author guidelines for research

If you cannot use our Word template:

Tips

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A list of abbreviations and/or symbols is optional but it may be very helpful if numerous abbreviations and special symbols are scattered throughout the text.

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Based on NLM guidelines Citing Medicine

Medicine, Biomedicine

Mathematics, Physics, Statistics

Physics

Social Sciences, Psychology

Humanities, Linguistics, Philosophy

Tip

Include important original content in a chapter or a chapter appendix, not in the book appendix because any appendix in the back matter of a book will appear with unrestricted access in the eBook on SpringerLink.

Tips

Use the indexing function in Word or the index command in LaTeX to identify the index term as your write your text and indicate, on average, one or two index entry terms per manuscript page to be included in the index.

Manuscript files can be in the following formats: DOC, DOCX, or RTF. Microsoft Word documents should not be locked or protected. 

LaTeX manuscripts must be submitted as PDFs.  .

We encourage you to present and discuss your findings concisely.

Use a standard font size and any standard font, except for the font named “Symbol”. To add symbols to the manuscript, use the Insert → Symbol function in your word processor or paste in the appropriate Unicode character.

Manuscript text should be double-spaced.

Do not format text in multiple columns.

Manuscripts must be submitted in English. 

You may submit translations of the manuscript or abstract as supporting information.  .

Define abbreviations upon first appearance in the text.

Do not use non-standard abbreviations unless they appear at least three times in the text.

Keep abbreviations to a minimum.

PLOS uses “Vancouver” style, as outlined in the  .

We recommend using MathType for display and inline equations, as it will provide the most reliable outcome. If this is not possible, Equation Editor or Microsoft's Insert→Equation function is acceptable.

Avoid using MathType, Equation Editor, or the Insert→Equation function to insert single variables (e.g., “a² + b² = c²”), Greek or other symbols (e.g., β, Δ, or ′ [prime]), or mathematical operators (e.g., x, ≥, or  ±) in running text. Wherever possible, insert single symbols as normal text with the correct Unicode (hex) values.

Do not use MathType, Equation Editor, or the Insert→Equation function for only a portion of an equation. Rather, ensure that the entire equation is included. Equations should not contain a mix of different equation tools. Avoid “hybrid” inline or display equations, in which part is text and part is MathType, or part is MathType and part is Equation Editor.

 Use correct and established nomenclature wherever possible.

Manuscript Organization

Manuscripts should be organized as follows. Instructions for each element appear below the list.

• Download sample title, author list, and affiliations page (PDF)
• Download sample manuscript body (PDF)

Parts of a Submission

Include a full title and a short title for the manuscript.

Titles should be written in sentence case (only the first word of the text, proper nouns, and genus names are capitalized). Avoid specialist abbreviations if possible. For clinical trials, systematic reviews, or meta-analyses, the subtitle should include the study design.

Author list

Author names and affiliations.

Enter author names on the title page of the manuscript and in the online submission system.

On the title page, write author names in the following order:

• First name (or initials, if used)
• Middle name (or initials, if used)
• Last name (surname, family name)

Each author on the list must have an affiliation. The affiliation includes department, university, or organizational affiliation and its location, including city, state/province (if applicable), and country. Authors have the option to include a current address in addition to the address of their affiliation at the time of the study. The current address should be listed in the byline and clearly labeled “current address.” At a minimum, the address must include the author’s current institution, city, and country.

If an author has multiple affiliations, enter all affiliations on the title page only. In the submission system, enter only the preferred or primary affiliation. Author affiliations will be listed in the typeset PDF article in the same order that authors are listed in the submission.

Corresponding author

The submitting author is automatically designated as the corresponding author in the submission system. The corresponding author is the primary contact for the journal office and the only author able to view or change the manuscript while it is under editorial consideration.

The corresponding author role may be transferred to another coauthor. However, note that transferring the corresponding author role also transfers access to the manuscript. (To designate a new corresponding author while the manuscript is still under consideration, watch the video tutorial below.)

Only one corresponding author can be designated in the submission system, but this does not restrict the number of corresponding authors that may be listed on the article in the event of publication. Whoever is designated as a corresponding author on the title page of the manuscript file will be listed as such upon publication. Include an email address for each corresponding author listed on the title page of the manuscript.

Consortia and group authorship

If a manuscript is submitted on behalf of a consortium or group, include its name in the manuscript byline. Do not add it to the author list in the submission system. You may include the full list of members in the Acknowledgments or in a supporting information file.

PubMed only indexes individual consortium or group author members listed in the article byline. If included, these individuals must qualify for authorship according to our criteria .

Author contributions

Provide at minimum one contribution for each author in the submission system. Use the CRediT taxonomy to describe each contribution. Read the policy and the full list of roles .

Contributions will be published with the final article, and they should accurately reflect contributions to the work. The submitting author is responsible for completing this information at submission, and we expect that all authors will have reviewed, discussed, and agreed to their individual contributions ahead of this time.

PLOS ONE will contact all authors by email at submission to ensure that they are aware of the submission.

Cover letter

Upload a cover letter as a separate file in the online system. The length limit is 1 page.

The cover letter should include the following information:

• Summarize the study’s contribution to the scientific literature
• Relate the study to previously published work
• Specify the type of article (for example, research article, systematic review, meta-analysis, clinical trial)
• Describe any prior interactions with PLOS regarding the submitted manuscript
• Suggest appropriate Academic Editors to handle your manuscript ( see the full list of Academic Editors)
• List any opposed reviewers

IMPORTANT: Do not include requests to reduce or waive publication fees in the cover letter. This information will be entered separately in the online submission system.

The title, authors, and affiliations should all be included on a title page as the first page of the manuscript file.  

The Abstract comes after the title page in the manuscript file. The abstract text is also entered in a separate field in the submission system.  

The Abstract should:

• Describe the main objective(s) of the study
• Explain how the study was done, including any model organisms used, without methodological detail
• Summarize the most important results and their significance
• Not exceed 300 words

Abstracts should not include:

• Abbreviations, if possible

Introduction

The introduction should:

• Provide background that puts the manuscript into context and allows readers outside the field to understand the purpose and significance of the study
• Define the problem addressed and why it is important
• Include a brief review of the key literature
• Note any relevant controversies or disagreements in the field
• Conclude with a brief statement of the overall aim of the work and a comment about whether that aim was achieved

Materials and Methods

The Materials and Methods section should provide enough detail to allow suitably skilled investigators to fully replicate your study. Specific information and/or protocols for new methods should be included in detail. If materials, methods, and protocols are well established, authors may cite articles where those protocols are described in detail, but the submission should include sufficient information to be understood independent of these references.

Supporting reproducibility with protocols

To enhance the reproducibility of your results, we recommend and encourage you to make your protocols public. There are several options:

Protocols associated with Research Articles

Protocol documents may be uploaded as Supporting Information or linked from the Methods section of the article. For laboratory protocols, we recommend protocols.io. Include the DOI link in the Methods section of your manuscript using the following format: http://dx.doi.org/10.17504/protocols.io.[PROTOCOL DOI]. This allows editors and reviewers to consult the detailed step-by-step protocol when evaluating your manuscript. You can choose to keep the protocol private on the protocols.io platform until your article is published—at which time it will be published automatically. 

Protocols published in their own right

PLOS ONE offers two options for publishing stand-alone protocol articles: Lab Protocols that describe reusable methodologies and Study Protocols that describe detailed plans and proposals for research projects. Specific guidelines apply to the submission of Lab Protocol and Study Protocol manuscripts. Read the detailed instructions for submitting Lab Protocols and Study Protocols .

Results, Discussion, Conclusions

These sections may all be separate, or may be combined to create a mixed Results/Discussion section (commonly labeled “Results and Discussion”) or a mixed Discussion/Conclusions section (commonly labeled “Discussion”). These sections may be further divided into subsections, each with a concise subheading, as appropriate. These sections have no word limit, but the language should be clear and concise.

Together, these sections should describe the results of the experiments, the interpretation of these results, and the conclusions that can be drawn.

Authors should explain how the results relate to the hypothesis presented as the basis of the study and provide a succinct explanation of the implications of the findings, particularly in relation to previous related studies and potential future directions for research.

PLOS ONE editorial decisions do not rely on perceived significance or impact, so authors should avoid overstating their conclusions. See the PLOS ONE Criteria for Publication for more information.

Acknowledgments

Those who contributed to the work but do not meet our authorship criteria should be listed in the Acknowledgments with a description of the contribution.

Authors are responsible for ensuring that anyone named in the Acknowledgments agrees to be named.

Any and all available works can be cited in the reference list. Acceptable sources include:

• Published or accepted manuscripts
• Manuscripts on preprint servers, providing the manuscript has a citable DOI or arXiv URL.

Do not cite the following sources in the reference list:

• Unavailable and unpublished work, including manuscripts that have been submitted but not yet accepted (e.g., “unpublished work,” “data not shown”). Instead, include those data as supplementary material or deposit the data in a publicly available database.
• Personal communications (these should be supported by a letter from the relevant authors but not included in the reference list)
• Submitted research should not rely upon retracted research. You should avoid citing retracted articles unless you need to discuss retracted work to provide historical context for your submitted research. If it is necessary to discuss retracted work, state the article’s retracted status in your article’s text and reference list.

Ensure that your reference list includes full and current bibliography details for every cited work at the time of your article’s submission (and publication, if accepted). If cited work is corrected, retracted, or marked with an expression of concern before your article is published, and if you feel it is appropriate to cite the work even in light of the post-publication notice, include in your manuscript citations and full references for both the affected article and the post-publication notice. Email the journal office if you have questions.

References are listed at the end of the manuscript and numbered in the order that they appear in the text. In the text, cite the reference number in square brackets (e.g., “We used the techniques developed by our colleagues [19] to analyze the data”). PLOS uses the numbered citation (citation-sequence) method and first six authors, et al.

Do not include citations in abstracts. 

Make sure the parts of the manuscript are in the correct order  before  ordering the citations.

​ Formatting references

PLOS uses the reference style outlined by the International Committee of Medical Journal Editors (ICMJE), also referred to as the “Vancouver” style. Example formats are listed below. Additional examples are in the ICMJE sample references .

Journal name abbreviations should be those found in the National Center for Biotechnology Information (NCBI) databases . 

Supporting information

Authors can submit essential supporting files and multimedia files along with their manuscripts. All supporting information will be subject to peer review. All file types can be submitted, but files must be smaller than 20 MB in size.

Authors may use almost any description as the item name for a supporting information file as long as it contains an “S” and number. For example, “S1 Appendix” and “S2 Appendix,” “S1 Table” and “S2 Table,” and so forth.  

Supporting information files are published exactly as provided, and are not copyedited.

Supporting information captions

List supporting information captions at the end of the manuscript file. Do not submit captions in a separate file.

The file number and name are required in a caption, and we highly recommend including a one-line title as well. You may also include a legend in your caption, but it is not required.

In-text citations

We recommend that you cite supporting information in the manuscript text, but this is not a requirement. If you cite supporting information in the text, citations do not need to be in numerical order.

Figures and tables

Do not include figures in the main manuscript file. Each figure must be prepared and submitted as an individual file.

Cite figures in ascending numeric order at first appearance in the manuscript file.

