MANUSCRIPT CRITERIA AND INFORMATION

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Archives of Internal Medicine is an international, peer-reviewed medical journal that publishes a variety of high-quality articles that relate to the science and practice of internal medicine. We receive more than 2000 manuscripts per year; our acceptance rate is about 13%. Median turnaround time from submission to first decision is 7 to 10 days and that from acceptance to publication is 161 days.

All manuscripts prepared in a manner in keeping with our Editorial Policies and Manuscript Preparation requirements and submitted for consideration (see Manuscript Submission) must meet the following general criteria: material is original; writing is clear; study methods are appropriate; the data are valid; conclusions are reasonable and supported by the data; information is important; and topic has internal medicine interest. From these basic criteria, the Editors assess a manuscript’s eligibility for publication.

Categories of Manuscripts

Original Investigations. These reports include randomized controlled trials, intervention studies, studies of screening and diagnostic tests, cohort studies, cost-effectiveness analyses, case-control studies, and surveys with high response rates. Each manuscript should contain a structured abstract that clearly states an objective or hypothesis; the design and methods (including the study setting and dates, patients or participants with inclusion and exclusion criteria, or data sources and how these were selected for the study); the essential features of any interventions; any deviation from the trial protocol; details regarding patient consent; the main outcome measures; the main results of the study; a comment section placing the results in context with the published literature; and the conclusions. Maximum specifications: 2500 to 3000 words (not including abstract, tables, figures, and references); 25 to 50 references; 6 to 8 tables and figures.

Randomized Controlled Trials: Registered trials should include the registry and registration number (see Trial Registration later in these Instructions).

The CONSORT Checklist should be completed and submitted with the manuscript. In addition, a flow diagram illustrating the progress of patients throughout the trial should be included as a figure in the manuscript (see Figure for example). The checklist and flow diagram will be reviewed along with the manuscript.

Reviews. These manuscripts are systematic, critical assessments of literature and data sources pertaining to clinical topics, emphasizing factors such as cause, diagnosis, prognosis, therapy, or prevention. All articles or data sources should be selected systematically for inclusion and be critically evaluated, and the selection process should be described in the manuscript. The specific type of study or analysis, population, intervention, exposure, and tests or outcomes should be described for each article or data source. Maximum specifications: 3500 words (not including tables, figures, and references); 50 to 75 references; 6 to 8 tables and figures.

Systematic Reviews: The PRISMA Checklist should be completed and submitted with the manuscript. In addition, a flow diagram illustrating the progress of study selection and exclusion (as well as reasons for exclusion) should be included as a figure in the manuscript. The checklist and flow diagram will be reviewed along with the manuscript.

Meta-analyses: These manuscripts also will be considered as reviews.^1(pp847-848) Therefore, the completed PRISMA Checklist and flow diagram should be submitted with the main text. Blank templates of the checklist and flow diagram can be downloaded online.

Research Letters. These letters report original research that is limited in scope and contribution to prior evidence, or unique clinical observations of exceptional interest. Research Letters considered for publication undergo external peer review. They may have no more than 5 authors; other persons who have contributed to the study may be indicated in an Acknowledgment, with their permission, including their academic degrees, affiliation, contribution to the study, and an indication if compensation was received for their role. Research Letters should be divided into the following sections: To the Editor (which serves as an introduction), Methods, Results, and Comment. They should not include an abstract, but otherwise should follow all of the guidelines in the Manuscript Preparation requirements. Maximum specifications: 800 words, 8 references, 1 table or figure.

Clinical Observations. These short reports of original studies or evaluations or unique, first-time reports of a clinical case series must be of unusual quality and special interest to merit publication. Maximum specifications: 1200 words, 10 references, 2 tables or figures.

Commentaries. These companion articles provide expert analysis of and perspective on a specific article or series of articles in the journal. Commentaries should be well focused, scholarly, clearly presented, and must have no more than 2 authors. Maximum specifications: 1000 words, 10 references, 1 table or figure.

Brief Comments. Brief comments are short contextual commentaries that are solicited by the editors to place published manuscripts in context and discuss further need for research in that particular area. Maximum specifications: 600 words, 5 references, 2 authors.

Editorials. Editorials are commentaries written by the Editors or by their invitation that focus on 1 or a series of articles in the Archives or on topics of special importance to our readership. Maximum specifications: 1000 words, 10 references.

Letters to the Editor. Letters discussing a recent article in the journal should be received within 4 weeks of the article’s publication. Maximum specifications: 400 words, 5 references, 3 authors. Letters to the Editor will be considered for publication if they are accompanied by a cover letter stating that they are “for publication.” No figures will be considered.

Readers Reply. Readers Reply promotes online and interactive discussions among readers and the Archives community, including authors and the Editors. Unlike our formal, peer-reviewed Letters to the Editor and the responding In Reply that appear as published articles in Archives, Readers Reply is an online-only, moderated, non–peer-reviewed feature of the Archives Web site. Comments and discussion posted via Readers Reply are not an indexed, referenced, or archived publication in the journal. Only content that has not been published, posted, or submitted elsewhere is acceptable.

