with clinical validation, liver transplantation outcomes. Strong fit for Asian/European/American multi-center studies. Explicit preference for clinical relevance over purely descriptive epidemiology.

**When NOT to submit here.** Purely descriptive or methodology-only papers; case reports (auto-rejected); basic science without translational relevance; unregistered clinical trials; papers without clear clinical question.

| Dimension | Liver International | Clinical and Molecular Hepatology | Journal of Hepatology (EASL) | Alimentary Pharmacology & Therapeutics |
|-----------|--------------------|----------------------------------|------------------------------|----------------------------------------|
| Society | Wiley (independent) | KASL (Korean) | EASL (European) | Wiley (independent) |
| Scope | Clinical + experimental hepatology, international | Basic + clinical hepatology, Korean/Asian focus | Mechanistic + guideline-defining | GI/hepatology therapeutics |
| Impact factor | [verify JCR] | [verify JCR] | [verify JCR] | [verify JCR] |
| Emphasis | Clinical utility, translational, multi-disciplinary | Korean/Asian epidemiology, KASL alignment | High-impact mechanistic | Therapeutics, observational drug safety |
| OA model | Hybrid | Full OA | Hybrid | Hybrid |
| Methodology-only papers | Rejected | Case-by-case | Rejected | Rejected |
| Case reports | Rejected | Not mentioned | Rejected | Rejected |

---

## Submission Mechanics (Research Exchange / Free Format) — verified in-portal 2026-06

Liver International submits via **Wiley Research Exchange** (https://authors.wiley.com/journal/LIV), **Free Format**:

- **Initial submission needs no journal-specific reformatting.** Main manuscript may be a single file (title page + abstract + lay summary + main text + references + tables + figure legends). References may be in **any consistent style** at first submission; AMA is the journal house style for revision (see CSL below).
- **Upload slots** (no separate Title Page slot — embed title page as manuscript page 1):
  | Slot | What goes here |
  |---|---|
  | Main Manuscript (1, MS Word) | full manuscript incl. embedded tables + figure legends |
  | Figure | each figure as a separate image file if not embedded (TIFF 300 dpi / EPS 800 dpi); TIFFs are not inline-rendered in the proof — normal |
  | Table | only if tables are NOT embedded in the main document |
  | Supplementary Material for Review | supplement that will be published (e.g., Supplementary Methods + Tables) |
  | Additional File for Review but Not for Publication | reporting checklist (STROBE/etc.) — review aid, not published |
  | Cover letter / Comments | cover letter (not shown to reviewers) |
- **Reference style / CSL**: AMA-style superscript, >6 authors → first 3 + et al. Render with `/manage-refs render_pandoc.sh -j liver-international` (adds `citation_styles/liver-international.csl`: et-al-min 7, et-al-use-first 3, PMID removed, DOI kept).
- **AI disclosure**: Wiley requires AIGC tools declared **in the Methods section** with the **tool name(s)** (e.g., "Anthropic Claude", "OpenAI Codex"), not only in the cover letter. (This overrides any classical-style "no in-body AI disclosure" preference for this journal.)
- **ICMJE COI form upload is NOT required** — Wiley collects per-author COI in-portal + title page statement + cover letter. There is no COI/ICMJE upload slot.
- **Cascade resubmission** (e.g., after a different journal's rejection): portal "currently under consideration elsewhere?" = **No** (the prior submission is closed); "previously submitted to *this* journal?" = **No**. No disclosure of the prior rejection required.
- **Pitfall**: when reusing a prior version's STROBE/PRISMA/CONSORT attachment, verify the file content — a `/check-reporting` or `/self-review` **audit output is not a submission file** (it leaks "auto-fix"/JSON/compliance%/stale title). Upload only the official-format checklist. Read the compiled proof PDF to the last page (supplementary + additional files) before completing. See `submission-portal-verification.md` §9.6.

- **AI-use disclosure placement**: Methods
  <!-- machine-read by /self-review check_classical_style.py --profile; source: this profile's own "Wiley requires AIGC tools declared in the Methods section" -->

# Journal Profile: Medical Image Analysis (MedIA)

## Journal Identity

- **Full name**: Medical Image Analysis
- **Abbreviation**: Med Image Anal
- **Publisher**: Elsevier
- **ISSN**: 1361-8415 (print), 1361-8423 (online)
- **Frequency**: 8 issues/year
- **Impact Factor**: ~10.9 (JCR 2023), top-ranked in medical image computing
- **Open Access**: Hybrid (optional OA; Elsevier transformative agreements may apply)
- **Acceptance rate**: ~20%
- **Peer review**: Single-blind; associate editors with strong technical backgrounds

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | References | Figures |
|------|----------------|----------|------------|---------|
| Original Article | No strict limit (typically 8000-12000) | 200 words | No strict limit | No strict limit |
| Short Communication | 4000 words | 150 words | 30 | 6 |
| Review Article | No strict limit | 200 words | No strict limit | No strict limit |
| Position Paper | No strict limit | 200 words | No strict limit | No strict limit |

**Note**: MedIA is methods-focused with no strict word or figure limits for full articles. Papers are typically longer than clinical journals (8000-12000 words common). Quality and completeness are prioritized over brevity.

---

## Abstract Requirements

**Unstructured abstract, 200 words maximum:**

A single paragraph covering:
- Problem and clinical motivation (1-2 sentences)
- Proposed method or approach (2-3 sentences)
- Key experimental results with quantitative metrics (2-3 sentences)
- Significance or conclusion (1 sentence)

---

## Required Sections (Original Article)

1. **Introduction** — thorough literature review expected (longer than clinical journals); clear statement of contribution at end
2. **Related Work** (optional but common) — detailed comparison with prior methods
3. **Methods**
   - Mathematical formulation
   - Model architecture with diagrams
   - Training details: optimizer, learning rate, batch size, epochs, augmentation
   - Loss function
   - Implementation details
4. **Experiments**
   - Datasets: detailed description with statistics (patients, images, annotations)
   - Evaluation metrics: standard metrics for the task (Dice, AUC, FROC, etc.)
   - Comparison with state-of-the-art methods
   - Ablation study: systematic evaluation of each component's contribution
   - Cross-validation or train/val/test split details
5. **Results** — tables and figures with quantitative comparisons
6. **Discussion** — clinical relevance, limitations, failure cases
7. **Conclusion**

---

## Statistical Reporting

MedIA follows technical computing conventions rather than clinical statistical standards:
- Report all metrics with standard deviation or 95% CI across folds/runs.
- For segmentation: Dice coefficient, Hausdorff distance (95th percentile preferred), average surface distance.
- For detection: sensitivity, false positives per scan (FROC), precision-recall.
- For classification: AUC, sensitivity, specificity, accuracy, F1-score.
- Statistical significance testing between methods: paired tests (Wilcoxon signed-rank, paired t-test, DeLong for AUC comparison).
- Report results across multiple random seeds if stochastic training is involved.
- Effect of hyperparameter choices should be evaluated (sensitivity analysis or ablation).
- Computational cost: report training time, inference time per image/volume, GPU memory.
- Software framework and version (PyTorch, TensorFlow) must be identified.

---

## Figures

- **No strict figure limit** — use as many as needed for clarity
- **Required figure types**: model architecture diagram, qualitative result examples (success and failure cases), quantitative comparison tables/charts
- **Resolution**: 300 DPI (vector preferred for diagrams)
- **Format**: PDF, EPS, TIFF
- **Color**: Free, encouraged
- **LaTeX**: Manuscripts in LaTeX are common and well-supported; use Elsevier article class

---

## Manuscript Format

- **LaTeX strongly preferred** — use `elsarticle.cls` document class
- **Microsoft Word** also accepted but less common
- **Line numbering**: Required for review
- **Supplementary material**: Unlimited; common for additional experiments, video demonstrations
- **Code**: Strongly encouraged to share via GitHub; mention in Data/Code Availability statement

---

## Common Rejection Reasons

1. **Insufficient technical novelty** — MedIA expects novel methodology; applying existing methods to new datasets without methodological contribution is insufficient
2. **No comparison with state-of-the-art** — must compare against recent competitive methods on same datasets
3. **Missing ablation study** — each proposed component must be justified experimentally
4. **Single dataset evaluation** — multi-dataset evaluation strongly preferred for generalizability claims
5. **No failure case analysis** — reviewers expect honest discussion of when the method fails
6. **Poor reproducibility** — missing implementation details, no code availability
7. **Weak clinical motivation** — pure technical novelty without medical relevance may be redirected to computer vision venues
8. **Unfair comparisons** — different training data, augmentation, or post-processing between proposed and baseline methods

---

## Cover Letter

Should emphasize:
- Technical contribution (novel method, not just novel application)
- Clinical relevance and potential impact
- Reproducibility (code/data availability plans)
- Suggested reviewers with relevant expertise (3-5 recommended)

---

## Author Guidelines URL

https://www.elsevier.com/journals/medical-image-analysis/1361-8415/guide-for-authors

---

## Positioning

Medical Image Analysis is appropriate when:
- Novel computational method for medical image analysis with rigorous evaluation
- Comprehensive benchmark study establishing new baselines
- Methodological innovation (new architecture, training strategy, representation) validated on medical data
- Multi-dataset evaluation with ablation demonstrating each component's contribution

Not appropriate for: clinical validation studies without methodological contribution (use clinical journals), application of off-the-shelf models without modification (use application-specific journals), pure computer vision without medical data (use CVPR/MICCAI proceedings).

---

## Differentiation from Related Venues

| Dimension | MedIA | IEEE TMI | MICCAI |
|-----------|-------|---------|--------|
| Format | Journal (long) | Journal (short, page limit) | Conference proceedings |
| Review cycle | 3-6 months | 3-6 months | Annual deadline |
| Length | 8000-12000 words | 10-12 pages (IEEE 2-col) | 8-10 pages |
| Emphasis | Method depth + ablation | Broader scope, shorter papers | Novelty + preliminary results |
| Impact factor | ~10.9 | ~10.6 | N/A (proceedings) |

# Journal Profile: Nature Medicine

## Journal Identity

- **Full name**: Nature Medicine
- **Abbreviation**: Nat Med
- **Publisher**: Springer Nature
- **ISSN**: 1078-8956 (print), 1546-170X (online)
- **Frequency**: Monthly (12 issues/year)
- **Impact Factor**: ~82 (JCR 2023), top-ranked translational medicine journal
- **Open Access**: Hybrid (transformative agreements may cover OA at many institutions)
- **Acceptance rate**: ~8% for Articles
- **Peer review**: Single-blind; in-house editors with PhD/MD backgrounds handle triage

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | References | Figures |
|------|----------------|----------|------------|---------|
| Article | No strict limit (typically 3000-5000) | 150 words (unstructured) | 50 | 8 |
| Brief Communication | 1500 words | 3 sentences (unstructured) | 20 | 4 |
| Review | No strict limit | 150 words | No limit | No limit |
| Analysis | 3000 words | 150 words | 50 | 6 |
| Correspondence | 500 words | None | 10 | 1 |
| Resource | No strict limit | 150 words | 50 | 8 |

Word counts include Methods summary in main text. Detailed Methods go in Online Methods.

---

## Abstract Requirements

**Unstructured abstract, 150 words maximum:**

A single paragraph, no headings. Must include:
- Study rationale (1 sentence)
- What was done (design, N, key method)
- Main findings (primary result with effect size)
- Significance (1 sentence: why this matters)

**Critical**: Nature Medicine abstracts are very short (150 words). Every word must count. No background preamble — start with the gap or objective.

---

## Required Journal-Specific Elements

### 1. Online Methods

Detailed methods go in the Online Methods section (separate from main text). This section has no word limit and should include:
- Study design and participants
- Detailed protocols
- Statistical analysis
- Code availability
- Data availability

The main-text Methods summary is typically 1-2 paragraphs referencing the Online Methods.

### 2. Reporting Summary

Nature Research Reporting Summary required at submission. Covers:
- Study design, statistical methods, data availability
- Life sciences: ethics, clinical trial registration
- Software and code availability

### 3. Data Availability Statement

Mandatory. Must specify: what data, where deposited, accession codes, access conditions.

### 4. Code Availability Statement

Mandatory if computational methods are used. Must specify: repository URL, version, DOI.

---

## Required Sections (Article)

1. **Introduction** — 2-3 paragraphs; concise, end with study aims
2. **Results** — presented first (before Methods in main text); subheadings encouraged
3. **Discussion** — 3-4 paragraphs; limitations discussed within
4. **Methods** (summary in main text) — brief overview referencing Online Methods
5. **Online Methods** — full methodological detail (no word limit)
6. **References**
7. **Acknowledgements**
8. **Author Contributions** — specific per-author contributions
9. **Competing Interests** — or "The authors declare no competing interests"
10. **Extended Data** — up to 10 figures/tables, peer-reviewed (unlike Supplementary)

**Note**: Nature Medicine uses Results-before-Methods order in the main text.

---

## Statistical Reporting

Nature Medicine follows Nature Research statistical guidelines:
- Report exact P values where possible; state as P < 0.001 if below that threshold.
- 95% CI for all primary outcomes.
- Effect sizes required; do not report P values alone.
- For multiple comparisons: describe correction method (Bonferroni, FDR, etc.) or justify if none applied.
- Sample sizes and how they were determined must be stated (power analysis preferred).
- For each statistical test: state the test name, whether one-tailed or two-tailed, and the exact value of N.
- Data distribution: state whether normality was tested and which test was used.
- Box plots: define center line, box limits, whiskers, and individual data points shown.
- Source data for all figures must be provided.
- Statistical software and version must be identified in Methods.

---

## Figures

- **Maximum 8 figures** for Articles, 4 for Brief Communications
- **Extended Data**: up to 10 additional figures/tables (peer-reviewed, unlike Supplementary)
- **Supplementary Information**: unlimited (not peer-reviewed, for completeness)
- **Resolution**: 300 DPI (bitmap), vector preferred (PDF, EPS, AI)
- **Figure size**: single column (88 mm) or double column (180 mm)
- **Color**: free, no charges
- **Panels**: Label a, b, c (lowercase); scale bars required for microscopy/imaging
- **Source data**: Raw data for each figure must be provided as Source Data files

---

## Common Rejection Reasons

1. **Insufficient translational impact** — Nature Medicine requires clear bridge from bench to bedside; pure methodology papers rejected
2. **Lack of clinical validation** — AI/computational studies need clinical or at least large retrospective clinical cohort validation
3. **Single-center without external validation** — multi-site strongly preferred
4. **Abstract too long** — 150-word limit is strictly enforced
5. **Methods in wrong location** — main text should have Results before Methods summary
6. **Missing data/code availability** — mandatory for all computational studies
7. **Overclaiming causation** — editors flag causal language in observational designs
8. **Incremental advance** — must demonstrate substantial advance over existing methods/knowledge

---

## Cover Letter

Nature Medicine cover letters are read carefully by editors. Must include:
- Why this study is important for Nature Medicine's readership (translational impact)
- Key finding in 1-2 sentences
- Why the study is timely
- Statement of originality (not published/submitted elsewhere)
- Suggested reviewers (3-5, with brief justification for each)
- Opposed reviewers (optional)

---

## Author Guidelines URL

https://www.nature.com/nm/submission-guidelines

---

## Positioning

Nature Medicine is appropriate when:
- AI/ML study with clinical validation on large, diverse patient cohort
- Multi-center prospective study with clinical endpoint
- Novel biomarker or diagnostic with translational path
- First-in-human results for novel therapeutic approach
- Large-scale genomic/proteomic study with disease mechanism insight

Not appropriate for: pure technical methodology (use Nature Methods or Nature Machine Intelligence), small retrospective studies, incremental improvements to existing methods, studies without clinical relevance.

---

## Brief Communication vs Article

| Dimension | Article | Brief Communication |
|-----------|---------|-------------------|
| Scope | Full study, multiple analyses | Single key finding |
| Abstract | 150 words | 3 sentences |
| Body | ~3000-5000 words | 1500 words |
| Figures | 8 | 4 |
| Use when | Comprehensive study | Striking result, rapid publication |

---

## AI Writing Disclosure Policy
- **Requirement level:** Required
- **Permitted scope:** Language editing only — AI/LLM tools (e.g., ChatGPT, Claude) may assist with language, grammar, and readability but cannot be listed as authors; AI must not generate scientific content, interpret results, or draw conclusions; authors bear full responsibility for accuracy and integrity
- **Disclosure location:** Methods — describe the AI tool name, version, and how it was used in the Methods section; Nature Portfolio requires disclosure in the manuscript body, not just a cover letter; also captured in the Nature Research Reporting Summary
- **AI-generated images:** Banned — AI-generated images are not permitted in published figures; any image manipulation must follow Nature's image integrity policies; computational visualizations from AI research tools must be clearly labeled
- **Policy URL:** https://www.nature.com/nature-portfolio/editorial-policies/ai

# Journal Profile: NEJM

## Journal Identity

- **Full name**: The New England Journal of Medicine
- **Abbreviation**: NEJM, N Engl J Med
- **Publisher**: Massachusetts Medical Society
- **ISSN**: 0028-4793 (print), 1533-4406 (online)
- **Frequency**: Weekly (52 issues/year)
- **Impact Factor**: ~176 (JCR 2023), ranked 1st among general medical journals
- **Open Access**: Hybrid (selected articles OA; most subscription-based)
- **Acceptance rate**: ~5% for Original Articles
- **Peer review**: Single-blind; dedicated statistical review for all manuscripts

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | References | Figures/Tables |
|------|----------------|----------|------------|----------------|
| Original Article | 2700 words | 250 words (structured) | 40 | 4 |
| Special Article | 2700 words | 250 words (unstructured) | 40 | 4 |
| Review Article | 3500 words | 250 words (unstructured) | 100 | 5 |
| Case Records (MGH) | Commissioned | N/A | 30 | 6 |
| Clinical Practice | Commissioned | None | 40 | 3 |
| Brief Report | 1500 words | 150 words | 15 | 2 |
| Correspondence | 175 words | None | 5 | 1 |

Word counts exclude abstract, references, tables, and figure legends.

---

## Abstract Requirements

**Structured abstract, 250 words maximum (Original Articles):**

```
Background: [Context and knowledge gap — why this study was needed]
Methods: [Study design, setting, participants, interventions, primary outcome]
Results: [Key findings with numerical results, effect sizes, CIs, P values]
Conclusions: [Main conclusion — 1-2 sentences directly answering the question]
```

**Critical**: NEJM uses a 4-heading structured abstract (Background, Methods, Results, Conclusions). The abstract must stand alone as a complete summary. ClinicalTrials.gov registration number required at end of abstract for trials.

---

## Required Sections (Original Article)

1. **Introduction** — brief (2-3 short paragraphs); state the gap and end with the study objective
2. **Methods**
   - Ethics: IRB/ethics committee approval statement
   - Study design and oversight: registration number, funding source, role of funder
   - Participants: eligibility criteria, enrollment dates
   - Interventions or exposures
   - Outcomes: primary endpoint clearly stated
   - Statistical analysis: prespecified plan, sample size rationale
3. **Results** — begin with enrollment/demographics; report primary endpoint first
4. **Discussion** — concise (4 paragraphs max); start with key findings, address limitations explicitly

**Note**: NEJM does not use a separate "Conclusions" heading in the body. The final paragraph of Discussion serves as the conclusion.

---

## Statistical Reporting

NEJM has exceptionally rigorous statistical standards:
- Report exact P values (two-sided) to 2 decimal places; use P < 0.001 below that threshold.
- 95% CI mandatory for primary and key secondary outcomes.
- Hazard ratios, odds ratios, relative risks with CIs.
- Absolute risk differences and number needed to treat (NNT) for clinical trials.
- Sample size calculation with assumptions (power, alpha, expected effect size, dropout rate).
- Pre-specified primary outcome; secondary outcomes clearly labeled.
- Interim analyses and stopping rules described.
- For non-inferiority trials: margin justification required.
- Subgroup analyses: pre-specified; present with forest plot and interaction P values.
- Missing data handling explicitly described (multiple imputation preferred).
- Statistical software and version stated in Methods.

---

## Figures

- **Maximum 4 figures/tables combined** — extremely limited; plan carefully
- **Resolution**: 300 DPI minimum
- **Format**: EPS, TIFF, or PDF for figures; editable (Word) for tables
- **Color**: Free online; authors may be charged for print color
- **Supplementary Appendix**: Unlimited eFigures, eTables, eMethods; published online-only
- **CONSORT/study flow**: counts as one figure
- **Figure quality**: Professional quality expected; NEJM may redraw accepted figures

---

## Common Rejection Reasons

1. **Insufficient sample size or clinical impact** — NEJM expects large, definitive trials (typically N > 1000) or landmark observational studies
2. **Narrow specialty focus** — must have broad relevance to general medical practice
3. **Incremental findings** — results must be practice-changing, not confirmatory
4. **Methodological concerns** — inadequate randomization, high dropout, or missing pre-registration for trials
5. **Overclaiming** — causal language in observational studies; overgeneralization
6. **Word count violations** — NEJM has among the strictest limits (2700 words); excess length is immediate concern

---

## Cover Letter

Must include:
- Brief statement of what the study adds (1-2 sentences)
- Confirmation of exclusivity (not under consideration elsewhere)
- Trial registration number (if applicable)
- Disclosure of related published or submitted manuscripts
- Suggested reviewers (optional)
- Any potential conflicts of interest

---

## AI Writing Disclosure Policy
- **Requirement level:** Required
- **Permitted scope:** Language editing only — AI/LLM tools may be used for grammar and language editing; AI cannot generate scientific content, interpret data, or draw conclusions; AI tools cannot be listed as authors
- **Disclosure location:** Methods — describe the AI tool name, version, and how it was used
- **AI-generated images:** Not permitted — AI-generated clinical images, pathology, or radiology images are not allowed
- **Policy URL:** https://www.nejm.org/author-center/new-manuscripts

---

## Author Guidelines URL

https://www.nejm.org/author-center/new-manuscripts

---

## Positioning

| Feature | NEJM | The Lancet | JAMA |
|---------|------|-----------|------|
| IF | ~176 | ~169 | ~120 |
| Abstract style | 4-heading structured | Unstructured (300 words) | 7-heading structured |
| Word limit (Original) | 2700 | 3500 | 3000 |
| OA model | Hybrid | Hybrid | Hybrid |
| Unique feature | Strictest word limit, clinical focus | Global health strength | Key Points box |
| AI/radiology | Rare, only practice-changing | Occasional | Via JAMA Network |

NEJM is appropriate when:
- Large RCT with unambiguous clinical endpoint (mortality, major morbidity)
- Practice-changing finding with immediate impact on patient care
- Landmark epidemiological study with public health implications
- Novel therapeutic approved or likely to change guidelines

Not appropriate for: small studies, technical methodology papers, AI without clinical validation, narrow subspecialty findings, pilot/exploratory studies.

# NEJM AI

## Journal Identity

- **Full name**: NEJM AI
- **Abbreviation**: NEJM AI
- **Publisher**: NEJM Group (owned and published by the Massachusetts Medical Society)
- **ISSN**: 2836-9386 (digital-only)
- **Frequency**: Monthly (12 issues/year) with continuous publication
- **Impact Factor**: None yet (journal launched January 2024; no Journal Citation Reports JIF assigned as of mid-2026 — verify Clarivate JCR / Scopus CiteScore at submission time)
- **Open Access**: No author-pays model; **no submission or publication fees**. Author Accepted Manuscript may be deposited in a noncommercial repository at acceptance (CC BY-NC-ND default; CC BY-ND or CC BY for Coalition S / NIH / NIHR / UKRI / Wellcome). **Datasets, Benchmarks, and Protocols are freely available immediately on publication.**
- **Editor-in-Chief**: Isaac (Zak) Kohane (Harvard Medical School, Biomedical Informatics)
- **Relevant imaging/eval editors**: Xiaoxuan Liu (SPIRIT-AI/CONSORT-AI), Judy Wawira Gichoya (radiology informatics), Venkatesh Murthy (radiology/cardiac imaging), Pranav Rajpurkar (medical imaging AI), Roxana Daneshjou, David Ouyang
- **Submission**: NEJM AI online submission system; contact editorial.ai@nejm.org. **No presubmission inquiries** (full manuscripts only).

## Aims and Scope

Interdisciplinary journal facilitating dialogue among stakeholders using AI to transform medicine; **intentionally pairs "pre-clinical" and clinical articles**. Covers AI methodologies and data science applied to biomedical informatics, connected health, telemedicine, **medical images and imaging**, personalized medicine, policy and regulation, and ethical/medicolegal implications. AI "must meet the same bar for clinical evidence as other clinical interventions." Rigorous NEJM-Group peer review plus dedicated statistical review.

## Manuscript Types and Word Limits

Word-count limits include introduction through conclusion/discussion; **exclude** abstract, figure legends, and table notes.

| Type | Abstract | Body (max) | Tables + Figures | Notes |
|------|----------|-----------|------------------|-------|
| **Original Article** | Structured (B/M/R/C) ≤300 w | **3,000** | up to 5 | Clinical trials of AI, AI-assisted dx/tx, breakthrough pre-clinical, rigorous evaluations of medical AI |
| **Datasets, Benchmarks, and Protocols** | Structured (B/M/R/C) ≤300 w | **3,000** | up to 5 | New datasets, shared benchmarks, **reproducible/novel protocols or study designs adaptable to other trials**; immediately full OA |
| Case Study | Unstructured | 2,000 | up to 5 | First-person deployment lessons |
| Review | Unstructured | 3,000 | up to 5 | Usually solicited |
| Perspective | Unstructured | 1,200 | 1 central | Usually solicited |
| Policy Corner | Unstructured | 2,000 | 2 central | Multi-stakeholder policy |
| Editorial | Unstructured | 1,000 | none | Solicited; ≥1 reference |
| Letter | none | 400 | 1 | ≤5 refs; first ref = article discussed |

All original-research article types require a **1–2 sentence short description** in addition to the abstract.

## Abstract Format

**Structured: Background, Methods, Results, Conclusions** (4 headings), **≤300 words**, for all original research. Report key findings as **key data, not unsupported statements**. (Note: this differs from npj DM's 3-heading and Lancet DH's 5-heading abstracts — NEJM AI needs its own 4-heading variant.)

## Required Sections / Submission Elements

1. Title page (single corresponding author; ORCID for corresponding at submission, all authors at acceptance)
2. Structured abstract (B/M/R/C ≤300 w) + 1–2 sentence short description
3. Introduction → Methods → Results → Discussion/Conclusion (standard IMRAD; not Nature Methods-last)
4. Funding/support statement (mandatory if funded)
5. **Data-sharing statement** (ICMJE-compliant)
6. Code availability / reproducibility (ML reporting — see below)
7. **Author contributions** including who wrote the first draft (and any paid writing assistance)
8. **AI-use disclosure** (in both cover letter and manuscript)
9. Ethics/consent statement: IRB approval, **how informed consent was obtained and which body approved the consent document**, Declaration of Helsinki adherence
10. **Diversity/representativeness supplementary table** (clinical research studies)
11. Tables embedded in manuscript; **figures uploaded as separate files**
12. COI disclosure for every author via **Convey** (published with article)

## Citation Style

NEJM/Vancouver-style numbered references (verify exact NEJM AI formatting in the Formatting Guide for Authors PDF). AI-generated material **cannot be cited as a primary source**; all quoted material fully attributed.

## Reporting Guidelines

- **Machine-learning methodology** must be reported in detail: problem statement + clinical relevance; dataset source/size/characteristics + collection + preprocessing; **written permission for any datasets/databases**; algorithms/models with hyperparameters and configurations; evaluation metrics + validation strategy (cross-validation or separate test set); comprehensive results + comparisons + statistics; limitations + data biases + clinical implications; ethics (consent, data privacy); **reproducibility (code availability + implementation steps)**.
- Recommended checklist: **TRIPOD-AI or MI-CLAIM**.
- Trials: CONSORT flow diagram + checklist.

## Statistics (statistical-review desk — strict)

- Methods must state **sample-size/power** considerations and primary/secondary analysis methods.
- **Missing-data** handling described; complete-case generally not acceptable as primary unless missingness is rare.
- Significance tests accompanied by **confidence intervals**; CIs adjusted to match any significance-level adjustment.
- **Two-sided P values unless the design requires one-sided** (e.g., non-inferiority / TOST). P formatting: >0.01 → 2 decimals; 0.01–0.001 → 3 decimals; <0.001 → "P<0.001."
- Results to no more precision than meaningful (e.g., odds ratios to 2 significant digits).
- **Observational studies**: signed/dated prespecified SAP encouraged (deposit in a repository); prespecified FWER/FDR control or **limit secondary/exploratory analyses to point estimates + 95% CI with no P values** and a note that intervals are unadjusted for multiplicity; show confounder distribution stratified by exposure; sensitivity to unmeasured confounding; **encourage retesting findings in an independent study**.
- Prefer absolute counts/rates before relative risks; **avoid odds ratios** where they overestimate risk.

## Trial Registration

AI-intervention **trials** enrolling patients after 2025-01-01 must register in a **WHO ICTRP-compliant** database. (A diagnostic/evaluation reader study that does not prospectively assign subjects to intervention vs comparison groups for a health outcome is generally **not** a "clinical trial" requiring ICTRP registration — confirm at submission; an OSF prospective registration is a strength but is not an ICTRP registry.)

## Authorship & Corresponding-Author Policy

- ICMJE authorship criteria; **no author limit** (Commentary types prefer <10).
- **Only ONE corresponding author** during submission and revision; that author is the manuscript guarantor. After acceptance, additional reader-contact authors may be designated, but the original corresponding author remains the corresponding author of record.
- **Co-first / co-senior allowed**: "Drs. A and B contributed equally to this manuscript" at the end of the author list.

## Prior Publication

Not published nor under consideration elsewhere, EXCEPT: research presented at scientific meetings; results released to government agencies for statutory/urgent public-health needs; **articles posted on a preprint server** (allowed). Cascaded NEJM manuscripts accepted.