Figure captions

Figure captions must be inserted in the text of the manuscript, immediately following the paragraph in which the figure is first cited (read order). Do not include captions as part of the figure files themselves or submit them in a separate document.

At a minimum, include the following in your figure captions:

• A figure label with Arabic numerals, and “Figure” abbreviated to “Fig” (e.g. Fig 1, Fig 2, Fig 3, etc). Match the label of your figure with the name of the file uploaded at submission (e.g. a figure citation of “Fig 1” must refer to a figure file named “Fig1.tif”).
• A concise, descriptive title

The caption may also include a legend as needed.

Cite tables in ascending numeric order upon first appearance in the manuscript file.

Place each table in your manuscript file directly after the paragraph in which it is first cited (read order). Do not submit your tables in separate files.

Tables require a label (e.g., “Table 1”) and brief descriptive title to be placed above the table. Place legends, footnotes, and other text below the table. 

Statistical reporting

Manuscripts submitted to PLOS ONE are expected to report statistical methods in sufficient detail for others to replicate the analysis performed. Ensure that results are rigorously reported in accordance with community standards and that statistical methods employed are appropriate for the study design.

Consult the following resources for additional guidance:

• SAMPL guidelines , for general guidance on statistical reporting
• PLOS ONE guidelines , for clinical trials requirements
• PLOS ONE guidelines , for systematic review and meta-analysis requirements
• EQUATOR , for specific reporting guidelines for a range of other study types

Reporting of statistical methods

In the methods, include a section on statistical analysis that reports a detailed description of the statistical methods. In this section:

• List the name and version of any software package used, alongside any relevant references
• Describe technical details or procedures required to reproduce the analysis
• Provide the repository identifier for any code used in the analysis (See our code-sharing policy .)

Statistical reporting guidelines:

• Identify research design and independent variables as being between- or within-subjects
• Describe any analysis carried out to confirm the data meets the assumptions of the analysis performed (e.g. linearity, co-linearity, normality of the distribution).
• If data were transformed include this information, with a reason for doing so and a description of the transformation performed
• Provide details of how outliers were treated and your analysis, both with the full dataset and with the outliers removed
• If relevant, describe how missing/excluded data were handled
• Define the threshold for significance (alpha)
• If appropriate, provide sample sizes, along with a description of how they were determined. If a sample size calculation was performed, specify the inputs for power, effect size and alpha. Where relevant, report the number of independent replications for each experiment.
• For analyses of variance (ANOVAs), detail any post hoc tests that were performed
• Include details of any corrections applied to account for multiple comparisons. If corrections were not applied, include a justification for not doing so
• Describe all options for statistical procedures. For example, if t-tests were performed, state whether these were one- or two-tailed. Include details of the type of t-test conducted (e.g. one sample, within-/between-subjects).
• Report the alpha level used
• Discuss whether the variables were assessed for collinearity and interaction
• Describe the variable selection process by which the final model was developed (e.g., forward-stepwise; best subset). See SAMPL guidelines .
• For Bayesian analysis explain the choice of prior trial probabilities and how they were selected. Markov chain Monte Carlo settings should be reported.

Reporting of statistical results

Results must be rigorously and appropriately reported, in keeping with community standards.

• Units of measurement. Clearly define measurement units in all tables and figures.
• Properties of distribution. It should be clear from the text which measures of variance (standard deviation, standard error of the mean, confidence intervals) and central tendency (mean, median) are being presented.
• Regression analyses. Include the full results of any regression analysis performed as a supplementary file. Include all estimated regression coefficients, their standard error, p-values, and confidence intervals, as well as the measures of goodness of fit.
• Reporting parameters. Test statistics (F/t/r) and associated degrees of freedom should be provided. Effect sizes and confidence intervals should be reported where appropriate. If percentages are provided, the numerator and denominator should also be given.
• P-values. Report exact p-values for all values greater than or equal to 0.001. P-values less than 0.001 may be expressed as p < 0.001, or as exponentials in studies of genetic associations.
• Displaying data in plots. Format plots so that they accurately depict the sample distribution. 3D effects in plots can bias and hinder interpretation of values, so avoid them in cases where regular plots are sufficient to display the data.
• Open data. As explained in PLOS’s Data Policy , be sure to make individual data points, underlying graphs and summary statistics available at the time of publication. Data can be deposited in a repository or included within the Supporting Information files.

Data reporting

All data and related metadata underlying the findings reported in a submitted manuscript should be deposited in an appropriate public repository, unless already provided as part of the submitted article.

See instructions on providing underlying data to support blot and gel results .

Repositories may be either subject-specific (where these exist) and accept specific types of structured data, or generalist repositories that accept multiple data types. We recommend that authors select repositories appropriate to their field. Repositories may be subject-specific (e.g., GenBank for sequences and PDB for structures), general, or institutional, as long as DOIs or accession numbers are provided and the data are at least as open as CC BY. Authors are encouraged to select repositories that meet accepted criteria as trustworthy digital repositories, such as criteria of the Centre for Research Libraries or Data Seal of Approval. Large, international databases are more likely to persist than small, local ones.

To support data sharing and author compliance of the PLOS data policy, we have integrated our submission process with a select set of data repositories. The list is neither representative nor exhaustive of the suitable repositories available to authors. Current repository integration partners include  Dryad and FlowRepository . Please contact [email protected] to make recommendations for further partnerships.

Instructions for PLOS submissions with data deposited in an integration partner repository:

• Deposit data in the integrated repository of choice.
• Once deposition is final and complete, the repository will provide you with a dataset DOI (provisional) and private URL for reviewers to gain access to the data.
• Enter the given data DOI into the full Data Availability Statement, which is requested in the Additional Information section of the PLOS submission form. Then provide the URL passcode in the Attach Files section.

If you have any questions, please email us .

Accession numbers

All appropriate data sets, images, and information should be deposited in an appropriate public repository. See our list of recommended repositories .

Accession numbers (and version numbers, if appropriate) should be provided in the Data Availability Statement. Accession numbers or a citation to the DOI should also be provided when the data set is mentioned within the manuscript.

In some cases authors may not be able to obtain accession numbers of DOIs until the manuscript is accepted; in these cases, the authors must provide these numbers at acceptance. In all other cases, these numbers must be provided at full submission.

Identifiers

As much as possible, please provide accession numbers or identifiers for all entities such as genes, proteins, mutants, diseases, etc., for which there is an entry in a public database, for example:

• Entrez Gene
• Mouse Genome Database (MGD)
• Online Mendelian Inheritance in Man (OMIM)

Identifiers should be provided in parentheses after the entity on first use.

Striking image

You can choose to upload a “Striking Image” that we may use to represent your article online in places like the journal homepage or in search results.

The striking image must be derived from a figure or supporting information file from the submission, i.e., a cropped portion of an image or the entire image. Striking images should ideally be high resolution, eye-catching, single panel images, and should ideally avoid containing added details such as text, scale bars, and arrows.

If no striking image is uploaded, we will designate a figure from the submission as the striking image.

Additional Information Requested at Submission

Financial disclosure statement.

This information should describe sources of funding that have supported the work. It is important to gather these details prior to submission because your financial disclosure statement cannot be changed after initial submission without journal approval. If your manuscript is published, your statement will appear in the Funding section of the article.

Enter this statement in the Financial Disclosure section of the submission form. Do not include it in your manuscript file.

The statement should include:

• Specific grant numbers
• Initials of authors who received each award
• Full names of commercial companies that funded the study or authors
• Initials of authors who received salary or other funding from commercial companies
• URLs to sponsors’ websites

Also state whether any sponsors or funders (other than the named authors) played any role in:

• Study design
• Data collection and analysis
• Decision to publish
• Preparation of the manuscript

If they had no role in the research, include this sentence: “The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.”

If the study was unfunded, include this sentence as the Financial Disclosure statement: “The author(s) received no specific funding for this work."

Competing interests

This information should not be in your manuscript file; you will provide it via our submission system.

All potential competing interests must be declared in full. If the submission is related to any patents, patent applications, or products in development or for market, these details, including patent numbers and titles, must be disclosed in full.

Manuscripts disputing published work

For manuscripts disputing previously published work, it is  PLOS ONE  policy to invite a signed review by the disputed author during the peer review process. This procedure is aimed at ensuring a thorough, transparent, and productive review process.

If the disputed author chooses to submit a review, it must be returned in a timely fashion and contain a full declaration of all competing interests. The Academic Editor will consider any such reviews in light of the competing interest.

Authors submitting manuscripts disputing previous work should explain the relationship between the manuscripts in their cover letter, and will be required to confirm that they accept the conditions of this review policy before the manuscript is considered further.

Related manuscripts

Upon submission, authors must confirm that the manuscript, or any related manuscript, is not currently under consideration or accepted elsewhere. If related work has been submitted to  PLOS ONE  or elsewhere, authors must include a copy with the submitted article. Reviewers will be asked to comment on the overlap between related submissions.

We strongly discourage the unnecessary division of related work into separate manuscripts, and we will not consider manuscripts that are divided into “parts.” Each submission to  PLOS ONE  must be written as an independent unit and should not rely on any work that has not already been accepted for publication. If related manuscripts are submitted to  PLOS ONE , the authors may be advised to combine them into a single manuscript at the editor's discretion.

PLOS encourages authors to post preprints to accelerate the dissemination of research. Posting a manuscript on a preprint server does not impact consideration of the manuscript at any PLOS journal.

Authors posting preprints on  bioRxiv or medRxiv can choose to concurrently submit their manuscripts to relevant PLOS journals through the direct transfer service.

Authors submitting manuscripts in the life and health sciences to PLOS ONE  may choose to have PLOS forward their submission to bioRxiv or medRxiv, depending on the scope of the paper, for consideration for posting as a preprint.

Guidelines for Specific Study Types

Study design, reporting, and analyses are assessed against all relevant research and methodological technique standards held by the community. Guidelines for specific study types are outlined below.

Registered Reports

Submission and format requirements for Registered Report Protocols and Registered Reports are similar to those for a regular submission and may be specific to your study type. For instance, if your Registered Report Protocol submission is about a Clinical Trial or a Systematic Review, follow the appropriate guidelines.

For Registered Report Protocols:

• Provide enough methodological detail to make the study reproducible and replicable
• Confirm that data will be made available upon study completion in keeping with the PLOS Data policy ​
• Include ethical approval or waivers, if applicable
• Preliminary or pilot data may be included, but only if necessary to support the feasibility of the study or as a proof of principle 
• For meta-analyses or Clinical Trials, use the protocol-specific reporting guidelines PRISMA-P or SPIRIT respectively

For more guidance on format and presentation of a protocol, consult the sample template hosted by the Open Science Framework . Discipline-specific and study-specific templates are also available.

For Registered Report Research Articles:

• Report the results of all planned analyses and, if relevant, detail and justify all deviations from the protocol. 
• The manuscript may also contain exploratory, unplanned analyses.

Read more about Registered Report framework .