Readers Reply posts should not exceed 500 words and 5 references and must conform to the norms of civilized scholarly discourse and discussion. We encourage dialogue in and among the members of the medical community, with appropriate safeguards to patient privacy. Any contributions that do not meet these standards will be edited or removed.

Special Articles. These in-depth, scholarly communications may address any important topic in internal medicine, public health, research, ethics, health policy, or health prevention that is of interest to our readership and the wider health care community. Maximum specifications: 3500 words, 25 references, 6 tables or figures.

Less Is More. Manuscripts are designated as “Less Is More” by the Editors if the subject highlights the value of improved patient-centered outcomes associated with lesser intensity or quantity of interventions.

Perspectives. These brief “Less Is More” articles present patients’ and physicians’ perspectives on their health care experiences, with special emphasis on examples when more care is not always better, even to the point where it is perceived as harmful. Maximum specifications: 300 to 500 words, 2 authors.

Challenges in Clinical Electrocardiography. These peer-reviewed articles demonstrate challenges and pitfalls in electrocardiography (ECG) interpretation for practitioners in the office, hospital, and prehospital setting. Examples include misinterpreted ECG findings, artifacts, limitations of computer interpretations, and controversies. Each submission should include a brief text introduction, 1 ECG image, 1 or 2 pertinent questions, and an anonymized case discussion and patient course, if applicable. Maximum specifications: 1000 words; 5 bulleted summary points; 10 references. Images: Minimum 5 inches wide and 350 dpi. Labels should be added to electronic images only on a separate layer or by importing into applications such as Word, PowerPoint, or Illustrator; however, original image files must also be submitted. (For additional information, see Technical Requirements for Figures.)

Images From Our Readers. We welcome the submission of images from members of the health care community that have special significance to them and that would be of interest and relevance to our readers. Each image should carry with it a short, descriptive caption. We limit submissions to 8 per calendar year and no more than 4 in any one month.

Presubmission inquiries are discouraged. Manuscript submission for initial review ensures the thoughtful assessment by the Editors of its appropriateness for Archives of Internal Medicine, and this determination is made within 5 to 7 days.

Editorial Office Information

Archives of Internal Medicine, Rita F. Redberg, MD, MSc, Editor, University of California, San Francisco, Department of Medicine–Division of Cardiology, 505 Parnassus Ave, Ste M1180, Box 0124, San Francisco, CA 94143-0124; phone: (415) 476-3117; fax: (866) 465-1761; e-mail: archinternmed{at}jama-archives.org.

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Editorial Policies

Authorship Criteria and Required Statements. Each author should have participated sufficiently in the work to take public responsibility for appropriate portions of the content. One or more of the authors should take responsibility for the integrity of the work as a whole, from inception to publication. Authorship credit should be based only on (1) substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data; and (2) drafting the article or revising it critically for important intellectual content; and (3) final approval of the version to be published. Conditions 1, 2, and 3 must all be met.² 

At the time of original submission of the manuscript, the corresponding author is required to declare the contributions of all authors who meet these conditions in the cover letter.

At the time of manuscript revision or acceptance, the corresponding author and each coauthor is required to read, complete, and submit an authorship form with required statements on (1) authorship responsibility, criteria, and contributions, (2) financial disclosure, and either copyright transfer/publishing agreement or federal employment statement.^1(pp127-135) Authorship forms will be provided by e-mail at the appropriate point in the peer review process.

Authorship, as well as the involvement of any professional medical writer in the publication, must be declared upon original submission of the manuscript. Changes in the list of authors or the order of authors after peer review are not granted without submission to the journal by the corresponding author signed statements of consent to the change obtained from each author identified at the time of first submission.

Individuals who have contributed to the work described in the manuscript but who do not meet the criteria for authorship should be listed in the Acknowledgments. The corresponding author should obtain written permission from all individuals named in an Acknowledgment, since readers may infer their endorsement of data and conclusions^1(p146) and also must sign the Acknowledgment statement.

Group Authorship. If authorship is attributed to a group (either solely or in addition to 1 or more individual authors), all members of the group must meet the full criteria and requirements for authorship described in the authorship form. A group must designate at least 1 or more individuals as authors or members of a writing group who meet full authorship criteria and requirements and who will take responsibility for the group. Other group members who do not meet the criteria for authorship may be listed in the Acknowledgments.^2,3

Conflicts of Interest and Financial Disclosure. A conflict of interest may exist when an author (or the author’s institution or employer) has financial or personal relationships that could inappropriately influence (or bias) the author’s decisions, work, or manuscript. All authors are required to report potential conflicts of interest, including specific financial interests relevant to the subject of their manuscript. This required information should be supplied in their cover letter in addition to the financial disclosure form. Authors without relevant financial interests in the manuscript should indicate no such interests in the Acknowledgments section of the manuscript.⁴

All authors must provide detailed information regarding all financial and material support for the research and work, and each is required to sign and submit a full financial disclosure statement certifying all affiliations or financial involvement within the past 5 years and the foreseeable future with any organization or entity with a financial interest in or conflict with the subject matter or material discussed in the manuscript. Common relationships that should be disclosed include, but are not limited to, the following:

• • Full- or part-time employment
• • Consultancies
• • Honoraria
• • Speakers bureau
• • Stock ownership or options
• • Expert testimony
• • Grants received or pending
• • Patents filed, received, pending, or in preparation that represent potential future financial gain
• • Royalties
• • Donation of medical equipment

If authors are uncertain about what might constitute a potential financial conflict of interest, they should err on the side of full disclosure and should contact the Editorial Office if they have questions or concerns. Authors who have no relevant financial interests must provide a statement indicating that they have no financial interests related to the material in the manuscript.