## Peer Review

Single-blind; ≥2 outside reviewers for original research + dedicated **statistical/methodological review**; reviews requested within ~2 weeks (NEJM-family fast triage). Editors screen and only send suitable manuscripts to review. Optional **invitation/request-based accelerated review** (≈7-day decision) for urgent public-health / immediate-practice-change / meeting-timed work — request via editorial.ai@nejm.org (not guaranteed).

## Special Notes

- **3,000-word hard limit** for Original Article / Datasets-Benchmarks-Protocols is the dominant constraint — manuscripts written for Lancet DH (~3,500–5,000) or npj DM must be compressed heavily.
- **Datasets, Benchmarks, and Protocols** is a distinct, less-crowded lane for a pre-registered, reusable evaluation **protocol / study design + locked benchmark dataset**, with immediate full OA.
- Single corresponding author requirement conflicts with co-corresponding setups → designate one submitting/guarantor author up front.
- COI is collected via **Convey**, not ICMJE PDF forms generated elsewhere.
- Diversity/representativeness supplementary table is a hard requirement for clinical research.
- Archived via Portico; published under MMS copyright with Publishing Agreement + Authorship Statement at acceptance.

## Verification
- Source: NEJM AI Author Center / Editorial Policies / Article Types / Peer Review & Publication Process (author-guide text, verified 2026-06-14).
- Re-verify before submission: exact reference formatting (Formatting Guide PDF), current JCR/CiteScore status, and whether the study is classified as a "clinical trial" for registration.

# Journal Profile: Neuroradiology

## Journal Identity

- **Full name**: Neuroradiology
- **Abbreviation**: Neuroradiology
- **Publisher**: Springer Nature (European Society of Neuroradiology, ESNR)
- **ISSN**: 0028-3940 (print), 1432-1920 (online)
- **Frequency**: Monthly (12 issues/year)
- **Impact Factor**: ~3.4 (JCR 2023)
- **Open Access**: Hybrid (Springer transformative agreements may cover OA)
- **Acceptance rate**: ~30%
- **Peer review**: Single-blind; typically 2 reviewers

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | References | Figures/Tables |
|------|----------------|----------|------------|----------------|
| Original Article | 3500 words | 250 words (structured) | 35 | 6 |
| Review Article | 5000 words | 250 words | 60 | 8 |
| Technical Note | 2000 words | 150 words (unstructured) | 15 | 4 |
| Diagnostic Neuroradiology | 1500 words | 150 words | 10 | 6 |
| Interventional Neuroradiology | 3000 words | 250 words (structured) | 30 | 6 |
| Letter to the Editor | 500 words | None | 5 | 1 |
| Pictorial Review | 3000 words | 200 words | 20 | 12 |

Word counts exclude abstract, references, tables, and figure legends.

---

## Abstract Requirements

**Structured abstract for Original Articles and Interventional, 250 words maximum:**

```
Purpose: [Study aim — 1-2 sentences]
Methods: [Design, population, imaging protocol, analysis]
Results: [Key findings with statistics]
Conclusion: [Main conclusion — 1-2 sentences]
```

**Unstructured abstract for Technical Notes and Diagnostic Neuroradiology, 150 words.**

---

## Required Sections (Original Article)

1. **Introduction** — clinical context, gap, purpose (2-3 paragraphs)
2. **Methods** (Springer uses "Methods" not "Materials and Methods")
   - Study Design: IRB approval, retrospective/prospective
   - Patient Population: inclusion/exclusion, time period
   - Imaging Protocol: scanner model, sequence parameters (critical for neuroradiology)
   - Image Analysis: readers, blinding, measurement methods
   - Statistical Analysis: software, tests
3. **Results** — demographics, imaging findings, quantitative results
4. **Discussion** — comparison with literature, pathophysiological implications, limitations
5. **Conclusion** — brief (1-2 sentences)

---

## Statistical Reporting

- Report exact p-values; use p < 0.001 below that threshold.
- 95% CI for primary outcomes.
- For diagnostic accuracy: sensitivity, specificity, AUC with 95% CI.
- Inter-reader agreement: ICC with model/type specification, or kappa with weighting scheme.
- For volumetric measurements: Bland-Altman analysis with limits of agreement.
- Multiple comparisons: Bonferroni or false discovery rate correction.
- Statistical software and version must be identified.

---

## Neuroradiology-Specific Requirements

### Imaging Protocol Detail

Neuroradiology expects detailed MRI/CT protocol reporting:
- Scanner manufacturer, model, field strength
- Sequence names and key parameters (TR, TE, flip angle, slice thickness, matrix, FOV)
- Contrast agent: name, dose, injection rate, delay
- Post-processing: software, version, reconstruction parameters

### Anatomy and Pathology Terminology

Use standardized neuroradiology terminology:
- Stroke: use ASPECTS, mRS, NIHSS
- Tumors: WHO classification with molecular markers
- Vascular: use standard aneurysm measurement conventions
- Spine: use standard nomenclature for disc herniation (protrusion, extrusion, sequestration)

---

## Figures

- **Maximum 6 figures/tables** for original articles; **12 for Pictorial Reviews**
- **Resolution**: 300 DPI minimum
- **Format**: TIFF, EPS, JPEG (high quality)
- **Color**: Free online; Springer handles conversion
- **Neuroimaging conventions**: window/level should match clinical display; annotations with arrows/arrowheads; anatomical orientation labeled

---

## Common Rejection Reasons

1. **Insufficient imaging protocol detail** — neuroradiology readers expect MRI sequence-level specificity
2. **Small single-center retrospective** without novelty — Neuroradiology accepts more readily than AJNR but still needs contribution
3. **Missing inter-reader agreement** — for studies with subjective measurements
4. **Overlapping scope with AJNR** — if the study has a stronger North American angle, consider AJNR first
5. **Diagnostic Neuroradiology cases** too common — must be genuinely educational or rare

---

## Cover Letter

Should include:
- Relevance to European neuroradiology practice
- Brief summary of key findings
- Statement of originality
- Suggested reviewers with neuroradiology expertise

---

## Author Guidelines URL

https://www.springer.com/journal/234/submission-guidelines

---

## Positioning

Neuroradiology is appropriate when:
- Brain, spine, or head/neck imaging study with clinical relevance
- AI applied to neuroimaging with diagnostic validation
- Interventional neuroradiology outcome study (thrombectomy, embolization, stenting)
- Advanced imaging technique (perfusion, diffusion, spectroscopy) in neurological disease
- Pictorial reviews of neuroradiology topics

Not appropriate for: body imaging, non-neurological applications, pure methodology without neuroimaging data.

---

## Differentiation from AJNR

| Dimension | Neuroradiology | AJNR |
|-----------|---------------|------|
| Society | ESNR (European) | ASNR (American) |
| Impact factor | ~3.4 | ~3.5 |
| Scope | Diagnostic + interventional neuro | Diagnostic + interventional + spine |
| Geography | European/international | North American/international |
| Case reports | "Diagnostic Neuroradiology" category | "Case Report" (limited acceptance) |
| Pictorial reviews | Accepted (up to 12 figures) | Less common format |

# npj Digital Medicine

## Journal Identity

- **Full name**: npj Digital Medicine
- **Abbreviation**: npj Digit. Med.
- **Publisher**: Nature Portfolio (Springer Nature)
- **ISSN**: 2398-6352 (online)
- **Frequency**: Continuous (online only)
- **Impact Factor**: High-impact digital health journal
- **Open Access**: Yes (CC BY 4.0 or CC BY-NC-ND 4.0)
- **APC**: ~EUR 2,490 (check current rates)

## Manuscript Types and Word Limits

| Type | Abstract | Manuscript Body | References | Notes |
|------|----------|----------------|------------|-------|
| Article | Structured | No strict limit (concise recommended) | No cap | Primary research |
| Review | Structured | No strict limit | No cap | |
| Brief Communication | Unstructured | Shorter than Article | No cap | |
| Perspective | Unstructured | ~3,000 | No cap | |
| Comment | Unstructured | ~1,500 | No cap | |
| Matters Arising | Brief summary | ≤ 1,200 | 15 | No APC; on npj Digit. Med. papers only |

## Abstract Format

Structured with three headings:
1. **Background**
2. **Methods**
3. **Results**

Typical length 250-350 words (no explicit cap stated).

## Keywords

Not explicitly required in guidelines.

## Required Sections

Nature-style order (Methods after Discussion):
1. **Introduction**
2. **Results**
3. **Discussion**
4. **Methods** (placed after Discussion)
5. **Data Availability Statement**
6. **Code Availability Statement** (if custom code used)
7. **Acknowledgements** (including funding)
8. **Author Contributions** (CRediT recommended)
9. **Competing Interests** (mandatory, even if none)
10. **References**
11. **Figure Legends** (after References)
12. **Tables** (at end)

## Citation Style

- Nature referencing style (numbered, square brackets)
- Numbered sequentially in order of appearance
- More than 5 authors: first author only, then "et al."
- Journal names: italicized, abbreviated with full stops
- Volume numbers: **bold**
- URLs: cited parenthetically in text, not in reference list
- Example: `Schott, D. H., Collins, R. N. & Bretscher, A. Secretory vesicle transport velocity... *J. Cell Biol.* **156**, 35-39 (2002).`

## Reporting Guidelines

| Study Type | Required Checklist |
|------------|-------------------|
| Randomized trials | CONSORT |
| Systematic reviews | PRISMA |
| Observational studies | STROBE |
| Diagnostic/prognostic | STARD, TRIPOD |
| AI diagnostic accuracy | STARD-AI |
| AI intervention trial | CONSORT-AI |
| AI prediction model | TRIPOD+AI |
| Qualitative research | COREQ or SRQR |
| Case reports | CARE |

Nature Portfolio Reporting Summary required with revised manuscript.

## Portal Mechanics

Facts about the submission system itself, recorded at first submission. These are not author
guidelines — they are what the portal does, and several of them are stated only on the
submission form. Read by `/sync-submission` `check_portal_mirror.py`.

- **Submission system**: SNAPP (Springer Nature Article Processing Platform)
- **Fields that REPLACE the manuscript**: Author Contributions · Competing Interests · Data Availability · Acknowledgements

  The form says so at each of them: *"This replaces any statement written within the manuscript
  and is the one that we will publish."* The manuscript file is the copy reviewers read; the
  portal box is the copy the world gets. Paste the manuscript section verbatim — do not
  re-compose it, which is how a co-first-authorship sentence and a "the funder had no role"
  sentence each came one click from vanishing.
- **No equal-contribution checkbox**: co-first authorship survives only if it is typed into the
  Author Contributions box. A † footnote on the title page does not reach the published record.
- **Code Availability has no dedicated field**: append it to the Data Availability text.
- **Research funding is structured** (funder + grant ID) with nowhere for a role disclaimer, so
  "The funder had no role in study design…" must live in the Acknowledgements box.
- **Accepted figure formats**: `.jpeg`, `.tiff`, `.eps` — **`.png` is not offered**. Line art and
  text-bearing figures should go as TIFF + LZW, flattened onto white (a surviving alpha channel
  prints black).
- **Cover letter is a file upload** (PDF), not a paste field.
- **Figure embedding**: figures are uploaded separately; embedding them in the manuscript file
  as well produces a compiled review PDF with every figure twice.
- **Known auto-extraction losses**: title and abstract come through exactly, but the affiliation
  parser silently drops intermediate levels (e.g. a college inside a university). Check author
  affiliations against the manuscript one by one; do not trust the extracted values.

## Special Notes

- **Initial submission formatting is relaxed**; strict formatting required only at acceptance.
- **Methods section after Discussion** (Nature family convention, not standard IMRAD).
- **No Supplementary Methods allowed**: all methods must be in main manuscript.
- **Single-blind peer review**; typical first decision ~4-6 weeks; desk reject rate ~50%+.
- **ORCID required** for corresponding author before final submission.
- **Data Availability and Code Availability** statements mandatory.
- **LLM/AI policy**: LLMs cannot be authors; document use in Methods section.
- **Figures**: 300 dpi minimum; panel labels lowercase bold (a, b, c); colorblind-accessible palettes required (avoid red/green).
- **Supplementary Information**: single merged PDF; large tables as separate "Supplementary Data" files.
- **Preprints** encouraged and do not compromise novelty.
- **Manuscript transfer service**: rejected papers can transfer to other Nature Portfolio journals with referee reports.
- **Statistics section mandatory**: must include test name, n, alpha level, one-tailed vs two-tailed, exact P values.

- **AI-use disclosure placement**: Methods
  <!-- machine-read by /self-review check_classical_style.py --profile; source: the profile's own AI policy line: "document use in Methods section" -->

# Journal Profile: Nutrition, Metabolism and Cardiovascular Diseases (NMCD)

## Journal Identity

- **Full name**: Nutrition, Metabolism and Cardiovascular Diseases
- **Abbreviation**: Nutr Metab Cardiovasc Dis
- **Publisher**: Elsevier
- **ISSN**: 0939-4753 (print) / 1590-3729 (online)
- **Frequency**: Monthly
- **Impact Factor**: ~3.9 (recent JCR; verify at submission)
- **Open Access**: Hybrid — APC USD 3,560 for gold open access; subscription model available
- **Peer review**: Single-blind; statistical review where methodology is heavy

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | References | Figures/Tables |
|------|----------------|----------|------------|----------------|
| Original Article | 4,000 words | 250 (structured) | 60 max | 6 max |
| Systematic Review / Meta-analysis | 6,000 words | 250 (structured) | 120 max | 8 max |
| Viewpoint / Short Review | 3,000 words | 200 (unstructured) | 50 max | 4 max |
| Institutional Review | as Original | as Original | as Original | as Original |
| Short Communication | 1,500 words | 200 | 20 max | 2 max |
| Letter to the Editor | 800 words | none | 10 max | 1 max |

Word counts exclude abstract, references, tables, and figure legends.

---

## Abstract Requirements

**Structured abstract for Original Article, 250 words maximum, with 3 headings:**

```
Background and Aims: [Context + specific research question or hypothesis]
Methods and Results: [Design, setting, population, exposures, outcomes, statistical approach + primary results with effect sizes, 95% CIs, P values]
Conclusion: [Direct answer to Aims with clinical or public-health implication]
```

The merged "Methods and Results" heading is a NMCD-specific stylistic choice. Reviewers and the editorial system check this heading exactly.

---

## Required Journal-Specific Elements

### 1. Graphical Abstract (optional)

Encouraged for Original Articles and Meta-analyses; uploaded as a separate file at submission.

### 2. Article Information

- Author affiliations with department, institution, city, country
- Corresponding author full contact details
- Funding statement with grant identifiers
- Disclosures: per-author ICMJE conflicts of interest
- Data availability statement
- Ethical statement (IRB or equivalent + informed consent)

---

## Required Sections (Original Article)

1. **Introduction** — 2–3 paragraphs ending with clear aims
2. **Methods**
   - Ethics approval with body name
   - Study design and setting
   - Participants and eligibility
   - Variables / definitions (nutrition exposures and metabolic measures defined explicitly)
   - Outcomes (primary, secondary, exploratory clearly distinguished)
   - Statistical analysis with software and versions
3. **Results** — STROBE/CONSORT flow; primary outcome before secondary
4. **Discussion** — Strengths and Limitations sub-paragraphs; conclude with mechanistic and clinical/public-health implications
5. **Conclusion** — brief; avoid overclaiming

---

## Statistical Reporting

- Exact P values to 3 decimal places (P < 0.001 below threshold)
- 95% CI for all primary effect estimates
- Effect sizes appropriate to design (HR, OR, mean difference, absolute risk difference)
- Proportional-hazards assumption check (Schoenfeld) when Cox is used
- For nutrition exposures: report measurement method (FFQ, 24h recall, weighed records) with validation reference
- For metabolic biomarkers: report assay, intra- and inter-assay CV, and calibration source
- Sensitivity analyses for major analytic choices (missing data, alternative cutpoints, exposure misclassification)
- Software and version reported

---

## Figures

- **Maximum 6 figures/tables combined** for Original Article
- Resolution: 300 DPI minimum
- Format: TIFF, EPS, PDF, or high-quality PNG
- Color: encouraged
- Supplementary material: online-only supplement permitted

---

## Common Rejection Reasons

1. **Insufficient nutrition–metabolism–cardiovascular linkage** — manuscripts framed as pure cardiology or pure nutrition without the crossover axis are redirected
2. **Single-center cohort without external comparison** — population-based or multicenter preferred
3. **Missing measurement-method detail for nutrition exposures** — methodology bar is high for dietary assessment
4. **Overclaiming on observational data** — wide-CI estimates without exploratory qualifier
5. **Abstract heading mismatch** — using Background/Methods/Results/Conclusions instead of Background and Aims/Methods and Results/Conclusion
6. **AI policy non-compliance** — undisclosed AI use or AI listed as author
7. **Reference style violations** — failing to follow numbered citation order with first-6-then-et-al rule

---

## Cover Letter

Must include:
- Brief statement of novelty and the nutrition–metabolism–CVD crossover relevance
- Confirmation manuscript is not under consideration elsewhere
- Confirmation all authors meet ICMJE criteria
- Disclosure of related manuscripts (same cohort, same group)
- Suggested reviewers (3–5; senior PI curates)
- AI disclosure aligned with the in-manuscript declaration

---

## AI Writing Disclosure Policy

- **Requirement level**: Required
- **Disclosure template** (verbatim, immediately before references):
  > "During the preparation of this work the author(s) used [NAME OF TOOL / SERVICE] in order to [REASON]. After using this tool/service, the author(s) reviewed and edited the content as needed and take(s) full responsibility for the content of the publication."
- **Permitted scope**: AI/LLM tools may be used for language editing, structural review, and consistency checks; AI cannot be listed as author
- **Disclosure location**: Dedicated declaration immediately before the references
- **AI-generated images**: Elsevier policy prohibits AI generation or alteration of images
- **Grammar/spell-check exception**: Basic grammar/spelling/punctuation tools need no declaration
- **Policy URL**: https://www.elsevier.com/about/policies-and-standards/the-use-of-generative-ai-and-ai-assisted-technologies-in-writing-for-elsevier

---

## Submission Portal

https://www.editorialmanager.com/nmcd

---

## Author Guidelines URL

https://www.sciencedirect.com/journal/nutrition-metabolism-and-cardiovascular-diseases/publish/guide-for-authors

---

## Positioning

| Criterion | NMCD | EJPC | JACC: Advances | Atherosclerosis |
|-----------|------|------|----------------|------------------|
| **Society** | independent (Elsevier) | ESC/EAPC | ACC | EAS-affiliated (Elsevier) |
| **Impact Factor** | ~3.9 | ~8 | not indexed yet | ~5 |
| **Open Access** | Hybrid | Hybrid | Full Gold OA | Hybrid |
| **Geographic stance** | International | Europe-centric | Global | International (Europe-centric) |
| **Primary framing** | Nutrition–metabolism–CVD crossover | Cardiovascular prevention | Cardiovascular broad | Atherosclerosis / lipid biology |
| **Abstract first heading** | Background and Aims | Aims | Background | Background and Aims |
| **Word cap (Original)** | 4,000 | 5,000 | 5,000 (incl. refs+legends) | varies |

**Choose NMCD when:**
- Nutrition exposure or metabolic intervention is integral to the exposure or interpretation
- Mediterranean diet, MASLD, metabolic syndrome, or insulin-resistance pathway is the central narrative
- Crossover audience (cardiology + nutrition + endocrinology) matters

**Choose EJPC instead when:**
- Primary prevention angle dominates over the nutrition crossover
- ESC ecosystem reach matters more than the Elsevier cardio-metabolic platform

**Choose JACC: Advances instead when:**
- AHA-aligned framework application (e.g., CKM staging) is the central methodological contribution
- ACC ecosystem and Full Gold OA matter

**Choose Atherosclerosis instead when:**
- Lipid or plaque biology is the dominant mechanistic axis
- The contribution is more about vascular biology than nutrition/metabolic clustering

---

## Verification

- **Source (compact harvest):** local profile library (2026-05 fetch from https://www.sciencedirect.com/journal/nutrition-metabolism-and-cardiovascular-diseases/publish/guide-for-authors)
- **Source (detail authored):** based on harvested compact + Elsevier publisher-level AI policy + NMCD-specific abstract heading verbatim
- **Date (promoted to public):** 2026-05-21
- **Notes:** Verify APC and IF directly on the journal site at submission. Word limits sourced from compact harvest.

# Journal Profile: PLOS Medicine

## Journal Identity

- **Full name**: PLOS Medicine
- **Abbreviation**: PLoS Med
- **Publisher**: Public Library of Science (PLOS)
- **ISSN**: 1549-1277 (print), 1549-1676 (online)
- **Frequency**: Continuous online publication (monthly issues)
- **Impact Factor**: ~10.5 (JCR 2023), ranked among top general medicine/public health journals
- **Open Access**: Full OA (APC ~$3,000; fee assistance available)
- **Acceptance rate**: ~10%
- **Peer review**: Single-blind; academic editors (section-specific) + external reviewers

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | References | Figures/Tables |
|------|----------------|----------|------------|----------------|
| Research Article | 3500 words | 300 words (structured) | No limit | No strict limit |
| Meta-Research Article | 3500 words | 300 words (structured) | No limit | No strict limit |
| Systematic Review & Meta-Analysis | 4000 words | 300 words (structured) | No limit | No strict limit |
| Essay | 3000 words | ~150 words (unstructured) | No limit | 5 |
| Perspective | 2000 words | None | 30 | 3 |
| Guidelines and Guidance | 4000 words | 300 words | No limit | No strict limit |

Word counts exclude abstract, references, and figure legends. PLOS has no strict reference or figure caps but encourages conciseness.

---

## Abstract Requirements

**Structured abstract, 300 words maximum (Research Articles):**

```
Background: [Context, existing evidence, knowledge gap]
Methods and Findings: [Study design, setting, participants, dates,
    primary and secondary outcomes, key results with effect sizes,
    CIs, P values, and study limitations — yes, limitations go here]
Conclusions: [Main conclusion, implications for practice or policy]
```

**Critical**: PLOS Medicine uses a 3-heading abstract (Background, Methods and Findings, Conclusions). Uniquely, the "Methods and Findings" section must include key study limitations. The abstract should mention the study's limitations before the Conclusions heading.

---

## Required Sections (Research Article)

### 1. Author Summary

A 150-200 word plain-language summary (distinct from abstract), structured as:
- **Why Was This Study Done?** (2-3 bullet points)
- **What Did the Researchers Do and Find?** (2-3 bullet points)
- **What Do These Findings Mean?** (2-3 bullet points including limitations)

This is read by non-specialists and media; avoid jargon.

### 2. Body Sections

1. **Introduction** — brief (3-4 paragraphs); state the gap and end with study aim
2. **Methods**
   - Ethics statement (first paragraph): IRB/ethics approval, informed consent
   - Study design: cite reporting guideline used (STROBE, CONSORT, PRISMA, etc.)
   - Setting and participants: dates of enrollment, inclusion/exclusion criteria
   - Variables and outcomes: primary and secondary defined
   - Statistical analysis: pre-specified plan, software, handling of confounders and missing data
   - Prospective protocol or analysis plan: registration or pre-registration encouraged
3. **Results** — begin with participant flow; report primary outcome first
4. **Discussion** — begin with key findings summary; include explicit limitations paragraph; end with implications for policy/practice

### 3. Data Availability Statement

Mandatory. Data must be publicly available or authors must explain restrictions. PLOS enforces data sharing more strictly than most journals.

---

## Statistical Reporting

- Report exact P values (e.g., P = 0.03); use P < 0.001 below that threshold.
- 95% CI required for all primary outcomes.
- Effect sizes with units (absolute and relative measures).
- For observational studies: report adjusted and unadjusted estimates; specify confounder selection method.
- DAG (directed acyclic graph) encouraged for causal inference studies.
- For meta-analyses: heterogeneity (I², tau²), publication bias assessment, sensitivity/subgroup analyses.
- Multiple comparisons: state correction method or declare as exploratory.
- Missing data: report proportion missing; describe handling (complete case, imputation).
- Bayesian analyses accepted with prior justification.
- Statistical software and version must be identified.
- For prediction models: discrimination (AUC) and calibration required; TRIPOD checklist.
- Reproducibility: analysis code sharing strongly encouraged.

---

## Figures

- **No strict maximum** — but reviewers may request reduction if excessive
- **Resolution**: 300 DPI minimum
- **Format**: TIFF or EPS preferred; PDF acceptable
- **Color**: Free (online-only journal)
- **Supporting Information**: Unlimited supplementary figures, tables, methods, datasets
- **Figure panels**: Label A, B, C with self-explanatory legends
- **Flow diagrams**: CONSORT, PRISMA, or STARD as appropriate
- **Data visualization**: Encourage informative plots over simple bar charts

---

## Common Rejection Reasons

1. **Insufficient general medical/public health relevance** — findings must matter beyond one specialty or setting
2. **Scope mismatch** — pure clinical/subspecialty work without broader implications
3. **Methodological concerns** — inadequate adjustment for confounders, selection bias, or missing data
4. **Reporting guideline non-compliance** — EQUATOR checklists strictly required
5. **No data availability** — PLOS enforces open data; no plan = desk reject
6. **Overclaiming in abstract** — limitations must be stated in abstract (not just Discussion)
7. **Insufficient novelty for the field** — must advance knowledge meaningfully

---

## Cover Letter

Must include:
- Brief description of the study and its significance (2-3 sentences)
- Statement of relevance to PLOS Medicine readership
- Confirmation that the manuscript is not under consideration elsewhere
- Data availability confirmation
- Any relevant competing interests
- Suggested academic editor or section (optional)

---

## AI Writing Disclosure Policy
- **Requirement level:** Required (Permissive)
- **Permitted scope:** All tasks permitted — AI/LLM tools may be used for writing, editing, data analysis, code generation, and other manuscript preparation tasks; AI cannot be listed as authors; authors retain full responsibility for accuracy and integrity of all content including AI-generated text
- **Disclosure location:** Methods (or appropriate section) — must disclose the AI tool name, version, and how it was used; describe what content was generated or edited by AI; follows PLOS-wide AI policy
- **AI-generated images:** Permitted with disclosure — AI-generated or AI-manipulated images must be explicitly disclosed; provide tool name, version, and prompts used; images must not misrepresent data
- **Policy URL:** https://journals.plos.org/plosmedicine/s/submission-guidelines#loc-ai-assisted-technologies

---

## Author Guidelines URL

https://journals.plos.org/plosmedicine/s/submission-guidelines

---

## Positioning

| Feature | PLOS Medicine | JAMA Netw Open | BMC Medicine | BMJ Open |
|---------|--------------|---------------|--------------|----------|
| IF | ~10.5 | ~13.8 | ~7.5 | ~3.0 |
| OA model | Full OA | Full OA | Full OA | Full OA |
| APC | ~$3,000 | ~$3,500 | ~$3,690 | ~$2,590 |
| Abstract style | 3-heading (limits in abstract) | 7-heading (JAMA format) | Structured (varied) | Structured (varied) |
| Unique feature | Author Summary + open data | JAMA Network prestige | Fast review | High acceptance |
| MA/SR | Strong fit | Good fit | Strong fit | Acceptable |
| AI policy | Permissive (all uses OK) | Moderate (editing only) | ICMJE-standard | ICMJE-standard |
| Global health | Core strength | Accepted | Good | Good |

PLOS Medicine is appropriate when:
- Study has clear public health or health policy implications
- Systematic review or meta-analysis on a broadly relevant topic
- Meta-research (research on research, reporting quality, publication bias)
- Global health study with population-level impact
- Study requiring permissive AI disclosure (AI-assisted analysis integral to methods)
- Data sharing is fully possible (no proprietary restrictions)

Not appropriate for: narrow subspecialty clinical studies, technical AI methodology without health impact, studies where data cannot be shared, case reports.

- **AI-use disclosure placement**: Methods
  <!-- machine-read by /self-review check_classical_style.py --profile; source: this profile's own "Disclosure location: Methods (or appropriate section) — must disclose the AI tool name" -->

# Journal Profile: Radiology (RSNA)

## Basic Information

- **Publisher:** Radiological Society of North America (RSNA)
- **Impact Factor:** ~19.0 (2023–2024) — flagship journal of radiology
- **Scope:** Original research in diagnostic and interventional radiology; any imaging modality; clinical and translational
- **Sister journals:** Radiology:AI (AI-specific), Radiology:Cardiothoracic, RadioGraphics (educational)
- **Open Access:** Optional (RSNA Open Access); standard subscription model
- **Language:** American English

---

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | Figures | References |
|------|----------------|----------|---------|------------|
| Original Research | 3000 words | 250 words | **6 (strictly enforced)** | 40 |
| Review | 4000 words | 250 words | 8 | 60 |
| Technical Developments | 3000 words | 250 words | 6 | 30 |
| Case Reports | 1000 words | None | 4 | 8 |
| Letters | 500 words | None | 1 | 5 |

**⚠️ 6-figure limit is strictly enforced.** Supplementary figures are allowed and should be used for additional cases, subgroup analyses, and detailed methods.

---

## Abstract Requirements

**Structured abstract, 250 words maximum:**

```
Background: [Clinical problem and why it matters — 1–2 sentences]
Purpose: [Specific aims — usually 1 sentence]
Materials and Methods: [Design, population, exposure/index test, outcome,
                        statistical analysis]
Results: [Primary results with statistics, 95% CI, exact p-value;
          secondary results briefly]
Conclusion: [Main conclusion — 1–2 sentences]
```

---

## Required Journal-Specific Elements

### 1. Summary Statement

A single sentence (≤ 50 words) that captures the essential finding. Placed immediately before the abstract.

"[Index test/intervention] [demonstrated/showed/reduced] [outcome] in [population], suggesting [clinical implication]."

This is the first thing an editor reads. Make it compelling and specific.

### 2. Advances in Knowledge

3 bullet points, placed at the end of the manuscript (after Discussion, before References). Each bullet ≤ 2 sentences.