Human subjects research

Manuscripts should conform to the following reporting guidelines:

• Studies of diagnostic accuracy:  STARD
• Observational studies:  STROBE
• Microarray experiments:  MIAME
• Other types of health-related research: Consult the  EQUATOR  web site for appropriate reporting guidelines

Methods sections of papers on research using human subjects or samples must include ethics statements that specify:

• The name of the approving institutional review board or equivalent committee(s) . If approval was not obtained, the authors must provide a detailed statement explaining why it was not needed
• Why written consent could not be obtained
• That the Institutional Review Board (IRB) approved use of oral consent
• How oral consent was documented

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

• Explicitly describe 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, environmental exposures, or similar factors in their analysis

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.”

For papers that include identifying, or potentially identifying, information, authors must download the Consent Form for Publication in a PLOS Journal , which the individual, parent, or guardian must sign once they have read the paper and been informed about the terms of PLOS open-access license. The signed consent form should not be submitted with the manuscript, but authors should securely file it in the individual's case notes and the methods section of the manuscript should explicitly state that consent authorization for publication is on file, using wording like:

The individual in this manuscript has given written informed consent (as outlined in PLOS consent form) to publish these case details.

For more information about  PLOS ONE  policies regarding human subjects research, see the  Publication Criteria  and  Editorial Policies .

Manuscripts describing observational clinical studies are subject to all policies regarding human research  and community standards for reporting observational research as outlined by the STROBE statement. Furthermore, authors submitting work of this nature should pay special attention to the following requirements:

• If the submitted manuscript is very similar to previous work, authors must provide a sound scientific rationale for the submitted work and clearly reference and discuss the existing literature.
• The sampling strategy and eligibility criteria of enrolled subjects should be described in sufficient detail.
• Sample size calculations should be justified with relevant inputs defined.
• Independent and dependent variables considered for statistical analysis should be clearly defined and justified.
• The validity and reliability testing of self-developed data collection tools should be reported.
• Conclusions should be appropriate for the study design, with indications on how the study results will contribute to the base of academic knowledge.

Clinical trials

Clinical trials are subject to all  policies regarding human research .  PLOS ONE  follows the  World Health Organization's (WHO) definition of a clinical trial :

All clinical trials must be registered in one of the publicly-accessible registries approved by the  WHO  or  ICMJE  (International Committee of Medical Journal Editors). Authors must provide the trial registration number. Prior disclosure of results on a clinical trial registry site will not affect consideration for publication. We reserve the right to inform authors' institutions or ethics committees, and to reject the manuscript, if we become aware of unregistered trials.

PLOS ONE  supports prospective trial registration (i.e. before participant recruitment has begun) as recommended by the ICMJE's  clinical trial registration policy .  Where trials were not publicly registered before participant recruitment began , authors must:

• Register all related clinical trials and confirm they have done so in the Methods section
• Explain in the Methods the reason for failing to register before participant recruitment

Clinical trials must be reported according to the relevant reporting guidelines, i.e.  CONSORT  for randomized controlled trials,  TREND  for non-randomized trials, and  other specialized guidelines  as appropriate. The intervention should be described according to the requirements of the  TIDieR checklist and guide . Submissions must also include the study protocol as supporting information, which will be published with the manuscript if accepted.

Authors of manuscripts describing the results of clinical trials must adhere to the  CONSORT  reporting guidelines appropriate to their trial design, available on the  CONSORT Statement web site . Before the paper can enter peer review, authors must:

• The name of the registry and the registration number must be included in the Abstract.
• Provide a copy of the trial protocol as approved by the ethics committee and a completed  CONSORT checklist  as supporting information (which will be published alongside the paper, if accepted). This should be named S1 CONSORT Checklist.
• Include the  CONSORT flow diagram  as the manuscript's “Fig 1”

Any deviation from the trial protocol must be explained in the paper. Authors must explicitly discuss informed consent in their paper, and we reserve the right to ask for a copy of the patient consent form.

The name of the registry and the registry number must be provided in the Abstract. If the trial is registered in more than one location, please provide all relevant registry names and numbers.

Lab Protocols

Lab Protocols consist of two interlinked components: a step-by-step protocol hosted on protocols.io , and a peer-reviewed article in  PLOS ONE that contextualises the protocol.

The PLOS ONE   article component must comply with the general PLOS ONE   submission guidelines (detailed above) and criteria for publication . In addition, the PLOS ONE article component should:

• Describe the value that the protocol adds to the published literature. Lab Protocols describing routine methods or extensions and modifications of routine methods that add little value to the published literature will not be considered for publication.
• Linking, in the Introduction section, to at least one supporting peer-reviewed publication in which the protocol was applied to generate data. or
• Providing validation or benchmarking data, which demonstrates that the underlying method achieves its intended purpose.
• Provide the step-by-step protocol as a supporting information (S1) file. 

We encourage you to post your protocol to the protocols.io platform before submitting your manuscript to PLOS ONE . Posting your protocol prior to submission is not considered prior publication by PLOS ONE and will not affect your eligibility to publish a Lab Protocol.

Authors submitting a Lab Protocol can also use protocols.io’s protocol entry service  at no cost: the team at protocols.io will enter your protocol for you and format it in a way that takes advantage of the platform’s features. You will have an opportunity to review and make further changes before your protocol is shared with anyone else. 

If you would like to use protocols.io's protocol entry service in connection with a Lab Protocol submission, please contact [email protected] to request the customer code.

If you prefer to submit your manuscript to PLOS ONE before posting your protocol to protocols.io, then you must still provide your step-by-step protocol as a supporting information (S1) file in a format of your choosing. You will be expected to replace this file with a protocols.io PDF later in the editorial process.

Study Protocols

Study Protocols describe plans for conducting research projects and consist of a single article on  PLOS ONE .

Study Protocols must comply with the  PLOS ONE  general submission guidelines (detailed above in this article) and any guidelines specific to the related research study type. In addition, the protocol must:

• Relate to a research study that has not yet generated results.
• Be submitted before recruitment of participants or collection of data for the study is complete.
• Meet the same standards for ethics of experimentation and research integrity as the research study. If it involves human or animal subjects, cell lines or field sampling , or has potential biosafety implications , prior approval from the relevant ethics body must be obtained prior to submission. Please contact us if you have a valid reason for not obtaining approval. 

Additional prerequisites apply for these study types:

• The trial must be registered prior to submission of your protocol in one of the publicly accessible registries approved by the WHO or ICMJE (International Committee of Medical Journal Editors).
• The name of the registry and the trial or study registration number must be included in the Abstract.
• A copy of the protocol that was approved by the ethics committee must be submitted as a supplementary information file. Please provide an additional English translation if the original document is not in English. Please note that the protocol will be published with the manuscript if accepted.
• A SPIRIT schedule of enrollment, interventions, and assessments must be included as the manuscript’s Figure 1, and a completed SPIRIT checklist must be uploaded as Supporting Information file S1.
• A completed PRISMA-P checklist must be provided as a supporting information (SI) file. See PRISMA-P Explanation and Elaboration for more information on completing your checklist.

Study Protocols must also comply with general PLOS ONE   criteria for publication and in addition you should:

• include the word “Protocol” in your Title.
• the aim, design, and settling
• the sample size calculation
• how data saturation will be determined (for qualitative studies)
• the characteristics of participants e.g., inclusion and exclusion criteria, sample selection criteria, variables to be measured, randomization and blinding criteria (where applicable), and how informed consent will be obtained 
• how materials will be selected and used e.g., where and how they will be sourced, the processes, interventions, or comparisons to be used, the outcomes to be measured, and when and how they will be measured
• the data management plan
• safety considerations
• the type of data and statistical analyses to be used
• the status and timeline of the study, including whether participant recruitment or data collection has begun
• where and when the data will be made available. See our Data Availability policy for more.
• include an analysis of preliminary or pilot data, only if it is necessary to support the feasibility of the study or as a proof of principle. This is optional.
• we encourage authors you to register with OSF and provide the your registration number in the Materials and Methods section. This is optional.
• optionally add any other SI files, figures or tables that elaborate or authenticate the protocol: e.g., any reporting checklists applicable to your study type.

Read the supporting information guidelines for more details about adding SI files.

Study Protocols are subject to the same editorial and peer review process as all other articles, and are eligible for both signed and published peer review .

You can expedite the review process by providing:

• proof of external funding. This is typically your funding approval letter and a list of the names and credentials of the funders who conducted the external peer review of the protocol. Include an English translation if needed.
• proof of ethics approval (if required). This is typically the approval or waiver letter from the relevant ethics body and a copy of the protocol approved by this body. 

The proof of external funding and approval or waiver letter are used for internal purposes and do not form part of the published Study Protocol. Expedited review is conducted by an internal Staff Editor only and bypasses the external review process. 

If the Study Protocol describes a replication study or involves re-analysis of published work, we will invite the author of the initial or replicated study to provide a signed review. 

We encourage you to share your Study Protocol with other researchers, either before or after submission. You can publish it on your website or  protocols.io , or submit it for posting on  medRxiv  or another preprint server.

Animal research

All research involving vertebrates or cephalopods must have approval from the authors' Institutional Animal Care and Use Committee (IACUC) or equivalent ethics committee(s), and must have been conducted according to applicable national and international guidelines. Approval must be received prior to beginning research.

Manuscripts reporting animal research must state in the Methods section:

• The full name of the relevant ethics committee that approved the work, and the associated permit number(s).
• Where ethical approval is not required, the manuscript should include a clear statement of this and the reason why. Provide any relevant regulations under which the study is exempt from the requirement for approval.
• Relevant details of steps taken to ameliorate animal suffering.

This study was carried out in strict accordance with the recommendations in the Guide for the Care and Use of Laboratory Animals of the National Institutes of Health. The protocol was approved by the Committee on the Ethics of Animal Experiments of the University of Minnesota (Protocol Number: 27-2956). All surgery was performed under sodium pentobarbital anesthesia, and all efforts were made to minimize suffering.

Authors should always state the organism(s) studied in the Abstract. Where the study may be confused as pertaining to clinical research, authors should also state the animal model in the title.

To maximize reproducibility and potential for re-use of data, we encourage authors to follow the Animal Research: Reporting of In Vivo Experiments (ARRIVE) guidelines for all submissions describing laboratory-based animal research and to upload a completed  ARRIVE Guidelines Checklist  to be published as supporting information.

Non-human primates

Manuscripts describing research involving non-human primates must report details of husbandry and animal welfare in accordance with the recommendations of the Weatherall report, The use of non-human primates in research , including:

• Information about housing, feeding, and environmental enrichment.
• Steps taken to minimize suffering, including use of anesthesia and method of sacrifice, if appropriate.

Random source animals

Manuscripts describing studies that use random source (e.g. Class B dealer-sourced in the USA), shelter, or stray animals will be subject to additional scrutiny and may be rejected if sufficient ethical and scientific justification for the study design is lacking.

Unacceptable euthanasia methods and anesthetic agents

Manuscripts reporting use of a euthanasia method(s) classified as unacceptable by the American Veterinary Medical Association or use of an anesthesia method(s) that is widely prohibited (e.g., chloral hydrate, ether, chloroform) must include at the time of initial submission, scientific justification for use in the specific study design, as well as confirmation of approval for specific use from their animal research ethics committee. These manuscripts may be subject to additional ethics considerations prior to publication.