Authors’ conflicts of interest and financial disclosure statements are held by the editorial office. For all accepted manuscripts, authors’ reported relevant financial interests and declarations of no relevant financial interests will be published. Decisions about whether financial information provided by authors should be published, and thereby disclosed to readers, are usually straightforward. Although Editors are willing to discuss disclosure of specific financial information with authors, the Archives of Internal Medicine’s policy is one of complete disclosure of all relevant financial interests.

This policy applies to all manuscript submissions, including letters to the editor.

Funding/Support and Role of the Sponsor. All financial and material support for the research and the work must be clearly and completely identified in the Acknowledgments section of the manuscript. The specific role of the funding organization or sponsor in each of the following should be specified: design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.⁴

Data Access and Responsibility. For reports containing original data, at least 1 author (eg, the principal investigator) should indicate that he or she “had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis”).⁴For industry-sponsored studies, this statement must be provided by an investigator who is not employed by any commercial funder, and an independent data analysis must be conducted by statisticians at an academic institution with access to the raw data set, rather than only by statisticians employed by the company sponsoring the research. Details of this independent statistical analysis, the name and institutional affiliation of the independent statistician, and whether compensation or funding was received for conducting the analyses should be reported in the Acknowledgment.⁵

Duplicate Publication or Submission. Manuscripts are received with the understanding that they have not been published previously in print or electronic format and are not under consideration by another publication or electronic medium. When submitting a manuscript, authors should include copies of related, possibly duplicative material that has been previously published or is currently under consideration elsewhere. If publication of the findings occurs in press reports, interviews, or other formats after submission but before publication of the manuscript in the Archives, the Editors must be notified immediately.

Reference to and Identification of Patients. Refer to patients by number (or, in anecdotal reports, by fictitious given names). Do not use real names or initials in the text, tables, or illustrations. A signed statement of patient consent must accompany all photographs of patients in which a possibility of identification exists (see Patient Consent form). It is not sufficient to cover the eyes to mask identity.

Reporting Race/Ethnicity. If race and/or ethnicity is reported, indicate who classified individuals as to race/ethnicity, the classifications, and whether the options were defined by the investigator or the participant. Explain why race and/or ethnicity was assessed in the study.⁶

Reporting Sex-Specific Results. When sufficient data for each sex is available, separate analyses should be reported on sex-specific results.

Ethical Requirements. All research involving human participants must have been approved by the authors’ institutional review board or equivalent committee(s) and that board must be named by the authors in the manuscript.^1(p226) For research involving human participants, informed consent must have been obtained (or the reason for lack of consent explained, eg the data were analyzed anonymously) and all clinical investigation must have been conducted according to the principles expressed in the Declaration of Helsinki.⁷ Authors should be able to submit, upon request, a statement from the research ethics committee or institutional review board indicating approval of the research as well as a sample of a patient consent form.

For studies involving humans categorized by race/ethnicity, age, disease/disabilities, religion, sex/gender, sexual orientation, or other socially constructed groupings, authors should, as much as possible,

• • Make explicit their methods of categorizing human populations;
• • Define categories in as much detail as the study protocol allows;
• • Justify their choices of definitions and categories, including, for example, whether any rules of human categorization were required by their funding agency;
• • Explain whether (and if so, how) they controlled for confounding variables such as socioeconomic status, nutrition, or environmental exposures.

In addition, outmoded terms and potentially stigmatizing labels should be changed to more current, acceptable terminology. Examples: “Caucasian” should be changed to “white” or “of [Western] European descent” (as appropriate); “cancer victims” should be changed to “patients with cancer.”

Reporting of Animal Studies and Ethical Treatment of Animals. For studies involving animals, all work must have been conducted according to relevant national and international guidelines and prior approval obtained for all protocols from the author’s institutional or other relevant ethics committee and the institution name and permit numbers provided at submission (see example below). For research involving nonhuman primates, all studies must be performed in accordance with the recommendations of the Weatherall report,⁸ “The use of nonhuman primates in research.” Where unregulated animals are used or ethics approval is not required by a specific committee, the article should include a clear statement of this and the reasons why ethical approval is not required.

We also strongly encourage all authors to comply with the “Animal Research: Reporting In Vivo Experiments” (ARRIVE) guidelines,⁹ developed by NC3Rs (National Centre for the Replacement, Refinement, and Reduction of Animals in Research) to improve standards of reporting to ensure that the data from animal experiments can be fully scrutinized and utilized. Relevant information should be included in the appropriate section of the article (eg, title, abstract, method) as outlined in the guidelines. Please note that these guidelines can be applied to any area of bioscience research using laboratory animals.