Cover: (a) methodological advance, (b) main clinical finding with effect size, (c) implication.

Example:
```
Advances in Knowledge
■ A deep learning model for detecting pulmonary embolism on CT angiography
  was trained on 5000 examinations across three institutions.
■ The model achieved a sensitivity of 91% (95% CI: 87–94%) and specificity
  of 96% (95% CI: 93–98%), comparable to expert radiologists.
■ This externally validated model may support radiologist workflow in high-
  volume centers by flagging urgent examinations.
```

---

## Required Sections (Original Research)

1. **Introduction** — brief (200–300 words); end with explicit purpose statement
2. **Materials and Methods**
   - Ethics: IRB number + consent or waiver statement
   - Study Design: state prospective or retrospective
   - Participants: inclusion/exclusion criteria, flowchart
   - Image Analysis: technique, readers, blinding
   - Statistical Analysis: software (R or SAS; version), tests, significance threshold
3. **Results** — primary outcome first, then secondary
4. **Discussion** — 3–4 paragraphs; Limitations as penultimate paragraph
5. **Conclusion** — brief (1–2 sentences)
6. **Advances in Knowledge** — 3 bullets (see above)

---

## Statistical Reporting

Radiology endorses **SAMPL guidelines** (Statistical Analyses and Methods in the Published Literature):
- Report exact p-values (P = .034), never P < .05
- 95% CI for all primary outcomes
- Effect sizes with units
- NNT/NNH for clinical outcomes where applicable
- Diagnostic accuracy: sensitivity, specificity, AUC, all with 95% CI

---

## Differentiation from Radiology:AI

| Dimension | Radiology | Radiology:AI |
|-----------|-----------|-------------|
| Focus | Clinical radiology (any modality) | AI/ML methodology and validation |
| AI papers | Only if AI is validated clinically | AI at any development stage |
| Required novelty | Large prospective or multi-center | Can be single-center |
| Reporting guideline | SAMPL | CLAIM |
| Acceptance bar | ~5–8% | ~15–20% |
| Impact factor | ~19 | ~8 |

**Use Radiology if:** AI is fully clinically validated, study is large/multi-center, primary novelty is clinical not technical.
**Use Radiology:AI if:** Paper is primarily about AI methodology, training, validation, or comparison.

---

## Figures

- **Maximum 6 figures** — plan carefully; multi-panel counts as one figure
- **Resolution:** 300 DPI (600 DPI for line art)
- **Format:** EPS or TIFF
- **Figure panels:** Label A, B, C, etc.; panels should be self-explanatory from legend
- **Supplementary figures:** Unlimited; use freely for additional cases, ROC curves, calibration plots

---

## Common Rejection Reasons

1. **Below novelty threshold** — Radiology expects findings that change practice or open new research directions; replication studies rarely accepted unless very large-scale
2. **Figure limit exceeded** — submitting 8 figures will cause desk rejection
3. **Missing Summary statement or Advances in Knowledge** — reviewed immediately on submission
4. **Underpowered study** — sample sizes of N < 200 are unusual for Radiology original research; N < 100 almost never accepted
5. **Retrospective single-center** — not automatically rejected, but must provide very strong novelty
6. **Overclaiming in Abstract** — editors are sensitive to "first," "largest," "gold standard" language without justification
7. **Statistical reporting errors** — Radiology statistical editors check carefully

---

## Cover Letter

Must include:
- Summary statement (same as in manuscript)
- Statement that all authors approved the submission
- Disclosure of any related manuscripts under review
- Patient consent/IRB statement (brief)

Suggested reviewers: 3–5 names with email addresses (RSNA specifically encourages this).

---

## Author Guidelines URL

https://pubs.rsna.org/page/radiology/submission-guidelines

---

## Positioning

Radiology is appropriate when:
- Large prospective or multi-center study (N ≥ 500 preferred)
- Practice-changing finding in major disease category (lung cancer, stroke, liver disease)
- Head-to-head comparison demonstrating superiority of a new modality/technique
- Landmark AI study with external validation and clinical endpoint

Not appropriate for: small retrospective series, incremental technical improvements, studies limited to a rare condition (unless first of its kind with major impact).

---

## AI Writing Disclosure Policy
- **Requirement level:** Required
- **Permitted scope:** Language editing only — AI/LLM tools may assist with language polishing and editing but cannot be listed as authors and must not generate scientific content, interpret data, or draw conclusions
- **Disclosure location:** Methods + Acknowledgments — describe the AI tool, version, and how it was used; RSNA requires disclosure in both the Methods section and Acknowledgments
- **AI-generated images:** Banned — AI-generated or AI-manipulated images in figures are not permitted; AI use in image analysis as part of the study methodology is acceptable and must be described in Methods
- **Policy URL:** https://pubs.rsna.org/page/ai-policy

# Radiology: Artificial Intelligence (RYAI)

## Journal Identity

- **Full name**: Radiology: Artificial Intelligence
- **Abbreviation**: Radiol Artif Intell
- **Publisher**: Radiological Society of North America (RSNA)
- **ISSN**: 2638-6100
- **Frequency**: Bimonthly
- **Impact Factor**: ~8.1 (2024)

## Manuscript Types and Word Limits

| Type | Abstract | Manuscript Body | Figures | Tables |
|------|----------|----------------|---------|--------|
| Original Research | 250 | 3500 | 7 | 5 |
| Technical Note | 250 | 1500 | 4 | 3 |
| Review Article | 250 | 5000 | 10 | 5 |
| Letter to Editor | none | 500 | 1 | 1 |

Word counts exclude abstract, references, figure legends, and tables.

## Abstract Format

Structured with four headings:
1. **Purpose**
2. **Materials and Methods**
3. **Results**
4. **Conclusion**

Maximum 250 words. Must be self-contained.

## Citation Style

- Vancouver (numbered) style.
- Numbered sequentially in order of first appearance in text.
- Use superscript numbers in the manuscript body.
- Format: Author(s). Title. Journal Abbreviation. Year;Vol(Issue):Pages.
- List all authors if 6 or fewer; if 7+, list first 3 followed by "et al."

## Keywords

- 3-5 keywords required.
- MeSH terms preferred.
- Listed alphabetically.

## Required Elements

### For All Manuscripts
- **Title page**: title, short title (50 chars), authors with affiliations, corresponding author, word count, number of figures/tables/references.
- **Key Points**: Not required (unlike AJR).
- **Data Availability Statement**: Required. Must specify whether data and code are available and under what conditions.
- **Author Contributions**: CRediT taxonomy required.
- **Conflict of Interest Disclosures**: Required for all authors.
- **Funding**: Grant numbers and funding sources.

### For AI Studies (Mandatory)
- **CLAIM Checklist**: Must be completed and submitted as supplemental material for any study involving AI/ML in medical imaging.
- **AI Disclosure in Methods**: Must describe any use of AI tools in the research process (data collection, analysis, writing assistance). Specific tools and versions must be named.
- **AI Disclosure in Acknowledgments**: Must acknowledge AI writing assistance if used, specifying the tool and its role.
- **Code Availability**: Strongly encouraged. GitHub repository or equivalent.
- **Model Card**: Encouraged for studies introducing new AI models.

## Reporting Guidelines

Match study type to required checklist:

| Study Type | Required Checklist |
|------------|-------------------|
| Diagnostic accuracy (AI) | STARD-AI |
| Prediction model | TRIPOD+AI |
| Any AI study in imaging | CLAIM 2024 |
| Randomized trial with AI | CONSORT-AI |
| Systematic review of AI | PRISMA 2020 |

Multiple checklists may apply (e.g., CLAIM + STARD-AI for a diagnostic AI study).

## Supplemental Materials

- Strongly encouraged.
- Can include additional tables, figures, methods details, code.
- Supplemental material is peer-reviewed.
- Common supplements: expanded methods, additional performance metrics, subgroup analyses, CLAIM checklist.

## Formatting Notes

- Double-spaced, 12-point font.
- Line numbers required on the manuscript.
- Pages numbered consecutively.
- Abbreviations defined at first use in both abstract and body (independently).
- SI units preferred; conventional units acceptable with SI in parentheses.

## Statistical Reporting

- Report exact p-values (e.g., P = .034); use P < .001 only when value is below that threshold. Never report only "P < .05".
- 95% CI required for all primary performance metrics (AUC, sensitivity, specificity, accuracy).
- For AI model comparisons: use DeLong test for AUC comparison; McNemar test for paired sensitivity/specificity.
- Calibration must accompany discrimination for prediction models: calibration plot + Hosmer-Lemeshow or calibration slope/intercept.
- Subgroup performance metrics required for fairness assessment (CLAIM requirement).
- Effect sizes with units; avoid "significant" without accompanying statistics.
- Statistical software and version must be named in Methods.
- Statistical review for all accepted manuscripts.

## Review Process

- Single-blind peer review.
- Typical first decision: 4-6 weeks.
- Revisions usually due within 60 days.

## Special Considerations for Education-Research Manuscripts

- Paper 1 (S5 Multi-agent Validation) and Paper 2 (MLLM Image Reliability) are strong fits for RYAI.
- CLAIM checklist is mandatory for both.
- Emphasis on reproducibility: pipeline code, prompt templates, and evaluation criteria should be described in detail or provided as supplements.
- For LLM/MLLM studies: model version, API date, temperature settings, prompt text (or reference to supplement) must be reported in Methods.

---

## AI Writing Disclosure Policy
- **Requirement level:** Required
- **Permitted scope:** Language editing only — AI/LLM tools may assist with language editing and manuscript preparation but cannot be listed as authors; must not generate scientific content, interpret data, or draw conclusions
- **Disclosure location:** Methods + Acknowledgments — must describe the AI tool name, version, and specific role in both the Methods section (under "AI Disclosure in Methods") and Acknowledgments (under "AI Disclosure in Acknowledgments"); this is distinct from AI used as the research subject
- **AI-generated images:** Banned — AI-generated or AI-manipulated images in figures are not permitted; AI models studied as research subjects must follow CLAIM checklist reporting
- **Policy URL:** https://pubs.rsna.org/page/ai-policy

- **AI-use disclosure placement**: Methods
  <!-- machine-read by /self-review check_classical_style.py --profile; source: this profile's own "AI Disclosure in Methods: Must describe any use of AI tools in the research process" -->

# Journal Profile: Skeletal Radiology

## Journal Identity

- **Full name**: Skeletal Radiology
- **Abbreviation**: Skeletal Radiol
- **Publisher**: Springer Nature (International Skeletal Society)
- **ISSN**: 0364-2348 (print), 1432-2161 (online)
- **Frequency**: Monthly (12 issues/year)
- **Impact Factor**: ~2.1 (JCR 2023)
- **Open Access**: Hybrid (Springer transformative agreements may cover OA)
- **Acceptance rate**: ~30-35%
- **Peer review**: Single-blind; typically 2 reviewers

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | References | Figures/Tables |
|------|----------------|----------|------------|----------------|
| Scientific Article | 3500 words | 250 words (structured) | 35 | 6 |
| Review Article | 5000 words | 250 words | 60 | 10 |
| Case Report | 1500 words | 150 words (unstructured) | 10 | 6 |
| Technical Report | 2000 words | 150 words (unstructured) | 15 | 4 |
| Pictorial Essay | 3000 words | 200 words | 20 | 12 |
| Test Yourself | 1000 words | None | 5 | 6 |
| Letter to the Editor | 500 words | None | 5 | 1 |

Word counts exclude abstract, references, tables, and figure legends.

---

## Abstract Requirements

**Structured abstract for Scientific Articles, 250 words maximum:**

```
Objective: [Study aim]
Materials and Methods: [Design, population, imaging, analysis]
Results: [Key findings with statistics]
Conclusion: [Main conclusion — 1-2 sentences]
```

**Unstructured abstract for Case Reports and Technical Reports, 150 words.**

---

## Required Sections (Scientific Article)

1. **Introduction** — clinical context, gap, purpose (2-3 paragraphs)
2. **Materials and Methods**
   - Study Design: IRB, retrospective/prospective
   - Patient Population: inclusion/exclusion, time period
   - Imaging Protocol: modality, scanner, sequence parameters
   - Image Analysis: readers, blinding, measurement methods
   - Statistical Analysis: software, tests
3. **Results** — demographics, imaging findings, diagnostic performance
4. **Discussion** — comparison with literature, clinical implications, limitations
5. **Conclusion**

---

## Statistical Reporting

- Report exact p-values; use p < 0.001 below that threshold.
- 95% CI for primary outcomes.
- For diagnostic accuracy: sensitivity, specificity, AUC with 95% CI.
- Inter-reader agreement: ICC with model/type, or kappa with weighting scheme.
- For measurement studies: Bland-Altman with limits of agreement, SEM, MDC.
- Statistical software and version must be identified.

---

## MSK-Specific Requirements

### Imaging Protocol

- MRI: field strength, coil, sequences (PD FS, T1, T2, contrast-enhanced), slice thickness
- CT: scanner, kVp, reconstruction kernel, reformats
- US: transducer frequency, dynamic maneuvers
- Radiography: projections, positioning

### Anatomy and Classification

Use standardized MSK terminology and classification systems:
- Fractures: AO/OTA classification
- Tumors: WHO classification with imaging-pathology correlation
- Arthritis: grading systems (Kellgren-Lawrence, OMERACT for US)
- Sports injuries: standardized grading (e.g., muscle injury: British Athletics classification)

---

## Figures

- **Maximum 6 figures/tables** for scientific articles; **12 for Pictorial Essays**
- **Resolution**: 300 DPI minimum
- **Format**: TIFF, EPS, JPEG
- **Color**: Free online
- **MSK imaging conventions**: appropriate window/level, anatomical annotations, comparison with contralateral side when relevant

---

## Common Rejection Reasons

1. **Overlap with AJR or Radiology MSK content** — needs unique MSK-specific contribution
2. **Case reports too common** — must be genuinely rare or educationally unique
3. **Missing imaging protocol** — essential for MSK imaging reproducibility
4. **Small sample for diagnostic accuracy** — needs enough cases per pathology category
5. **No inter-reader agreement** for subjective findings

---

## Cover Letter

Should include:
- Relevance to MSK radiology
- Key finding summary
- Statement of originality

---

## Author Guidelines URL

https://www.springer.com/journal/256/submission-guidelines

---

## Positioning

Skeletal Radiology is appropriate when:
- MSK imaging study (tumor, sports, arthritis, metabolic bone disease)
- AI applied to MSK imaging with diagnostic evaluation
- Case report of rare MSK pathology with high-quality imaging
- MRI technique validation for MSK application
- Pictorial essay on MSK imaging topic

Not appropriate for: non-MSK imaging, purely surgical outcomes without imaging focus, orthopedic biomechanics without imaging component.

# Journal Profile: Stroke (AHA/ASA)

## Basic Information

- **Publisher:** American Heart Association / American Stroke Association (Wolters Kluwer / Lippincott)
- **Society:** AHA / ASA
- **Editor-in-Chief:** Argye E. Hillis
- **Frequency:** Monthly
- **Scope:** Full cerebrovascular spectrum across three science categories — Basic/Translational, Clinical, Population
- **Open Access:** Hybrid (subscription + optional Gold OA with APC)
- **Language:** American English
- **Submission email:** stroke@strokeahajournal.org
- **ISSN:** 0039-2499 (print) / 1524-4628 (online); ISSN-L 0039-2499
- **Rejection rate:** approximately 50% at first review (AHA journal page)

---

## Scope — Covered Topics

### Basic / Translational
- Cerebrovascular biology, neurovascular unit, blood-brain barrier
- Animal models of ischemic stroke, ICH, SAH
- Neuroinflammation, neuroprotection, reperfusion injury
- Stroke genetics, genomics, and biomarkers

### Clinical
- Acute ischemic stroke management (IV thrombolysis, endovascular therapy, imaging selection)
- Intracerebral and subarachnoid hemorrhage
- Transient ischemic attack and minor stroke
- Secondary stroke prevention
- Cerebral small vessel disease, vascular cognitive impairment
- Neurorehabilitation and recovery
- Pediatric stroke

### Population
- Stroke epidemiology, risk factors, global burden
- Disparities in stroke care and outcomes
- Health services research, stroke systems of care, implementation science

---

## Manuscript Types and Word Limits

| Type | Body Word Limit | Abstract | Figures/Tables | References |
|------|----------------|----------|----------------|------------|
| Original Research | 5,000 | 300 (structured) | 8 combined | ≤50 |
| Brief Report | 2,000 | 250 (structured) | 4 combined | ≤20 |
| Research Letter | 750 | None | 1 combined | ≤5 |
| Review / Progress Review | 8,000 | 250 (unstructured) | 6 (+ key figure JPG) | unlimited |
| Emerging Therapy Critique | 2,500 | 250 | 4 | ≤30 |
| Comments and Opinions | 3,000 | None | 2 | ≤30 |
| Special Report | 8,000 | 250 | variable | variable |
| Stroke Images (clinical) | 150 | None | 2 | ≤5 |
| Stroke Images (basic) | 350 | None | 2 | ≤10 |
| Illustrative Teaching Case | 2,000 | 150 | 4 | ≤20 |
| InterSECT | 2,000 | 150 | 4 | ≤20 (max 5 authors) |
| Editorial (invited) | 1,500 | None | 2 | ≤20 |
| Letter to the Editor | 500 | None | 1 | ≤5 |

*Verify exact current limits on the author instructions page before submission — AHA periodically updates its limits.*

---

## Abstract Requirements

**Structured 300-word abstract for Original Research:**

```
Background: [Clinical question; rationale]
Methods: [Study design, population, interventions/exposures, outcomes, statistical approach]
Results: [Key numerical results with effect sizes and 95% CI]
Conclusions: [Main conclusion; clinical or scientific implication]
```

Research Letters and Comments/Opinions submit without an abstract.

---

## Graphic Abstract (Required at Revision)

At the revision stage, authors must submit a Graphic Abstract summarizing the key finding visually. AHA provides dimension and content guidelines on the author page — verify at time of revision.

---

## Domain-Specific Outcome Measures

### For Acute Ischemic Stroke Clinical Studies

- **Functional outcome at 90 days:** mRS (modified Rankin Scale); good outcome commonly mRS 0–2
- **Recanalization:** mTICI for endovascular; TIMI for older IV tPA studies
- **Symptomatic intracranial hemorrhage (sICH):** state definition (ECASS II, ECASS III, SITS-MOST, NINDS, or Heidelberg)
- **Early neurological change:** NIHSS change at 24 hours, discharge
- **Mortality at 90 days**

### For Prevention / Epidemiology Studies

- **Recurrent stroke (ischemic / hemorrhagic / any):** state composite definition
- **MACE:** define components
- **Time-to-event:** Kaplan-Meier + Cox proportional hazards (test PH assumption)

### For Imaging Studies

- **Diagnostic accuracy:** sensitivity, specificity, AUC with 95% CI
- **Inter-rater agreement:** kappa or ICC
- **Report reference standard** (follow-up imaging, clinical adjudication, autopsy)

### For Basic / Translational Studies

- **ARRIVE 2.0** compliance for animal experiments
- **Sample-size justification** and randomization/blinding reporting
- **Sex as a biological variable** reported explicitly (NIH policy)

---

## Required Sections

1. **Introduction** — Background; knowledge gap; specific aim
2. **Methods**
   - Ethics: IRB/IACUC approval + informed consent or waiver
   - Study design, setting, participants, timeframe
   - Exposures, interventions, outcomes with explicit definitions
   - Statistical analysis
   - Reporting-guideline citation (STROBE / CONSORT / PRISMA / STARD / TRIPOD / ARRIVE)
   - **Data Availability Statement — required**
3. **Results**
   - Participant flow, baseline characteristics
   - Primary and secondary outcomes with effect sizes and 95% CI
   - Subgroup and sensitivity analyses
4. **Discussion** — with Limitations subsection
5. **Conclusion**

---

## Reference Style

- **Vancouver numbered system**
- Superscript reference numbers in the text
- List the **first 10 authors followed by "et al."** when there are more than 10 authors
- Journal abbreviations per Index Medicus / NLM
- Include DOI or PMID when available

---

## Statistical Reporting Expectations

- Effect sizes with 95% CI — not p-values alone
- State statistical software (name, version, key packages)
- Time-to-event: Kaplan-Meier with log-rank; Cox regression with PH assumption check
- Diagnostic accuracy: AUC with 95% CI (DeLong); sensitivity/specificity with Clopper-Pearson CI
- Missing data handling: complete-case, multiple imputation, IPW — specify and justify
- Basic/translational: sample-size justification, randomization, blinding, sex as biological variable

---

## Revision Process

- 90-day window for major revision
- Graphic Abstract required at revision
- Cover Image submission encouraged for accepted manuscripts
- AHA multi-journal transfer option for rejected manuscripts (ATVB, Circulation Research, Hypertension, S:VIN, JAHA) — editor-initiated

---

## Common Rejection Reasons

1. **Scope/novelty insufficient** — incremental confirmatory work without clear advance
2. **Underpowered single-center retrospective series** without external validation
3. **Weak comparator / selection bias** in observational studies
4. **Missing reporting-guideline checklist**
5. **Outcome definition vagueness** — mRS, mTICI, sICH must be pre-specified and cited
6. **Basic science:** insufficient mechanism, missing sex-as-biological-variable, poor ARRIVE compliance

---

## Author Guidelines URL

https://www.ahajournals.org/stroke/author-instructions

---

## AI Writing Disclosure Policy

Stroke (AHA journals) has an explicit generative-AI policy:

1. **AI cannot be an author** (ICMJE) — AI tools cannot take responsibility for the work.
2. **Generative AI is permitted with documentation.** List all AI tools used in the Acknowledgments.
3. **When AI is used in research design, data analysis, or figure preparation,** describe it in the Methods section with sufficient detail for reproducibility (tool name, version, prompts where relevant).
4. **Grammar and spell-check tools** do not require disclosure.
5. **AI-based image generation or manipulation is prohibited** in scientific figures (angiograms, histology, brain imaging).
6. **Corresponding author remains responsible** for the accuracy of any AI-assisted content, including references.

Always re-check the AHA/ASA author instructions at submission for updates.

---

## Positioning

Stroke (AHA) is appropriate when:
- The work targets the global (primarily North American / European) stroke research community
- The study spans basic, translational, clinical, or population science of cerebrovascular disease
- Hybrid (subscription or optional Gold OA) publication is acceptable
- The work has potential for cross-AHA journal transfer on rejection

Stroke (AHA) is less appropriate for: purely interventional device / technical notes (consider JNIS), purely imaging-diagnostic work without cerebrovascular focus (consider AJNR, Neuroradiology), or Asia-Pacific-targeted work where no-APC OA is preferred (consider Journal of Stroke).

---

## Verification note

Profile built 2026-04-19 from the Stroke author-instructions PDF set (7 files). Article-type limits, AI policy, Vancouver 10-author rule, 90-day revision window, and Graphic Abstract requirement were transcribed directly from the source PDFs. ISSN verified against ISSN Portal (https://portal.issn.org/resource/ISSN/1524-4628) on 2026-04-19: print 0039-2499, online 1524-4628, ISSN-L 0039-2499, publisher Lippincott Williams & Wilkins.

# The BMJ

## Journal Identity

- **Full name**: The BMJ (formerly British Medical Journal)
- **Abbreviation**: BMJ
- **Publisher**: BMJ Group (British Medical Association)
- **ISSN**: 0959-8138 (print), 1756-1833 (online)
- **Frequency**: Continuous online + weekly print
- **Impact Factor**: 93.7 (JCR 2023), ranked 3rd among general medical journals
- **Open Access**: All research articles are open access
- **Acceptance rate**: ~7% overall, ~4% for research articles
- **Open peer review**: Yes (prepublication history posted if accepted)

## Article Types Relevant to Medical Education

### Research
- Accepts original research in medical education
- Structured abstract (Objectives, Design, Setting, Participants, Main outcome measures, Results, Conclusions)
- Word limit: ~4000 words (body), excludes abstract/references/tables
- Max 6 tables/figures
- ICMJE compliant, Vancouver references [square brackets]
- Requires: STROBE checklist, data sharing statement, summary box ("What is already known" / "What this study adds")
- Mandatory: patient/public involvement (PPI) reporting, sex/gender disaggregation
- ScholarOne submission system

### Education (COMMISSIONED ONLY)
- **Does NOT accept unsolicited submissions**
- Must submit proposal via Education Article Proposal Form + Declaration of Financial Interests
- Topics: common/serious conditions, international appeal, multi-specialty interest
- Encourages patient involvement and co-production
- Financial interests can disqualify authors

## Key Requirements for ALL Manuscripts

### Title page
- Title with study design subtitle
- Authors: names, ORCiD (mandatory for corresponding author), affiliations, positions
- Single corresponding author with full address and email

### Contributorship and guarantor
- Contributorship statement (who did what: planning, conduct, reporting)
- Identify guarantor(s) who accept full responsibility
- Required statement: "The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted."

### Competing interests
- Declaration required from ALL authors before review
- Authors with financial ties to industry cannot write clinical editorials
- Use BMJ competing interest form

### AI use policy
- Applies to all content types, all formats (text, audio, video, images, data, diagrams)
- Must disclose any AI tool use in manuscript preparation

### Copyright
- Authors retain copyright, grant exclusive licence to BMJ
- Non-commercial author reuse without permission

### Data sharing
- Required for research articles
- Must state data availability

### Summary box (Research articles)
- "What is already known on this topic" (2-3 bullet points)
- "What this study adds" (2-3 bullet points)

### Reporting guidelines
- Observational studies: STROBE
- Trials: CONSORT
- Education QI: SQUIRE 2.0
- Completed checklist uploaded with submission

## Submission Process

- Via ScholarOne: submit.bmj.com
- Word preferred, figures as separate TIFF/JPEG/PDF files (not embedded)
- Tables as separate Word files (no Excel)
- Cover letter required
- Can select alternative BMJ journal if rejected (transfer service)
- First decision: 2-3 weeks (often days for desk reject)
- Final decision: 8-10 weeks

## Review Process

1. Senior research editor screens on submission day
2. ~50% desk rejected (insufficient originality, not general audience, topic outside scope)
3. If promising → handling editor → external peer review + patient reviewer
4. Research manuscript meeting: statistics editor + handling editor + 4-7 research editors
5. Decisions: provisional acceptance, request revisions, rejection
6. Open peer review: all reviews published with accepted article

## Statistical Reporting

- Dedicated statistics editor reviews all research articles.
- Report exact p-values to 2-3 significant figures (e.g., P = .023); use P < .001 for values below that threshold.
- 95% CI mandatory for all primary outcomes; report alongside (not instead of) p-values.
- Absolute risk differences preferred over relative risks alone; report NNT where clinically meaningful.
- Effect sizes with units required.
- For observational studies: report both adjusted and unadjusted estimates.
- Sex and gender disaggregation of results required (SAGER guidelines).
- Avoid "significant" without accompanying statistics; use "statistically significant (P = .03)" or report the effect size with CI.
- Statistical software and version must be identified in Methods.

## Strategic Notes for an education-research manuscript

- **Education section**: NOT suitable (commissioned only, proposal required)
- **Research section**: Theoretically possible but very competitive (4% acceptance)
  - Would need to frame as having broad relevance beyond radiology
  - Pilot study with n=24 likely too small for The BMJ Research
  - Null primary findings reduce appeal for high-impact general journal
- **Alternative BMJ journals**: BMJ Open (IF ~3.0, more realistic), or stay with BMC Medical Education
- **Transfer service**: If rejected from The BMJ, can transfer to BMJ Open automatically

---

## AI Writing Disclosure Policy
- **Requirement level:** Required
- **Permitted scope:** All tasks — AI tools may be used for writing, editing, and other manuscript preparation tasks, but cannot be listed as authors; authors are accountable for all content including AI-generated text; follows ICMJE + COPE guidance
- **Disclosure location:** Methods + Acknowledgments — must disclose the AI tool name, version, and how it was used; applies to all content types (text, audio, video, images, data, diagrams)
- **AI-generated images:** Must be declared — AI-generated or AI-manipulated images, diagrams, and data visualizations must be explicitly disclosed; not blanket banned but full transparency required
- **Policy URL:** https://www.bmj.com/company/the-bmjs-position-on-ai-and-large-language-models/

# The Lancet

## Journal Identity

- **Full name**: The Lancet
- **Abbreviation**: Lancet
- **Publisher**: Elsevier (The Lancet Group)
- **ISSN**: 0140-6736
- **Frequency**: Weekly
- **Impact Factor**: Among the highest in general medicine
- **Open Access**: Hybrid (The Lancet Digital Health is fully OA; The Lancet offers OA options)
- **APC**: See Lancet OA policies

## Manuscript Types and Word Limits

| Type | Abstract | Manuscript Body | References | Figures/Tables |
|------|----------|----------------|------------|----------------|
| Article | 300 w (structured) | 3,500 (4,500 for RCTs) | 30 | 5 |
| Review | 150 w (unstructured) | 4,500 | 75 | 5-6 encouraged |
| Comment | None | 750 | 10 | 1 |
| Correspondence | None | 400 | 5 | 1 |
| Viewpoint | None | 2,500 | 30 | Varies |

Word counts exclude abstract, references, tables, and figure legends.

## Abstract Format

Structured with five headings (for Articles):
1. **Background**
2. **Methods**
3. **Findings**
4. **Interpretation**
5. **Funding**

Maximum 300 words. No references. RCT abstracts: include recruitment dates, group sizes with sex breakdown, primary outcome with effect size and CI, adverse events.

## Keywords

Not required (Lancet journals handle indexing internally).