Humane endpoints

Manuscripts reporting studies in which death of a regulated animal (vertebrate, cephalopod) is a likely outcome or a planned experimental endpoint, must comprehensively report details of study design, rationale for the approach, and methodology, including consideration of humane endpoints. This applies to research that involves, for instance, assessment of survival, toxicity, longevity, terminal disease, or high rates of incidental mortality.

Full details of humane endpoints use must be reported for a study to be reproducible and for the results to be accurately interpreted.

For studies in which death of an animal is an outcome or a planned experimental endpoint, authors should include the following information in the Methods section of the manuscript:

• The specific criteria (i.e. humane endpoints) used to determine when animals should be euthanized.
• The duration of the experiment.
• The numbers of animals used, euthanized, and found dead (if any); the cause of death for all animals.
• How frequently animal health and behavior were monitored.
• All animal welfare considerations taken, including efforts to minimize suffering and distress, use of analgesics or anaesthetics, or special housing conditions.

If humane endpoints were not used, the manuscript should report:

• A scientific justification for the study design, including the reasons why humane endpoints could not be used, and discussion of alternatives that were considered.
• Whether the institutional animal ethics committee specifically reviewed and approved the anticipated mortality in the study design.

Observational and field studies

Methods sections for submissions reporting on any type of field study must include ethics statements that specify:

• Permits and approvals obtained for the work, including the full name of the authority that approved the study; if none were required, authors should explain why
• Whether the land accessed is privately owned or protected
• Whether any protected species were sampled
• Full details of animal husbandry, experimentation, and care/welfare, where relevant

Paleontology and archaeology research

Manuscripts reporting paleontology and archaeology research must include descriptions of methods and specimens in sufficient detail to allow the work to be reproduced. Data sets supporting statistical and phylogenetic analyses should be provided, preferably in a format that allows easy re-use.  Read the policy .

Specimen numbers and complete repository information, including museum name and geographic location, are required for publication. Locality information should be provided in the manuscript as legally allowable, or a statement should be included giving details of the availability of such information to qualified researchers.

If permits were required for any aspect of the work, details should be given of all permits that were obtained, including the full name of the issuing authority. This should be accompanied by the following statement:

If no permits were required, please include the following statement:

Manuscripts describing paleontology and archaeology research are subject to the following policies:

• Sharing of data and materials.  Any specimen that is erected as a new species, described, or figured must be deposited in an accessible, permanent repository (i.e., public museum or similar institution). If study conclusions depend on specimens that do not fit these criteria, the article will be rejected under  PLOS ONE 's  data availability criterion .
• Ethics.   PLOS ONE   will not publish research on specimens that were obtained without necessary permission or were illegally exported.

Systematic reviews and meta-analyses

A systematic review paper, as defined by The Cochrane Collaboration , is a review of a clearly formulated question that uses explicit, systematic methods to identify, select, and critically appraise relevant research, and to collect and analyze data from the studies that are included in the review. These reviews differ substantially from narrative-based reviews or synthesis articles. Statistical methods (meta-analysis) may or may not be used to analyze and summarize the results of the included studies.

Reports of systematic reviews and meta-analyses should include a completed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist and flow diagram to accompany the main text. Blank templates are available here:

• Checklist: PDF or Word document
• Flow diagram: PDF or Word document

Authors must also state in their “Methods” section whether a protocol exists for their systematic review, and if so, provide a copy of the protocol as supporting information and provide the registry number in the abstract.

If your article is a systematic review or a meta-analysis you should:

• State this in your cover letter
• Select “Research Article” as your article type when submitting
• Include the PRISMA flow diagram as Fig 1 (required where applicable)
• Include the PRISMA checklist as supporting information

Meta-analysis of genetic association studies

Manuscripts reporting a meta-analysis of genetic association studies must report results of value to the field and should be reported according to the guidelines presented in Systematic Reviews of Genetic Association Studies  by Sagoo  et al.

On submission, authors will be asked to justify the rationale for the meta-analysis and how it contributes to the base of scientific knowledge in the light of previously published results. Authors will also be asked to complete a  checklist (DOCX)  outlining information about the justification for the study and the methodology employed. Meta-analyses that replicate published studies will be rejected if the authors do not provide adequate justification.

Personal data from third-party sources

For all studies using personal data from internet-based and other third-party sources (e.g., social media, blogs, other internet sources, mobile phone companies), data must be collected and used according to company/website Terms and Conditions, with appropriate permissions. All data sources must be acknowledged clearly in the  Materials and Methods section .

In the Ethics Statement, authors should declare any potential risks to individuals or individual privacy, or affirm that in their assessment, the study posed no such risks. In addition, the following Ethics and Data Protection requirements must be met.

For interventional studies , which impact participants’ experiences or data, the study design must have been prospectively approved by an Ethics Committee, and informed consent is required. The Ethics Committee may waive the requirement for approval and/or consent.

For observational studies  in which personal experiences and accounts are not manipulated, consultation with an Ethics or Data Protection Committee is recommended. Additional requirements apply in the following circumstances:

• If information used could threaten personal privacy or damage the reputation of individuals whose data are used, an Ethics Committee should be consulted and informed consent obtained or specifically addressed.
• If authors accessed any personal identifying information, an Ethics or Data Protection Committee should oversee data anonymization. If data were anonymized and/or aggregated before access and analysis, informed consent is generally not required.

Authors reporting research using cell lines should state when and where they obtained the cells, giving the date and the name of the researcher, cell line repository, or commercial source (company) who provided the cells, as appropriate.

Authors must also include the following information for each cell line:

For  de novo  (new) cell lines , including those given to the researchers as a gift, authors must follow our policies for  human subjects research  or  animal research , as appropriate. The ethics statement must include:

• Details of institutional review board or ethics committee approval; AND
• For human cells, confirmation of written informed consent from the donor, guardian, or next of kin

For established cell lines , the Methods section should include:

• A reference to the published article that first described the cell line; AND/OR
• The cell line repository or company the cell line was obtained from, the catalogue number, and whether the cell line was obtained directly from the repository/company or from another laboratory

Authors should check established cell lines using the  ICLAC Database of Cross-contaminated or Misidentified Cell Lines  to confirm they are not misidentified or contaminated. Cell line authentication is recommended – e.g., by karyotyping, isozyme analysis, or short tandem repeats (STR) analysis – and may be required during peer review or after publication.

Blots and gels

Please review PLOS ONE ’s requirements for reporting blot and gel results and providing the underlying raw images .

Manuscripts reporting experiments using antibodies should include the following information:

• The name of each antibody, a description of whether it is monoclonal or polyclonal, and the host species.
• The commercial supplier or source laboratory.
• The catalogue or clone number and, if known, the batch number.
• The antigen(s) used to raise the antibody.
• For established antibodies, a stable public identifier from the Antibody Registry .

The manuscript should also report the following experimental details:

• The final antibody concentration or dilution.
• A reference to the validation study if the antibody was previously validated. If not, provide details of how the authors validated the antibody for the applications and species used. 

Small and macromolecule crystal data

Manuscripts reporting new and unpublished three-dimensional structures must include sufficient supporting data and detailed descriptions of the methodologies used to allow the reproduction and validation of the structures. All novel structures must have been deposited in a community endorsed database prior to submission (please see our list of recommended repositories ).

Small molecule single crystal data

Authors reporting X-Ray crystallographic structures of small organic, metal-organic, and inorganic molecules must deposit their data with the Cambridge Crystallographic Data Centre (CCDC), the Inorganic Crystal Structure Database (ICSD), or similar community databases providing a recognized validation functionality. Authors are also required to include the relevant structure reference numbers within the main text (e.g. the CCDC ID number), as well as the crystallographic information files (.cif format) as Supplementary Information, along with the checkCIF validation reports that can be obtained via the International Union of Crystallography (IUCr).

Macromolecular structures

Authors reporting novel macromolecular structures must have deposited their data prior to initial submission with the Worldwide Protein Data Bank (wwPDB), the Biological Magnetic Resonance Data Bank (BMRB), the Electron Microscopy Data Bank (EMDB), or other community databases providing a recognized validation functionality. Authors must include the structure reference numbers within the main text and submit as Supplementary Information the official validation reports from these databases.

Methods, software, databases, and tools

PLOS ONE  will consider submissions that present new methods, software, databases, or tools as the primary focus of the manuscript if they meet the following criteria:

Software submissions

Manuscripts whose primary purpose is the description of new software must provide full details of the algorithms designed. Describe any dependencies on commercial products or operating system. Include details of the supplied test data and explain how to install and run the software. A brief description of enhancements made in the major releases of the software may also be given. Authors should provide a direct link to the deposited software from within the paper.

Database submissions

For descriptions of databases, provide details about how the data were curated, as well as plans for long-term database maintenance, growth, and stability. Authors should provide a direct link to the database hosting site from within the paper.

New taxon names

Zoological names.

When publishing papers that describe a new zoological taxon name, PLOS aims to comply with the requirements of the  International Commission on Zoological Nomenclature (ICZN) . Effective 1 January 2012, the ICZN considers an online-only publication to be legitimate if it meets the criteria of archiving and is registered in ZooBank, the ICZN's official registry.

For proper registration of a new zoological taxon, we require two specific statements to be included in your manuscript.

In the  Results  section, the globally unique identifier (GUID), currently in the form of a Life Science Identifier (LSID), should be listed under the new species name, for example:

You will need to contact  Zoobank  to obtain a GUID (LSID). Please do this as early as possible to avoid delay of publication upon acceptance of your manuscript. It is your responsibility to provide us with this information so we can include it in the final published paper.

Please also insert the following text into the  Methods  section, in a sub-section to be called “Nomenclatural Acts”:

All PLOS articles are deposited in  LOCKSS . If your institute, or those of your co-authors, has its own repository, we recommend that you also deposit the published online article there and include the name in your article.

Botanical names

When publishing papers that describe a new botanical taxon, PLOS aims to comply with the requirements of the International Code of Nomenclature for algae, fungi, and plants (ICN). The following guidelines for publication in an online-only journal have been agreed such that any scientific botanical name published by us is considered effectively published under the rules of the Code. Please note that these guidelines differ from those for zoological nomenclature, and apply only to seed plants, ferns, and lycophytes.

Effective January 2012, the description or diagnosis of a new taxon can be in either Latin or English. This does not affect the requirements for scientific names, which are still to be Latin.

Also effective January 2012, the electronic PDF represents a published work according to the ICN for algae, fungi, and plants. Therefore the new names contained in the electronic publication of PLOS article are effectively published under that Code from the electronic edition alone, so there is no longer any need to provide printed copies.

Additional information describing recent changes to the Code can be found  here .

For proper registration of the new taxon, we require two specific statements to be included in your manuscript.

Journal staff will contact IPNI to obtain the GUID (LSID) after your manuscript is accepted for publication, and this information will then be added to the manuscript during the production phase

In the  Methods  section, include a sub-section called “Nomenclature” using the following wording:

Fungal names

When publishing papers that describe a new botanical taxon, PLOS aims to comply with the requirements of the International Code of Nomenclature for algae, fungi, and plants (ICN). The following guidelines for publication in an online-only journal have been agreed such that any scientific botanical name published by us is considered effectively published under the rules of the Code. Please note that these guidelines differ from those for zoological nomenclature.