Manuscripts That Pose Security Risks. Authors and reviewers are expected to notify editors if a manuscript could be considered to report dual use research of concern (ie, research that could be misused by others to pose a threat to public health and safety, agriculture, plants, animals, the environment, or material).¹⁰ The editor in chief will evaluate manuscripts that report potential dual use research of concern and, if necessary, consult additional reviewers.

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

Trial Registration. In concert with the International Committee of Medical Journal Editors (ICMJE),^11,12 the Archives of Internal Medicine will require, as a condition of consideration for publication, registration of all trials in a public trials registry that is acceptable to the ICMJE (ie, the registry must be owned by a not-for-profit entity, be publicly accessible, and require the minimum registration data set as described by the ICMJE). Acceptable trial registries include http://www.clinicaltrials.gov, http://www.isrctn.com, http://www.anzctr.org.au, http://www.trialregister.nl, and http://www.umin.ac.jp/ctr. For this purpose, the ICMJE defines a clinical trial as any study that prospectively assigns human subjects to intervention or comparison groups to evaluate the cause-and-effect relationship between a medical intervention and a health outcome. Studies designed for other purposes, such as to study pharmacokinetics or major toxicity (eg, phase 1 trials), are exempt. The trial registry name and URL and the registration number should be included at the end of the abstract at the time of submission, and also in the space provided on the online manuscript submission form. Trials must be registered at or before the onset of subject enrollment. This policy of prospective registration applies to any clinical trial starting enrollment after July 2005. Trials that began before July 2005 should be registered retrospectively before journal submission. For trials that began before July 2005 but that were not registered before September 13, 2005, trials must have been registered before journal submission.

Embargo Policy. Information regarding the content and publication date of accepted manuscripts is confidential. Information contained in or about accepted articles cannot appear in print, radio, television, or in electronic form or be released to the media until 3 pm CST on the second and fourth Mondays of the month. (Note: For August and December, which each have only 1 issue, the embargo lifts on the second Monday of the month.)

Depositing Research Manuscripts With an Approved Public Repository. All Archives Journal articles reporting original research are made freely available 12 months after publication, from 1998 forward, subject to certain conditions. The Archives Journals’ Editors and Publishers believe that the public is best served by accessing the freely available research articles on the journal Web site, to ensure access to the final published version, any corrections, and related Web features. However, some funding organizations require that authors of manuscripts reporting research deposit those manuscripts with an approved public repository, such as PubMed Central. Authors have the Archives Journals’ permission on the following conditions:

• 1. Permission is granted only for manuscripts reporting research funded by not-for-profit organizations to be deposited in not-for-profit, publicly available repositories.
• 2. Permission is granted to post only the manuscript reporting research that was submitted and accepted for publication but not the final, edited, formatted, and published article.
• 3. Authors must ensure that the posted manuscript links back to the published article on the Archives Journals Web site to provide readers with access to the final reviewed and edited version plus any corrections and letters, as well as the article-related features only available on the Archives Journals Web site.
• 4. Authors who submit their manuscripts to an approved public repository, such as PubMed Central, must indicate that the manuscript may not be made available to the public sooner than 12 months after publication in the Archives Journals.

If authors adhere to these requirements, they may submit the final accepted version of the manuscript to the repository, if and only if the repository ensures that the deposited manuscript will not be made available to the public during the 12-month embargo following publication in the Archives Journals.

The published article is protected by copyright at the time of publication and thereafter (see http://pubs.ama-assn.org/misc/conditions.dtl). This research access policy does not include permission to use the Archives Journal logo and trademarks. The Archives Journal article of record is the final published version; the Archives Journals assume no responsibility for earlier versions because substantive changes and corrections may occur during the postacceptance editing process. Authors may contact the Archives Journals with any questions at jama-comments{at}jama-archives.org.

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Manuscript Preparation

Structure of Manuscript. The content of the manuscript should be prepared in accordance with the AMA Manual of Style¹ and/or the Uniform Requirements for Manuscripts Submitted to Biomedical Journals.² All copy must be typed double-spaced with 1-inch margins, numbered consecutively, beginning with the title page. Do not justify lines. Do not use line numbering. Double-space throughout, including title page, abstract, text, acknowledgments, references, legends, and tables.

Length of Manuscript. While the Editors occasionally approve nonconforming manuscripts, they do so only when they are considered to possess exceptional merit. Submissions that do not conform to recommended space limitations are subjected to a particularly rigorous editorial review and are thus less likely to be accepted than those that fall within recommended guidelines.

As a rule of thumb, 3 typed double-spaced pages translate into 1 typeset page when manuscripts are prepared in 12-point font with standard 1-inch (2.5-cm) margins. The right margin should be unjustified (ragged). Authors should make allowance for tables and illustrations; use a rough estimate of one-quarter page for each table and each figure.

Title Page (page 1 of manuscript). Titles should not exceed 75 characters, including punctuation and spacing. Avoid using declarative sentences or questions as titles. Avoid abbreviations in the title, abstract, and text.

This page must also include a word count for the text only, exclusive of the title, abstract, references, tables, and figure legends, and financial disclosure information as a footnote.

Give full names, highest academic degrees, and institutional affiliations of all authors. (If an author’s affiliation has changed since the work was done, list the new affiliation as well.) Designate a corresponding author and include a complete mailing address, telephone number, fax number, and e-mail address. Specify the address to which requests for reprints should be sent.