## Required Sections

1. **Introduction**
2. **Methods** (end with "Role of the funding source" subheading)
3. **Results** (no subheadings for RCTs)
4. **Discussion** (no subheadings for RCTs)

Mandatory additional elements:
- **Research in Context panel**: Evidence before this study (with search strategy), Added value, Implications
- **Data Sharing Statement**: must specify what/when/where/with whom/how; "undecided" not acceptable
- **Contributors**: specific contributions per author; at least one must verify underlying data
- **Declaration of Interests** (ICMJE form, covering past 3 years)
- **Role of the Funding Source** statement

## Citation Style

- Vancouver (numbered) style with superscript numbers after punctuation
- Two refs: comma, no space (e.g., ^1,2); three+ consecutive: en-dash (e.g., ^1-3)
- 6 or fewer authors: list all; 7+: first 3 then "et al."
- Journal abbreviations per Index Medicus
- No references in Summary, Research in Context, or Search strategy panels
- Preprints: mark as "[preprint]" before reference

## Reporting Guidelines

| Study Type | Required Guideline |
|------------|-------------------|
| Randomized trials | CONSORT 2025 |
| AI intervention trials | CONSORT-AI |
| Observational studies | STROBE |
| Diagnostic accuracy | STARD |
| Systematic reviews | PRISMA |
| AI/ML studies | CLAIM, TRIPOD+AI |
| Genetic associations | STREGA |
| Global health estimates | GATHER |
| Sex/gender reporting | SAGER |

## Statistical Reporting

Strict in-house statistical conventions enforced by statistical editors:
- Exact p-values to 2 significant figures (e.g., P = .023); cap at P < .0001.
- 95% CI required for all primary outcomes; report alongside (not instead of) p-values.
- Means with SDs for normal distributions; medians with IQRs for skewed data.
- Absolute risk differences required alongside relative measures (RR, OR, HR).
- RCT abstracts: include effect size with CI and p-value for primary outcome; adverse events quantified.
- Decimal separator: midline dot (·) per Lancet house style.
- Sex/gender disaggregated results required per SAGER guidelines.
- Statistical editors review all accepted manuscripts.
- Statistical software and version must be identified in Methods.

## Special Notes

- **Single-blind peer review**; most papers rejected at editorial triage.
- **All figures redrawn** into Lancet style by in-house illustrators; submit editable vector files.
- **Decimal points**: use midline dots (·), not periods.
- **Serial comma required** before final "and"/"or".
- **Drug names**: use rINN (recommended international non-proprietary name).
- **Supplementary material**: single PDF with table of contents, numbered pages, references numbered separately.
- **Proofs**: must return within 48 hours; no stylistic changes permitted.
- **Sex/gender/race/ethnicity**: detailed reporting required per SAGER guidelines; explain data collection methods in Methods.
- **AI policy**: generative AI only for readability/language; disclose in Acknowledgments with tool name, version, exact prompts.
- **Author signatures** from all authors required before publication.
- **Tables**: supply in separate Word document (not Excel/PDF); do not merge cells.

---

## AI Writing Disclosure Policy
- **Requirement level:** Required
- **Permitted scope:** Language editing only — generative AI may be used only for readability and language improvement; AI cannot be listed as an author; authors are fully responsible for accuracy of all content
- **Disclosure location:** Acknowledgments — must disclose the AI tool name, version, and the exact prompts used; also reference in the cover letter
- **AI-generated images:** Banned — Elsevier policy explicitly prohibits use of generative AI or AI-assisted tools to create or alter images in submitted manuscripts (including enhancing, obscuring, moving, removing, or introducing features); AI-generated artwork and graphical abstracts also not permitted; sole exception is when AI imaging is part of the research methodology itself (e.g., biomedical imaging research), which must be fully described in Methods; The Lancet further restricts AI use to language/readability only (Elsevier policy; confirmed Apr 2026)
- **Policy URL:** https://www.thelancet.com/publishing-with-the-lancet

- **AI-use disclosure placement**: Acknowledgments
  <!-- machine-read by /self-review check_classical_style.py --profile; source: this profile's own "generative AI only for readability/language; disclose in Acknowledgments" -->

# The Lancet Digital Health

## Journal Identity

- **Full name**: The Lancet Digital Health
- **Abbreviation**: Lancet Digit Health
- **Publisher**: Elsevier (The Lancet Group)
- **ISSN**: 2589-7500
- **Frequency**: Monthly
- **Impact Factor**: ~24.1 (2024)
- **Open Access**: Yes (Gold OA, CC BY 4.0 default)
- **APC**: See https://www.thelancet.com/publishing-open-access

## Manuscript Types and Word Limits

| Type | Abstract | Manuscript Body | References | Figures/Tables |
|------|----------|----------------|------------|----------------|
| Article | 300 w (structured) | 3,500 | 30 | 5 combined |
| Review | 300 w | 5,000 | 100 | 5 |
| Comment | None | 1,500 | 15 | 1 |
| Correspondence | None | 500 | 5 | 1 |
| Viewpoint | None | 2,000 | 20 | 2 |

Word counts exclude abstract, references, tables, and figure legends.

## Abstract Format

Structured with five headings (for Articles):
1. **Background**
2. **Methods**
3. **Findings**
4. **Interpretation**
5. **Funding**

Maximum 300 words. No references in abstract.

## Keywords

Not required (indexing handled by editorial team).

## Required Sections

1. **Introduction**
2. **Methods** (include AI model details for AI/ML studies)
3. **Results**
4. **Discussion**

Mandatory additional elements:
- **Research in Context panel** (after abstract): Evidence before this study, Added value of this study, Implications of all the available evidence
- **Role of the Funding Source** statement
- **Contributors** (specific contributions per author)
- **Declaration of Interests** (ICMJE form)
- **Data Sharing Statement** (what, when, where, with whom, how)
- **Code Availability** (encouraged for AI/ML studies)

## Citation Style

- Vancouver (numbered) style with superscript numbers
- Superscript after punctuation; consecutive numbers with en-dash (e.g., ^1-3,7)
- 6 or fewer authors: list all; 7+: first 3 then "et al."
- Use PubMed/MEDLINE journal abbreviations
- Include DOI where available
- No "Ibid." or "op. cit."

## Reporting Guidelines

| Study Type | Required Guideline |
|------------|-------------------|
| Randomized trials | CONSORT |
| AI intervention trials | CONSORT-AI |
| Observational studies | STROBE |
| Diagnostic accuracy | STARD |
| Systematic reviews | PRISMA |
| Prediction models | TRIPOD (+AI extension) |
| AI/ML studies | CLAIM |
| Qualitative research | SRQR or COREQ |
| Quality improvement | SQUIRE |

Completed checklist with page numbers must be uploaded at submission.

## Statistical Reporting

Follows Lancet Group statistical conventions:
- Exact p-values to 2 significant figures (e.g., P = .023); cap at P < .0001.
- 95% CI required for all primary outcomes; report as (lower--upper) with en-dash.
- Means with SDs for normally distributed data; medians with IQRs for skewed data.
- For AI/ML studies: discrimination (AUC/C-statistic with 95% CI) and calibration (calibration plot minimum) required.
- TRIPOD+AI or CLAIM checklist compliance is mandatory for AI studies; statistical reporting must align with checklist items.
- For diagnostic accuracy: sensitivity, specificity, PPV, NPV, likelihood ratios -- all with 95% CI.
- Decimal separator: midline dot (·) per Lancet house style.
- Statistical software and version must be identified in Methods.

## Special Notes

- **Ranked #1** in medical informatics by IF and CiteScore.
- **Single-blind peer review**; triage decision in 1-2 weeks; full review 4-8 weeks.
- **Research in Context panel mandatory** for all Articles: must include systematic search strategy.
- **Supplementary appendix**: single PDF, not copyedited, referenced as "(appendix p X)".
- **Line numbering**: continuous throughout manuscript.
- **Decimal points**: use midline dots (ALT+0183 on PC; ALT+SHIFT+9 on Mac).
- **Preprints allowed**: disclose at submission; update with link upon acceptance.
- **AI disclosure**: in Methods or Acknowledgements; AI tools cannot be authors.
- **Transfer between Lancet journals** available if not suitable for this journal.
- Figures redrawn into Lancet style by in-house illustrators.

## Figures (technical specs)

- **Editable vector strongly preferred**: `.eps`, `.pdf`, `.svg` (saved directly from the plotting device for editability). Adobe Illustrator `.ai` emailed to the handling editor.
- **Not accepted** as primary figure files: `.png`, `.jpeg`, `.tiff`, `.bmp`, `.gif`, `.psd`. Raster only as a last resort at ≥300 dpi (photographs/scans at ≥300 dpi).
- Forest plots and trial profiles must be black and white; avoid multiple dotted lines; convert 3D to 2D.
- Do not download figures from websites (resolution/copyright). Midline-dot decimals inside figures.

## Required Submission Forms

- **ICMJE COI form** — one per author; the manuscript Declaration of Interests must match the signed forms.
- **Author Statement form** — signed; for **observational studies at least two authors must have accessed and verified the data, named by their initials**; contents must match the Contributors section.
- **ICMJE author-transfer / signature form** — corresponding author confirms all signatures/statements are accurate (also used when transferring between Lancet journals).
- **Sex/gender and race/ethnicity reporting confirmation** — at submission, confirm whether these are reported/analysed and, if not, explain why.
- **Equitable Partnership Declaration** — **triggers only for research conducted in 1–6 low/middle-income countries with at least one author not based in the study country**; does NOT trigger for all-high-income-country studies, ≥7 countries, or systematic/modelling reviews.
- **Reporting-guideline checklist** — uploaded at submission with page numbers.

## AI Writing Disclosure Policy

- **Requirement**: disclosure required (moderate). Permitted use is limited to language editing; AI tools must not generate scientific content, conclusions, figures, or tables.
- **Authorship**: LLMs/AI cannot be listed as authors.
- **Disclosure location**: Methods (if AI used in study methods, with tool name, version, and prompts for replication) and/or Acknowledgements (for writing assistance), applied with human oversight.
- **AI-generated study objects** (e.g., images that are themselves the subject of study) must be described in full in the Methods.
- For Comment/Correspondence (blue-section content): generative AI permitted only for grammar/spelling; not for translation at submission.

## Cover Letter

- ≤ ~400 words (convention; desk-reject risk above 500).
- Structure: opening (journal + article type + title) → why this matters / novelty over the closest prior work → key findings (each with one effect size + 95% CI) → reporting standards + ethics + registration → 3 suggested reviewers (no recent collaboration; not the closest competitor's authors).
- State data-sharing intent; declare no competing interests or list them; note preprint/concurrent-submission status.

## Common Rejection Reasons

- Scope mismatch (not a digital-health/clinical-AI question with practice or policy relevance).
- Incremental advance over recent flagship work without a clearly articulated added value.
- Body/abstract/reference/display-item overflow; non-contiguous or excessive display items.
- Missing or incomplete Research in Context panel (especially the systematic-search description in "Evidence before this study").
- Non-vector figures; figures with doubtful copyright.
- "Undecided" or vague Data Sharing Statement.
- AI/ML study without external validation or without a clinical-utility/impact claim.

## Positioning vs npj Digital Medicine

| Dimension | The Lancet Digital Health | npj Digital Medicine |
|-----------|---------------------------|----------------------|
| Family / tier | Lancet (Elsevier); higher IF | Nature Portfolio |
| Desk-reject | Frequent, fast (≈1–2 wk triage) | Less frequent |
| Abstract | 5 headings incl. Findings + Funding, ≤300 w | Background/Methods/Results, no Funding heading |
| Structure | IMRAD (Methods after Introduction) | Methods after Discussion (Nature) |
| Methods subheadings | Permitted; Results/Discussion **no subheadings** | Short **bold run-in** Methods headings required |
| Research in Context | Mandatory panel | Not required |
| Reference cap | ≤30 (Article) | No strict cap |
| Data/Code availability | Data sharing mandatory; code encouraged | Data **and** Code availability mandatory; Reporting Summary at revision |

## Verification

- **Last verified**: 2026-06-11.
- **Gate source**: official Information for Authors PDF — https://www.thelancet.com/pb-assets/Lancet/authors/tldh-info-for-authors-1778587678573.pdf (plus the Observational/Meta/RCT guideline PDFs and the artwork guidelines).

- **AI-use disclosure placement**: Methods or Acknowledgements
  <!-- machine-read by /self-review check_classical_style.py --profile; source: this profile's own "AI disclosure: in Methods or Acknowledgements; AI tools cannot be authors" -->

# Journal Profile: World Journal of Hepatology

## Journal Identity
- **Full name:** World Journal of Hepatology
- **Abbreviation:** World J Hepatol
- **Publisher:** Baishideng Publishing Group Inc., Pleasanton, CA, USA
- **ISSN:** 1948-5182 (online-only)
- **Frequency:** Continuous online publication
- **Open Access:** Mandatory full OA, **CC BY-NC 4.0** (no commercial reuse, no AI-training reuse)
- **Acceptance rate:** ~30–40 % (estimated; verify at journal site)
- **Peer review:** External anonymous peer review by ≥ 2 reviewers; in-house editor selects reviewers; 17-step editorial workflow.

## Manuscript Types and Word Limits

Each study design has its own dedicated writing guidelines URL on the BPG site. Article types relevant to retrospective hepatology cohort work:

| Type (BPG section #) | Detailed writing guide |
|---|---|
| Retrospective Cohort Study (3.11) | https://www.wjgnet.com/bpg/GerInfo/210 |
| Retrospective Study (3.12) | https://www.wjgnet.com/bpg/GerInfo/211 |
| Observational Study (3.14) | https://www.wjgnet.com/bpg/GerInfo/200 |
| Prospective Study (3.15) | https://www.wjgnet.com/bpg/GerInfo/201 |
| Clinical Trials Study (3.13) | https://www.wjgnet.com/bpg/GerInfo/196 |
| RCT (3.16) | https://www.wjgnet.com/bpg/GerInfo/209 |
| Randomized Clinical Trial (3.17) | https://www.wjgnet.com/bpg/GerInfo/202 |
| Case-Control Study (3.10) | https://www.wjgnet.com/bpg/GerInfo/195 |
| Basic Study (3.18) | https://www.wjgnet.com/bpg/GerInfo/218 |
| Evidence-Based Medicine (3.19) | https://www.wjgnet.com/bpg/GerInfo/198 |
| Systematic Review (3.20) | https://www.wjgnet.com/bpg/GerInfo/203 |
| Meta-Analysis (3.21) | https://www.wjgnet.com/bpg/GerInfo/278 |
| Case Report (3.23) | https://www.wjgnet.com/bpg/GerInfo/187 |
| Editorial / Frontier / Field of Vision / Opinion / Expert Consensus / Evidence Review / Review / Minireview | various GerInfo URLs |
| Correspondence / Letter to Editor (3.24) | https://www.wjgnet.com/bpg/GerInfo/219 |

Word limits, abstract format, and reference caps are defined per article type at each URL above — there is no single shared word limit across types.

## Abstract Requirements
Per article type. Retrospective Cohort Study and Observational Study guides require structured abstracts (Background, Aim, Methods, Results, Conclusions) with explicit study design label.

## Required Sections
Standard IMRAD per study-type guide. Core elements:
1. **Title page** (concise informative title; running title; full author names and affiliations; corresponding author with email)
2. **Abstract** (structured per article type)
3. **Keywords**
4. **Core Tip** (3–5 sentence summary, Baishideng-specific element placed after Abstract)
5. **Introduction**
6. **Materials and Methods**
7. **Results**
8. **Discussion**
9. **Article Highlights** (4-paragraph structured: Background, Research motivation, Research objectives, Research methods, Research results, Research conclusions, Research perspectives) — Baishideng-specific
10. **Acknowledgements**
11. **Footnote / Conflict-of-Interest / Informed-consent / Institutional-review-board / Helsinki / STROBE compliance statements** (Baishideng-specific footnote block)
12. **References** (Vancouver, with PMID and DOI for every entry)
13. **Tables / Figures**

## Statistical Reporting
- Statistical methods named with software and version.
- Reporting guideline named in Methods (STROBE for cohort/observational; STARD for diagnostic accuracy; PRISMA for SR/MA; CONSORT for RCT; ARRIVE for animals; CARE for case reports).
- 95% CI mandatory; effect sizes with measures of variability.

## Figures
- High-resolution TIFF / EPS / PNG, ≥ 300 dpi.
- Color allowed (OA supports color at no extra charge).
- All figures must have CC BY-NC 4.0-compatible permissions if reproducing prior work.

## Common Rejection Reasons
1. Submission outside the wjgnet/F6Publishing platform (no email submissions accepted).
2. Missing Article Highlights or Core Tip block (Baishideng-specific).
3. References without PMID or DOI for indexed sources.
4. Inadequate ethics block in footnote (CoI / IRB / Helsinki / STROBE compliance) — manuscript returned without review.
5. Word/format violations of the article-type-specific writing guide.

## Cover Letter
Submission via F6Publishing (https://www.f6publishing.com). Cover letter should:
- Quote manuscript ID after assignment.
- Confirm originality and CC BY-NC 4.0 acceptance.
- Note any prior peer review at sister BPG journal (transfer is supported).

## AI Writing Disclosure Policy
- **Requirement level:** Required (BPG declares ICMJE conformity).
- **Permitted scope:** AI tools may not be authors; AI use disclosed in Methods.
- **Special note:** BPG explicitly reserves rights against AI-training reuse: "All rights are reserved, including those for text and data mining, AI training, and similar technologies. For all open access content, the relevant licensing terms apply" — i.e., CC BY-NC 4.0 prohibits commercial AI training on these articles.
- **Disclosure location:** Methods + Acknowledgements.
- **Policy URL:** https://www.wjgnet.com/bpg/gerinfo/287 (ICMJE conformity statement; verify)

## Author Guidelines URL
https://www.wjgnet.com/bpg/gerinfo/204 (BPG common guide; first published 2017-05-02, last updated 2026-03-24)

Submission portal: https://www.f6publishing.com
Help desk: https://www.f6publishing.com/helpdesk
Contact: editorialoffice@wjgnet.com (general); j.l.wang@wjgnet.com (peer-review appeals); j.p.yan@wjgnet.com (revision/second-decision appeals)

## Positioning

**When to submit here.** Korean / Asian / global retrospective hepatology cohort studies, MASLD natural history, observational studies, biomarker validation, and basic hepatology research that wants fast OA dissemination, accepts CC BY-NC 4.0, and is willing to follow Baishideng's article-type-specific structural requirements (Core Tip, Article Highlights, dedicated writing guide per study design). Useful as a **secondary fallback** when authors want a Q3-tier OA hepatology venue with broader acceptance bandwidth than CMH / Hepatology International. APC is typically cheaper than full-OA AASLD/Springer venues.

**When NOT to submit here.** Studies that need top-tier indexing impact (Q1) — World J Hepatol historically sits Q3-Q4. Authors who require CC BY (BPG mandates CC BY-NC). Manuscripts whose data the authors plan to license commercially or feed into AI training (CC BY-NC blocks both). Studies under embargo from another society where transfer to BPG is not permitted.

| Dimension | World J Hepatol | World J Gastroenterol | Hepatol Comm | CMH |
|---|---|---|---|---|
| Publisher | Baishideng | Baishideng | Wolters Kluwer/AASLD | KASL |
| Tier | Q3–Q4 | Q1–Q2 | Q1 | Q1 (KASL flagship) |
| OA license | CC BY-NC 4.0 | CC BY-NC 4.0 | CC BY or CC BY-NC-ND | CC BY |
| Acc. rate (est.) | ~30–40 % | ~30–35 % | ~30–35 % | ~25–30 % |
| Hepatology focus | Dedicated | Broad GI/Hep | Dedicated | Dedicated |
| AI-training reuse | Prohibited | Prohibited | Permitted (CC BY) | Permitted (CC BY) |

- **AI-use disclosure placement**: Methods
  <!-- machine-read by /self-review check_classical_style.py --profile; source: this profile's own "AI tools may not be authors; AI use disclosed in Methods" -->

# AI Validation Study — Template for Radiology

## Overview

Template for studies that develop, validate, or compare AI/ML models for medical imaging tasks. Must follow at least one of STARD-AI, TRIPOD+AI, or CLAIM depending on the study type. This template extends the standard IMRAD structure with AI-specific requirements.

---

## Applicable Reporting Guidelines

Select based on study type (multiple may apply):

| Study Type | Primary Guideline | Also Consider |
|------------|------------------|---------------|
| Diagnostic accuracy of AI | STARD-AI | CLAIM |
| AI prediction model (development) | TRIPOD+AI (Type 1a/1b) | CLAIM |
| AI prediction model (validation) | TRIPOD+AI (Type 2a/2b/3) | CLAIM |
| Any AI study in medical imaging | CLAIM 2024 | STARD-AI or TRIPOD+AI |
| AI-assisted reader study | STARD-AI + reader study guidelines | CLAIM |
| LLM/MLLM evaluation | CLAIM + custom LLM reporting | -- |

---

## Title

- Include the AI/ML method, clinical task, and study type.
- Good: "Validation of a Deep Learning Model for Automated Detection of Intracranial Hemorrhage on Noncontrast CT: A Multicenter Study"
- Good: "Large Language Model Performance in Radiology Board-Style Questions: A Multi-Agent Validation Study"
- Avoid: vague terms like "novel," "state-of-the-art," or "revolutionary."

---

## Abstract (Structured, 250 words)

Follow the target journal's format. Include:
- **Purpose**: Clinical problem + study objective.
- **Materials and Methods**: Dataset size and source, model type, reference standard, primary metric.
- **Results**: Primary performance metric with 95% CI, key comparison result.
- **Conclusion**: Clinical implication, not just "the model performed well."

---

## Introduction (3-4 paragraphs)

### Paragraph 1: Clinical Problem
- The specific clinical task and its importance.
- Current diagnostic performance, error rates, or workflow bottlenecks.
- Why AI could help (workload, accuracy, speed, access).

### Paragraph 2: Current AI Landscape
- Prior AI approaches for this task (brief, cite key studies).
- Gaps: limited validation, single-center, no reader comparison, no generalizability data.
- For LLM studies: current evidence on LLM/MLLM performance in medical domains.
- For NLP/LLM extraction studies: name 2-3 closest prior extraction or report-mining papers/systems
  and state the substantive delta (task, dataset, input constraints, method, validation, or workflow),
  not merely that the new system is "novel."

### Paragraph 3: Study Objective
- Precise aim with study design mentioned.
- Hypothesis if applicable.
- Template: "The purpose of this study was to {develop and validate / externally validate / compare} {model/system} for {task} using {dataset description}."

---

## Materials and Methods

### 4.1 Study Design
- Retrospective vs prospective.
- Single-center vs multicenter.
- Development vs validation vs both.
- Dates of data collection.
- If development+validation: describe the temporal or geographic separation.

### 4.2 Dataset

#### Source and Collection
- Institution(s), imaging modality, date range.
- How cases were identified (consecutive, sampled, queried).
- Inclusion and exclusion criteria (be specific).

#### Dataset Splitting (for development studies)
- Training / validation / test split ratios and method.
- **Critical**: confirm patient-level splitting (not image or exam level).
- Temporal split preferred over random split (state which was used).
- If external test set: describe source and independence.

#### Dataset Characteristics
- Total cases, positive/negative distribution.
- Demographics: age, sex, relevant clinical variables.
- Image characteristics: scanner models, protocols, acquisition parameters.
- Case complexity distribution if relevant.

### 4.3 Reference Standard
- How ground truth was established (pathology, follow-up, expert consensus, clinical diagnosis).
- Number of annotators, their experience level.
- Annotation process: independent reading, consensus, adjudication.
- Blinding: annotators blinded to model output and clinical information?
- Inter-annotator agreement reported (kappa, ICC).
- Timing between index test and reference standard.

### 4.4 AI Model

#### For Traditional DL Models
- Architecture (e.g., ResNet-50, U-Net, YOLO v8) with citation.
- Input: image size, preprocessing steps (normalization, augmentation).
- Training: optimizer, learning rate (schedule), batch size, epochs, early stopping criteria.
- Loss function.
- Hardware: GPU model, training time.
- Framework and version (PyTorch 2.x, TensorFlow 2.x).

#### For LLM/MLLM Studies
- Model name and version (e.g., GPT-4o, Claude 3.5 Sonnet, Gemini 1.5 Pro).
- API access date range (models change over time).
- Temperature and other generation parameters.
- Prompt design: system prompt, few-shot examples, chain-of-thought.
- Full prompts in supplement (or verbatim in methods if short).
- If multi-agent: agent roles, interaction protocol, consensus mechanism.
- Input format: text-only, image+text, structured data.
- For report-text extraction: list each supplied text field separately (e.g., findings, impression,
  clinical history, indication, prior diagnosis, referral text). State whether fields that may contain the
  target label were masked, excluded, or evaluated in a sensitivity analysis.
- For fine-tuning, LoRA, prompt-engineering, or multi-agent claims: include a same-backbone zero-shot or
  few-shot comparator using the identical input fields, output schema, and test split.

#### For Pipeline/System Studies
- End-to-end system description.
- Each stage: input, processing, output.
- Decision points and thresholds.
- Human-in-the-loop components.

### 4.5 Comparators (if applicable)
- Reader study design: number of readers, experience levels, subspecialty.
- Reading conditions: blinding, clinical information provided, time constraints.
- AI-assisted vs unassisted reading protocol.
- Washout period between reading sessions.

### 4.6 Statistical Analysis
- **Primary metric**: AUC, sensitivity, specificity, accuracy, F1 -- state which and why.
- **Confidence intervals**: 95% CIs for all primary metrics (bootstrap or exact binomial).
- **Comparison tests**: DeLong test for AUC comparison, McNemar for sensitivity/specificity.
- **Adaptation ablation**: when claiming benefit from fine-tuning, LoRA, prompt design, or a wrapper,
  pre-specify the paired comparison against the same-backbone zero-shot/few-shot baseline and report the
  uncertainty for the delta, not only the adapted model's standalone performance.
- **Input-contamination sensitivity**: for NLP/LLM extraction, report the primary analysis with the
  pre-specified input fields and, when applicable, a sensitivity analysis excluding fields likely to
  contain the answer.
- **Calibration**: calibration plot, Brier score, calibration slope/intercept (for prediction models).
- **Subgroup analyses**: pre-specified subgroups with rationale.
- **Multiple comparisons**: correction method if applicable.
- **Sample size**: justification or power analysis if prospective.
- **Software**: version numbers for all statistical packages.

### 4.7 Ethics
- IRB approval with protocol number.
- Informed consent status.
- Data de-identification method.

---

## Results

> **Results = facts and numbers only.** No interpretation, no "why," no prior study
> comparisons. See SKILL.md Phase 4 anti-interpretation guardrails.

### 5.1 Dataset Characteristics
- Flow diagram (Figure 1): screening, exclusions, final cohorts.
- Table 1: demographics and baseline characteristics by split (train/val/test) or group.
- Class distribution: positive/negative cases per split.

### 5.2 Model Performance (Primary Endpoint)
- Table 2: Primary performance metrics with 95% CIs.
- ROC curve (Figure 2) with AUC and CI.
- At the chosen operating point: sensitivity, specificity, PPV, NPV.
- How the operating point was selected (Youden, clinical threshold, fixed sensitivity).

### 5.3 Reader Comparison (if applicable)
- Table 3: Reader performance vs AI performance.
- Statistical comparison (DeLong, McNemar).
- AI-assisted vs unassisted reader performance.
- Reading time comparison if measured.

### 5.4 Subgroup Analysis
- Performance by key subgroups (age, sex, scanner, pathology subtype, difficulty).
- Present as table or forest plot.
- State the numbers; do NOT interpret why subgroups differ (save for Discussion).

### 5.5 Error Analysis
- Types of errors (false positives and false negatives).
- Representative examples (Figure 3+): correctly classified, false positive, false negative.
- Describe error patterns factually; do NOT speculate on causes (save for Discussion).

### 5.6 Calibration (for prediction models)
- Calibration plot (Figure).
- Brier score, calibration slope, intercept.
- Hosmer-Lemeshow or similar test.

---

## Discussion

> **Before writing:** Collect anchor papers and user input via SKILL.md Phase 5a
> interactive planning gate.

### Paragraph 1: Summary
- Restate key findings without repeating exact numbers.
- Frame in context of the study aim.

### Paragraphs 2-3: Performance in Context (anchor paper driven)
- Organize around anchor papers provided by the user.
- For each anchor paper: state their result → compare with ours → explain discrepancy.
- Compare to prior models on the same task (cite specific AUC/accuracy from prior studies).
- Compare to human reader performance (if applicable).
- Explain performance differences: data, methodology, population.

### Paragraph 4: Clinical Deployment Implications
- Where in the workflow would this fit? (triage, second reader, standalone, quality assurance)
- What is the intended use case?
- What decision, workflow step, or downstream action changes if the model is correct? State this before
  making a clinical-utility claim.
- Implementation considerations: speed, hardware, integration.
- Regulatory pathway considerations (if relevant).

### Paragraph 5: Limitations
Typical AI study limitations to address honestly:
1. Retrospective design and selection bias.
2. Single-center / limited generalizability.
3. Reference standard limitations (imperfect ground truth).
4. Dataset size and class imbalance.
5. Temporal/geographic bias (training and test from same distribution).
6. For LLMs: model version changes, non-reproducibility, API dependency.
7. No prospective clinical validation.
8. No assessment of clinical outcome impact.
For each: (a) what it is, (b) how mitigated, (c) direction of residual bias.

### Conclusion
- One to two sentences: main finding and primary clinical implication.
- Must be a citable statement — memorable and specific.

---

## Special Required Sections

### Data Availability Statement
- Template: "The datasets generated and/or analyzed during the current study are {available in the [repository name] repository, [URL] / not publicly available due to [reason] but are available from the corresponding author on reasonable request}."

### Code Availability
- Template: "The code for {model training / analysis / evaluation} is available at {URL}."
- If not available: "Code is available from the corresponding author on reasonable request."

### AI Disclosure
- In Methods: "Large language model {name, version} was used for {specific task}. The model was accessed via {API/interface} between {dates}. Generation parameters were set to {temperature, etc.}."
- In Acknowledgments: "{Tool name} was used for {writing assistance / code generation / data analysis}. All AI-generated content was reviewed and verified by the authors."