You will need to contact either  Mycobank  or  Index Fungorum  to obtain the GUID (LSID). Please do this as early as possible to avoid delay of publication upon acceptance of your manuscript. It is your responsibility to provide us with this information so we can include it in the final published paper. Effective January 2013, all papers describing new fungal species must reference the identifier issued by a recognized repository in the protologue in order to be considered effectively published.

In the  Methods  section, include a sub-section called “Nomenclature” using the following wording. Note that this example is for taxon names submitted to MycoBank; please substitute appropriately if you have submitted to Index Fungorum using the prefix http://www.indexfungorum.org/Names/NamesRecord.asp?RecordID=.

Qualitative research

Qualitative research studies use non-quantitative methods to address a defined research question that may not be accessible by quantitative methods, such as people's interpretations, experiences, and perspectives. The analysis methods are explicit, systematic, and reproducible, but the results do not involve numerical values or use statistics. Examples of qualitative data sources include, but are not limited to, interviews, text documents, audio/video recordings, and free-form answers to questionnaires and surveys.

Qualitative research studies should be reported in accordance to the  Consolidated criteria for reporting qualitative research (COREQ) checklist  or Standards for reporting qualitative research (SRQR) checklist . Further reporting guidelines can be found in the Equator Network's  Guidelines for reporting qualitative research .

You may be eligible for APC support

Many institutional partners globally have publishing agreements with PLOS to allow their corresponding authors to publish with reduced or no APCs. To determine if your corresponding author is eligible, please visit our institutional partners page  to determine what kind of agreement your institution has with PLOS.

If your corresponding author is affiliated with a participating institution, they must follow the instructions below to demonstrate eligibility.

If your corresponding author is not from a participating institution and requires assistance paying publishing fees, please consider applying for a fee waiver at submission.

Defining the Role of Authors and Contributors

Page Contents

• Why Authorship Matters
• Who Is an Author?
• Non-Author Contributors
• Artificial Intelligence (AI)-Assisted Technology

1. Why Authorship Matters

Authorship confers credit and has important academic, social, and financial implications. Authorship also implies responsibility and accountability for published work. The following recommendations are intended to ensure that contributors who have made substantive intellectual contributions to a paper are given credit as authors, but also that contributors credited as authors understand their role in taking responsibility and being accountable for what is published.

Editors should be aware of the practice of excluding local researchers from low-income and middle-income countries (LMICs) from authorship when data are from LMICs. Inclusion of local authors adds to fairness, context, and implications of the research. Lack of inclusion of local investigators as authors should prompt questioning and may lead to rejection.

Because authorship does not communicate what contributions qualified an individual to be an author, some journals now request and publish information about the contributions of each person named as having participated in a submitted study, at least for original research. Editors are strongly encouraged to develop and implement a contributorship policy. Such policies remove much of the ambiguity surrounding contributions, but leave unresolved the question of the quantity and quality of contribution that qualify an individual for authorship. The ICMJE has thus developed criteria for authorship that can be used by all journals, including those that distinguish authors from other contributors.

2. Who Is an Author?

The ICMJE recommends that authorship be based on the following 4 criteria:

• Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND
• Drafting the work or reviewing it critically for important intellectual content; AND
• Final approval of the version to be published; AND
• Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

In addition to being accountable for the parts of the work done, an author should be able to identify which co-authors are responsible for specific other parts of the work. In addition, authors should have confidence in the integrity of the contributions of their co-authors.

All those designated as authors should meet all four criteria for authorship, and all who meet the four criteria should be identified as authors. Those who do not meet all four criteria should be acknowledged—see Section II.A.3 below. These authorship criteria are intended to reserve the status of authorship for those who deserve credit and can take responsibility for the work. The criteria are not intended for use as a means to disqualify colleagues from authorship who otherwise meet authorship criteria by denying them the opportunity to meet criterion #s 2 or 3. Therefore, all individuals who meet the first criterion should have the opportunity to participate in the review, drafting, and final approval of the manuscript.

The individuals who conduct the work are responsible for identifying who meets these criteria and ideally should do so when planning the work, making modifications as appropriate as the work progresses. We encourage collaboration and co-authorship with colleagues in the locations where the research is conducted. It is the collective responsibility of the authors, not the journal to which the work is submitted, to determine that all people named as authors meet all four criteria; it is not the role of journal editors to determine who qualifies or does not qualify for authorship or to arbitrate authorship conflicts. If agreement cannot be reached about who qualifies for authorship, the institution(s) where the work was performed, not the journal editor, should be asked to investigate. The criteria used to determine the order in which authors are listed on the byline may vary, and are to be decided collectively by the author group and not by editors. If authors request removal or addition of an author after manuscript submission or publication, journal editors should seek an explanation and signed statement of agreement for the requested change from all listed authors and from the author to be removed or added.

The corresponding author is the one individual who takes primary responsibility for communication with the journal during the manuscript submission, peer-review, and publication process. The corresponding author typically ensures that all the journal’s administrative requirements, such as providing details of authorship, ethics committee approval, clinical trial registration documentation, and disclosures of relationships and activities are properly completed and reported, although these duties may be delegated to one or more co-authors. The corresponding author should be available throughout the submission and peer-review process to respond to editorial queries in a timely way, and should be available after publication to respond to critiques of the work and cooperate with any requests from the journal for data or additional information should questions about the paper arise after publication. Although the corresponding author has primary responsibility for correspondence with the journal, the ICMJE recommends that editors send copies of all correspondence to all listed authors.

When a large multi-author group has conducted the work, the group ideally should decide who will be an author before the work is started and confirm who is an author before submitting the manuscript for publication. All members of the group named as authors should meet all four criteria for authorship, including approval of the final manuscript, and they should be able to take public responsibility for the work and should have full confidence in the accuracy and integrity of the work of other group authors. They will also be expected as individuals to complete disclosure forms.

Some large multi-author groups designate authorship by a group name, with or without the names of individuals. When submitting a manuscript authored by a group, the corresponding author should specify the group name if one exists, and clearly identify the group members who can take credit and responsibility for the work as authors. The byline of the article identifies who is directly responsible for the manuscript, and MEDLINE lists as authors whichever names appear on the byline. If the byline includes a group name, MEDLINE will list the names of individual group members who are authors or who are collaborators, sometimes called non-author contributors, if there is a note associated with the byline clearly stating that the individual names are elsewhere in the paper and whether those names are authors or collaborators.

3. Non-Author Contributors

Contributors who meet fewer than all 4 of the above criteria for authorship should not be listed as authors, but they should be acknowledged. Examples of activities that alone (without other contributions) do not qualify a contributor for authorship are acquisition of funding; general supervision of a research group or general administrative support; and writing assistance, technical editing, language editing, and proofreading. Those whose contributions do not justify authorship may be acknowledged individually or together as a group under a single heading (e.g. "Clinical Investigators" or "Participating Investigators"), and their contributions should be specified (e.g., "served as scientific advisors," "critically reviewed the study proposal," "collected data," "provided and cared for study patients," "participated in writing or technical editing of the manuscript").

Because acknowledgment may imply endorsement by acknowledged individuals of a study’s data and conclusions, editors are advised to require that the corresponding author obtain written permission to be acknowledged from all acknowledged individuals.

Use of AI for writing assistance should be reported in the acknowledgment section.

4. Artificial Intelligence (AI)-Assisted Technology

At submission, the journal should require authors to disclose whether they used artificial intelligence (AI)-assisted technologies (such as Large Language Models [LLMs], chatbots, or image creators) in the production of submitted work. Authors who use such technology should describe, in both the cover letter and the submitted work in the appropriate section if applicable, how they used it. For example, if AI was used for writing assistance, describe this in the acknowledgment section (see Section II.A.3). If AI was used for data collection, analysis, or figure generation, authors should describe this use in the methods (see Section IV.A.3.d). Chatbots (such as ChatGPT) should not be listed as authors because they cannot be responsible for the accuracy, integrity, and originality of the work, and these responsibilities are required for authorship (see Section II.A.1). Therefore, humans are responsible for any submitted material that included the use of AI-assisted technologies. Authors should carefully review and edit the result because AI can generate authoritative-sounding output that can be incorrect, incomplete, or biased. Authors should not list AI and AI-assisted technologies as an author or co-author, nor cite AI as an author. Authors should be able to assert that there is no plagiarism in their paper, including in text and images produced by the AI. Humans must ensure there is appropriate attribution of all quoted material, including full citations.

Next: Disclosure of Financial and Non-Financial Relationships and Activities, and Conflicts of Interest

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Instructions for Authors

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

Original Investigation

Caring for the critically ill patient, brief report, research letter, systematic review (without meta-analysis), narrative review, special communication, clinical challenge, diagnostic test interpretation, a piece of my mind, letter to the editor, letter in reply.

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

Meta-analysis

• Cohort Study
• Case-Control Study
• Cross-sectional Study
• Case Series
• Economic Evaluation
• Decision Analytical Model
• Comparative Effectiveness Research
• Genetic Association Study
• Diagnostic/Prognostic Study
• Quality Improvement Study
• Survey Study
• Qualitative Study

Manuscript Submission

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

What to Expect

Editorial and Peer Review

The jama network advantage.

• JAMA-Express

Authorship Form and Publishing Agreement

Publication.

• Postpublication Online Commenting

Reprints/e-Prints

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

Editorial Policies for Authors

Authorship and Disclosures

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

Journal Policies, Forms, Resources

Decisions and Management of Editorial Conflicts of Interest

Publishing agreement, unauthorized use.

• Patient Permission Form
• AMA Manual of Style
• EQUATOR Network
• About This Journal

Contact Information

JAMA , Kirsten Bibbins-Domingo, PhD, MD, MAS, Editor in Chief, 330 N Wabash Ave, Chicago, IL 60611-5885; telephone: (312) 464-4444; fax: (312) 464-5824; email: [email protected] . Manuscripts should be submitted online at http://manuscripts.jama.com .

Determine My Article Type

Categories of articles.

Original Investigation full info

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

• ≤5 tables and/or figures
• Structured abstract

Data Sharing Statement

Follow EQUATOR Reporting Guidelines

Caring for the Critically Ill Patient full info

Original research reports, preferably clinical trials or systematic reviews that address virtually any aspect of critical illness, from prevention and triage, through resuscitation and acute treatment, to rehabilitation and palliative care.

• See also requirements for Clinical Trial , Meta-analysis , and Systematic Review

Brief Report full info

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

It is very rare for this journal to publish case reports.

• 15 references
• ≤3 tables and/or figures

Research Letter full info

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

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

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Clinical Review and Education

Systematic Review (without meta-analysis) full info

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

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

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

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

Narrative Review full info

Up-to-date review for clinicians on a topic of general common interest from the perspective of internationally recognized experts in these disciplines.

The focus should be an update on current understanding of the physiology of the disease or condition, diagnostic consideration, and treatment.

These reviews should address a specific question or issue that is relevant for clinical practice.

• 2000-3500 words
• 3-part structured abstract
• No Key Points
• Subtitle should be "A Review"

Special Communication full info

This journal publishes very few of these types of articles.