If the manuscript was presented at a meeting, please specify the name of the meeting, the city where it was held, and the exact date on which the paper was read or the poster was presented.

Abstract (page 2 of manuscript). Include a structured abstract of no more than 300 words for reports of original data from clinical or basic science investigations and reviews (including meta-analyses). Original Investigations, Reviews, and Special Articles require abstracts (abstracts for Special Articles should be unstructured); other types of articles in the journal do not.

Abstracts consist of 4 paragraphs labeled Background, Methods, Results, Conclusions. Because abstracts are the most visible part of a manuscript, special attention will be paid to the quality of abstract. Authors are expected to adhere to the quality criteria for abstracts, as outlined in “The Need for Concrete Improvement in Abstract Quality”¹³ and “Writing Informative Abstracts for Journal Articles.”¹⁴ These criteria are summarized in the following tabulation (adapted from JAMA¹³):

• 1. Abstract headings are consistent with structured abstract format.
• 2. Data in abstract are consistent with text, tables, and figures.
• 3. Data or information in the abstract are presented in the text, tables, or figures.
• 4. Years of study and length of follow-up are provided.
• 5. Results for Main Outcome Measures are presented in Results section (avoid selective reporting).
• 6. Results are quantified with numerators, denominators, odds ratios, and confidence intervals where appropriate.
• 7. Absolute differences rather than relative differences are presented wherever possible (eg, “Mortality declined from 6% to 3%” rather than “Mortality declined 50%”).
• 8. For randomized trials, analysis is identified as intent-to-treat or evaluable patient analysis.
• 9. For surveys, response rate is provided in Results.
• 10. For multivariate analysis, factors controlled for in model are briefly summarized.
• 11. Conclusions follow from information contained within the abstract.

Style of Writing. The style of writing should conform to acceptable English usage and syntax. Slang, medical jargon, obscure abbreviations, and abbreviated phrasing are to be avoided.

Statistics. Authors are encouraged to consult “Reporting Statistical Information in Medical Journal Articles.”¹⁵ Describe statistical methods with enough detail to enable a knowledgeable reader with access to the original data to reproduce the reported results. When possible, quantify findings and present them with appropriate indicators of measurement error or uncertainty (such as confidence intervals). Avoid relying solely on statistical hypothesis testing, such as the use of P values, which fails to convey important quantitative information. Give details about randomization. Describe the methods for and success of any blinding of observations. Report complications of treatment. Give numbers of observations. Report losses to observation (such as dropouts from a clinical trial). For multivariate models, report all variables included in models, and report model diagnostics and proportion of variance explained by both individual variables and the complete model.

Where sufficient data are available for both male and female subjects, separate analyses should be performed and reported for each sex.

Put a general description of methods in the “Methods” section. Restrict tables and figures to those needed to explain the argument of the article and to assess its support. Use graphs as an alternative to tables with many entries; do not duplicate data in graphs and tables. Avoid nontechnical uses of technical terms in statistics, such as random (which implies a randomizing device), normal, significant, correlations, and sample. Define statistical terms, abbreviations, and most symbols.

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

Drug Names. The generic (nonproprietary) name of a drug is preferred in almost all instances. If it is necessary to include the brand (proprietary or trade) name for reproduction or interpretation of the study, the brand name should be given parenthetically, following the generic name, at first mention in the abstract, text, and each figure or table in which it appears. In addition, the brand name and supplier’s name and location should be given in the “Methods” section. In the case in which a manuscript is comparing various brands of a single product, or in which an adverse event is described that might be unique to a single brand of product, both the brand name and generic name should appear at first mention and the brand name(s) should be used thereafter.

Authors submitting manuscripts or letters to the editor regarding adverse drug or medical device reactions, reportable diseases, and the like should also report such to the relevant government agency.

Gene Names, Symbols, and Accession Numbers. Authors describing genes or related structures in a manuscript should include the names and official symbols provided by the US National Center for Biotechnology Information (NCBI) or the HUGO Gene Nomenclature Committee. Before submission of a research manuscript reporting on large genomic data sets (eg, protein or DNA sequences), the data sets should be deposited in a publicly available database, such as NCBI’s GenBank, and a complete accession number (and version number, if appropriate) must be provided in the “Methods” section or the Acknowledgments section of the manuscript.

Reproduced Material. Acknowledge illustrations from other publications and, when applicable, include author(s), title of article, title of journal or book, volume number, page(s), month, and year. The publisher’s permission to reproduce in print and online and in Archives licensed versions should be submitted to the Archives when the manuscript is submitted. Tables and illustrations should be original work and only rarely should they be reproduced material. (See Permission to Reproduce Copyright-Protected Material Form.)

Acknowledgments. List all persons who have made substantial contributions to the work reported in the manuscript (including writing and editing assistance), but who are not authors; any financial interest in the subject matter or materials discussed in the manuscript; any research or project support/funding; grant support. Manuscripts with statistical evaluations should include the name and affiliation of statistical reviewer(s). Authors should also obtain written permission to include the names of individuals in the Acknowledgement section.

