0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......

JAMA Internal Medicine Instructions For Authors

General Information

JAMA Internal Medicine is an international peer-reviewed journal providing innovative and clinically relevant research for practitioners in general internal medicine and internal medicine subspecialities. The Editor of JAMA Internal Medicine is Rita F. Redberg, MD, MSc, University of California San Francisco School of Medicine, San Francisco, California. The journal is published online every Monday and in print each month. We receive more than 3000 submissions per year, of which we accept approximately 12%. Manuscripts undergo rigorous peer review and careful statistical assessment within 2 to 3 weeks of submission; the interval between acceptance and publication is 87 days.

Manuscripts should be submitted online via the online manuscript submission and review system. For more information, see Manuscript Submission.

Editorial Office Contact Information

JAMA Internal Medicine, Rita F. Redberg, MD, MSc, Editor, University of California, San Francisco, Department of Medicine, Division of Cardiology, 505 Parnassus Ave, Ste M1180, Box 0124, San Francisco, CA 94143-0124; telephone: (415) 476-3117(415) 476-3117; fax: (866) 465-1761; e-mail: jamainternalmed@jamanetwork.org.

Editorial Policies for Authors

Most of JAMA Internal Medicine’s editorial policies for authors are summarized in these instructions. Citations to editorials with additional information are also provided.

Authorship Criteria and Conditions and Authorship Form

Each author should have participated sufficiently in the work to take public responsibility for appropriate portions of the content. One or more of the authors should take responsibility for the integrity of the work as a whole, from inception to published article.1,2 According to the guidelines of the International Committee of Medical Journal Editors (ICMJE), as revised in 2013,1 authorship credit should be based on the following 4 criteria: (1) substantial contributions to conception or design of the work, or the acquisition, analysis, or interpretation of data for the work; and (2) drafting of the work or revising it critically for important intellectual content; and (3) final approval of the version to be published; and (4) 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 four criteria should be acknowledged (see Acknowledgment Section.)

All authors (ie, the corresponding author and each coauthor) must read, complete, and submit an Authorship Form with required statements on Authorship Responsibility, Criteria, and Contributions, (2) disclosure of Funding and Conflicts of Interest, and either Copyright Transfer/Publishing Agreement or Federal Employment Statement.2(pp127-135) In addition, authors are required to identify their contributions to the work described in the manuscript. Authorship Forms will be sent to authors for completion after manuscripts have been submitted (see sample Authorship Form). 

For reports of original data and systematic reviews, authors’ specific contributions will be published in the Acknowledgment section (see Manuscript Preparation and Submission Requirements, Acknowledgment Section). All other persons who have made substantial contributions to the work reported in this manuscript (eg, data collection, analysis, 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. Written permission to include the names of individuals in the Acknowledgment section must be obtained (see Manuscript Preparation and Submission Requirements, Acknowledgment Section).

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 Duplicate/Previous Publication or Submission). Authors of manuscripts reporting original data or systematic reviews must provide an access to data statement from at least 1 named author, often the corresponding author (see also Data Access and Responsibility). 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.

Role of the Corresponding Author

The corresponding author (or coauthor designee) 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 typescript and proof, make decisions regarding release of information in the manuscript to the news media, federal agencies, or both, and will be identified as the corresponding author in the published article. The corresponding author is responsible for ensuring that the Acknowledgment section of the manuscript is complete (see Acknowledgment Section) and is responsible for ensuring that the conflict of interest disclosures reported in the Acknowledgment section of the manuscript are accurate, up-to-date, and consistent with the information provided in each author’s Authorship Form (see Conflicts of Interest and Financial Disclosures). The corresponding author also must sign the Acknowledgment statement part of the Authorship Form confirming that all persons who have contributed substantially but who are not authors are identified in the Acknowledgment section and that written permission from each person acknowledged has been obtained (see sample Authorship Form and Acknowledgment Section for more details).