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

• 50 references
• ≤4 tables and/or figures
• Requires a presubmission inquiry

Clinical Challenge full info

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

• "What Would You Do Next?" with 4 single-phrase plausible treatment options describing possible courses of action with 1 being preferred
• Case presentation: 250 words
• Discussion: 500-600 words
• ≤10 references
• 1-2 small figures
• Patient permission required

Diagnostic Test Interpretation full info

This article requires a presubmission inquiry.

Presentation of the results of a diagnostic test from a single patient with exploration of the clinical application of the test result; intended to help clinicians understand the underlying rationale in ordering tests, interpreting test results, and acting on the diagnostic test findings.

• How Do You Interpret These Test Results? (or What Would You Do Next?) with 4 plausible responses
• Case presentation: 200 words
• Discussion: 650 words

Viewpoint full info

May address virtually any important topic in medicine, public health, research, discovery, prevention, ethics, health policy, or health law and generally are not linked to a specific article.

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

A Piece of My Mind full info

Personal vignettes (eg, exploring the dynamics of the patient-physician relationship) taken from wide-ranging experiences in medicine; occasional pieces express views and opinions on the myriad issues that affect the profession.

• ≤1600 words
• Patient permission may be needed

Poetry full info

Original poems related to the medical experience, whether from the point of view of a health care worker or patient, or simply an observer.

• No longer than 44 lines

Correspondence

Letter to the Editor full info

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

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

Letter in Reply full info

Replies by authors of original articles to letters from readers.

Determine My Study Type

Randomized Clinical Trial full info

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

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

Parallel-Design Double-blind Trial full info

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

Crossover Trial full info

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

Equivalence and Noninferiority Trial full info

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

Cluster Trial full info

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

Nonrandomized Clinical Trial full info

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

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

Meta-analysis full info

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

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

Cohort Study full info

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

• Follow STROBE Reporting Guidelines

Case-Control Study full info

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

Cross-sectional Study full info

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

Case Series full info

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

• Follow Reporting Guidelines

Economic Evaluation full info

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

• Follow CHEERS Reporting Guidelines

Decision Analytical Model full info

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

Comparative Effectiveness Research full info

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

• Follow ISPOR Reporting Guidelines

Genetic Association Study full info

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

• Follow STREGA Reporting Guidelines

Diagnostic/Prognostic Study full info

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

• Follow STARD Reporting Guidelines or TRIPOD Reporting Guidelines

Quality Improvement Study full info

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

• Follow SQUIRE Reporting Guidelines

Survey Study full info

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

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

Qualitative Study full info

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

• Follow SRQR Reporting Guidelines or COREQ Reporting Guidelines

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

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

These manuscripts are original research reports, preferably clinical trials, or systematic reviews (see above classifications for manuscript submission requirements by category of article) that address virtually any aspect of critical illness, from prevention and triage, through resuscitation and acute treatment, to rehabilitation and palliative care. Manuscripts that provide new insights into the diagnosis, prognosis, and treatment of critically ill patients, as well as those that explore pathophysiological, technological, ethical, or other related aspects of critical care medicine, are welcome. Follow EQUATOR Reporting Guidelines . For reports of original data and systematic reviews, a structured abstract is required; see instructions for preparing Abstracts for Reports of Original Data or Abstracts for Reviews . A list of 3 Key Points is required (see guidance on preparing Key Points ). Maximum length: 3000 words of text (not including abstract, tables, figures, acknowledgments, references, and online-only material) with no more than a total of 5 tables and/or figures.

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

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

This article type requires a presubmission inquiry to [email protected] .

The journal will consider 2 types of review articles:

Systematic Reviews

These types of Review articles differ by the scope and level of analysis of the literature searches and the titles used. Systematic Reviews require a complete systematic search of the literature using multiple databases, covering many years, and grading of the quality of the cited evidence. Narrative Reviews do not require a rigorous literature search but should rely on evidence and should be written by established experts in the field. See below for more detail on each type of Review.

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

Behavioral Treatment of Obesity: A Systematic Review

Behavioral Treatment of Obesity: A Review (note: the word "narrative" is not included in the subtitle)

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

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

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

Prospective authors interested in submitting a review manuscript should prepare a detailed outline of the proposed article. There should also be a brief summary of the extent and quality of the literature supporting the proposed review. Alternatively, if a draft of the manuscript has been completed, this can be sent. Prospective authors should also summarize their publication record in the field. Send this information to the editorial office via email to Mary McDermott, MD, at [email protected] .

Specific Components of a Systematic Review

Key Points (75-100 words)

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

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

Abstract (350 words)

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

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

Introduction (150-250 words)

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

Methods/Literature Search (150-250 words)

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

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

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

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

Results (1000-1250 words)

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

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

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

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

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

Conclusions

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

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

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

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

Follow additional instructions for preparation and submission of Tables .

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

Additional figures that illustrate pathophysiology or clinical presentation may be considered. Note: All figures will be re-created. For each proposed illustration, the authors should provide a list of the elements to be included in the illustration; 3-4 relevant recent references; example illustrations, if available; a working figure title and legend; and an explanation of how this new illustration would add to the published literature. We encourage videos, if appropriate, to illustrate a point made or process described in the Review.

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

Narrative Reviews on clinical topics provide an up-to-date review for clinicians on a topic of general common interest from the perspective of internationally recognized experts in these disciplines. The focus of Narrative Reviews will be an update on current understanding of the physiology of the disease or condition, diagnostic consideration, and treatment. These reviews should address a specific question or issue that is relevant for clinical practice. Narrative Reviews do not require (but may include) a systematic review of the literature search. Recommendations should be supported with evidence and should rely on recent systematic reviews and guidelines, if available, emphasizing factors such as cause, diagnosis, prognosis, therapy, or prevention.

The basic structure of manuscripts reporting Narrative Reviews should include the following: Abstract (structured abstract of no more than 300 words); Introduction (150-250 words); Methods, if included (150-250 words); Discussion/Observations (1000-1250 words, with the following subsections, if appropriate: Pathophysiology, Clinical Presentation, Assessment and Diagnosis, Treatment, and Prognosis); and Conclusions (2-3 sentences).

Typical length: 2000-3500 words (maximum), with no more than a total of 5 tables and/or figures, and no more than 50-75 references. For an example of this type of article, see JAMA . 2015;314(23):2544-2554 .

Specific Components of a Narrative Review

Abstract (300 words)

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

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

The first 2 to 3 sentences of the Introduction should draw in readers in such that they want to continue reading the article and should establish the importance of the Review. Reviews should include the clinical question or issue and its importance for general medical practice, specialty practice, or public health. The first paragraph should provide a general summary of the clinical problem (eg, obesity). The next paragraph should focus on the specific aspect of the clinical problem the article will explore (eg, treatments for obesity). Briefly summarize the epidemiology of the disease. This information should include disease prevalence and incidence and perhaps discussion of the presence and frequency of any relevant subpopulations and any geographic or seasonal variations of the disease if these are relevant. The third paragraph should discuss exactly what material will be covered in the Review (eg, obesity treatments).

Methods (150-250 words)

A Methods section is not required for Narrative Reviews, but may be included to summarize a literature search that was conducted for this Review. If included, briefly describe the characteristics of the literature searched and included in the review, including the bibliographic databases and other sources searched, search terms used, dates included in the search, date the literature search was conducted, and any process used to evaluate the literature.

Discussion/Observations (1000-1250 words)

The principal observations of the Narrative Review generally should include the subsections listed below, although each section may not be necessary for some topics. The word counts following each subsection are suggested to assist with keeping the overall Observations section limited to 1000-1250 words.

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

For most Narrative Reviews, tables should be included that summarize the epidemiology, diagnostic tools, and therapies available for the disease. In some cases, these 3 topics may not all be relevant to the review topic and tables may be appropriately modified to fit the review. Include a fourth table that compares the findings of the review and current clinical practice recommendations or diagnostic and therapeutic uncertainty or controversies.

Table 1: Major epidemiologic and burden of disease facts Table 2: Major diagnostic tools available Table 3: Major therapies available Table 4: Current clinical practice recommendations and/or diagnostic and therapeutic uncertainty, and controversies

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

Figures that illustrate pathophysiology or clinical presentation may be included. Note: All figures will be re-created. For each proposed illustration, the authors should provide a list of the elements to be included in the illustration; 3-4 relevant recent references; example illustrations, if available; a working figure title and legend; and an explanation of how this new illustration would add to the published literature. We encourage videos, if appropriate, to illustrate a point made or process described in the Review.

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

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

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

Authors should provide 4 single-phrase plausible treatment options describing possible courses of action with one of these being the most correct response for the question "What Would You Do Next?" Manuscripts should include a brief discussion of the relevant clinical issues and provide well-supported (evidence-based) explanations discussing the 4 potential courses of action. For a recently published example, see JAMA . 2022;327(24):2448-2449. doi:10.1001/jama.2022.8384 .

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

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

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

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

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

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

Manuscripts not meeting these guidelines will not be considered.

Diagnostic Test Interpretation presents the results of a diagnostic test from a single patient and explores the clinical application of the test result. The Diagnostic Test Interpretation is intended to help clinicians understand the underlying rationale in ordering tests, interpreting test results, and acting on the diagnostic test findings.

The diagnostic test result must be obtained from the care of an actual patient and must include that patient's written permission. The JAMA Network Patient Permission form should be read and completed and signed by the patient (or a family member if the patient has died, is a minor, or is an adult without decisional capacity) and included at the time of manuscript submission. The results of laboratory, pathologic, or radiographic tests are appropriate but clinical images are not. Results of the diagnostic test of interest (and related tests) and the range of reference values should be included after the case. Authors of manuscripts based on clinical images should consult the instructions for Clinical Challenge .

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

Manuscripts for Diagnostic Test Interpretation should have the following sections:

Case presentation. The case presentation should be brief and focus on the diagnostic test in question. At the end of the case presentation the pertinent diagnostic test results and reference ranges should be provided (200 words). Include: JAMA Exclude: Specialty Journals, JNO Comments: How do you interpret these test results? How do you interpret these test results? (or What would you do next?) Four plausible responses should be provided. While most Diagnostic Test Interpretation articles will pose the question "How do you interpret these results?" a subset may more appropriately focus on the next best step regarding workup of the abnormal test result. In these cases, the question "How do you interpret these test results?" can be replaced with "What would you do next?" Either question should be presented in the format of a multiple choice question with a single correct (or best) answer. The answers may be brief phrases or short sentences, should be similar in length, and should be arranged alphabetically by first word in the answer. Response options should not describe treatments (about 50 words). Include: CAR,ONC Exclude: JAMA, DER, IMD, NEU, OPH, PED, OTO, PSY, SUR, JNO Comments: How do you interpret these test results? Test characteristics. A brief review of the diagnostic test should be provided (approximately 200 words). For biomarkers, this should include a brief description of the related physiology. Test accuracy should be reported using sensitivity and specificity or likelihood ratios, and predictive values should be provided for common clinical scenarios. Please use likelihood ratios whenever possible, since they do not depend on disease prevalence. The prevalence of the disease should be stated so that the pretest probability may be estimated. For example, "For patients with a typical disease prevalence of 10%, the predictive values of positive and negative test results are approximately 50% and 1%, respectively." Discussion of the application and utility of the diagnostic test should be based on a high-quality systematic review or authoritative practice guideline. If a more recent, original study supersedes or adds meaningfully to the prior synthesis of research, that article also should be cited. The approximate fee for the test should be provided. For example, some fees for laboratory tests can be obtained from the Medicare fee schedules . Radiology procedure fees can be found at the Medicare Physician Fee Schedule website . Application of test result to this patient. A brief discussion of how the diagnostic test result will facilitate the next steps in a patient's management should be presented. Please also address the correct answer to the question about test interpretation in this section (200 words). What Are Alternative Diagnostic Testing Approaches? If there are different testing strategies that can be used to evaluate patients to establish a diagnosis, please discuss them (100 words). Patient Outcome. Long-term follow-up (most recent as possible) regarding the patient's condition and outcome of treatment is necessary (100 words). Clinical Bottom Line. Please provide a bulleted list of 3-5 items that reflect the most important message readers should obtain from this article.