References. List references in consecutive numerical order (not alphabetically). All subsequent reference citations should be to the original number. Cite all references in the text or tables. Unpublished data and personal communications should not be listed as references. References to journal articles should include (1) author(s) (list all authors and/or editors up to 6; if more than 6, list first 3 and “et al”), (2) title, (3) journal name (as abbreviated in Index Medicus), (4) year, (5) volume number, (6) issue number, and (7) inclusive page numbers, in that order. References to books should include (1) author(s) (list all authors and/or editors up to 6; if more than 6, list first 3 and “et al”), (2) chapter title (if any), (3) editor (if any), (4) title of book, (5) city of publication, (6) publisher, and (7) year. Volume and edition numbers, specific pages, and name of translator should be included when appropriate. The reference numbers in the reference list (if any) should be keystroked. Do not let the word-processing program generate the reference numbers, using such features as automatic footnotes or endnotes. The author is responsible for the accuracy and completeness of the references and for their correct text citation. Do not include “personal communications” in the list of references. Authors who name an individual as a source for information in a personal communication, be it through conversation, a letter, e-mail message, or telephone call, should obtain written permission from the named individual.

Web References. Please keep a print copy of any reference to Web-only information. If the URL changes or disappears, interested readers may contact the corresponding author for a copy of the information.

Tables, Illustrations, Legends. Number all tables and illustrations in the order of their citation in the text. Include a title for each table and figure—a brief, succinct phrase, preferably no longer than 10 to 15 words. Tables and illustrations should be original work and only rarely should they be reproduced material.

Tables. Tables should be able to stand alone, without the need to refer to the text. Table titles should convey complete information about the study population, research question, methods, and sample size. Table footnotes should include adequate descriptions of outcome variables, covariates in multivariate models, and model diagnostics, where relevant.

Title all tables and number them in order of their citation in the text. If a table must be continued, repeat the title on a second sheet, followed by “continued.” Make certain each item in the table is in its own table cell. Do not use paragraph returns (to start new rows) or tabs (to start new columns) to format the table. See Instructions for Table Creation for further information.

Illustrations. For initial manuscript submissions, all figures should be submitted as individual digital files. If your manuscript is accepted, you may be asked to submit a high-quality original of each figure as outlined below:

• • For original drawings or illustrations, provide a signed copyright transfer (see box on the authorship form) from the illustrator(s). The illustrator will be contacted with instructions for completing the copyright transfer at the appropriate time.
• • For images and illustrations originally created digitally, see Digital Art Submissions.
• • For digitally enhanced images (eg, computed tomographic or magnetic resonance imaging scans, blots, photographs, photomicrographs, ultrasound images, x-ray films), clearly identify in the figure legends as electronically enhanced or manipulated. You may be asked to provide clearly labeled copies of the enhanced images and 3 copies of the original images.

See Technical Requirements for Figures for more details.

Digital Art Submissions. RGB color submissions are preferred. Calibrated color proofs may be submitted with color digital files for reference during production. The canvas size of continuous-tone images should be at least 5 inches wide (depth not important) with an image resolution of at least 350 ppi. Line art images should have a minimum resolution of 1270 ppi. Formats accepted are TIF, GIF, JPG, EPS, BMP, Photoshop, CorelDraw, PowerPoint, Excel, or Word. (See Technical Requirements for Figures.)

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

When inappropriate image adjustments are detected by the JAMA and Archives Journals staff, authors will be asked for an explanation and will be requested to submit the image as originally captured prior to any adjustment, cropping, or labeling. Authors may be asked to resubmit the image prepared in accordance with the above standards. Deliberate alteration of images that results in misrepresentation of data may be reported to the author’s institution or funding agency.

Legends. Include double-spaced legends (maximum length, 40 words) on separate pages. Indicate magnification and stain used for photomicrographs and method of enhancement for digitally enhanced images.

Appendixes. Archives of Internal Medicine does not print appendixes. Should an appendix be necessary, it must be included in the manuscript at the time of submission. If a manuscript containing an appendix is accepted for publication, the appendix will be posted online at the time of publication, with a reference to the appendix appearing in print. Appendixes may be uploaded as “supplemental files” but should not be included in the manuscript file.

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

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

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

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

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

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

Online-Only Figures: Online-only figures should be inserted in the document and numbered consecutively according to the order of citation as eFigure 1, eFigure 2, etc. Figure titles should be set in Arial font, 12 point, bold, and single-spaced. Text within figures should be set as Arial font, 10 point. Figure legends should be set in 8 point and single-spaced. Graphs and diagrams should be exported directly out of the software application used to create them in a vector file format, such as WMF, and then inserted into the Word document. Image file formats such as JPG, TIF, and GIF are generally not suitable for graphs. Photographs, including all radiological images, should be prepared as JPG (highest option) or TIF (uncompressed ) files at a resolution of 300 dpi and width of 3 to 5 inches, but the resolution of photographic files with an original resolution less than 300 dpi should not be increased digitally to achieve a 300-dpi resolution. Photographs should be inserted in the document with the “Link to File” button turned off. Wide figures may be presented using a landscape orientation. See also instructions for Figures above.