Changes in Authorship

Authors should determine the order of authorship among themselves and should settle any disagreements among themselves before submitting their manuscripts. 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(pp134-135)

Group Authorship

If authorship is attributed to a group (either solely or in addition to 1 or more individual authors), all members of the group must meet the full criteria and requirements for authorship described above, and all group member authors must complete the Authorship Form.3 If all members of a group do not meet all authorship criteria, a group must designate at least 1 or more individuals as authors or members of a writing group who meet full authorship criteria and requirements and who will take responsibility for the group. Other group members who do not meet the criteria for authorship may be listed as collaborators in the Acknowledgment.2(p135-138) Both authors and collaborators will be noted in published articles and in PubMed records.

Conflicts of Interest and Financial Disclosures

A conflict of interest may exist when an author (or the author’s institution or employer) has financial or personal relationships that could inappropriately influence (or bias) the author’s decisions, work, or manuscript. All authors are required to disclose potential conflicts of interest on the JAMA Internal Medicine Authorship Form or in an attachment to the form and in the Acknowledgment section of the manuscript. 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 or funding, 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,1 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 also should include this information in the Acknowledgment section of the submitted manuscript.

Authors without conflicts of interest, including relevant financial interests, activities, relationships, and affiliations, should indicate no such interests in the Acknowledgments section of the manuscript.4 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 have established policies and thresholds for reporting financial interests and other conflicts of interest, the JAMA Network journals require 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 of products used in the management of hypertension, not only those relationships with companies whose specific products 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 financial information provided by authors should be published, and thereby disclosed to readers, are usually straightforward. Although Editors are willing to discuss disclosure of specific financial information with authors, the JAMA Network journals’ policy is one of complete disclosure of all relevant financial interests, 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.

Authors also are required to report detailed information regarding all financial and material support for the research and work, including but not limited to grant support, funding sources, and provision of equipment and supplies, in the Acknowledgment section of the manuscript.

Funding/Support and Role of Funder/Sponsor

All financial and material support (eg, grant identification, transfer agreement) for the research and the work must be clearly and completely identified in an Acknowledgment section of the manuscript. The specific role of the funding organization or sponsor in each of the following should be specified: “design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.”4,5

Data Access and Responsibility

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, who are independent of any commercial funder or sponsor, must indicate that he or she “had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis”.4 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.

Acknowledgment Section

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 (see sample Authorship Form); 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.

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 (see sample Authorship Form).

Duplicate/Previous Publication or Submission

Manuscripts are considered with the understanding that they have not been published previously in print or electronic format and are not under consideration by another publication or electronic medium. Copies of related or possibly duplicative materials (ie, those containing substantially similar content or using the same or similar data) that have been previously published or are currently under consideration elsewhere must be provided at the time of manuscript submission. If publication of the findings occurs in press reports, interviews, or other formats after submission but before publication of the manuscript in JAMA Internal Medicine, the Editors must be notified immediately.

Timeliness of Data

Research reports submitted to JAMA Internal Medicine 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. Because manuscripts in which the most recent data have been collected more than 5 years ago (ie, prior to 2008) ordinarily will receive lower priority for publication, authors of such manuscripts should provide a detailed explanation of the relevance of the information in light of current knowledge and medical practice.

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. Interventions include but are not limited to drugs, surgical procedures, devices, behavioral treatments, process-of-care changes, and the like. All manuscripts reporting clinical trials must include a copy of the trial protocol including the complete statistical analysis plan (see Protocols), a flow diagram, and a completed trial checklist (see CONSORT Flow Diagram and Checklist). All clinical trials must be registered at an appropriate online public registry (see Trial Registration requirements). These and other requirements for manuscript preparation are detailed in Categories of Articles, Clinical Trial. For additional guidance on reporting cluster trials, noninferiority and equivalence trials, pragmatic trials, and trials with patient-reported outcomes, see Extensions of the CONSORT Statement.

Trial Registration:

In concert with ICMJE, JAMA Internal Medicine 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).1,6,7 Acceptable trial registries include the following and others listed at http://www.icmje.org:

For this purpose, a clinical trial is any study that prospectively assigns human subjects to intervention or comparison groups to evaluate the cause-and-effect relationship between an intervention and a health outcome. 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. Trials must be registered at or before the onset of subject enrollment. 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. Studies designed for other purposes, such as to study pharmacokinetics or major toxicity (eg, phase 1 trials), are exempt. 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.