The overall text of the manuscript should have a maximum of 850 words, no more than 10 references, and no more than 3 authors. At least 1 of the authors, ideally the corresponding author, should have sufficient expertise and experience with the topic. The case presentation must not have been previously published.

For an example of this article type, see JAMA . 2022;327(13):1284-1285. doi:10.1001/jama.2022.2037 .

If there are questions about patient identifiability, please contact the editorial office. Authors interested in submitting a manuscript for Diagnostic Test Interpretation should contact the editorial office prior to manuscript preparation and submission by sending an email to Kristin Walter at [email protected] .

Viewpoints may address virtually any important topic in medicine, public health, research, discovery, prevention, ethics, health policy, or health law and generally are not linked to a specific article. Viewpoints should be well focused, scholarly, and clearly presented but should not include the findings of new research or data that have not been previously published.

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

Most essays published in A Piece of My Mind are personal vignettes (eg, exploring the dynamics of the patient-physician relationship) taken from wide-ranging experiences in medicine; occasional pieces express views and opinions on the myriad issues that affect the profession. If the patient(s) described in these manuscripts is identifiable, a Patient Permission form , which provides consent for publication, must be completed and signed by the patient(s) or family member(s) and submitted with the manuscript. Manuscripts that describe identifiable patients that do not have a signed form will not be reviewed. Omitting data or making data less specific to deidentify patients is acceptable, but changing any such data is not acceptable. Fictional or composite accounts are not permitted.

Manuscripts are not published anonymously or pseudonymously and must have no more than 3 authors. All manuscripts must be submitted formally via the journal's manuscript submission system; we do not review drafts or unfinished manuscripts prior to submission. Length limit: 1600 words.

Poems related to the medical experience, whether from the point of view of a health care worker or patient, or simply an observer, will be considered. Poems should be original, not previously published or under consideration elsewhere, no longer than 44 lines, and with individual lines no longer than 55 characters (including spaces). Authors should submit each poem separately (ie, one poem per submission record, and only one author per poem). Submissions containing multiple poems will be returned with instructions to split into individual files. Do not submit artwork, music/audio, or other accompanying materials, which are not considered. All poems must be submitted online via the online manuscript submission and review system . Authors of poems that are accepted for publication are required to complete Authorship Forms and transfer copyright to the publisher as part of a publishing agreement. An email with links to the Authorship Form will be sent to authors for completion before final acceptance. Author requests to republish poems are generally granted by our permissions department following a formal request.

Questions about submitting poems (but not submissions) may be sent to [email protected] .

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

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

Clinical Trial

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

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

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

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

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

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

Trial Registration:

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

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

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

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

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

CONSORT Flow Diagram and Checklist:

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

Figure. Profile of a Randomized Clinical Trial

Trial Protocol

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

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

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

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

Other Observational Studies

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

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

Format My Manuscript

Manuscript preparation and submission requirements.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Abstracts for Reports of Original Data:

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

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

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

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

Abstracts for Meta-analysis:

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

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

Abstracts for Systematic Reviews or Special Communications:

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

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

Abstracts for Narrative Reviews or Special Communications:

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

Ratings of the quality of the evidence

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

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

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

To read more about units of measure, click here .

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

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

JAMA does not republish text, tables, figures, or other material from other publishers, except under rare circumstances. Please delete any such material and replace with originals.

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

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

Examples of reference style:

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

For more examples of electronic references, click here .

Tables and Figures

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

See also Tables and Figures .

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

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

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

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

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

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

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

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

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

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

Table Creation

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

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

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

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

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

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

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

Table 1. Baseline Values in the Editors' Health Study

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

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

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

Table 2. Blood Pressure Values Stratified by Age

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

Table 3. Patient Data by Study Group

Table 4. Patient Data by Study Group

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

Table Footnotes

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

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

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

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

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

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

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

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

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

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

Image Integrity

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

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

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

Acceptable Figure Files for Initial Submission and Review

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

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

Figure File Requirements for Publication

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

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

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

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

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

Figure Titles and Legends (Captions)

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

Figures With Labels, Arrows, or Other Markers

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

Number of Figures

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

General Figure Guidelines

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

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

Table of Figure Requirements

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

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

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

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

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

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

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

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

Flow diagram

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

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

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

Survival plot

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

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

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

Box-and-whisker plot (box plot)

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

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

Forest plot

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

The data are presented both tabularly and graphically.

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

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

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

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

Scatterplot

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

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

Illustration

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

Required minimum resolution for publication: ≥350 ppi

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

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

Photographs and other clinical images

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

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

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

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

Line drawings

To illustrate anatomy or procedures.

Line drawings are almost always black and white.

Required minimum resolution for publication: ≥600 ppi

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

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

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

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

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

Online-Only Text

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

Online-Only References

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

Online-Only Tables

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

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

Online-Only Figures

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

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

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

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

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

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

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

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

Guidelines for Optimal Video Quality

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

Additional Considerations for Filming Surgical Procedures

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

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

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

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

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

After Submission

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

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

At the time of manuscript submission, authors may preselect the option to have their manuscript and reviewers' comments automatically referred to one of the JAMA Network specialty journals if the manuscript is not accepted by JAMA .

JAMA -EXPRESS

JAMA -EXPRESS provides rapid peer review and publication of major clinical trials and other original research studies that have immediate or public health importance. Authors who wish to have manuscripts considered for JAMA -EXPRESS should send the manuscript file and a request letter to [email protected] or call (312) 464-4444. Authors will be notified promptly whether the manuscript is approved for rapid peer review. Authors of those manuscripts determined not to qualify for rapid review may be invited to submit the manuscript for further consideration under the standard review process.

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

After Revision/Acceptance

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

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

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

If accepted for publication, all articles are published quickly in one of JAMA 's weekly print/online issues; selected articles are published Online First.

After Publication

Postpublication correspondence.

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

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

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

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

About Previous Release of Information, Embargo, and Access

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

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

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

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

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

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

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

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

The journal makes all JAMA research articles free public access 6 months after publication on the journal website.

Authors of research articles may deposit the accepted version (ie, the peer-reviewed manuscript that you submitted on which this decision is based) of the manuscript in a repository of your choice on or after the date of publication provided that it links to the final published version on the journal website. You may not deposit the published article (version of record), which is the final copyedited, formatted, and proofed version published by the journal. The journal will deposit a copy of the published research article into PubMed Central (PMC) at the time of publication, where it will be publicly available 6 months after publication. A few weeks after publication, you may obtain your PMCID on the PMC site at: https://www.ncbi.nlm.nih.gov/pmc/pmctopmid/ . These options apply only to research articles. Non-research articles may not be deposited into repositories.

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

Author Responsibilities

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

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

• substantial contributions to conception or design of the work, or the acquisition, analysis, or interpretation of data for the work; and
• drafting of the work or reviewing it critically for important intellectual content; and
• final approval of the version to be published; and
• agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

To read more about authorship, click here .

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

Definitions and Terms of Conflicts of Interest Disclosures:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Requirements for Reporting

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

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

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

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

General Considerations

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

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

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

Sample Size Calculations

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

Descriptive Statistics

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

Statistical Procedures

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

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

Missing Data

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

Primary Outcomes, Multiple Comparisons, and Post Hoc Comparisons

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

Statistical Analysis Subsection

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

Reporting Standards and Data Presentation

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

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

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

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

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

Reporting Age

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

Reporting Sex and Gender

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

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

Reporting Race and Ethnicity

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

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

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

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

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

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

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

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

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

Patient Permission Form:

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

AI Used in Manuscript Preparation

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

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

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

AI Used in Research

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

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

Also address the following:

Methods Section

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

Results Section

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

Discussion Section

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

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

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

Journal Policies

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Last Updated: August 14, 2024

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Submission guidelines

Format of articles, cover letter, revised manuscripts, tex/latex files, writing your manuscript, copy editing services, acknowledgements, author contributions, competing interests, data availability, ethics declarations, approval for animal experiments, approval for human experiments, consent to participate/consent to publish.

• Supplementary information

Figure legends

General figure guidelines, figures for peer review, figures for publication, statistical guidelines, chemical and biological nomenclature and abbreviations, gene nomenclature, characterisation of chemical and biomolecular materials, registered reports.

Scientific Reports publishes original research in two formats: Article and Registered Report. For Registered Reports, see section below . In most cases, we do not impose strict limits on word count or page number. However, we strongly recommend that you write concisely and stick to the following guidelines:

• Articles should ideally be no more than 11 typeset pages
• The main text should be no more than 4,500 words (not including Abstract, Methods, References and figure legends)
• The title should be no more than 20 words, should describe the main message of the article using a single scientifically accurate sentence, and should not contain puns or idioms
• The abstract should be no more than 200 words

For a definitive list of which limits are mandatory please visit the submission checklist page .

Please do not include any references in your Abstract. Make sure it serves both as a general introduction to the topic and as a brief, non-technical summary of the main results and their implications. Abstract should be unstructured, i.e. should not contain sections or subheadings.

We allow the use of up to 6 keywords/key phrases that can be used for indexing purposes. These should represent the main content of the submission.

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

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

• Introduction
• Results (with subheadings)
• Discussion (without subheadings)

You should then follow the main body of text with:

• References (limited to 60 references, though not strictly enforced)
• Acknowledgements (optional)
• Data availability statement (mandatory)
• Additional Information (including a Competing Interests Statement)
• Figure legends (these are limited to 350 words per figure)
• Tables (maximum size of one page)

Please note, footnotes should not be used. 

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

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

Your submission must also include:

• A cover letter
• Individual figure files and optional supplementary information files

For first submissions (i.e. not revised manuscripts), you may incorporate the manuscript text and figures into a single file up to 3 MB in size. Whilst Microsoft Word is preferred we also accept LaTeX, or PDF format. Figures can be inserted in the text at the appropriate positions, or grouped at the end.

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

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

In your cover letter, you should include:

• The affiliation and contact information of your corresponding author
• A brief explanation of why the work is appropriate for Scientific Reports
• The names and contact information of any reviewers you consider suitable
• The names of any referees you would like excluded from reviewing

Finally, you should state whether you have had any prior discussions with a Scientific Reports Editorial Board Member about the work described in your manuscript.