---

## Common Pitfalls to Avoid

1. **Data leakage**: Preprocessing (normalization statistics) computed on full dataset before splitting.
2. **Image-level splitting**: Splitting by image rather than by patient allows the same patient in train and test.
3. **Missing CIs**: Reporting AUC = 0.95 without confidence interval is incomplete.
4. **No calibration**: AUC measures discrimination only; calibration is essential for prediction models.
5. **Overclaiming**: "Our model outperformed radiologists" when CIs overlap or test set is small.
6. **Missing error analysis**: Knowing where the model fails is as important as overall metrics.
7. **Vague prompts**: For LLM studies, not providing the exact prompts used.
8. **No intended use**: Not specifying where in the clinical workflow the model would be deployed.
9. **Cherry-picked operating point**: Choosing the threshold that looks best on the test set.
10. **Ignoring prevalence**: Reporting PPV/NPV without discussing the study prevalence vs real-world prevalence.
11. **Input-text contamination**: clinical history, indication, impression, or referral text contains the target diagnosis or label.
12. **Missing same-backbone baseline**: fine-tuning or prompt-engineering benefit is claimed without a zero-shot/few-shot comparator on the same task.
13. **Presence-only novelty**: the Introduction says the task is novel but does not position the work against the closest 2-3 prior papers or systems.

# Paper Type: Animal Study

## Overview

- **Reporting guideline:** ARRIVE 2.0 (2020) — mandatory
- **Ethical approval:** IACUC (Institutional Animal Care and Use Committee) approval number required
- **Typical word count:** 3500–5000 words
- **Structure:** Abstract → Introduction → Materials and Methods → Results → Discussion → Conclusions
- **Key requirement:** 3Rs (Replacement, Reduction, Refinement) statement in Methods

---

## ARRIVE 2.0 — Essential 10 Items

These 10 items are the minimum required for publication. **All must be present.**

| # | Item | Where in Paper |
|---|------|----------------|
| 1 | Study design | Methods: Study Design |
| 2 | Sample size | Methods: Sample Size |
| 3 | Inclusion/exclusion criteria | Methods: Animals |
| 4 | Randomization | Methods: Randomization |
| 5 | Blinding | Methods: Blinding |
| 6 | Outcome measures | Methods: Outcome Measures |
| 7 | Statistical methods | Methods: Statistical Analysis |
| 8 | Experimental animals | Methods: Animals |
| 9 | Experimental procedures | Methods: Procedures |
| 10 | Results | Results section |

---

## Structured Abstract (250 words)

```
Background: [Scientific rationale; why this animal model was used]
Objective: [Specific aim and hypothesis]
Methods: [Species, strain, sex, N per group, intervention, primary outcome,
          statistical test]
Results: [Primary outcome with effect size, 95% CI, and exact p-value]
Conclusions: [Main finding and translational implication]
```

---

## Introduction (400–600 words)

1. **Clinical/biological problem:** Why does this research question matter?
2. **Gap in knowledge:** What is unknown and why animal work is needed to address it.
3. **Rationale for animal model:** Why was this species/model chosen? What aspects of the human condition does it recapitulate? Cite validation literature for the model.
4. **Hypothesis and aims:** State explicitly. "We hypothesized that [X]. To test this, we [aim 1], [aim 2], [aim 3]."
5. **3Rs statement:** "All procedures were performed in accordance with the 3Rs principles (Replacement, Reduction, Refinement)."

---

## Materials and Methods (1200–1800 words)

### 2.1 Ethical Approval

"All animal experiments were approved by the Institutional Animal Care and Use Committee of [Institution] (protocol number [XXXXX]) and conducted in accordance with the [National Institutes of Health Guide for the Care and Use of Laboratory Animals / Korean Animal Protection Act / relevant local regulation]."

### 2.2 Animals (ARRIVE Essential Item 8)

Report all of the following:
- Species, strain, substrain (e.g., Sprague-Dawley rat, Charles River, Wilmington, MA)
- Source (commercial vendor or in-house breeding)
- Sex (justify if single sex: biological rationale required)
- Age and weight at the start of the experiment (mean ± SD or range)
- Health status (specific pathogen-free, germ-free, etc.)
- Any genetic modification (full genotype for transgenic models)

### 2.3 Housing and Husbandry (ARRIVE Recommended)

- Housing conditions: cage type, group or individually housed, N per cage
- Environmental conditions: temperature (°C), humidity (%), light cycle (e.g., 12h light/12h dark, lights on at 07:00)
- Access to food and water (ad libitum or restricted; specify diet)
- Acclimatization period before experiment
- Any enrichment provided

### 2.4 Study Design (ARRIVE Essential Item 1)

State clearly:
- Design type: parallel group, crossover, factorial
- Control groups: sham, vehicle, naïve
- Number of experimental groups and treatment allocations
- Timeline (from baseline to final outcome measurement)

Include a figure showing the experimental design timeline if complex.

### 2.5 Sample Size Justification (ARRIVE Essential Item 2)

**Required.** Calculate using G*Power or equivalent. Report:
- Effect size expected (based on pilot data or literature)
- α (0.05) and β (0.20, i.e., 80% power)
- Formula used
- Calculated N per group
- Inflation for expected attrition (typically +15–20%)

"Sample size was estimated using G*Power (version 3.1.9.7) based on a two-sample t-test with an expected effect size of Cohen's d = [X] (derived from [pilot data/[Author Year]]). With α = 0.05 and 80% power, [N] animals per group were required. Accounting for an estimated [15]% attrition, [N] animals per group were enrolled."

### 2.6 Inclusion and Exclusion Criteria (ARRIVE Essential Item 3)

State pre-specified criteria applied at the time of animal selection AND during the experiment. Common exclusion reasons: failure to reach surgical endpoint, infection, weight loss >20%, death before planned outcome measurement.

"Animals were excluded if: (a) they failed to recover from anesthesia, (b) technical failure of the intervention occurred, or (c) the primary outcome could not be measured. All exclusions were recorded in the study log."

### 2.7 Randomization (ARRIVE Essential Item 4)

"Animals were randomly allocated to treatment groups using [computer-generated random numbers / block randomization / stratified randomization] with block size [N]. Allocation was performed by [person] who was not involved in [surgery/treatment/outcome assessment]."

If randomization was not performed, justify.

### 2.8 Blinding (ARRIVE Essential Item 5)

"Outcome assessment was performed by [role] who was blinded to group allocation. [Describe specifically what was blinded at each stage: surgery, treatment, outcome assessment, statistical analysis.]"

If full blinding was not possible, explain why and what steps were taken to minimize bias.

### 2.9 Anesthesia and Procedures (ARRIVE Essential Item 9)

- Anesthetic agent, dose, route (e.g., isoflurane 2–3% via inhalation, ketamine 80 mg/kg + xylazine 10 mg/kg i.p.)
- Monitoring during anesthesia (temperature, heart rate, respiratory rate)
- Analgesia (pre- and post-operative)
- Humane endpoints: criteria for euthanasia
- Specific surgical or experimental procedure: describe in enough detail for replication

### 2.10 Outcome Measures (ARRIVE Essential Item 6)

For each outcome:
- Primary or secondary
- Operational definition
- Measurement method and equipment (manufacturer, location)
- Timing of measurements
- Observer reliability (if applicable: ICC, kappa)

### 2.11 Statistical Analysis (ARRIVE Essential Item 7)

- State the primary outcome and the test used for the primary analysis
- Parametric vs. non-parametric decision (justify based on distribution)
- Mixed-effects models for repeated measures (preferred over repeated ANOVA)
- Correction for multiple comparisons (Bonferroni, FDR — state which and why)
- Handling of missing data
- Software: R (version X.X.X) or SPSS (version X.X); packages used
- Significance threshold: α = 0.05 (two-tailed)

---

## Results (900–1200 words)

### 3.1 Animal Attrition

Report in a CONSORT-style flow diagram or table:
- Animals enrolled
- Animals excluded (reason)
- Animals analyzed per group

"Of [N] enrolled animals, [N] were excluded: [N] due to [reason 1], [N] due to [reason 2]. Final analysis included [N] animals per group."

### 3.2 Baseline Characteristics

Table comparing groups at baseline (weight, age, any baseline measurements). Include statistical comparison — groups should be comparable.

### 3.3 Primary Outcome

Report: mean ± SD (or median [IQR]) for each group. Effect size with 95% CI. Exact p-value.

"[Primary outcome] was significantly [higher/lower] in [Group A] compared with [Group B] ([mean ± SD] vs. [mean ± SD]; difference, [X] [units]; 95% CI, [lower–upper]; P = [exact value])."

### 3.4 Secondary Outcomes and Adverse Events

Report all pre-specified secondary outcomes. **Always report adverse events** (infections, weight loss, unexpected deaths) even if none occurred: "No adverse events were observed during the study period."

---

## Discussion (600–800 words)

1. Summary of main findings (with effect size)
2. Mechanistic interpretation
3. Comparison with previous animal studies of same model or intervention
4. Translational relevance: how do findings relate to the human condition?
5. Limitations: model limitations (does not fully recapitulate human disease), single sex (if applicable), limited follow-up, sample size
6. Future directions

---

## Common Animal Study Pitfalls

1. **Missing IACUC number** — always required; reviewers check this.
2. **No sample size justification** — G*Power calculation is mandatory.
3. **Not reporting sex** — increasing pressure to include both sexes or justify exclusion.
4. **Confounding housing conditions** — different cages, litters, or technicians are confounders; report and control.
5. **Outcome assessor not blinded** — blinding of outcome assessment is the most important bias control in animal studies.
6. **Inconsistent or missing humane endpoints** — specify pre-determined criteria for euthanasia.
7. **Reporting group means without individual data points** — show individual data (dot plots) for small N.
8. **Using repeated ANOVA without accounting for sphericity** — use linear mixed-effects models instead.

# Paper Type: Case Report

## Overview

- **Reporting guideline:** CARE 2013 (mandatory)
- **Typical word count:** 1000–1500 words (short-form) or 2000–3000 words (extended with literature review)
- **Default mode:** Short-form (1000-1500 words). Use `--extended` for longer format.
- **Structure:** Title → Abstract → Introduction → Case Presentation → Discussion → Conclusions → Patient Perspective (optional) → Informed Consent
- **Key requirement:** Patient consent/anonymization documented

---

## CARE 2013 Checklist Quick Reference

| # | Item | Section | Description |
|---|------|---------|-------------|
| 1 | Title | Title | Diagnosis or main symptom AND "case report" |
| 2 | Key words | Abstract | 2-5 keywords covering the case |
| 3 | Abstract | Abstract | Structured: Introduction, Case Presentation, Conclusion |
| 4 | Introduction | Introduction | Background with references, why this case is reportable |
| 5 | Patient information | Case Presentation | Demographics, main symptoms, medical history |
| 6 | Clinical findings | Case Presentation | Physical examination, key clinical findings |
| 7 | Timeline | Case Presentation | Important dates and events in table or figure |
| 8 | Diagnostic assessment | Case Presentation | Methods, pathological findings, challenges, reasoning |
| 9 | Therapeutic intervention | Case Presentation | Types, administration, duration, changes |
| 10 | Follow-up and outcomes | Case Presentation | Clinician-assessed and patient-assessed outcomes, adherence, adverse events |
| 11 | Discussion | Discussion | Strengths, limitations, relevant literature, rationale for conclusions |
| 12 | Patient perspective | Optional | Patient's own views when available |
| 13 | Informed consent | End | Documentation that consent was obtained |

> Full CARE checklist: https://www.care-statement.org/checklist

---

## When to Write a Case Report

Case reports are appropriate when the case demonstrates:
- A rare or previously unreported condition or presentation
- An unusual complication of a known condition or procedure
- A novel diagnostic approach or therapeutic intervention
- An important teaching point with clinical relevance
- A paradoxical or unexpected finding

---

## Title

Format: "[Condition/Diagnosis]: [What makes it unusual]" or "[Unusual presentation/complication] of [condition]"

Example: "Cerebral Venous Sinus Thrombosis Presenting as Isolated Neck Pain: A Case Report and Literature Review"

Keep ≤ 15 words. Include "Case Report" in the title or subtitle.

---

## Structured Abstract (150–250 words)

```
Introduction: [Why this case is being reported — one sentence on rarity or teaching value]

Case Presentation: [Age, sex, key presenting complaint, key imaging/lab findings, diagnosis]

Clinical Findings: [Key examination and investigation results]

Treatment/Intervention: [What was done]

Outcome: [Follow-up duration, outcome at last follow-up]

Conclusion: [Take-home message — what this case adds to the literature]
```

---

## Introduction (200–400 words)

1. Clinical background: Briefly describe the condition (2–3 sentences; cite key references).
2. Why this case is unusual: State the rarity explicitly. If known epidemiology: "The reported incidence is [X per 100,000 person-years]."
3. Objective: "We report a case of [condition] presenting with [unusual feature] and discuss [management strategy/diagnostic approach/teaching point]."

---

## Case Presentation (600–1200 words)

### Patient Information

- Age and sex (no name or specific dates — protect anonymity)
- Chief complaint
- Relevant medical history, medications, allergies, family history, social history
- Any relevant prior treatments or procedures

### Clinical Findings

- Physical examination findings
- Vital signs (if relevant)

### Diagnostic Assessment (Imaging — Key Section for Radiology Cases)

Structure imaging descriptions as:

```
[Modality and technique]: [Acquisition parameters if relevant]
  → Findings: [Location, size, morphology, signal/density characteristics,
               enhancement pattern, associated findings]
  → Impression: [Radiological diagnosis or differential]
```

Example:
"Contrast-enhanced MRI of the brain (1.5 T, gadolinium 0.1 mmol/kg) demonstrated a 2.3 × 1.8 cm extra-axial mass in the right cerebellopontine angle with hypointense T1, hyperintense T2 signal, and homogeneous enhancement. Mass effect on the ipsilateral facial and vestibulocochlear nerves was evident."

List relevant laboratory findings in a table.

### Clinical Timeline Table

| Date | Event |
|------|-------|
| Day 0 | Symptom onset — [description] |
| Day 3 | Emergency department presentation |
| Day 5 | Imaging: [key finding] |
| Day 7 | Diagnosis established / Procedure performed |
| Day 14 | Discharge |
| Month 3 | Follow-up: [outcome] |

### Therapeutic Intervention

Describe exactly what was done:
- Medical management: drug names, doses, duration
- Surgical/procedural management: technique, approach, materials used, any intraoperative findings
- Multidisciplinary involvement

### Follow-up and Outcome

- Follow-up duration (e.g., "At 6-month follow-up")
- Functional outcome (use validated scales where applicable: mRS, GCS, NIHSS, Karnofsky)
- Imaging outcome (if follow-up imaging available)
- Any complications of treatment

---

## Discussion (400–800 words)

1. **Literature context:** How does this case compare to previously reported cases? Cite key papers. Include a brief systematic search if cases are very rare ("A PubMed search using the terms '[terms]' identified [N] previously reported cases").
2. **Pathophysiology:** Explain the underlying mechanism if relevant.
3. **Diagnostic challenge:** Why was this case difficult to diagnose, or what did imaging add?
4. **Management rationale:** Why was this treatment chosen? What are the alternatives?
5. **Learning points:** What should clinicians take from this case?

---

## Learning Points Box (Required)

3–5 concise, specific, clinically actionable statements:

```
Learning Points
• [Specific diagnostic or management insight]
• [Imaging finding or pattern to recognize]
• [Management principle or pitfall to avoid]
• [When to consider this diagnosis]
```

---

## Conclusion (100–200 words)

"We report a case of [condition] with [unusual feature]. [Key diagnostic or management point]. This case highlights the importance of [clinical lesson]. [Any implications for practice or future research]."

---

## Patient Perspective (Optional)

If the patient consented to provide a statement about their experience, include a brief paragraph in their own words. This is increasingly encouraged by CARE guidelines and some journals.

---

## Informed Consent Statement

At the end of the case report, include one of these statements:

**Option A (patient consented):**
"Written informed consent was obtained from the patient for publication of this case report and any accompanying images."

**Option B (patient deceased/consent waiver):**
"The institutional review board waived the requirement for informed consent for this retrospective case report. All identifying information has been removed."

**Option C (minor patient):**
"Written informed consent was obtained from the patient's legal guardian for publication of this case report."

---

## Required Figures

| Item | Content |
|------|---------|
| Figure 1 | Key imaging findings (annotated; typically 3–6 panels) |
| Figure 2 | Timeline figure or pathology if relevant |
| Table 1 | Clinical and laboratory data at presentation |
| Table 2 | Comparison with published similar cases (if ≥5 exist) |

---

## Similar Case Literature Search

When writing the Discussion, systematically search for previously reported similar cases:

**Search strategy:**
1. Primary: PubMed — `"[condition]"[Title] AND "case report"[Publication Type]`
2. If <5 results, broaden: `"[condition]"[Title/Abstract] AND (case report[ti] OR case series[ti])`
3. Optional: Google Scholar for non-indexed case reports

**Data extraction from each similar case:**
- Author and year
- Patient age and sex
- Key presenting features
- Diagnostic method
- Treatment approach
- Outcome at follow-up

**Comparison table (include if >=5 similar cases found):**

| Author (Year) | Age/Sex | Key Presentation | Diagnosis Method | Treatment | Outcome |
|---------------|---------|-----------------|-----------------|-----------|---------|
| Current case | ... | ... | ... | ... | ... |
| [Prior case 1] | ... | ... | ... | ... | ... |

If <5 similar cases exist, state explicitly: "To our knowledge, only [N] similar cases have been reported in the English literature [citations]."

---

## Common Case Report Pitfalls

1. **Failing to explain why the case is unusual** — state rarity explicitly with epidemiological data.
2. **Missing patient consent statement** — most journals will reject without this.
3. **Identifying information in images** — check DICOM metadata, remove patient labels from figures.
4. **Vague imaging descriptions** — give exact size, location, signal characteristics, and enhancement pattern.
5. **Overclaiming in Discussion** — case reports cannot establish causality; use "may," "suggest," "is consistent with."
6. **Insufficient literature context** — do a PubMed search for similar cases; cite all relevant ones.
7. **Too long a Discussion** — case reports are not reviews; keep Discussion focused on this case's lessons.

# Paper Type: Case Series

## Overview

- **Reporting guideline:** CARE adapted for multiple patients; for ≥5 patients consider PROCESS/SCARE
  (surgical) where applicable. A case series is a **methods-light mini-cohort**, not a stack of
  separate case reports — it needs cohort-style methods that a single case report does not.
- **Typical word count:** 1500–3000 words (varies by patient count and synthesis depth).
- **Structure:** Title → Abstract (structured) → Introduction → Methods → Results (summary table +
  per-case vignettes) → Discussion (cross-case synthesis) → Conclusions → Ethics/Consent.
- **Key requirement:** A real Methods section (design, setting, case identification, eligibility,
  protocol) AND per-patient consent/anonymization. The contribution is the **pattern across cases**,
  which a single case cannot show.

---

## How a case series differs from a case report

| Dimension | Case report (n=1) | Case series (n≥2, typically 3–20) |
|-----------|-------------------|-----------------------------------|
| Methods | Narrative only | Explicit: design, setting, dates, identification source, eligibility, protocol |
| Backbone | Chronological narrative | **Summary table of all cases** + per-case vignettes |
| Contribution | A single instructive case | A **cross-case pattern** (subtypes, spectrum, common features) |
| Denominator | Not expected | Selection/ascertainment must be stated; screened pool ideally given |
| Limitations | n=1 caveats | Cohort-level: selection bias, small n, retrospective design, no comparator |

---

## Methods (the section a case report omits)

State each of these — reviewers read a series as a small observational study:

1. **Study design and setting** — retrospective vs prospective; single vs multi-centre; date range.
2. **Case identification** — how cases were found (registry/database query, consecutive referrals,
   departmental archive). Name the source and the search terms or referral pathway.
3. **Eligibility** — inclusion and exclusion criteria as a numbered list, not prose. State whether
   cases were **consecutive** and, ideally, the **screened pool size** (how many were assessed to
   arrive at the included n).
4. **Data/measurement protocol** — for imaging series, the acquisition parameters per modality; for
   clinical series, the measurement instruments and definitions.
5. **Assessment process** — who reviewed/adjudicated, independence, experience, how disagreement was
   resolved.

## Results — the summary table is the backbone

- Open Results with a **summary table enumerating every case** (one row per patient): identifier,
  age/sex, key presentation, investigation/modality, decisive finding, and the assigned category or
  outcome. The table lets the reader see the pattern before the vignettes.
- Follow with **compact per-case vignettes** in a consistent order (the same fields each time), each
  anchored to its table row and figure.
- Group cases by subtype/pattern when a taxonomy exists (e.g., arterial / venous / neurogenic), so the
  series reads as a comparison rather than a list.

## Discussion — synthesize across cases

- Lead with the **cross-case pattern**: which features were reproducible, which varied, and what the
  series adds beyond isolated reports.
- Compare subtypes against each other and against the literature.
- **Cohort-level limitations are mandatory and specific**: selection/ascertainment bias (referral or
  database-query series is not a denominator of all disease), small n, retrospective design,
  non-uniform protocols, absence of a comparator or confirmatory standard, limited follow-up.
- **No prevalence/proportion claims from a selected series**: a referral series cannot estimate how
  common a subtype is. Report counts, not rates, unless a true denominator exists.

## Ethics and consent

- Per-patient written consent for publication, or a documented IRB waiver basis for an anonymised
  retrospective series (cite the determination rather than asserting "per policy").
- De-identify every case: remove dates where non-essential, institution identifiers, and image
  metadata; confirm image panels are stripped of identifiers.

## Required figures/tables

- **Table 1 (mandatory):** all-cases summary (one row per patient).
- **Figures:** representative images per case or per subtype, each labeled to its case number.
- Optional: a pattern/flow figure if the series defines a taxonomy or diagnostic algorithm.

## Common pitfalls

- Writing N separate case reports with no Methods and no summary table (the most common reviewer
  rejection for a series).
- Implying prevalence or effectiveness from a selected/referral series.
- Omitting the screened pool size, so consecutiveness and selection cannot be judged.
- Cohort-level limitations missing or generic ("more studies are needed") rather than naming
  selection bias, small n, and absent comparator.
- Inconsistent per-case fields, so the cases cannot be compared.

## Cross-references

- Single-patient structure: `paper_types/case_report.md` + `exemplar_case_report.md`.
- Narrative/figure anatomy: `make-figures` `exemplar_plots/clinical_timeline.md` and
  `imaging_panel.md`.
- Reviewer probes for series-specific defects: `peer-review`/`self-review`
  `domain-probes/case_report.md` (CR8 covers selection/ascertainment and no-rate-from-a-series).

# Cross-National Comparison Study — Paper Type Template

## Overview

Template for cross-national (binational) comparative studies using nationally representative datasets from two or more countries. Covers three study architectures: (A) Parallel Survey Analysis using cross-sectional surveys (e.g., KNHANES + NHANES), (B) Discovery/Validation Cohort using claims databases (e.g., NHIS + JMDC), and (C) Binational Birth/Longitudinal Cohort with sibling comparison. Applicable to prevalence comparisons, association studies, trend analyses, and composite health metric evaluations.

---

## Title

- Include "Cross-National," "Binational," or country names.
- Specify the study design in a subtitle.
- Under 20 words preferred.

### Title Templates

| Pattern | Example |
|---------|---------|
| `Cross-national comparison of {X} and {Y} in {Country A} and {Country B}: a nationwide representative comparative study` | Depression and diabetes in Korea and the US |
| `Binational association between {X} and {Y} in {Country A} and {Country B}: a nationally representative cross-sectional study` | PUFA and depression in Korea and the US |
| `Maternal {exposure} and {outcome} in offspring: a binational cohort study` | Pregestational diabetes and neuropsychiatric risk |
| `Burden of {outcome} after {exposure} in {Country A} and {Country B}: a binational population-based cohort study` | Cardiovascular outcomes after infection |
| `Trends in {outcome} among {population}, {year range}: a nationwide representative study` | Physical activity trends (single-country variant) |

Notes:
- "Binational" is increasingly preferred over "Cross-national" for two-country studies.
- Always include the year range for trend studies.
- The subtitle pattern is consistent: "a nationwide representative {comparative/cross-sectional/cohort} study."

---

## Abstract (Structured, 250 words max)

### Background
- State the known relationship and the cross-national evidence gap.
- Template: "Although {known relationship} has been suggested, evidence remains limited across cultural contexts. This study {compared/examined} {association} in {Country A} and {Country B}."

### Methods
- Name both datasets with years and sample sizes.
- State that datasets were analyzed independently.
- Name the harmonization approach and statistical methods.

### Results
- Report sample sizes from each dataset.
- Key findings with weighted odds ratios (wOR) or aHRs and 95% CIs from each country.
- Highlight convergent or divergent findings across countries.

### Conclusion
- Main conclusion emphasizing cross-national consistency or divergence.
- Implication for policy or future research.

#### Discovery/Validation Variant
- Results structure: "In the {weighted} discovery cohort, {N} individuals were included... Similar patterns were observed in the validation cohort."

---

## Introduction (3-4 paragraphs, ~400-500 words)

### Paragraph 1: Global Burden Statement
- Cite GBD or WHO prevalence figures with projections.
- Template: "{Condition} remains a {highly prevalent / growing} global health {threat/challenge}."

### Paragraph 2: Prior Evidence (Single-Country Limitations)
- Summarize existing single-country evidence.
- Flag limitations: "were limited to single-country cohorts," "did not adjust for key confounders," "have not taken broad population approaches."
- If relevant, cite Mendelian randomization evidence showing ancestral or population differences.

### Paragraph 3: Cross-National Gap and Study Aim
- Template: "To our knowledge, no prior study has evaluated {association} within a cross-national comparative framework."
- Template: "To address this gap, we analyzed nationally representative data from {Dataset A} and {Dataset B} collected between {years} to compare {outcome} in {Country A} and {Country B}."
- Optional: justify the country pairing with cultural, genetic, or healthcare system differences.

### Variation: Trend Studies
- Replace the cross-national gap with a temporal gap: "there is a lack of large-scale studies examining how {X} patterns have evolved across pre-, intra-, and post-pandemic periods."

---

## Materials and Methods (~1000-1400 words)

### 3.1 Data Sources

Describe each dataset separately with parallel structure:

Template:
> This study utilized {Dataset A} for {years} and {Dataset B} for {years}.
>
> {Dataset A} is a {population-based, cross-sectional / cohort} survey conducted by {Agency A} using a stratified, multistage probability sampling design to assess the health and nutritional status of the noninstitutionalized {Country A} population.
>
> {Dataset B}, administered by {Agency B}, is a {biennial / annual} survey designed to represent the noninstitutionalized {Country B} population using a similar multistage probability sampling approach.
>
> Both surveys include standardized health interviews, physical examinations, and laboratory tests, and collect extensive information on sociodemographic characteristics, health behaviors, and medical conditions.

#### Common Dataset Pairings

| Country A Dataset | Country B Dataset | Use Case |
|-------------------|-------------------|----------|
| KNHANES (Korea) | NHANES (US) | Nutrition, metabolic, mental health, composite score comparisons |
| NHIS (Korea) | JMDC (Japan) | Claims-based cohort and birth cohort studies |
| K-COV-N (NHIS+KDCA) | JMDC (Japan) | Disease-specific cohort (discovery/validation) |
| KCHS (Korea) | — (single-country) | National trend studies with temporal phases |

Notes:
- Survey years may be non-consecutive if specific variables are only collected in certain cycles. Always explain excluded years.
- For claims-based binational studies, shift the description to: "This binational cohort study included {N} individuals from {Country A} and {N} from {Country B}, from {start} to {end}."

### 3.2 Ethics Approval

- Separate IRB approvals per country, listed together.
- Template: "The {Dataset A} protocol was approved by {IRB A} ({numbers}), and the {Dataset B} protocol was approved by {IRB B} ({numbers}). All participants provided written informed consent. Both surveys comply with the ethical principles outlined in the Declaration of Helsinki, and their de-identified data are publicly accessible for research purposes."

### 3.3 Variable Harmonization

Three-layer harmonization framework:

#### Layer 1: Identical Instruments
- Variables measured with the same validated instrument in both datasets (e.g., PHQ-9 for depression, fasting glucose + HbA1c for diabetes).
- Template: "{Instrument} was used in both {Dataset A} and {Dataset B}."

#### Layer 2: Country-Specific Cutoffs with Clinical Justification
- Variables where clinical thresholds differ by national guidelines.
- Template: "{Variable} was defined using country-specific standards: {cutoff A} in {Country A} and {cutoff B} in {Country B}, reflecting established national guidelines."
- Common example: BMI >=25 in East Asia (Asia-Pacific cutoff) vs. BMI >=30 in US/Europe (WHO Western cutoff).

#### Layer 3: Operationally Different Variables Mapped to Equivalent Categories
- Variables measured differently but mappable to equivalent categories.
- Common examples:
  - Income: quintiles (Korea) vs. poverty-income ratio (US) → binary high/low.
  - Smoking/alcohol: mapped to equivalent categorical levels.

#### Key Harmonization Decisions (Reference Table)

| Variable | Typical Resolution |
|----------|-------------------|
| Obesity | Country-specific BMI cutoffs with justification |
| Income | Equivalent binary or tertile split |
| Depression | Identical instrument (PHQ-9) with same cutoff |
| Diabetes | Identical lab criteria (FG >=126 or HbA1c >=6.5%) |
| Physical activity | Identical framework (IPAQ-SF → MET-min/week) |

#### Core Principle
> "We applied harmonized variable definitions and conducted weighting and preprocessing separately for each dataset to preserve internal validity."

**Never pool raw data across countries.** Each dataset is analyzed independently.

#### ICD-10-Level Harmonization (Claims-Based Studies)
For binational cohort studies using claims databases, harmonization is done at the ICD-10 code level rather than questionnaire items. Apply the same code definitions, exposure/outcome assessments, and analytical approaches to both cohorts.