Videos. For editorial and peer review of an initial submission, submit videos in .mov, .wmv, .mpg, .mpeg, .mp4, or .avi file format. Individual videos should be less than 5 minutes long. To facilitate uploading and reviewing, the initial video submitted should not exceed 10 MB. Verify that all videos are viewable in QuickTime or Windows Media Player before submission. For each video, provide a citation in the appropriate place in the manuscript text and include a title (a brief phrase, preferably no longer than 10-15 words) and a caption/legend (a brief description or summary of the content) at the end of the manuscript. In the video caption/legend, specify the video file format. If the author does not hold copyright to the video, the author must obtain permission for the video to be published in the Archives of Internal Medicine. This permission must be for unrestricted use in all print, online, and licensed versions of Archives of Internal Medicine. (See Permission to Reproduce Copyright-Protected Material Form.) Submit the completed form to the editorial office.

Note: If the manuscript and accompanying video(s) are accepted for publication, all video files will be placed into a journal video frame and may be edited by the journal staff according to journal style.

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Manuscript Submission

Manuscripts should be submitted via our online manuscript submission and review system (http://manuscripts.archinternmed.com). Please note that although preliminary information must be entered into the online submission form, the following should also be included on the title page of the manuscript: manuscript title, names and affiliations of all authors, word count, and contact information of the corresponding author.

Cover letters accompanying manuscripts at original submission must include an introduction to the content of the manuscript submitted, a 250-word explanation of how the content of the manuscript advances the field and expertly informs the medical community and why this manuscript is best suited for publication in the Archives of Internal Medicine. In addition, the corresponding author is required to declare the contributions of all authors according to our criteria for authorship.

Cover letters accompanying revised manuscripts should include a summary of the documents returned (e.g., Response to Reviewers, additional figures or tables as separate files) and notice of any request to amend the author list or declaration of author contributions.

Signed authorship and disclosure forms, with the manuscript number indicated, should be scanned and e-mailed to archinternmed@jama-archives.org. See Manuscript Checklist and details in these Instructions for additional requirements.

Please note: To ensure expeditious handling of your submission, authors should adhere closely and in full to our stated Editorial Policies and the specifications outlined in these Instructions for Authors when submitting their manuscript and related materials. Manuscripts that are out of compliance when checked immediately after upload into our system will be returned for updating and resubmission.

(Manuscripts submitted by regular mail will NOT be reviewed and will not be returned. Authors will be notified by e-mail to resubmit electronically. If authors do not receive an acknowledgment e-mail notification within 2 days, they should contact the Archives’ office via e-mail or telephone [(415) 476-3117].)

On the submission form, authors will be asked to suggest 4 peer reviewers who are knowledgeable on the subject matter of the manuscript. A short list (no more than 5) of peer reviewers whom the authors wish to have excluded from review of the manuscript may also be included.

To ensure that the electronic submission is usable, please adhere to the following guidelines when submitting your manuscript electronically and supply all required data and information in the respective fields of the online submission form.

• • Text: Save the text in Word, WordPerfect, RTF, or text.
• • Tables: Tables must be inserted at the end of the manuscript text file, after all references and figure legends. Make certain that each item in the table is in its own table cell. Do not use paragraph returns (to start new rows) or tabs (to start new columns) to format the table.
• • Figures: Please refer to the instructions in Technical Requirements for Figures for guidelines at submission and acceptance. Each figure must be submitted in a separate file. Figures should be submitted as high-resolution TIF or JPG files. Photographic images must be 5 inches (13 cm) wide at 300 pixels per inch (120 pixels per centimeter), minimum. This requirement applies to each part for multipart figures. Save them as TIF (with LZW compression), JPG (with “maximum quality” setting), or PSD (native Adobe Photoshop format). Please do not add arrowheads, “a,” “b,” asterisks, etc, directly to the image file. Arrows, asterisks, and other indicators may be indicated in a separate layer in Photoshop, or a composite figure in PowerPoint may be submitted.
• • Manuscripts received are not to be under consideration by another publication. If related work has been submitted elsewhere, a full explanation of its relation to the current submission and a copy of that related work must be included with the article submitted to Archives of Internal Medicine. Reviewers will be asked to comment on the overlap between related submissions.
• • Copyright Form and Patient Consent: Upon notification of an assigned manuscript number, the corresponding author should scan and e-mail (archinternmed{at}jama-archives.org) or fax the completed author responsibility and competing interests and financial disclosure forms for all authors to the editorial office: (866) 465-1761. On the cover page, please indicate the date that the manuscript was submitted electronically and the manuscript number. At the same time, please send a signed statement of informed consent to publish (in print and online and licensed versions) patient photographs and pedigrees from all persons who can be identified in such photographs and pedigrees.

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Editorial Review and Publication

Peer Review. Manuscripts are commonly (but not invariably) sent to expert consultants for peer review. Peer reviewer identities are kept confidential. Authors, by special request, may keep their identities confidential but must submit a second electronic file of the manuscript with all identifying information edited out. Reviews and decisions on submitted manuscripts in which the editor or one of the associate editors is a coauthor, or has a conflict of interest, are managed independently by an associate editor from another institution, in conjunction with a member of the editorial board. If needed, the final editorial decision will involve a member of the editorial board who does not have such a potential conflict.