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

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

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

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

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

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

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

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

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

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

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

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

Claim 10% off English editing from Nature Research Editing Service

Claim 10% off American Journal Experts

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

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

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

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

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

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

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

In your reference list, you should:

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

Published papers:

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

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

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

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

Online material:

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

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

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

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

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

Please be aware:

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

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

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

Examples of declarations are:

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

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

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

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

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

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

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

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

Please note that:

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

Supplementary Information

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

1. Line art, graphs, charts and schematics

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

2. Photographic and bitmap images

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

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

3. Chemical structures

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

4. Stereo images

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

1. Chemical identity

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

2. Combinational compound libraries

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

3. Biomolecular identity

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

4. Biological constructs

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

5. Sample purity

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

6. Spectral data

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

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

7. Crystallographic data for small molecules

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

8. Macromolecular structural data

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

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

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Cite government publications as a book, report, or website as appropriate. If there is no named author on the cover or title page, use the agency or department as the author. If the document is a report or publication, include the report number or other identifier after the title. If citing a website, include the entire URL.

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Reference Citation: Information to Include

Government Entity. (Year, Month Day). Publication title in sentence case and italics . Parent Agency If Applicable. URL_but_not_active_hyperlink

Specific Example: Government Website

In-text Citation Options

Land conservationists can support wildlife refuges, particularly those for migratory birds, by purchasing a Federal Duck Stamp, which, according to the U.S. Fish & Wildlife Service (2021) also are “miniature works of art.”

Land conservationists can support wildlife refuges, particularly those for migratory birds, by purchasing a Federal Duck Stamp, which are also “miniature works of art” (U.S. Fish & Wildlife Service, 2021).

References Page Entry

U.S. Fish and Wildlife Service. (2021, June 28). Duck stamp: Put your stamp on conservation . U.S. Department of the Interior. https://www.fws.gov/birds/get-involved/duck-stamp.php

Note : This government web page has a “last updated” date, so you can use that.  For government websites with no date, use n.d. in place of the date and add a retrieval date.  See our page for General Website to see how this should look.

The Internal Revenue Service (2023) reported that the Inflation Reduction Act included clean energy tax credits for low-income communities.

The Inflation Reduction Act included clean energy tax credits for low-income communities (Internal Revenue Service, 2023).

Internal Revenue Service. (2023, September). Increased energy investment credit for solar and wind facilities benefitting low-income communities . U.S. Department of the Treasury. https://www.irs.gov/newsroom/increased-energy-investment-credit-for-solar-and-wind-facilities-benefitting-low-income-communities

Specific Example: PDF of a Government Report

In the 2016 National Survey of Fishing, Hunting, and Wildlife-Associated Recreation, the U.S. Fish & Wildlife Service (2018) reported that Americans spent $75.9 billion dollars – 48 percent of all wildlife recreation expenditures – on wildlife watching (p. 39).

Wildlife watchers spent $12.1 billion dollars in 2016 purchasing equipment (e.g., cameras and bird feed) in pursuit of their hobby (U.S. Fish & Wildlife Service, 2018, p. 39).

U.S. Fish and Wildlife Service. (2018, April). 2016 national survey of fishing, hunting, and wildlife-associated recreation (Publication FHW/16-NAT). U.S. Department of the Interior. https://wsfrprograms.fws.gov/subpages/nationalsurvey/nat_survey2016.pdf

Specific Example: O*Net Entry

O*Net’s report on auditing mentioned that to stand out in this industry, auditors must have excellent communication skills (National Center for O*NET Development, 2019). 

To stand out, auditors must have excellent communication skills (National Center for O*NET Development, 2019).

 References Page Entry  

National Center for O*NET Development. (2019). Auditors (O*Net Report No. 13-2011.02). https://www.onetonline.org/link/summary/13-2011.02

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Key Guidelines for Responding to Reviewers

Affiliations.

• 1 Department of Pediatric surgery, Zaghouan Hospital, Research Laboratory LR12SP13, University of Monastir Faculty de Medicine of Monastir, Monastir, Monastir, Tunisia.
• 2 Ibn Nafiss Pneumology Department, Abderrahmene Mami Hospital, Ariana, University of Tunis El Manar Faculty of Medicine of Tunis, Tunis, Tunis, Tunisia.
• 3 Department of Physical Medicine and Rehabilitation, Fattouma Bourguiba University Hospital Monastir, University of Monastir Faculty of Dental Medicine of Monastir, Monastir, Tunisia.
• 4 Hôpital Farhat HACHED, Laboratoire de recherche LR12SP09 «Insuffisance cardiaque», 4000 Sousse, Université de Sousse Faculté de Médecine de Sousse, Sousse, 4000, Tunisia.
• PMID: 39246824
• PMCID: PMC11377928
• DOI: 10.12688/f1000research.154614.1

Background: The process of preparing a scientific manuscript is intricate, encompassing several critical stages, including pre-writing, research development, drafting, peer review, editing, publication, dissemination, and access. Among these, the peer review process (PRP) stands out as a pivotal component requiring seamless collaboration among editors, reviewers, and authors. Reviewers play a crucial role in assessing the manuscript's quality and providing constructive feedback, which authors must adeptly navigate to enhance their work and meet journal standards. This process can often appear daunting and time-consuming, as authors are required to address numerous comments and requested changes. Authors are encouraged to perceive reviewers as consultants rather than adversaries, viewing their critiques as opportunities for improvement rather than personal attacks.

Methods: Opinion article.

Aim: To equip authors with practical strategies for engaging effectively in the PRP and improving their publication acceptance rates.

Results: Key guidelines include thoroughly understanding and prioritizing feedback, maintaining professionalism, and systematically addressing each comment. In cases of significant disagreement or misunderstanding, authors have the option to refer the issue to the editor. Crafting a well-organized and scientific "response to reviews" along with the revised manuscript can substantially increase the likelihood of acceptance. Best practices for writing an effective response to reviews include expressing gratitude, addressing major revisions first, seeking opinions from co-authors and colleagues, and adhering strictly to journal guidelines. Emphasizing the importance of planning responses, highlighting changes in the revised manuscript, and conducting a final review ensures all corrections are properly documented.

Conclusion: By following these guidelines, authors can enhance their manuscripts' quality, foster positive relationships with reviewers, and ultimately contribute to scholarly advancement.

Keywords: Academic publishing; Manuscript evaluation; Manuscript review process; Peer assessment; Peer review; Research quality; Review; Reviewer comments; Revision guidelines; manuscript assessment.

Copyright: © 2024 Hidouri S et al.

PubMed Disclaimer

Conflict of interest statement

No competing interests were disclosed.

• Ben Saad H: Scientific medical writing in practice: the <<IMR@D(R)>> format. Tunis. Med. 2019 Mar;97(3):407–425. - PubMed
• Ben Saad H: Scientific medical writing in practice: How to succeed the writing style? Tunis. Med. 2019 Feb;97(2):273–285. - PubMed
• Dergaa I, Ben Saad H: Artificial intelligence and promoting open access in academic publishing. Tunis. Med. 2023 Jun 5;101(6):533–536. - PMC - PubMed
• Dergaa I, Zakhama L, Dziri C, et al. : Enhancing scholarly discourse in the age of artificial intelligence: A guided approach to effective peer review process. Tunis. Med. 2023 Oct 5;101(10):721–6. Epub 20231005. - PMC - PubMed
• Melki S, Ben Hassine D, Chebil D, et al. : Major mistakes in scientific medical writing based on manuscripts’ reviews. Tunis. Med. 2024 Jan 5;102(1):13–18. 10.62438/tunismed.v102i1.4715 - DOI - PMC - PubMed
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2 In 3 Laid-Off Workers Happier Building Freelancing Careers

Workers who are laid off are planning on building freelancing careers instead of going back to ... [+] traditional nine-to-five jobs, and the majority are happier calling their own shots.

Many Americans worry about losing their jobs on a daily basis. What about you? Have you ever wondered how you’d make ends meet if you faced a layoff? As industries undergo rapid changes, more Americans are turning to freelancing and side hustles to earn a living. And it makes sense. Working in a job that could end at any moment, creates stress and limits your control over your work-life balance. You become a passenger on your ship. But when you take control of an uncertain situation, you become captain of your ship.

Flexibility has become one of the most sought-after values in a company. And many employees insist that the return-to-the-office movement diminishes their flexibility, which they need for a better work-life balance. Whether you’re looking for extra income to supplement your full-time job or to create your own job, the gig economy provides flexibility and a way to get hired or create work and gain experience.

Scientific data from Jitjatjo bears out that the flexibility trend is the driving factor behind the rise in non-traditional jobs. Workers want greater control over their lives and more free time. Sixty-three percent of employees switching from typical office hours to flexible gig work say that setting their own schedule makes gig work more attractive than a traditional office job.

Across all age groups, 44% of U.S. respondents say they would consider leaving their full-time role for contingent work if it allowed a four-day workweek, and 53% of those who have made the switch attribute it to their interest in flexibility and work-life balance. Jitjatjo’s report finds that 74% of Americans under 45 believe flexible workers will drive America's future economy eventually—not traditional/full-time workers.

According to a new research study from SideHustles.com , there’s another reason for the jump in freelance jobs. As more workers are laid-off, there is a trend for them to build freelance careers instead of seeking another traditional nine-to-five job. Why? You guessed it. Flexibility. SideHustles.com surveyed over 1,220 laid-off Americans who had been laid off within the past 12 months to gather insight into how they’re handling these shifts, leveraging new skills and adapting to a freelance-driven economy. Of the respondents, 23% were Gen Z, 53% were millennials, 20% were Gen X and four percent were baby boomers. Key findings include:

• 44% of recently laid-off Americans have a side hustle, and nearly one in two recently laid-off Americans plan to pursue freelancing full-time instead of returning to traditional employment.
• Nearly one in six recently laid-off Americans (15%) report earning at least $2,000 per month from freelancing.
• 68% of those recently laid-off believe they’ll always need a side hustle, and 67% depend on it to make ends meet.
• 62% of recently laid-off workers learned new skills to pursue freelancing or side hustles, and almost half of recently laid-off Americans (47%) have learned to use AI to pursue freelancing or side hustle opportunities.
• Two in three recently laid-off people say they are happier freelancing than they did before being laid off.

Gen Z is the most likely to have a side hustle (49%), while Gen X is the most likely to freelance (24%). Millennials stood out as the most likely to be doing both, with 28% are engaging in side hustles and freelancing. The percentage of recently laid-off Americans who plan to freelance full-time instead of seeking employment, by generation:

• Gen Z (43%)
• Millennials (46%)
• Gen X (44%)

Percentage of recently laid-off Americans who are happier now freelancing than in their previous jobs, by generation:

• Gen Z (66%)
• Millennials (66%)
• Gen X (63%)

Nearly half of American workers have side hustles , and the numbers continue to rise. According to Jason O’Brien, COO at TollFreeForwarding.com , searches for side hustles to augment incomes are projected to increase by 441% over the next five years. It’s no wonder these studies show more Americans—especially younger workers—are turning to freelancing and side hustles to make ends meet in an uncertain economy. They’re no longer depending on big business to determine their economic future. They are determined to build a career that gives them more autonomy for work-life balance and say-so over their economic future. And most important, the majority are happier building their own freelancing careers and calling their own shots.