### 3.4 Study Population

- State inclusion/exclusion criteria applied to each dataset separately.
- For composite score studies (e.g., Life's Essential 8): calculate the score identically in both countries.
- For cohort studies: apply parallel exclusion cascades to each country's dataset.

### 3.5 Statistical Analysis

#### Architecture A: Parallel Survey Analysis

```
Step 1 — Separate analysis per country
  "Data from {Dataset A} and {Dataset B} were analyzed separately."
  Complex survey design: "appropriate stratification, clustering, and sampling weights were applied."

Step 2 — Sequential model building
  Model 1: adjusted for age and sex
  Model 2: additionally adjusted for {income, education, smoking, alcohol, BMI, comorbidities}
  Results as weighted odds ratios (wOR) with 95% CI

Step 3 — Subgroup / interaction analyses
  Stratified by: sex, age group, education, income, alcohol, smoking, obesity, comorbidities
  "Weighted odds ratios are adjusted for all covariates except the stratification variable."

Step 4 — Advanced modeling (choose as appropriate)
  - Restricted cubic spline (RCS) with 3 knots for nonlinear dose-response
  - Weighted quantile sum (WQS) regression for composite exposure component contribution
  - Beta-coefficient comparison across time periods (trend studies)
```

Notes:
- Never pool datasets into a single regression.
- Compare results side-by-side in the same table.
- Multicollinearity: check via VIF; values <2.0 acceptable.
- Missing data: variables with <5% missingness → complete case; higher → multiple imputation (5 datasets).

#### Architecture B: Discovery/Validation Cohort

```
Step 1 — Full analysis in discovery cohort
  PS-based balancing (overlap weighting, SIPTW, or matching)
  Cox proportional hazards → aHR with 95% CI
  Stratification and time-dependent analyses

Step 2 — Replication in validation cohort
  "The study applied similar methodologies to the {validation cohort} as those used for the discovery cohort."
  Same ICD-10 codes, exposure/outcome definitions, follow-up duration, and PS approach.

Step 3 — Subgroup analyses
  Disease severity, treatment dosage, temporal era stratification
```

#### Architecture C: Binational Birth/Longitudinal Cohort

```
Step 1 — Full-cohort SIPTW-weighted Cox regression (primary)
Step 2 — Sibling comparison analysis (addresses unmeasured familial confounding)
Step 3 — Independent validation in second country (sibling pairs or full cohort)
```

For multiple primary outcomes: apply Bonferroni correction (p < 0.05/K).

#### Software and Significance
- SAS for survey-weighted analyses and Cox regression.
- R for WQS regression and advanced modeling.
- Python for ML components if applicable.
- "A two-sided p value of less than 0.05 was considered statistically significant."

---

## Results (~800-1200 words)

### 4.1 Study Population
- Report sample sizes from each dataset: "{N_A} from {Dataset A} and {N_B} from {Dataset B}."
- Demographics table (Table 1) with columns per country.

### 4.2 Primary Findings
- Present results from each country in parallel.
- For parallel survey studies: wORs from both countries in the same table.
- For discovery/validation: primary results from discovery, confirmation from validation.

### 4.3 Subgroup and Advanced Analyses
- Stratification results by country.
- Dose-response (RCS) or component contribution (WQS) results.
- Time-dependent or era-specific results if applicable.

### 4.4 Sensitivity Analyses
- Confirm findings with alternative definitions, negative controls, or sibling comparisons.

### Rules
- Same as original article: no interpretation, no causal language.
- Present both countries' results for every analysis.

---

## Discussion (4-5 paragraphs, ~800-1200 words)

### Paragraph 1: Summary of Key Findings
- Highlight cross-national consistency or divergence.
- State whether findings were replicated across countries.

### Paragraphs 2-3: Comparison with Prior Literature
- Compare with prior single-country and cross-national studies.
- Discuss population-specific factors (cultural, genetic, healthcare system) that may explain differences.

### Paragraph 4: Clinical and Policy Implications
- Policy relevance across different healthcare systems.
- Public health recommendations.

### Paragraph 5: Limitations

Standard limitation categories for cross-national studies:

| # | Category | Template |
|---|----------|----------|
| 1 | Cross-sectional design | "The cross-sectional design precludes inference of causality." Mitigation: "the dose-response relationship and consistency across subgroups support plausibility." |
| 2 | Dataset differences | "Differences exist between {Dataset A} and {Dataset B} in data collection methods, diagnostic criteria, and survey protocols." Mitigation: "we applied harmonized variable definitions and conducted weighting and preprocessing separately for each dataset to preserve internal validity." |
| 3 | Temporal coverage mismatch | "{Dataset A} included selected survey years, whereas {Dataset B} provided continuous data." Mitigation: "appropriate sampling weights and consistent analytic criteria." |
| 4 | Self-report bias | "The use of self-reported data may introduce recall bias." Mitigation: "both surveys utilize validated instruments administered by trained personnel." |
| 5 | Country-specific definitions | "Obesity and income were defined using country-specific standards." Mitigation: "these definitions reflect established national guidelines and were applied consistently within each dataset, allowing for valid within-country comparisons." |
| 6 | Multiple comparisons | "Subgroup analyses were not adjusted for multiple comparisons." Mitigation: "based on prespecified variables of clinical and epidemiological relevance." |
| 7 | Unmeasured confounders | "Differences in healthcare systems, cultural factors, and unmeasured confounders may influence the relationship." |
| 8 | Population representativeness | "Both cohorts are from East Asian and Western populations; extrapolation to other regions requires caution." |

Each limitation followed by mitigation. End with strength-as-buffer: "our use of large, nationally representative samples allows for a broad understanding of population-level trends."

### Conclusion
- Citable statement emphasizing cross-national convergence or divergence.
- Specific policy or clinical recommendation.

---

## Tables

- **Table 1**: Baseline characteristics by country (separate columns per dataset).
- **Table 2**: Primary association results (wOR or aHR with 95% CI) from both countries in parallel columns.
- **Table 3**: Subgroup analyses by country.
- **Table S1+**: Variable harmonization details, ICD-10 codes, sensitivity analysis results.

## Figures

- **Figure 1**: Study flow diagram (per country or combined with country-specific branches).
- **Figure 2**: Forest plot of primary associations by country and subgroup.
- **Figure 3**: Restricted cubic spline dose-response curves (if applicable).
- Optional: Trend plots for temporal studies, WQS component weight bar charts.

---

## Boilerplate Sentences (Reusable)

### Survey Design
> "To account for the complex survey designs and ensure nationally representative estimates, appropriate stratification, clustering, and sampling weights were applied."

### Ethical
> "Both surveys comply with the ethical principles outlined in the Declaration of Helsinki, and their de-identified data are publicly accessible for research purposes."

### Separate Analysis Justification
> "For cross-national comparisons, data from {Dataset A} and {Dataset B} were analyzed separately."

### Within-Country Validity Defense
> "These definitions reflect established national guidelines and were applied consistently within each dataset, allowing for valid within-country comparisons and minimizing potential bias in the overall findings."

### Data Availability
> "Study protocol and statistical code: available from the corresponding author. Dataset: {public access URLs}."

---

## Checklist Before Submission

- [ ] Both datasets described with sampling design, years, and agency
- [ ] Separate IRB approvals per country listed
- [ ] Harmonization approach explicitly stated for all key variables
- [ ] Country-specific cutoffs justified with national guideline references
- [ ] Datasets analyzed independently (never pooled)
- [ ] Survey weights applied for cross-sectional surveys
- [ ] Results presented in parallel for both countries
- [ ] Subgroup analyses consistent across both datasets
- [ ] Limitations address dataset differences and temporal mismatch
- [ ] Within-country validity defense included
- [ ] Numbers consistent between text, tables, and figures
- [ ] Reporting guideline (STROBE) items addressed

# Paper Type: Letter to the Editor

## Overview

- **Purpose:** Concise scholarly comment on a recently published article, or a brief original observation
- **Word count:** 400–600 words (some journals allow up to 750)
- **Structure:** No abstract, no section headers, 3–5 references maximum
- **Key rule:** ONE main point. A letter with two main points is a letter that should not be published.

---

## When to Write a Letter

1. **Comment on a published article:** Methodological concern, missing analysis, alternative interpretation, replication in a different population
2. **Correspondence on your own article:** Response to a letter about your published paper
3. **Brief original observation:** Too small for a full paper but notable; single case or very small series

---

## Standard Letter Format

```
[Journal Name]
[Date]

To the Editor:

[Opening sentence: reference the article being commented on, with citation]

[Body: ONE main point, supported by evidence, analysis, or data]
[If applicable: additional supporting data, calculation, or comparison]

[Closing: what the main point means — brief, direct]

[Optional: acknowledgment of limitations of your own point]

Sincerely,
[Name, degree]
[Institution, City, Country]
[Email]
[On behalf of co-authors if any]

References
[Maximum 5 citations]
```

---

## Opening Sentence Templates

**Commenting on methodology:**
"We read with interest the article by [Author] et al. [citation] reporting [brief description]. However, we wish to raise a concern regarding [specific methodological point]."

**Providing additional data:**
"We read with interest the study by [Author] et al. [citation]. Our experience with [N] patients at [Institution] provides additional perspective on this topic."

**Alternative interpretation:**
"The study by [Author] et al. [citation] makes an important contribution. We would like to offer an alternative interpretation of the reported findings."

**Replication:**
"We have recently conducted an analysis of [similar cohort/dataset] that provides independent support for (or challenges) the findings of [Author] et al. [citation]."

---

## Body (200–350 words)

Make your ONE main point clearly. Structure:
1. State the specific concern or observation (1–2 sentences)
2. Provide supporting evidence: cite literature, provide a calculation, reference an existing guideline, or briefly describe your own data
3. Explain the clinical or scientific significance

**If pointing out a methodological issue:**
- Be specific: cite the exact figure/table/section where the issue appears
- Quantify the impact if possible ("This could overestimate sensitivity by approximately X percentage points")
- Propose what analysis should have been done

**If providing additional data:**
- State N, population, and key result with CI
- Keep statistics minimal — no full table, just the key number

---

## Closing (50–100 words)

"In summary, [restate main point in one sentence]. We believe [clinical or methodological implication]. [Optional: call for future research or transparency]."

---

## Response Letter Format (When Replying to a Letter About Your Paper)

If someone writes a letter about your article and the journal asks you to respond:

```
To the Editor:

We thank [Author] et al. for their interest in our study [citation] and for
raising the issue of [topic].

[Address each point they raised, one by one. Be concise and professional.
Do not dismiss their concerns; acknowledge what is valid, then explain
your position.]

[If they are correct: "We agree that [point]. This limitation was
acknowledged in our Discussion [citation, page X]. We are planning
[future work] to address this."]

[If you disagree: "We respectfully disagree with [point] for the
following reasons: [evidence]. [Author Year] demonstrated that
[supporting evidence]."]

We thank [Author] et al. for contributing to the discussion of
[topic] in the field.

Sincerely,
[Name, degree]
[Institution]
```

---

## Common Letter Pitfalls

1. **More than one main point** — editors reject letters that try to make multiple arguments. Submit separately or pick the strongest point.
2. **Too long** — strictly stay within the word limit (check each journal); editors cut letters without revision.
3. **Personal or aggressive tone** — always professional and respectful, even when pointing out errors.
4. **Citing too many references** — maximum 5; focus on the 1–2 most directly relevant.
5. **Not referencing the specific article** — the opening must cite the article you are commenting on with the full journal citation.

# Paper Type: Systematic Review and Meta-Analysis

## Overview

- **Reporting guideline:** PRISMA 2020 (mandatory)
- **Quality assessment:** QUADAS-2 (diagnostic), RoB 2 (RCTs), MINORS (non-randomized surgical studies)
- **Registration:** PROSPERO required before data extraction (cite protocol)
- **Typical word count:** 4500–6000 words
- **Structure:** Abstract → Introduction → Methods → Results → Discussion → Conclusions

**Worked structure models** (paragraph order + what each paragraph must establish, synthetic):
`exemplar_methods/meta_analysis_prisma.md`, `exemplar_results/meta_analysis_prisma.md`,
`exemplar_discussion/meta_analysis_prisma.md`. This file carries the fuller prose templates;
the exemplars are the compact skeletons for confirming every load-bearing paragraph is present.

---

## Required at Phase 0 (Init)

Before writing, confirm:
1. PROSPERO registration number (or justify non-registration)
2. Search databases (PubMed, Embase, Cochrane, Web of Science minimum)
3. Search date and date of last update
4. Effect measure (OR, RR, HR, MD, SMD, AUC, sensitivity/specificity)
5. Planned subgroup analyses (pre-specified in protocol)

---

## Structured Abstract (250 words)

```
Background: [One sentence: why this systematic review is needed]
Purpose: [PICO: Population, Intervention/Index test, Comparator, Outcome]
Methods: [Databases searched, dates, study design, quality tool]
Results: [N studies, N patients, pooled estimate with 95% CI, 95% PI when I² > 50%, I²]
Conclusion: [Main finding, certainty of evidence]
```

---

## Introduction (400–600 words)

1. **Background:** Why is this question clinically important? What is the burden of disease or diagnostic challenge?
2. **Knowledge gap:** What do existing studies show, and why is a synthesis needed? (Reference 2–4 key studies or previous meta-analyses)
3. **Objective:** State the PICO question explicitly.
   - "The purpose of this systematic review and meta-analysis was to evaluate the diagnostic accuracy of [index test] for [condition] in [population]."
4. **PROSPERO registration:** "This review was prospectively registered with PROSPERO (CRD[number])."

---

## Methods (1200–1800 words)

### 2.1 Protocol and Registration
State PROSPERO number. Confirm adherence to PRISMA 2020.

### 2.2 Search Strategy
List all databases with dates. Provide full search string for at least one database (or supplementary). Include grey literature (ClinicalTrials.gov, conference abstracts if applicable).

**Example:**
"MEDLINE (via PubMed) was searched from inception to [date] using the following strategy: ([MeSH term 1] OR [free text term]) AND ([MeSH term 2] OR [free text term]) AND ([MeSH term 3]). The complete search strategies for all databases are provided in Supplementary Table 1."

### 2.3 Eligibility Criteria

**Inclusion criteria table:**

| Criterion | Specification |
|-----------|---------------|
| Study design | [Prospective/retrospective, cross-sectional, RCT, etc.] |
| Population | [Patient characteristics, age, clinical setting] |
| Index test | [Specific test/intervention] |
| Reference standard | [Gold standard or comparator] |
| Outcomes | [Primary and secondary] |
| Language | English (and specify others if included) |
| Time period | [If applicable] |

**Exclusion criteria:** [List explicitly, not just "did not meet inclusion criteria"]

### 2.4 Study Selection
"Two reviewers (initials) independently screened titles/abstracts, then full texts. Inter-reviewer agreement was [% agreement / Cohen's kappa = X.XX] at the title/abstract stage and [% agreement / Cohen's kappa = X.XX] at the full-text stage. [N] discrepancies were resolved by consensus or a third reviewer (initials). The screening process is summarized in the PRISMA 2020 flow diagram (Figure 1)."

### 2.5 Data Extraction
"Two reviewers independently extracted data using a standardized form. The following variables were extracted: [list 8–15 variables]. Disagreements were resolved by discussion."

**Data extraction table template (Supplementary Table):**

| Study | Year | Country | Design | N | Age (mean±SD) | [Variable 1] | [Variable 2] | Outcome measure | Follow-up |
|-------|------|---------|--------|---|--------------|-------------|-------------|-----------------|-----------|

### 2.6 Quality Assessment
Specify which tool and how it was applied:
- **QUADAS-2** (4 domains: patient selection, index test, reference standard, flow and timing) → 2 reviewers, signaling questions → low/high/unclear risk
- **RoB 2** (5 domains for RCTs) → randomization, deviations, missing data, outcomes, reporting
- **MINORS** (12 items for non-randomized surgical studies) → score 0–24

### 2.7 Statistical Analysis

**Pooling:**
"We pooled effect estimates using a random-effects model with the DerSimonian-Laird estimator. We chose a random-effects model a priori given the expected clinical heterogeneity across studies."

**Heterogeneity:**
"Statistical heterogeneity was assessed using the I² statistic (threshold: I² > 50% indicates substantial heterogeneity) and Cochran's Q test (P < 0.10). The τ² (between-study variance) and 95% prediction interval were reported."

**Subgroup analyses (pre-specified):**
List subgroup variables. Example: scanner type, field strength, patient age group, reference standard type.

**Sensitivity analyses:**
- Leave-one-out analysis
- Restricting to prospective studies only
- Restricting to studies with low QUADAS-2 risk of bias

**Publication bias:**
"Publication bias was assessed using Egger's test (for continuous outcomes) or Deeks' funnel plot asymmetry test (for diagnostic accuracy) when ≥10 studies were available. Trim-and-fill analysis was performed if asymmetry was detected."

**Software:** R (version X.X.X), packages: `meta`, `metafor`. Seed: set.seed(42).

---

## Results (1200–1500 words)

### 3.1 Study Selection
"Database searches identified [N] records. After removing [N] duplicates, [N] records were screened, of which [N] were excluded at the title/abstract stage. A total of [N] full-text articles were assessed for eligibility; [N] were excluded [with reasons]. Finally, [N] studies (N = [total patients]) were included in the systematic review, of which [N] were included in the meta-analysis. The PRISMA 2020 flow diagram is shown in Figure 1."

### 3.2 Study Characteristics
"Included studies were published between [year] and [year]. Sample sizes ranged from [N] to [N] participants (median [N], IQR [N–N]). [N] studies were prospective and [N] were retrospective. Studies were conducted in [list countries]."

Reference the characteristics table.

### 3.3 Quality Assessment
"Quality assessment results are summarized in Figure 2 (QUADAS-2 summary plot). [N] studies were rated at low risk of bias across all four domains. The most common methodological concern was [domain]: [N/N] studies had high or unclear risk."

### 3.4 Quantitative Synthesis
"[N] studies (N = [patients]) contributed to the primary meta-analysis. The pooled [effect measure] was [value] (95% CI, [lower]–[upper]; I² = [value]%, τ² = [value], P for heterogeneity = [value]). The 95% prediction interval ranged from [value] to [value], indicating that in a new study setting, the true effect could be as low as [value]."

Report each subgroup analysis with test for subgroup interaction (P for interaction).

### 3.5 Publication Bias
If ≥10 studies: "Egger's test showed [evidence/no evidence] of funnel plot asymmetry (P = [value]). Trim-and-fill analysis imputed [N] studies, resulting in an adjusted pooled estimate of [value] (95% CI, [lower]–[upper])."

---

## Discussion (800–1000 words)

1. **Summary of evidence:** Restate main finding in one sentence with the effect size and units.
2. **Context with prior meta-analyses:** Compare your estimate to the 2–3 most recent related meta-analyses.
3. **Heterogeneity explanation:** Clinical (population, technique) vs. statistical. Subgroup findings.
4. **Quality of evidence:** Comment on overall QUADAS-2/RoB2/MINORS findings. GRADE (if applicable): downgrade for risk of bias, inconsistency, indirectness, imprecision, publication bias.
5. **Limitations:** (a) cannot rule out publication bias; (b) retrospective study designs; (c) clinical heterogeneity; (d) limited number of studies for subgroup analyses.
6. **Clinical implications:** What should clinicians take from this?

---

## Conclusions (100–150 words)

"In this systematic review and meta-analysis of [N] studies including [N] patients, [index test] demonstrated a pooled [metric] of [value] (95% CI, [lower]–[upper]) for [condition/outcome]. [One sentence on heterogeneity or quality.] These findings suggest that [clinical recommendation or need for further research]."

---

## Required Figures and Tables

| Item | Content |
|------|---------|
| Figure 1 | PRISMA 2020 flow diagram |
| Figure 2 | Forest plot (primary outcome) |
| Figure 3 | Funnel plot (if ≥10 studies) |
| Figure 4 | QUADAS-2 / RoB 2 summary plot |
| Table 1 | Study characteristics |
| Table 2 | Quality assessment results |
| Suppl. Table 1 | Full search strategy (all databases) |
| Table 3 (or next) | GRADE Summary of Findings table |
| Table 4 (or next) | Per-study risk of bias table (NOS domain scores for comparative; JBI item scores for single-arm) |
| Suppl. Table 2 | Excluded studies with reasons |

---

## Common Meta-Analysis Pitfalls

1. **Not registering on PROSPERO** before data extraction — reviewers will ask.
2. **Fixed-effects model without justification** — use random-effects unless strong homogeneity and similar populations.
3. **Reporting I² without prediction interval** — I² tells proportion, not magnitude; prediction interval shows the range of true effects.
4. **Subgroup analyses not pre-specified** — post-hoc subgroups must be labeled as exploratory.
5. **Including studies where the same dataset was used multiple times** — check for overlapping populations.
6. **Misinterpreting non-significant Egger's test** — power is often low; state the limitation.
7. **Confusing statistical significance with clinical significance** — a statistically significant pooled OR = 1.05 may be clinically trivial.
8. **Missing duplicate publications** — check corresponding author + institution + dates.
9. **Not reporting absolute numbers** — always provide N patients per group, not just proportions.
10. **Ignoring GRADE** — many high-impact journals now expect GRADE certainty of evidence ratings.

# NHIS Cohort Study — Paper Type Template

## Overview

Template for population-based cohort studies using national health insurance claims databases (e.g., Korean NHIS, HIRA, KDCA, or equivalent national registries). Follows the IMRAD structure with specific patterns for emulated target trial frameworks, propensity score balancing, and claims-based outcome definitions. Applicable to vaccination effectiveness, disease-risk, and longitudinal exposure-outcome studies using administrative health data.

---

## Title

- Include study design: "A Nationwide Population-Based Cohort Study" or "An Emulated Target Trial."
- Specify the population or exposure: "Among Adults Aged 50 Years and Older."
- Under 20 words preferred.
- Good: "Association Between Statin Use and Dementia Risk: A Nationwide Population-Based Cohort Study"
- Bad: "Investigating Statins and Brain Health Using Big Data"

---

## Abstract (Structured, 250 words max)

### Background / Purpose
- One to two sentences. State the clinical question and gap.
- Template: "Evidence on the association between {exposure} and {outcome} at the population level remains limited."

### Methods
- Data source (nationwide cohort, N, date range).
- Emulated target trial or standard cohort design.
- Propensity score method (overlap weighting, SIPTW, or 1:1 matching).
- Cox proportional hazards model for aHRs with 95% CIs.
- Three to four sentences maximum.

### Results
- Final analytic cohort size after exclusions.
- Primary aHR with 95% CI.
- Key subgroup or time-dependent findings.
- Three to four sentences maximum.

### Conclusion
- One to two sentences. Restate the main finding and population-level implication.
- Be specific about effect magnitude and clinical relevance.

---

## Introduction (3-4 paragraphs, ~400-500 words)

### Paragraph 1: Disease Burden and Clinical Context
- Establish the clinical importance with global or national prevalence data.
- Cite GBD, WHO, or national registry statistics.
- Describe current clinical practice or public health approach.

### Paragraph 2: Prior Evidence and Knowledge Gap
- Summarize key prior studies (single-country cohorts, small sample sizes, limited follow-up).
- Flag specific limitations: "were limited to single-country cohorts," "did not adjust for key confounders," "lacked population-level data."
- State what remains unknown.

### Paragraph 3: Study Objective
- State the specific aim.
- If using emulated target trial: "Using an emulated target trial framework, we evaluated the association between {exposure} and {outcome} in a nationwide cohort of {N} individuals."
- Optional: preview key methodological strengths (large cohort, long follow-up, claims-linked data).

---

## Materials and Methods (~1000-1400 words)

### 3.1 Data Source

Describe the national claims database linkage. Standard components:

1. **Database identification**: Name the data sources (e.g., national health insurance claims, health examination records, disease registry).
2. **Population coverage**: State the coverage rate (e.g., "covers approximately 98% of the national population").
3. **Data domains**: Specify linked domains — outpatient and inpatient claims, pharmaceutical records, health examination results, death certificates, and any disease-specific registries.
4. **Anonymization**: State how personally identifiable information was handled.

Template:
> This {study type} utilized a large-scale, population-based, nationwide cohort comprising {N} individuals aged {X} years and older from {START DATE} to {END DATE}. The national universal health insurance system enables the integration of comprehensive health data across multiple domains. We integrated outpatient and inpatient data, pharmaceutical records, and death certificates from the national claims database, along with health examination data from the national health insurance service.

### 3.2 Ethics Approval

- State the approving body and protocol number.
- For claims-based studies: informed consent is typically waived due to use of anonymized records.
- Template: "This study was approved by {IRB/authority} (approval no. {NUMBER}). The requirement for informed consent was waived due to the use of anonymized health records."

### 3.3 Study Design Framework

If using the emulated target trial approach:
- State explicitly: "This study was designed and analysed following the emulated target trial framework, which mimics a randomized controlled trial."
- Reference a supplementary table mapping the target trial components (eligibility, treatment strategy, assignment, follow-up, outcome, causal contrast, analysis plan).

### 3.4 Study Population (Inclusion/Exclusion)

Standard three-tier exclusion cascade:
1. Death before index date.
2. Prevalent outcome (any documented diagnosis of the study outcome prior to the index date).
3. Missing demographic or health examination data (complete-case approach).

For disease-specific studies, add:
4. Disease-specific exclusion (e.g., diagnosis after the index date for subcohort studies).

Template:
> Participants were excluded if they (1) died before their assigned index date (n = {X}), (2) had any documented {outcome} diagnosis prior to the index date (n = {X}), or (3) lacked complete demographic information or health examination data (n = {X}). Following exclusions, {N} individuals were included in the final analytic cohort (Fig. 1).

Always include a CONSORT-style flow diagram (Fig. 1).

### 3.5 Exposure Definition

- Define the exposure with specific dates, codes, or criteria.
- For time-dependent exposures: address immortal time bias.
- Template for index date assignment: "To address immortal time bias, index dates for unexposed individuals were randomly assigned to match the distribution of index dates in the exposed group."
- Specify follow-up: "Participants were followed from the index date until the first occurrence of an outcome, death, or the end of follow-up ({END DATE}), whichever occurred first."

### 3.6 Outcome Definition

- Define using ICD-10 codes (defer code lists to supplementary table).
- For composite outcomes: define each component and the time windows.
- Template: "The primary outcomes were: (1) {OUTCOME 1}, (2) {OUTCOME 2}. Outcomes were identified using ICD-10 codes (Table S{X}). {COMPLICATION} was defined as a claim occurring within {X days} to {Y year} after the incident event."
- For stricter definitions: "An outcome was considered valid if at least two ICD-10 diagnostic claims within 1 year and related medication prescriptions were recorded."

### 3.7 Covariate Adjustment

Standard covariate set for national health insurance cohort studies:

| Category | Variables | Typical Categorization |
|----------|-----------|----------------------|
| Demographics | Age | 5-year bins or clinical cutoffs |
| | Sex | Male, Female |
| | Region of residence | Urban, Rural |
| | Household income | Low, Middle, High (percentile-based) |
| Clinical (exam) | BMI | Country-specific cutoffs (e.g., Asia-Pacific: <23.0, 23.0-24.9, >=25.0 kg/m2) |
| | Blood pressure | SBP/DBP threshold-based (e.g., SBP >=140 or DBP >=90 mmHg) |
| | Fasting blood glucose | Threshold-based (e.g., <100, >=100 mg/dL) |
| | GFR | Categories (e.g., <60, 60-89, >=90 mL/min/1.73 m2) |
| Comorbidity (claims) | Charlson comorbidity index | 0, 1, >=2 |
| | Medication history | Hypertension, Hyperlipidemia, Coronary artery disease |
| Behavioral (survey) | Smoking | Never, Former, Current |
| | Alcohol consumption | Frequency categories |
| | Physical activity | Sufficient/Insufficient (MET-based) |

Notes:
- BMI cutoffs should follow country-specific guidelines with explicit justification.
- Covariates are collected from the most recent data available prior to the individual index date.
- State the missing data approach (complete-case or multiple imputation with chained equations).

### 3.8 Statistical Analysis

#### Propensity Score Balancing

Three validated methods (choose one):

1. **Overlap weighting**: Maintains full sample size; weights each individual by the probability of being assigned to the opposite group.
2. **Stabilized IPTW**: Maintains full sample size; stabilized weights reduce variance.
3. **1:1 Propensity score matching**: Greedy nearest-neighbor within a specified caliper (e.g., 0.001 SD), without replacement.

Template:
> Propensity scores were estimated using multivariable logistic regression incorporating {list all covariates from 3.7}. Covariate balance was evaluated using standardized mean differences, with values <0.1 indicating adequate balance.

#### Effect Estimation

- Cox proportional hazards models for adjusted hazard ratios (aHRs) with 95% CIs.
- Optional: restricted mean survival time (RMST) for absolute clinical benefit.
- Censoring: outcome, death, or administrative end date (competing-risks framework).

#### Stratification and Time-Dependent Analysis

- Stratify by all major covariates (age, sex, income, region, BMI, smoking, alcohol, physical activity, comorbidities).
- Time-dependent effectiveness in interval bins (e.g., <1, 1-2, 2-4, 4-6, 6-8, >=8 years).
- Note: "Stratified analyses were adjusted for all covariates except the stratification variable."

#### Sensitivity Analyses

Common approaches for claims-based cohort studies:
- Stricter outcome definition (e.g., 2+ claims + medication prescription).
- Negative control outcomes (outcomes with no expected association).
- Mediation analysis (if plausible intermediate pathway exists).
- Alternative PS method (e.g., matching vs. weighting).
- Subgroup by exposure timing or severity.

#### Software and Significance

- State software and version (e.g., SAS 9.4, R, Python).
- "A two-sided p value of less than 0.05 was considered statistically significant."
- For multiple primary outcomes: consider Bonferroni correction.