Editing. Accepted manuscripts are edited according to AMA style and returned to the author for approval. Authors are responsible for all statements made in their work, including changes made by the manuscript editor and authorized by the corresponding author. If you wish to receive page proofs for approval, contact the manuscript editor assigned to your paper within 2 days of receiving the typescript.

Reprints. Reprints may be ordered from Reprints Desk when the edited manuscript is sent for approval to the corresponding author.

e-Prints. Corresponding authors who provide an e-mail address for publication will receive an electronic link that provides 25 free online accesses to the PDF view of their article.

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Manuscript Checklist

• • Electronic submission only.
• • On the title page, include a word count for text only, exclusive of title, abstract, references, tables, and figure legends.
• • On the title page, designate a corresponding author and provide his or her complete address, telephone and fax numbers, and e-mail address.
• • Include forms/statements signed by each author on (1) authorship criteria and responsibility, (2) financial disclosure, and (3) copyright transfer or federal employment.
• • Include statement signed by corresponding author that written permission has been obtained from all persons named in the acknowledgment.
• • For clinical trials, add trial registry name, registration number, and the URL for the registry. Include the CONSORT Checklist and flow diagram for randomized trials.
• • For systematic reviews, include the PRISMA Checklist and flow diagram.
• • Include research or project support/funding in an acknowledgment.
• • Double-space manuscript (text and references) and leave right margins unjustified (ragged). Do not use line numbering.
• • Figures uploaded as separate file (to be merged by the system).
• • Check all references for accuracy and completeness. Put references in proper format in numerical order, making sure each is cited in sequence in the text. It is advised not to use auto-numbering reference software.
• • Include a title for each table and figure—a brief, succinct phrase, preferably no longer than 10 to 15 words.
• • Provide an abstract that conforms with the required abstract format for Original Investigations, Reviews, and Special Articles (unstructured abstract). Be sure to consult the articles by Winker¹³ and Cummings et al¹⁴ before completing the abstract.
• • Include written permission from each individual identified as a source for personal communication.
• • Include informed consent forms for identifiable patient descriptions, photographs, and pedigrees.
• • Include written permission from publishers (or other copyright owner) to reproduce or adapt previously published illustrations and tables in the Archives (in print, online, and in Archives licensed versions) (see Permission to Reproduce Copyright-Protected Material Form).

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References

• 1. Iverson C, Christiansen S, Flanagin A, et al. American Medical Association Manual of Style: A Guide for Authors and Editors. 10th ed. New York, NY: Oxford University Press; 2007.
• 2. International Committee of Medical Journal Editors. Uniform Requirements for Manuscripts Submitted to Biomedical Journals. http://www.icmje.org.
• 3. Flanagin A, Fontanarosa PB, DeAngelis CD. Authorship for research groups. JAMA. 2002;288(24):3166-3168. Medline
• 4. DeAngelis CD, Fontanarosa PB, Flanagin A. Reporting financial conflicts of interest and relationships between investigators and research sponsors. JAMA. 2001;286(1):89-91. Medline
• 5. Fontanarosa PB, Flanagin A, DeAngelis CD. Reporting conflicts of interest, financial aspects of research, and role of sponsors in funded studies. JAMA. 2005;294(1):110-111. Medline
• 6. Winker MA. Measuring race and ethnicity: why and how? JAMA. 2004;292(13):1612-1614. Medline
• 7. World Medical Association. Declaration of Helsinki: Ethical principles for medical research involving human subjects. http://www.wma.net/en/30publications/10policies/b3/index.html. Accessed January 15, 2010.
• 8. Weatherall D. The use of nonhuman primates in research. December 2006. http://www.acmedsci.ac.uk/images/project/nhpdownl.pdf. Accessed February 11, 2011.
• 9. Kilkenny C, Browne WJ, Cuthill IC, Emerson M, Altman DG. Improving bioscience research reporting: the ARRIVE guidelines for reporting animal research. PLoS Biol. 2010;8(6):e1000412. doi:10.1371/journal.pbio.1000412. Medline
• 10. Journal Editors and Authors Group. Statement on scientific publication and security. Science. 2003;299(5610):1149. http://www.sciencemag.org/site/feature/data/security/statement.pdf. Accessed July 12, 2011.
• 11. DeAngelis CD, Drazen JM, Frizelle FA, et al; International Committee of Medical Journal Editors. Clinical trial registration: a statement from the International Committee of Medical Journal Editors. JAMA. 2004;292(11):1363-1364. Medline
• 12. Deangelis CD, Drazen JM, Frizelle FA, et al; International Committee of Medical Journal Editors. Is this clinical trial fully registered? a statement from the International Committee of Medical Journal Editors. JAMA. 2005;293(23):2927-2929. Medline
• 13. Winker MA. The need for concrete improvement in abstract quality. JAMA. 1999;281(12):1129-1130. Medline
• 14. Cummings P, Rivara FP, Koepsell TD. Writing informative abstracts for journal articles. Arch Pediatr Adolesc Med. 2004;158(11):1086-1088. Medline
• 15. Cummings P, Rivara FP. Reporting statistical information in medical journal articles. Arch Pediatr Adolesc Med. 2003;157(4):321-324. Medline

Last updated January 12, 2012.