---

## Results (~800-1200 words)

### 4.1 Study Population
- Total screened, excluded (with per-criterion counts), and final cohort.
- Reference the flow diagram (Fig. 1).
- Baseline characteristics table (Table 1) showing pre- and post-weighting/matching balance.
- Report SMDs to confirm adequate balance (<0.1).

### 4.2 Primary Endpoint
- aHR with 95% CI for the primary outcome.
- Event counts and incidence rates in exposed vs. unexposed groups.
- Template: "In the {weighted/matched} cohort, {exposure} was associated with a {increased/decreased} risk of {outcome} (aHR, {value}; 95% CI, {lower}-{upper})."

### 4.3 Secondary Endpoints and Subgroup Analyses
- Present secondary outcomes with aHRs and 95% CIs.
- Stratification results: forest plot (Fig. 2) or table.
- Time-dependent effectiveness: present by time interval.

### 4.4 Sensitivity Analyses
- Confirm or qualify main findings with sensitivity results.
- Reference supplementary tables and figures.

### Rules
- Same rules as original article: no interpretation in Results.
- Every table and figure must be referenced.
- Numbers must match tables exactly.
- Use "was associated with," not causal language.

---

## Discussion (4-5 paragraphs, ~800-1200 words)

### Paragraph 1: Summary of Key Findings
- Restate principal findings in context of the study aim.
- Paraphrase, do not repeat exact numbers.

### Paragraphs 2-3: Comparison with Prior Literature
- Anchor paper-driven comparison.
- Address concordant and discordant findings.
- Discuss potential reasons for discrepancies (population, exposure definition, follow-up duration, confounding adjustment).

### Paragraph 4: Clinical Implications
- Population-level public health implications.
- Policy relevance (screening, vaccination, treatment guidelines).

### Paragraph 5: Limitations

Standard limitation categories for claims-based cohort studies (ordered by severity):

| # | Category | Template |
|---|----------|----------|
| 1 | Generalizability | "The study population comprised predominantly {nationality/ethnicity} adults, which may limit generalizability to other populations." |
| 2 | Residual confounding | "Despite {PS method}, residual confounding from unmeasured variables cannot be entirely excluded." |
| 3 | ICD-based misclassification | "Both exposure and outcomes were identified through administrative records, which may be subject to misclassification." |
| 4 | Unmeasured confounders | "Data on {specific confounders} were unavailable." |
| 5 | Rare outcome precision | "Effectiveness estimates for rare outcomes should be interpreted cautiously due to low event counts and wide confidence intervals." |
| 6 | Missing comparator | "{Alternative treatment} was not widely available during the study period, precluding direct comparison." |
| 7 | Administrative coding accuracy | "ICD-based outcome definitions may not capture all clinically relevant cases." |

Follow each limitation with a mitigation sentence. End with a strengths paragraph.

### Conclusion
- One to two sentences. Citable statement with effect magnitude and implication.

---

## Tables

- **Table 1**: Baseline characteristics, pre- and post-weighting/matching, with SMDs.
- **Table 2**: Primary and secondary outcome aHRs with 95% CIs (overall and by subgroup).
- **Table S1+**: ICD-10 code definitions (supplementary).
- **Table S{X}**: Emulated target trial specification (if applicable).

## Figures

- **Figure 1**: Patient flow diagram (exclusion cascade with counts).
- **Figure 2**: Forest plot of stratified analyses.
- **Figure 3**: Time-dependent effectiveness plot (aHR by follow-up interval).
- Optional: Kaplan-Meier curves, RMST difference plots.

---

## ML Prediction Model Variant

When the NHIS cohort study is a machine learning prediction model (rather than Cox regression):

### Key Differences
- **Exposure → Prediction target**: Define the outcome prediction window (e.g., 5-year incidence).
- **PS balancing → Train/test split**: Stratified 80:20 split of discovery cohort.
- **Class imbalance**: Address with SMOTE or other oversampling techniques.
- **Model selection**: List candidate models with hyperparameters; ensemble top performers.
- **Evaluation**: Sensitivity, specificity, balanced accuracy, AUROC. Primary metric justified by class imbalance.
- **Feature importance**: MDI or SHAP values; ablation study for validation.
- **External validation**: Independent cohort with same preprocessing pipeline.
- **Software**: Python (TensorFlow/Scikit-learn) for ML; SAS for descriptive/inferential statistics.

---

## Checklist Before Submission

- [ ] Data source described with coverage rate, linked domains, and anonymization
- [ ] Ethics approval with specific protocol number
- [ ] Emulated target trial table in supplementary (if applicable)
- [ ] Exclusion cascade with per-criterion counts and flow diagram
- [ ] Immortal time bias addressed (random index date assignment or equivalent)
- [ ] All covariates listed with categorization and country-specific cutoff justification
- [ ] PS method specified with balance assessment (SMD < 0.1)
- [ ] ICD-10 codes deferred to supplementary table
- [ ] Time-dependent analysis with interval bins
- [ ] At least 2 sensitivity analyses performed
- [ ] Limitation paragraph covers generalizability, residual confounding, and misclassification
- [ ] Numbers consistent between text, tables, and figures
- [ ] Reporting guideline (STROBE or RECORD) items addressed

# Original Article — IMRAD Template

## Overview

Standard template for medical original research articles. Follows the Introduction, Materials and Methods, Results, and Discussion (IMRAD) structure used by virtually all biomedical journals.

---

## Title

- Concise and specific, under 20 words.
- Include the study design if space allows (e.g., "A Retrospective Cohort Study").
- Avoid questions, abbreviations (except universally known ones like CT, MRI, AI), and clever wordplay.
- Good: "Deep Learning Detection of Pulmonary Embolism on CT Angiography: A Multicenter Validation Study"
- Bad: "Can AI Find Clots? A Novel Approach Using Advanced Neural Networks"

---

## Abstract (Structured, 250 words max)

Four sections matching the journal's required headings (common variants shown):

### Purpose / Objective
- One to two sentences stating the study aim.
- Template: "To {evaluate/compare/assess/determine} {what} in {population/context}."

### Materials and Methods
- Study design, setting, dates, participants (N), key methods, primary outcome measure, statistical approach.
- Three to four sentences maximum.

### Results
- Key findings with specific numbers (effect sizes, CIs, p-values).
- Start with primary endpoint, then most important secondary findings.
- Three to four sentences maximum.

### Conclusion
- One to two sentences. Restate the main finding and its implication.
- Do NOT end with "further studies are needed."
- Be specific: "This model achieved diagnostic accuracy comparable to fellowship-trained radiologists and may reduce interpretation time for emergency CT studies."

---

## Introduction (3-4 paragraphs, ~400-500 words)

### Paragraph 1: Clinical Context
- Establish the clinical importance of the topic.
- Cite prevalence, incidence, or burden data.
- Describe current clinical practice or diagnostic approach.

### Paragraph 2: Knowledge Gap
- What is known from prior work (cite key studies).
- What remains unknown, uncertain, or unresolved.
- Why this gap matters clinically.

### Paragraph 3: Study Objective
- State the specific aim of this study.
- Include hypothesis if applicable (for confirmatory studies).
- Template: "The purpose of this study was to {aim}. We hypothesized that {hypothesis}."
- Optional final sentence previewing the approach: "We evaluated this in a {study design} of {N} patients at {setting}."

### Rules
- Do not review the entire literature; cite only what is needed to establish the gap.
- Do not describe methods or results.
- Do not state conclusions.
- Funnel structure: broad context to narrow focus.

---

## Materials and Methods (~800-1200 words)

### 3.1 Study Design and Setting
- One paragraph: design (retrospective/prospective, single/multicenter), institution(s), date range.
- Template: "This {retrospective cohort / prospective cross-sectional / etc.} study was conducted at {institution} between {start date} and {end date}."

### 3.2 Participants / Study Population
- Inclusion and exclusion criteria, stated explicitly.
- How participants were identified (database query, consecutive enrollment, random sampling).
- Final sample size with brief explanation of exclusions.
- For AI studies: dataset split (training/validation/test) with rationale.

### 3.3 Procedures / Intervention / Index Test
- Describe what was done in enough detail for replication.
- For imaging: scanner model, sequence parameters, contrast protocol.
- For AI: model architecture, input data, preprocessing, training procedure, hyperparameters.
- For reader studies: number of readers, experience level, blinding, reading environment.

### 3.4 Outcome Measures
- Define primary and secondary endpoints explicitly.
- State the reference standard and how it was established.
- Define any composite endpoints or derived variables.

### 3.5 Statistical Analysis
- Descriptive statistics approach (mean +/- SD or median [IQR]).
- Specific tests for each comparison (name the test, state the rationale).
- Significance level (two-sided, alpha = 0.05).
- Software and version.
- Sample size justification if applicable.
- See `section_templates/methods_statistical.md` for common paragraph templates.

### 3.6 Ethics
- IRB/Ethics committee approval (name, protocol number).
- Informed consent status (obtained, waived with reason).
- For retrospective studies: "The institutional review board of {institution} approved this retrospective study and waived the requirement for informed consent."

---

## Results (~800-1200 words)

### 4.1 Study Population
- Start with the total number screened, excluded (with reasons), and included.
- Reference the flow diagram (Figure 1) if applicable.
- Describe demographics and baseline characteristics, referencing Table 1.
- Template: "A total of {N} patients ({N} male, {N} female; mean age, {X} +/- {Y} years) were included."

### 4.2 Primary Endpoint
- Present the main result with effect size and 95% CI.
- Reference the relevant table or figure.
- Template: "The {metric} was {value} (95% CI, {lower}-{upper}; P = {value})."

### 4.3 Secondary Endpoints
- Present in order of importance or in the order listed in Methods.
- Each gets its own paragraph or sub-paragraph.

### 4.4 Subgroup and Sensitivity Analyses
- Present if pre-specified in Methods.
- Acknowledge if exploratory (not powered for subgroup differences).

### Rules
- Do NOT interpret findings; state them. Results answers "What?" only — never "Why?"
- Every table and figure must be referenced in the text.
- Numbers in text must match tables exactly.
- Report exact p-values; use "P < .001" only when truly below 0.001.
- Present data in the same order as Methods subsections.
- NO comparisons with prior literature (save for Discussion).
- NO causal language ("caused," "led to," "due to") — use "was associated with."
- NO evaluative adjectives without numbers ("high," "notable," "remarkable").
- NO hedge words implying interpretation ("suggests," "implies," "indicates importance").
- Banned openers: "Interestingly," "Notably," "Remarkably," "Surprisingly," "As expected."

---

## Discussion (4-5 paragraphs, ~800-1200 words)

> **Before writing:** The user should provide anchor papers (3-5 key references for
> comparison) and key findings to emphasize. See SKILL.md Phase 5a for the interactive
> planning gate. If not provided, identify anchor papers from the reference list.

### Paragraph 1: Summary of Key Findings
- Restate the principal findings in the context of the study aim.
- Do not repeat exact numbers from Results (paraphrase).
- One paragraph, 3-5 sentences.

### Paragraphs 2-3: Comparison with Prior Literature (anchor paper driven)
- Organize around anchor papers provided by the user.
- For each anchor paper: state their finding → compare with ours → explain discrepancy.
- Pattern: "Smith et al. [ref] reported {X} in {population}. In contrast/Similarly, our
  study found {Y}, which may be attributable to {methodological/population difference}."
- Include both concordant and discordant studies.

### Paragraph 4: Clinical Implications
- What does this mean for clinical practice, training, or future research?
- Be specific: "{AI tool} could be integrated into {specific workflow} to {specific benefit}."
- Avoid vague statements about "future directions."

### Paragraph 5: Limitations
- Ordered by severity (most impactful first).
- Be specific and honest.
- Do NOT start with "Our study has several limitations."
- For each limitation: (a) what it is, (b) how it was mitigated, (c) direction of residual bias.
- Template: "This study has limitations. First, the retrospective design at a single
  institution limits generalizability; however, the multicenter external test set partially
  addresses this, and any selection bias would likely inflate performance estimates."

### Conclusion (within Discussion, final paragraph or sentence)
- One to two sentences restating the single most important finding.
- Must be a citable statement — memorable and specific.
- Template: "In summary, {main finding} in {context}, suggesting {implication}."

---

## References

- Typically 30-40 for original articles.
- Prioritize recent references (within 5 years) for establishing current knowledge.
- Include seminal/classic references where appropriate.
- Every citation must be referenced in the text.
- Self-citation should be limited and justified.

---

## Tables

- **Table 1**: Demographics and baseline characteristics (always required).
  - Columns: overall cohort, comparison groups (if applicable).
  - Rows: age, sex, relevant clinical variables.
  - Include p-values for between-group comparisons if relevant.
- **Table 2+**: Results tables (primary/secondary endpoints, model performance, etc.).
- Use footnotes for abbreviations and statistical details.
- Do not duplicate data that is better shown in a figure.

## Figures

- **Figure 1**: Flow diagram (CONSORT/STARD/PRISMA as appropriate).
- Additional figures: performance curves (ROC, calibration), representative images, forest plots.
- Each figure needs a descriptive legend that allows the figure to be understood without reading the text.
- Minimum 300 dpi resolution for submission.

---

## Checklist Before Submission

- [ ] Title under 20 words, specific and informative
- [ ] Abstract numbers match Results/Tables
- [ ] Introduction ends with clear objective
- [ ] Methods sufficient for replication
- [ ] All tables/figures referenced in text
- [ ] Numbers consistent between text, tables, and figures
- [ ] Limitations discussed honestly
- [ ] All reporting guideline items addressed
- [ ] References complete and correctly formatted
- [ ] Word count within journal limits

# Paper Type: Technical Note

## Overview

- **Purpose:** Describe a novel technique, method, algorithm, or device — NOT clinical outcomes
- **Typical word count:** 1500–2500 words
- **Structure:** Abstract (unstructured or brief structured) → Introduction → Materials and Methods → Results (proof of concept) → Discussion → Conclusion
- **Key requirement:** Sufficient reproducibility data; must demonstrate feasibility, not efficacy

---

## What a Technical Note Is (and Is Not)

**IS:** A concise description of a new technique, workflow, algorithm, software tool, or modified procedure, with proof-of-concept validation data.

**IS NOT:** A clinical efficacy study. Technical notes do not aim to demonstrate that a new technique is better than existing ones — that requires a full original article with appropriate controls and statistical power.

---

## Abstract (150–200 words, unstructured or brief structured)

"We describe [technique/method/tool] for [application]. [One sentence on how it works]. Using [validation dataset / N cases / N samples], we demonstrated [key performance metric with value]. [One sentence on potential clinical or research utility]. [This technique is available / Code is available at [URL]]."

---

## Introduction (300–500 words)

1. **Clinical or research problem:** Why is a new technique needed? What is the limitation of existing methods?
2. **Description of the new approach:** Brief overview without technical detail (that belongs in Methods).
3. **Objective:** "The purpose of this technical note is to describe [technique] and demonstrate its feasibility in [application context]."

---

## Materials and Methods (600–1000 words)

This is the core of the technical note. Write in enough detail that the technique can be replicated by another group.

### System/Technique Description

Describe the method step by step. Use numbered steps or clear paragraphs. Include:

**For imaging techniques:**
- Equipment (manufacturer, model, software version)
- Acquisition parameters (field strength, sequence parameters, slice thickness, FOV, contrast agent if used)
- Post-processing steps
- Analysis software and version

**For software/algorithm:**
- Programming language and version (e.g., Python 3.10, PyTorch 2.0.1)
- Architecture description (high-level; detailed architecture in supplementary)
- Training/validation/test split
- Computational requirements (GPU, RAM, processing time per case)
- Availability: "Code is publicly available at [GitHub URL] under [license]"

**For procedural techniques:**
- Equipment, instruments, materials (with catalog numbers if novel)
- Step-by-step procedure
- Safety considerations and failure modes

### Validation Dataset

- Source: retrospective or prospective, single center
- N cases / samples
- Inclusion/exclusion criteria (brief)
- Reference standard used for comparison (if applicable)

### Evaluation Metrics

Define exactly what you measured and how:
- For segmentation: Dice similarity coefficient, Hausdorff distance
- For detection: sensitivity, specificity at fixed operating point
- For measurement tools: ICC with 95% CI against reference method (Bland-Altman analysis)
- For image quality: signal-to-noise ratio, contrast-to-noise ratio, or expert reader assessment

State how reproducibility was assessed (intra- and inter-observer variability).

---

## Results (400–600 words — Proof of Concept)

Report the key feasibility metrics. This section should be concise.

- Success rate (technical feasibility)
- Primary performance metric with 95% CI
- Processing time (if relevant)
- Any failure cases and their characteristics

"The technique was successfully applied in [N/N] ([%]) cases. [Primary metric] was [value] (95% CI, [lower]–[upper]). Mean processing time per case was [X ± SD] seconds on a [hardware specification]."

If comparing to an existing reference method:
"Compared with [reference method], [new technique] demonstrated [similar/higher/lower] [metric] ([value] vs. [value]; difference, [X]; 95% CI, [lower]–[upper]; P = [value])."

---

## Discussion (300–500 words)

1. **Summary of findings:** What did you demonstrate? Keep to feasibility.
2. **Technical advantages:** What does this technique offer that existing approaches do not?
3. **Limitations:**
   - Small validation set (cannot make efficacy claims)
   - Single-center, single-vendor
   - May not generalize (state conditions under which technique may fail)
   - Computational requirements (if any)
4. **Future directions:** What clinical validation is needed? Will you make the tool publicly available?

---

## Conclusion (50–100 words)

"We describe [technique] for [application]. Proof-of-concept validation in [N] [cases/samples] demonstrated [key metric]. This technique [potential utility]. [Clinical validation in larger prospective studies is warranted]."

---

## Supplementary Materials

Technical notes commonly require supplementary materials:
- Detailed algorithm pseudocode or flowchart
- Full acquisition parameter tables
- Additional validation cases (figures)
- Code repository link + usage instructions

---

## Common Technical Note Pitfalls

1. **Making efficacy claims instead of feasibility claims** — a technical note cannot conclude that the technique is better; say it "demonstrates feasibility" or "warrants further investigation."
2. **Missing reproducibility data** — always report intra- and inter-observer variability (ICC) for measurement tools.
3. **Insufficient Methods detail** — another lab must be able to replicate from your Methods alone.
4. **Not specifying software versions** — exact versions are required for reproducibility.
5. **Combining technical note and clinical study** — keep the paper focused; add clinical data in supplementary only if very limited.
6. **No code availability statement** — increasingly expected for algorithm papers; GitHub link strongly encouraged.

# Discussion Writing Guide

Reference for write-paper Phase 5 (Discussion).
Loaded on-demand when drafting the Discussion section.

---

## Purpose

Discussion answers: "Why do these results matter?" It connects your findings to
the broader clinical and scientific context. Results tells the reader *what* you found;
Discussion tells them *so what*.

---

## Specifications

- **Word limit**: 800 words for Radiology; check journal profile for others
- **No Table/Figure citations**: Do not reference Tables or Figures in Discussion
  (journal-specific — verify with loaded profile, but this is the default for Radiology)
- **No abbreviations**: In the first and last paragraphs, spell out all abbreviations
- **Structure**: 4-paragraph base (expandable to 5-6 for complex studies)

---

## 4-Paragraph Structure

### Paragraph 1: Summary of Key Findings

- 2-3 sentences restating the main findings
- Include the primary metric with its value (but do not repeat all numbers verbatim from Results)
- End with one sentence on clinical importance or implication

**Template**:
```
In this study, we evaluated [what was done].
We found that [main finding with key metric].
[Optional: secondary finding].
This finding suggests [core clinical interpretation in one sentence].
```

### Paragraphs 2-3 (or 2-4): Interpretation and Literature Comparison

- Organize by theme or finding, not by reviewer expectation
- Order by importance: most significant finding first
- For each comparison with prior work:
  1. State the prior finding with citation
  2. State whether your result agrees or disagrees
  3. If disagrees: explain the discrepancy (methodological or population differences)
- For unexpected results: offer a plausible explanation backed by references

**Rules**:
- Do not list prior studies mechanically ("A found X. B found Y. C found Z.")
- Only cite studies that directly relate to your findings — not tangential background
- Prefer high-impact journal references for comparisons
- Do not attack or disparage prior studies; present differences neutrally
- Speculation is acceptable if flagged as such and supported by a reference

### Limitation Paragraph

This is the most scrutinized paragraph. Write it with care.

**Tone: frank and objective**
- Acknowledge real limitations honestly
- Do not bury limitations under a pile of strengths
- Do not be self-deprecating either — state facts

**Structure for each limitation**:
1. What the limitation is
2. How it was mitigated (if at all)
3. What direction of bias it introduces (overestimate or underestimate)

**Checklist-guided limitations** (check the relevant guideline):
- **STROBE (cohort)**: Potential bias direction, generalizability
- **TRIPOD (prediction)**: Sample size, overfitting, missing data, data quality
- **STARD (diagnostic)**: Spectrum bias, verification bias, reader experience

**What NOT to do**:
- Do not open with "Our study has several limitations" (generic; dive straight in)
- Do not list 6+ limitations — 3-4 is sufficient for most studies
- Do not neutralize every limitation with "however, our study also has strengths"
  (a few strengths at the end are fine, but limitation-strength-limitation-strength
  ping-pong reads as defensive)

**Last sentence**: A future study recommendation is acceptable here.

**Study-design-specific limitation templates**:

- **Healthy volunteer / screening cohort bias**: Participants in voluntary health screening programs tend to be healthier, more health-conscious, and of higher socioeconomic status than the general population. This selection bias may limit generalizability and likely underestimates event rates compared to population-based cohorts. Mitigations: report the cohort's baseline characteristics against national statistics; acknowledge the direction of bias explicitly.
- **Surveillance bias (repeated screening)**: Participants with more frequent follow-up visits have higher probability of outcome detection. If the number of follow-up visits differs between groups, this asymmetry may inflate apparent event rates in the more-screened group. Report the number of scans/visits per participant (median, IQR) and note any group imbalance in surveillance intensity.

### Conclusion (Final Paragraph or Final Sentences)

- Must align with the Purpose statement from the Introduction
- State only conclusions directly supported by Results (no over-interpretation)
- End with a clinical implication or application, not "further studies are needed"
- Should be a citable, quotable statement

---

## Relationship with Introduction

Discussion and Introduction are a conversation:
- Introduction foreshadows the gap
- Discussion fills that gap with your findings

The reader should be able to read the Introduction's gap statement and the Discussion's
conclusion and see a direct logical connection. If they do not connect, either the
Introduction was too broad or the Discussion overclaims.

---

## Common Mistakes

1. **Repeating Results**: Restating numbers without adding interpretation
2. **Wandering off-topic**: Discussing tangential findings not in your Results
3. **Introducing new data**: Mentioning analyses not presented in Results
   (if needed, add to Supplementary first, then reference)
4. **Over-interpretation**: Claiming causation from observational data
5. **Too long**: Exceeding word limits signals lack of focus
6. **Literature dump**: Paragraphs of prior study summaries with no connection to your findings
7. **Defensive limitation writing**: Every limitation immediately countered with a strength
8. **Ignoring contradictory evidence**: Not addressing studies that found opposite results

---

## Stuckler's Alternative Structure (for non-radiology journals)

Some journals or fields prefer limitations before interpretation:

1. **Recap of findings**
2. **Limitations** (early — "psychologically unblock the reader")
3. **Strengths**
4. **Coherence with literature**
5. **Implications for future research**

Rationale: addressing limitations first disarms the reader's skepticism, making them
more receptive to your interpretation. Consider this structure for journals outside
the radiology tradition.

---

## Self-Check

Before finalizing Discussion:

- [ ] Within word limit (800 words for Radiology)?
- [ ] No Table/Figure citations in Discussion?
- [ ] No abbreviations in first and last paragraphs?
- [ ] Key findings summarized (not just repeated)?
- [ ] Each comparison with prior work includes: their finding, agreement/disagreement, explanation?
- [ ] Limitations are honest, specific, and include bias direction?
- [ ] Conclusion matches the Introduction's purpose statement?
- [ ] No new data introduced that is not in Results?
- [ ] No AI pattern phrases ("plays a crucial role", "sheds light on")?

# Introduction Writing Guide

Reference for write-paper Phase 6 (Introduction + Abstract).
Loaded on-demand when drafting the Introduction section.

---

## Specifications

- **Word count**: 300-400 words (most radiology journals)
- **Paragraphs**: 3-4
- **References**: 10-15 citations
- **Tense**: Present tense for established knowledge; past tense for specific prior study findings
- **Structure**: Funnel shape — broad context narrowing to specific gap and study objective

---

## Gap Storytelling: 5-Step Structure

The Introduction is a story that leads the reader inevitably to your research question.
The GAP is the single most important element — it determines accept vs. reject more than
methodology alone.

### Step 1: Disease Burden and Clinical Significance

Establish why this topic matters. Cite prevalence, clinical impact, or current practice gaps.
Keep it to 2-3 sentences — do not write a textbook introduction.

### Step 2: Existing Research Landscape

Summarize what is already known. Do NOT list studies mechanically ("Study A found X.
Study B found Y."). Instead, weave them into a narrative that builds toward the gap.

### Step 3: Most Relevant Prior Work (1-2 studies)

Highlight the closest prior work to your study. Describe what they did and what they
achieved. This sets the benchmark your study will build upon or challenge.

### Step 4: The GAP (critical)

State clearly what remains unknown, unsolved, or insufficient. This is the pivot point
of the entire Introduction.

Effective gap statements:
- "However, [prior approach] has not been validated in [your population/setting]."
- "Whether [finding] applies to [specific subgroup] remains unclear."
- "No study has directly compared [A] and [B] in [context]."

Weak gap statements (avoid):
- "There is limited research on..." (vague)
- "No study has ever..." (too absolute — likely incorrect)
- "The role of X is not fully understood" (every topic could claim this)

### Step 5: Study Objective

State the specific aim: "Therefore, the purpose of this study was to..."

- Use "purpose" or "aim" — avoid "goal" or "objective" interchangeably within one paper
- Match the objective precisely to the gap
- If there is a hypothesis, state it explicitly

---

## Three-Part Formula (complementary framing)

An alternative lens for the same structure (from academic writing pedagogy):

1. **The Debate**: Why should the reader care right now? What is the burning question?
2. **The Gap**: What do we know, and what is still missing?
3. **The Winning Study**: How does this study fill that gap?

This maps directly to Steps 1-2, Step 4, and Step 5 above.

---

## Common Mistakes

1. **Too much background**: Spending 200+ words on disease epidemiology before reaching the gap
2. **Mechanical literature listing**: "A et al. found X. B et al. found Y. C et al. found Z."
3. **Vague gap**: "Limited research exists" without specifying what specifically is unknown
4. **Mismatch**: Gap statement does not logically lead to the study objective
5. **Over-promising**: Implying the study will solve a problem it cannot address
6. **Too many references**: Citing 25+ references in the Introduction signals unfocused writing

---

## Gap Discovery Strategies

When struggling to articulate the gap:

1. Read the Discussion "future research" sections of related papers — authors explicitly state gaps
2. Read systematic review limitation sections — reviewers synthesize what is missing
3. Check if prior work was done in a different population, modality, or clinical setting
4. Look for methodological limitations in prior studies that your design addresses

---

## Self-Check

Before finalizing the Introduction:

- [ ] 300-400 words?
- [ ] 3-4 paragraphs?
- [ ] 10-15 references?
- [ ] Gap is specific, concrete, and compelling?
- [ ] Study objective directly follows from the gap?
- [ ] No AI pattern phrases ("In the rapidly evolving landscape of...")?
- [ ] Funnel structure maintained (broad → narrow)?

# Materials and Methods Writing Guide

Reference for write-paper Phase 3 (Methods).
Loaded on-demand when drafting the Materials and Methods section.

---

## Core Principles

1. **Reproducible**: Another researcher should be able to replicate your study from the Methods alone
2. **Sequential**: Describe procedures in the order they occurred
3. **Concise but thorough**: No unnecessary detail, but no critical omissions
4. **Checklist-aligned**: Every applicable item in the reporting guideline (STARD, STROBE, CONSORT, PRISMA) must have a corresponding sentence in Methods

---

## PICO-Based Structure

Write Methods in PICO order. This provides a natural, logical flow that reviewers expect.

### 1. Study Design + Ethics

- Single-center or multicenter
- Retrospective or prospective
- IRB approval statement with approval number
- Informed consent status ("informed consent was waived for this retrospective study")
- Reporting guideline declaration: "This study was reported in accordance with [STARD/STROBE/etc.]"

### 2. Population (P)

- Study period (start and end dates)
- Inclusion criteria (specific, operationalized)
- Exclusion criteria (with clinical justification for each)
- How patients were identified (database query, consecutive enrollment, etc.)
- **Time zero definition** (critical for retrospective cohorts): State explicitly when follow-up begins. For screening cohorts, time zero is typically the date of the first qualifying examination. For treatment studies, time zero is the date of treatment initiation. Misaligned time zero introduces immortal time bias. If there is a gap between eligibility assessment and time zero (e.g., cohort entry defined by a lab value but follow-up starting at a later visit), describe how this was handled.

**Common pitfalls to avoid**:
- Including inappropriate subjects (e.g., young adults in a pediatric study)
- Excessive interval between index test and reference standard
- Including only elective/surgical cases → selection bias
- Study period too long → equipment/protocol changes
- Including non-contrast studies when contrast is required

### 3. Intervention / Index Test (I)

- Imaging protocol: scanner model (manufacturer, city, country), acquisition parameters
- For CT/MR protocols: ask the technologist for exact parameters
- **Reader setup**: Number of readers, years of experience, subspecialty
  - Using only senior readers → overestimation risk (acknowledge in limitations)
- **Blinding**: State explicitly what information readers were blinded to
- **Quantitative measurements**: How cut-off values were determined
- **Reader disagreement resolution**: Consensus reading, third reader, or statistical approach
- Software used (name, version, manufacturer)

### 4. Comparator / Reference Standard (C)

- Does not need to be the "gold standard" — use the best available method
- State what reference standard was used and why
- Verify:
  - Was the same reference standard applied to all patients?
  - Was the reference standard interpreter blinded to index test results?
  - Was the interval between index test and reference standard reasonable?

### 5. Outcome / Statistical Analysis (O)

- Primary and secondary endpoints defined before describing statistical tests
- Statistical tests matched to data types and study design
- Software and version for statistical analysis
- Significance threshold (typically P < .05, two-sided)

---

## Backbone Article Strategy

**Before writing Methods, identify a backbone article** — a published study with a similar
design in a similar journal that serves as a structural template.

### Selection Criteria

1. Same study design (diagnostic accuracy → diagnostic accuracy, cohort → cohort)
2. Same modality (CT → CT, MRI → MRI)
3. Published in the target journal or a comparable journal
4. Recent publication (within 3-5 years)
5. Well-cited (validated structure)

### How to Use

- Mirror the M&M section structure and subsection order
- Reference the same statistical methods where applicable
- Use similar Table/Figure formatting
- Adopt the reference standard description approach
- **Never copy sentences** — structure and logic only

### Where to Find

1. **Auto-scan `manuscript/_src/refs.bib` first** — Phase 0 Step 5 ranks entries by study design + modality + target journal + PDF attachment. If one strong candidate emerges, the skill proposes it proactively rather than asking.
2. Search the target journal for recent studies with matching design (fallback when refs.bib has no candidate)
3. Check the reference lists of papers you are already citing
4. Ask the corresponding author or mentor for recommendations

---

## Checklist Cross-Reference

When writing Methods, keep the reporting checklist open and verify 1:1 coverage:

| Study Design | Checklist | Key M&M Items |
|-------------|-----------|---------------|
| Diagnostic accuracy | STARD | Blinding, index test detail, reference standard, sample size justification |
| RCT | CONSORT | Randomization, allocation concealment, blinding, ITT analysis |
| Observational | STROBE | Selection criteria, bias direction, confounders, missing data handling |
| Meta-analysis | PRISMA | Search strategy, selection process, data extraction, risk of bias tool |
| AI study | CLAIM 2024 | Data partitioning, model architecture, training details, external validation |

After drafting, go through the checklist item by item. For each item, confirm there is
a corresponding sentence in your Methods. Missing items are the most common reason for
desk rejection.

---

## Terminology Conventions

| Avoid | Use Instead |
|-------|-------------|
| "Increase" / "Decrease" (comparing two groups) | "Higher" / "Lower" or "Larger" / "Smaller" |
| "Show" (for patient actions) | "Had" / "Demonstrated" / "Exhibited" |
| "Prove" | "Suggest" / "Indicate" |
| "Efficacy" (outside RCTs) | "Effectiveness" |
| "Significant" (without p-value) | Always pair with exact p-value |

---

## Self-Check

Before finalizing Methods:

- [ ] Every checklist item has a corresponding sentence?
- [ ] Procedures described in chronological order?
- [ ] Reader blinding explicitly stated?
- [ ] Scanner/software details include manufacturer and location?
- [ ] Reference standard clearly defined with justification?
- [ ] Statistical methods match the data types and endpoints?
- [ ] IRB and consent statements present?
- [ ] Backbone article identified and structure referenced?

# Results Writing Guide

Reference for write-paper Phase 4 (Results).
Loaded on-demand when drafting the Results section.

---

## Core Principle: Mirror Symmetry with Methods

Results must follow the same order as Materials and Methods. Each M&M subsection
should have a corresponding Results subsection. If Methods describes the population
first, then the index test, then statistical analysis — Results presents population
characteristics first, then index test findings, then statistical comparisons.

| M&M Order | Results Counterpart |
|-----------|-------------------|
| Study population / Participants | Figure 1 (Flowchart) + Table 1 (Baseline characteristics) |
| Image analysis / Index test | Main diagnostic/measurement results |
| Statistical analysis methods | P-values, effect sizes, comparisons |

---

## Required Elements

### 1. Flowchart (Figure 1)

- Always present a patient flow diagram as Figure 1
- Numbers must be internally consistent across: Abstract, Methods, Results text, Tables, and the flowchart itself
- Show: initial cohort → exclusions (with reasons and counts) → final analysis set
- If applicable, show train/validation/test splits

### 2. Baseline Characteristics (Table 1)

- Present demographics and clinical characteristics of the study population
- Decimal places must be consistent throughout (pick one convention and hold it)
- Use footnotes for abbreviations and explanations
- Keep it concise — only variables relevant to the study

### 3. Main Results

- Present primary endpoint results first, then secondary endpoints
- Every result must include:
  - The metric value
  - 95% confidence interval (for primary endpoints)
  - Exact p-value (not "p < 0.05" unless truly < 0.001)
- Reference every Table and Figure at least once in the text

### 4. Figures

- Use the minimum number of figures that convey the key findings
- Each figure must be clear and high-resolution
- Representative cases: select typical examples, not cherry-picked best cases

---

## Strict Rules

### No Interpretation

Results contains **only factual findings**. Apply this self-check to every sentence:

1. Does this sentence explain "why"? → Move to Discussion
2. Does it reference another study? → Move to Discussion
3. Does it use "suggests" / "implies" / "indicates importance"? → Rewrite as factual statement
4. Does it use an evaluative adjective without a number ("high", "notable", "remarkable")? → Add the number or delete the adjective
5. Does it contain "interestingly" / "notably" / "remarkably" / "surprisingly"? → Delete the word

### No Unannounced Data

- **Data not described in Methods cannot appear in Results**
- If you discover an important finding during analysis that was not pre-specified, either:
  - Add the method to M&M (and note it as post-hoc)
  - Place it in Supplementary Materials

### Missing Data Handling

- Never leave table cells blank
- Use "NA" (not available) for missing data
- Add a footnote: "NA = not available" or "Data not available for N patients because [reason]"

### Tense

- **Text**: Past tense ("The sensitivity was 0.92")
- **Tables and Figures**: Present tense ("Table 1 shows...")

---

## Number Consistency Verification

Before finalizing Results, verify these cross-references:

| Check | Sources that Must Match |
|-------|----------------------|
| Total N | Abstract, Methods text, Figure 1, Table 1, Results text |
| Exclusion counts | Figure 1 boxes, Methods exclusion criteria |
| Subgroup N | Sum of subgroups = total N (or explain discrepancy) |
| Percentages | Numerator/denominator math verified |
| Primary metric | Abstract Results, Results text, relevant Table |

---

## Self-Check

Before finalizing Results:

- [ ] Follows the same order as Methods?
- [ ] Flowchart present with internally consistent numbers?
- [ ] Table 1 present with consistent decimal places?
- [ ] All primary endpoints have 95% CI and exact p-values?
- [ ] Every Table and Figure referenced in the text?
- [ ] Zero interpretation (no "why", no literature comparisons)?
- [ ] No blank cells in tables (NA with footnote instead)?
- [ ] All data in Results was described in Methods?

# Step 7.1 Extension — Classical Manuscript Style QC

A grep-based checklist that automatically verifies the global rule `~/.claude/rules/manuscript-style-classical.md` (11 items) for senior-MA-reviewer readiness. Run alongside the Step 7.1 AI Pattern Scan.

**Why**: Senior MA mentors routinely flag the § symbol, AI Disclosure boilerplate, prose-form eligibility criteria, em-dash overuse, and AI-style headings as "AI patterns." A manuscript-level automated grep blocks these in advance.

## Automated checks (run together at Phase 7.1 entry)

```bash
MD=manuscript/manuscript.md

# 1. Enforce 0 occurrences of the § symbol
N=$(grep -c "§" "$MD" || true)
[ "$N" -eq 0 ] || echo "FAIL: § symbol ${N} occurrence(s) — remove all or replace with (Methods)/(Results)"

# 2. No AI Disclosure paragraph in the body (only on the journal form / cover letter)
grep -inE "artificial intelligence disclosure|generative ai was not used|ai acknowledg(e)?ment" "$MD" \
    && echo "FAIL: AI Disclosure paragraph present in the body — move it to the cover letter / submission form"

# 3. Heading style — five main sections in uppercase + bold
for H in METHODS RESULTS DISCUSSION INTRODUCTION CONCLUSION; do
    grep -qE "^## \*\*${H}\*\*" "$MD" || echo "WARN: '## **${H}**' heading missing (or a variant)"
done

# 4. Eligibility / Inclusion criteria — numbered list recommended
grep -A 3 -inE "^#{2,4}.*(eligibility|inclusion criteria|exclusion criteria)" "$MD" \
    | grep -qE "\([0-9]+\)|^[0-9]+\." \
    || echo "WARN: Eligibility/Inclusion criteria may be prose — consider converting to a '(1)... (2)...' numbered list"

# 5. No grant-ID placeholder in the Funding section
grep -inE "grant\s*(id|number)?\s*[:#]\s*(TBD|TODO|XXX|\[insert\]|\[grant)" "$MD" \
    && echo "FAIL: Funding grant-ID placeholder remains — ask the senior author to enter it directly"

# 6. No PROSPERO chronology in the body (only the registration number, one line, is allowed)
grep -inE "prospero.*(amendment|chronology|lodged|registered on \d{4}-\d{2}-\d{2}.*amended)" "$MD" \
    && echo "FAIL: PROSPERO chronology / amendment lodging present in the body — move it to the supplementary"

# 7. Em-dash overuse (< 25 per manuscript recommended)
N=$(grep -o "—" "$MD" | wc -l | tr -d ' ')
[ "$N" -lt 25 ] || echo "WARN: ${N} em-dashes (>=25) — an AI-generation signal; redistribute with commas/colons"

# 8. 0 hand-typed reference-list entries
# Per the manuscript-references.md rule, in-text citations may only be [@bibkey] or [N].
# If the References section has hand-typed entries, the build artifact (.docx) must be verified — delegate to Step 7.6a.
```

## Pass criteria

- FAIL = 0 (must fix).
- WARN ≤ 2 (may be acknowledged after user review).
- Record the result in `qc/_pipeline_log.md` with a timestamp + the raw output.

## Responsibility boundary

This step performs **automated grep only**. The following are separate steps:
- Body rewrite for Patterns 19–21 (§, self-reference, AI Disclosure boilerplate) → `/humanize`
- Hand-typed reference verification → Step 7.6a `check_xref.py` (after the DOCX build)
- PRISMA arithmetic consistency → `/check-reporting prisma` Step 4d
- Entering the actual Funding grant-ID value → direct circulation to the senior author

## Related

- Global rule: `~/.claude/rules/manuscript-style-classical.md` (motivation for the 11 items)
- Circulation workflow: `~/.claude/rules/senior-mentor-circulation.md`
- AI-draft handling: `~/.claude/rules/ai-drafted-document-policy.md`
- No hand-typed references: `~/.claude/rules/manuscript-references.md`
- Related skills: `/humanize` (Patterns 19–21), `/check-reporting prisma` (Step 4d)

# Step 7.4a Reference — Audit Recovery Branch

Load this reference when Step 7.4 returns a fatal structural finding (category
`accuracy`, `data_fidelity`, `protocol_mismatch`, or `numerical_claim`), an unresolved
Step 7.3a primary-source disagreement, a persistent `[VERIFY-CSV]` tag, or a registry ↔
analysis inconsistency. The SKILL.md body carries only trigger table + routing table +
summary pointer; procedural detail lives here.

## Purpose

The linear polish flow (draft → review → revise → submit) assumes remaining issues are
prose-level. Some self-review findings are structural — they indicate that the
underlying data, protocol application, or analysis script is wrong, not that the prose
is wrong. Continuing through Step 7.5 – 7.6 in that case produces a polished manuscript
built on a broken foundation. This step makes the recovery loop explicit.

## Trigger Conditions (any one, from the Step 7.4 JSON report)

- A `severity: "fatal"` issue whose category is `accuracy`, `data_fidelity`,
  `protocol_mismatch`, or `numerical_claim`.
- An unresolved primary-source disagreement from Step 7.3a (P0 blocker).
- A `[VERIFY-CSV]` tag remains in the manuscript after two fix iterations.
- The self-review report flags inconsistency between the registered protocol (e.g.,
  PROSPERO record) and the delivered analysis.
- A reviewer-consensus record and the locked dataset disagree on inclusion of one or
  more studies.

**Do not attempt to fix these inline.** The `/self-review --fix` loop is text-level;
these findings require re-extraction, re-analysis, or re-registration. In-line text
patching papers over the defect and breaks downstream audit trails.

## Routing

| Symptom | Route to |
|---|---|
| MA pooled estimate / forest / subgroup / funnel numbers disagree with source | `/meta-analysis` Phase 10 (Self-Audit Recovery) |
| MA protocol vs. analysis mismatch (eligibility, outcome, subgroup) | `/meta-analysis` Phase 10 + registry amendment |
| Primary-study numerical claim disagrees with source Table/Figure | `/meta-analysis` Phase 6b (Post-Analysis Source Fidelity Audit), then return here |
| Non-MA manuscript: extraction error affecting Table 1 / primary endpoint | Return to this skill's Phase 2 (Tables & Figures) with corrected CSV, then re-enter Phase 3 – 7 for affected sections only |
| Non-MA manuscript: protocol amendment needed (e.g., IRB-registered outcome changed) | Halt and ask the user; protocol amendments are human-decision |

## Actions

1. **Halt the polish pipeline.** Do not run Step 7.5 (Generate Deliverables) or Step 7.6
   (DOCX Build). The current `manuscript/manuscript.md` is still a work-in-progress.
2. **Log the branch decision** to `qc/_pipeline_log.md`:
   ```
   ## Audit Recovery Branch (Step 7.4a)
   - Triggered by: {finding IDs from self-review JSON}
   - Routed to: {skill/phase}
   - Manuscript version frozen at: v{N}
   - Recovery workspace: {path}
   ```
3. **Invoke the routed skill** with the specific findings. For MA-type recovery, the
   `/meta-analysis` Phase 10 sprint rebuilds the extraction, analysis, figures, and
   manuscript-body numbers, and emits a `change_summary.md`.
4. **Re-entry.** When the upstream recovery completes and produces a new
   `manuscript/manuscript.md` (v{N+1}) plus a change summary:
   - Re-enter Phase 7 at Step 7.3 (Citation Verification) — not at Step 7.1, because
     recovery may have introduced new citations.
   - Carry the change summary through to Phase 8+ (cover letter) when applicable.
   - If the recovery required a registry amendment (PROSPERO or equivalent), confirm in
     Step 7.2 (Reporting Guideline Check) that the manuscript's Methods text cites the
     amendment date.
5. **Loop budget.** A single recovery cycle is expected. A second recovery cycle on the
   same manuscript is permitted but should prompt a root-cause review of Phase 2 / 6 /
   6b — repeated recoveries indicate upstream rigor gaps, not manuscript-level issues.

## Autonomous Mode

If `--autonomous` is ON and the recovery skill is also available, the orchestrator may
auto-invoke `/meta-analysis` Phase 10 and continue. If the recovery requires human
decision (protocol amendment, eligibility re-scope), the autonomous run stops and flags
`qc/_pipeline_log.md` with `RECOVERY_HALT_HUMAN_DECISION`.

# Title & Abstract Writing Guide

Reference for write-paper Phase 6 (Introduction + Abstract) and Phase 1 (Outline).
Loaded on-demand when drafting Title or Abstract.

---

## Title

### Three Title Types

| Type | Characteristics | When to Use |
|------|----------------|-------------|
| **Interrogative** | Poses a question ("Is X better than Y?") | Lower-impact journals; weaker evidence |
| **Descriptive** | States what was studied, includes design | Default choice for most submissions |
| **Declarative** | States the conclusion directly | Only with strong evidence (RCT-level) |

**Default to Descriptive** unless the study has RCT-level evidence (then Declarative is acceptable).

### Required Components (4 elements)

Every title should contain:

1. **Modality**: CT, MRI, ultrasound, radiograph, etc.
2. **Disease/Condition**: HCC, Crohn's disease, lung nodule, etc.
3. **What was evaluated**: Scoring system, revised criteria, AI model, etc.
4. **Purpose/Outcome**: Prediction, identification, comparison, validation, etc.

### Title Rules

- Include the study design (retrospective, prospective, multicenter, etc.)
- Remove filler words ruthlessly — every word must earn its place
- Word limit varies by journal (e.g., Radiology: 15 words)
- Do not use abbreviations in the title unless universally understood (CT, MRI, AI)

### Self-Check

Before finalizing, verify:
- [ ] All 4 components present (modality, disease, what, purpose)?
- [ ] Study design stated?
- [ ] Within journal word limit?
- [ ] No unnecessary filler words?

---

## Title Page — Author & Affiliation Order

Journals — and **every Nature Portfolio / npj technical check** — require the
title-page affiliations to be **numbered in the order the authors first introduce
them**, not grouped by institution. Do **not** hand-number them (an LLM groups by
institution or lets a late author keep a low number, which the technical check
bounces). The rule, stated once:

- **Affiliation 1 belongs to the first author's first affiliation.** Walk the author
  list left to right; each new affiliation gets the next integer the **first** time
  it appears; a repeat of an earlier affiliation reuses its number.
- The affiliation block is then listed in **ascending numeric order** (= first
  appearance), contiguous (1..N, no gaps), every number cited by ≥1 author.
- **Each affiliation ends with its city and country** (e.g. "…, Seoul, Republic of
  Korea").
- Corresponding authors get a `*` (and equal-contribution a `†`) appended to their
  superscript; the footnotes follow the block.

**Generate and verify this deterministically** rather than by hand:

```bash
# build the byline + affiliation block from an ordered authors file
python3 "${CLAUDE_SKILL_DIR}/scripts/build_title_page_affiliations.py" \
  --authors authors.yaml --out manuscript/title_page_affiliations.md

# verify an existing title page before submission (catches out-of-order numbering,
# gaps, undefined/orphan affiliations, and a missing city/country)
python3 "${CLAUDE_SKILL_DIR}/scripts/build_title_page_affiliations.py" \
  --check manuscript/title_page.md --strict
```

`authors.yaml` is an ordered `authors:` list (each with `name`, an ordered
`affiliations:` list of keys, optional `corresponding`/`equal_contribution`) plus an
`affiliations:` dict mapping each key to its full "Department, Institution, City,
Country" text. The script assigns the numbers; you never type a superscript.

---

## Abstract

### Structure

Most journals require a structured abstract: Background, Methods, Results, Conclusion.
Check the journal profile for the exact format (some use Purpose instead of Background,
or combine Background and Purpose).

### Word Limits (common)

| Journal | Limit |
|---------|-------|
| Radiology / KJR | 300 words |
| European Radiology | 250 words |
| European Journal of Radiology | 350 words |

Always check the loaded journal profile for the exact limit.

### Section-by-Section Rules

#### Background / Purpose

- Start with the specific gap — not a general disease overview
- No "Disease X is a major health concern" openers
- Go directly to what is unknown or insufficient about current methods
- 2-3 sentences maximum

#### Methods

- State: retrospective or prospective, single or multicenter
- Population: who, when (date range)
- Modality and key technical parameters
- Primary outcome and representative statistical method
- 3-5 sentences

#### Results

- Start with final included patient count (must match flowchart)
- Mean age and sex distribution
- Primary outcome with exact value, 95% CI, and p-value
- Key secondary outcomes (1-2 maximum)
- 3-5 sentences

#### Conclusion

- **This is where to invest the most effort** — reviewers and readers read this first
- 1-2 sentences only: state the core finding and its clinical implication
- Do not include limitations or "further studies are needed" (add only if reviewer requests)
- Must be a directly citable statement

### Abstract Self-Check

- [ ] All numbers match main text and tables?
- [ ] Conclusion does not overclaim beyond the evidence?
- [ ] Within word limit?
- [ ] Format matches journal requirements exactly?

---

## Visual Abstract

Many journals now require or encourage visual abstracts. European Radiology mandates them for
all Original Articles from first revision (Jan 2025). Submitting one voluntarily signals effort.

**Generation workflow:**
1. Check the target journal profile for visual abstract requirements and template availability.
2. Extract content: title, Key Point 1 → hypothesis, Key Point 3 → main finding, methodology
   bullets (<6 words each), patient cohort/modality/center badges.
3. Select a visual element: prefer the study's own figures (ROC, flow diagram) over illustrations.
4. Call `/make-figures` with visual abstract request, or run `generate_visual_abstract.py` directly.
5. The script fills a journal-specific PPTX template. If none exists, `medsci_default.pptx` is used.

**Design rules:**
- One page, landscape (16:9), per journal template
- Study question → Key method → Main result structure
- Use study's actual figures, not generic clip-art
- Every visual element must serve a purpose
- See `make-figures/references/medical_illustration_sources.md` for free illustration resources

# Statistical Methods — Section Templates for Radiology Papers

Reusable paragraph templates for the Statistical Analysis subsection of Methods. Adapt to the specific study; do not copy verbatim. All templates use past tense (Methods convention).

---

## 1. Descriptive Statistics

### Template
Continuous variables were expressed as mean +/- standard deviation or median (interquartile range [IQR]) depending on data distribution, which was assessed using the Shapiro-Wilk test. Categorical variables were reported as frequencies and percentages. Baseline characteristics were compared between groups using {the independent t test or Mann-Whitney U test} for continuous variables and {the chi-square test or Fisher exact test} for categorical variables, as appropriate.

### When to use each
- **Mean +/- SD**: normally distributed continuous data.
- **Median [IQR]**: skewed distributions, ordinal data, or small samples.
- **Shapiro-Wilk**: preferred normality test for n < 50; for larger samples, also consider visual inspection (Q-Q plot, histogram).

---

## 2. Comparison Tests

### Two-Group Continuous (Parametric)
Differences in {outcome} between {group A} and {group B} were compared using the independent-samples t test. For paired data (e.g., pre- vs post-intervention in the same subjects), the paired t test was used.

### Two-Group Continuous (Nonparametric)
Differences in {outcome} between groups were compared using the Mann-Whitney U test for independent samples or the Wilcoxon signed-rank test for paired samples.

### Categorical
The association between {variable 1} and {variable 2} was evaluated using the chi-square test. Fisher exact test was used when the expected cell count was less than 5.

### Multi-Group
Differences in {outcome} among {3+} groups were assessed using one-way analysis of variance (ANOVA) with post hoc pairwise comparisons using the Tukey honestly significant difference test. For non-normally distributed data, the Kruskal-Wallis test was used with post hoc Dunn test.

---

## 3. Diagnostic Accuracy

### Template
Diagnostic performance of {model/reader/test} was evaluated by calculating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy with exact binomial 95% confidence intervals (CIs). The area under the receiver operating characteristic curve (AUC) was calculated with 95% CIs using the DeLong method. The operating point was determined by {maximizing the Youden index / using a pre-specified sensitivity threshold of X% / clinical consensus}. AUC values were compared between {model A} and {model B} using the DeLong test for correlated ROC curves.

### Sensitivity/Specificity at Fixed Threshold
At the pre-specified operating point of {threshold}, sensitivity and specificity were calculated with 95% CIs using the exact binomial method.

### Multi-Class
For multiclass classification, per-class sensitivity and specificity were calculated using a one-versus-rest approach. The overall performance was summarized using the macro-averaged AUC.

---

## 4. Inter-Rater Agreement

### Two Raters, Categorical
Inter-rater agreement between {rater 1} and {rater 2} was assessed using Cohen kappa coefficient. Kappa values were interpreted as follows: less than 0, poor; 0-0.20, slight; 0.21-0.40, fair; 0.41-0.60, moderate; 0.61-0.80, substantial; and 0.81-1.00, almost perfect agreement.

### Multiple Raters, Categorical
Inter-rater agreement among {N} raters was assessed using Fleiss kappa with 95% CIs.

### Continuous Measurements
Inter-rater reliability for continuous measurements was assessed using the intraclass correlation coefficient (ICC) with a two-way random-effects model for absolute agreement (ICC[2,1] for single measures, ICC[2,k] for average measures). ICC values were interpreted as: less than 0.50, poor; 0.50-0.75, moderate; 0.75-0.90, good; and greater than 0.90, excellent.

### Weighted Kappa (Ordinal)
For ordinal ratings, inter-rater agreement was assessed using the weighted kappa coefficient with quadratic weights.

---

## 5. Survival Analysis

### Template
Overall survival and progression-free survival were estimated using the Kaplan-Meier method and compared between groups using the log-rank test. Median survival times were reported with 95% CIs. Multivariable analysis was performed using the Cox proportional hazards model, reporting hazard ratios (HRs) with 95% CIs. The proportional hazards assumption was verified using Schoenfeld residuals. Variables with P < .10 on univariable analysis were included in the multivariable model.

### Template (Retrospective Cohort — Time Zero + Interval Censoring)
Time zero was defined as the date of the first {qualifying examination / treatment / enrollment}. {Outcome} status was ascertained at subsequent {screening visits / follow-up examinations}, and the exact date of {outcome} onset was unknown. Therefore, the time to {outcome} was interval-censored between the last {negative / event-free} examination and the first {positive / event-detected} examination. Participants who remained {event-free / negative} at the last available examination were right-censored at that date. Standard Kaplan-Meier estimates were reported for comparability with prior literature, and interval-censored analyses using the Turnbull nonparametric maximum likelihood estimator were performed as {primary analysis / sensitivity analysis}.

### Template (Competing Risks)
Cumulative incidence of {primary outcome} was estimated using the cumulative incidence function (CIF), accounting for {competing event, e.g., non-cardiovascular death} as a competing risk. Group differences in cumulative incidence were compared using Gray test. The association between covariates and {primary outcome} was assessed using the Fine-Gray subdistribution hazard model, reporting subdistribution hazard ratios (sHRs) with 95% CIs. Cause-specific Cox proportional hazards models were also fitted for etiologic interpretation.

---

## 6. Sample Size Justification

### Template (Diagnostic Accuracy)
Based on an expected AUC of {X} for the AI model with a null hypothesis AUC of 0.50, a minimum of {N} cases ({n} positive, {n} negative) were required to achieve 80% power at a two-sided significance level of .05, using the method described by Hanley and McNeil. Accounting for {X%} expected data loss, a target enrollment of {N} was set.

### Template (Comparison Study)
To detect a difference of {X} in {metric} between {group A} and {group B}, assuming a standard deviation of {Y}, a sample of {N} per group was required to achieve {80/90}% power at a two-sided alpha of .05 using a {two-sample t test / chi-square test}. This calculation was performed using {software}.

### Template (No Formal Power Analysis)
No formal sample size calculation was performed for this {retrospective / exploratory} study. All eligible patients during the study period were included.

---

## 7. Multiple Comparison Correction

### Bonferroni
To account for multiple comparisons across {N} primary endpoints, a Bonferroni-corrected significance threshold of P < {0.05/N} was applied.

### Holm
Multiple comparisons were adjusted using the Holm-Bonferroni sequential correction method.

### False Discovery Rate
For exploratory analyses involving {N} comparisons, the Benjamini-Hochberg procedure was used to control the false discovery rate at 5%.

### No Correction (with justification)
Given that the {subgroup / secondary} analyses were pre-specified and hypothesis-driven, no correction for multiple comparisons was applied; these results should be interpreted with appropriate caution.

---

## 8. Software Statement

### Template (Python-primary)
Statistical analyses were performed using Python {version} (Python Software Foundation) with the following packages: scipy {version} for statistical tests, scikit-learn {version} for machine learning metrics, statsmodels {version} for regression analyses, and lifelines {version} for survival analysis. Figures were generated using matplotlib {version} and seaborn {version}.

### Template (R-primary)
Statistical analyses were performed using R {version} (R Foundation for Statistical Computing, Vienna, Austria). Key packages included pROC for ROC analysis, survival and survminer for survival analysis, irr for inter-rater reliability, and ggplot2 for visualization.

### Template (Mixed)
Data preprocessing and model development were performed using Python {version} with PyTorch {version}. Statistical analyses were performed using R {version} with the pROC, irr, and survival packages. All statistical tests were two-sided, and P < .05 was considered to indicate a statistically significant difference.

### Significance Statement (append to any software template)
All statistical tests were two-sided, and P < .05 was considered to indicate a statistically significant difference unless otherwise specified.

---

## 9. Ethics Statement

### Template (Retrospective, Consent Waived)
This retrospective study was approved by the institutional review board of {institution name} (protocol no. {number}), and the requirement for written informed consent was waived owing to the retrospective nature of the study. All procedures were performed in accordance with the Declaration of Helsinki.

### Template (Prospective, Consent Obtained)
This prospective study was approved by the institutional review board of {institution name} (protocol no. {number}). Written informed consent was obtained from all participants prior to enrollment.

### Template (Multi-Institutional)
This study was approved by the institutional review boards of all participating institutions: {institution 1} (protocol no. {X}), {institution 2} (protocol no. {Y}), and {institution 3} (protocol no. {Z}). {Informed consent was obtained from all participants / The requirement for informed consent was waived at all sites}.

### Template (Educational Study, No Patient Data)
This study was reviewed by the institutional review board of {institution name} and was determined to be exempt from full review (protocol no. {number}) as it involved educational evaluation with no patient data.

---

## 10. AI Disclosure Statement

### Template (AI Used in Research Pipeline)
{Model name} ({version}, {company}) was used for {specific task, e.g., generating educational content, classifying images, extracting structured data}. The model was accessed via {API / local deployment} between {start date} and {end date}. Generation parameters included a temperature of {X} and a maximum token length of {Y}. {All outputs were reviewed by a board-certified radiologist (author initials, X years of experience) / All outputs underwent multi-stage quality assurance as described in Section 2.X}.

### Template (AI Used in Writing)
{Tool name} ({version}) was used for {grammar checking / language editing / code generation for statistical analysis}. All AI-assisted content was critically reviewed, edited, and verified by the authors, who take full responsibility for the final manuscript.

### Template (Study About AI, No AI in Writing)
No AI writing tools were used in the preparation of this manuscript. The AI models evaluated in this study are described in Section 2.X.