Protocols:

Authors of manuscripts reporting clinical trials must submit trial protocols (including the complete statistical analysis plan) along with their manuscripts.

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

Flow Diagram

Figure. Flow diagram of subject progress through the phases of a randomized trial.8

Survey Research

Manuscripts reporting survey data, such as studies involving patients, clinicians, the public, or others, should report data collected as recently as possible, ideally within the past 2 years. Survey studies should have sufficient response rates (generally at least 60%) and appropriate characterization of nonresponders to ensure that nonresponse bias does not threaten the validity of the findings. For most surveys, such as those conducted by telephone, personal interviews (eg, drawn from a sample of households), mail, e-mail, or via the web, authors are encouraged to report the survey outcome rates using standard definitions and metrics, such as those proposed by the American Association for Public Opinion Research.9 In addition, authors should submit the survey instrument as an online-only supplement (see Online-Only Supplements and Multimedia).

Reports of Diagnostic Tests

These manuscripts may be classified as Original Investigations, Case Report/Case Series, or Research Letters. Authors of reports of diagnostic tests are encouraged to submit the STARD flow diagram and checklist.

Reports of Cost-effectiveness Analyses and Decision Analyses

These manuscripts may be classified as Original Investigations, Case Report/Case Series, or Research Letters. Authors of reports of cost-effectiveness analyses and decision analyses must submit a copy of the decision tree comprising their model. This is for editorial evaluation and review, not necessarily for publication, unless it is included in the body of the manuscript.

Reporting Race/Ethnicity

If race and/or ethnicity is reported, indicate in the “Methods” section who classified individuals as to race/ethnicity, the classifications, and whether the options were defined by the investigator or the participant. Explain why race and/or ethnicity was assessed in the study.10

Reporting Sex-Specific Results

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

Ethical Approval of Studies and Informed Consent

For all manuscripts reporting data from studies involving human participants, 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.11 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. For research involving human participants, informed consent must have been obtained (or the reason for lack of consent explained, eg, the data were analyzed anonymously) and all clinical investigation must have been conducted according to the principles expressed in the Declaration of Helsinki.11 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 as well as a sample of a patient consent form.

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

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

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

Identification of Patients in Descriptions, Photographs, Video, and Pedigrees

A signed statement of informed consent to publish (in print and online) 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) in such written descriptions, photographs, video, or pedigrees and should be submitted with the manuscript and indicated in the Acknowledgment section. Such persons should be offered the opportunity to see the manuscript before submission.2(p229-232) Omitting data or making data less specific to deidentify patients is acceptable, but changing any such data are 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 may not appear in an image.

Patient Permission Form:

The form is available here.

Reporting of Animal Studies and Ethical Treatment of Animals

For studies involving animals, all work must have been conducted according to relevant national and international guidelines and prior approval obtained for all protocols from the author’s institutional or other relevant ethics committee and the institution name and permit numbers provided at submission. For research involving nonhuman primates, all studies must be performed in accordance with the recommendations of the Weatherall report,12 “The use of nonhuman primates in research.” Where unregulated animals are used or ethics approval is not required by a specific committee, the article should include a clear statement of this and the reasons why ethical approval is not required.

We also strongly encourage all authors to comply with the “Animal Research: Reporting In Vivo Experiments” (ARRIVE) guidelines,13 developed by NC3Rs (National Centre for the Replacement, Refinement, and Reduction of Animals in Research) to improve standards of reporting to ensure that the data from animal experiments can be fully scrutinized and utilized. Relevant information should be included in the appropriate section of the article (eg, title, abstract, method) as outlined in the guidelines. Please note that these guidelines can be applied to any area of bioscience research using laboratory animals.

Personal Communications and Unpublished Data

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.

Manuscripts That Pose Security Risks

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

Previous or Planned Meeting Presentation or Release of Information

A complete manuscript following presentation at a meeting or publication of preliminary findings elsewhere (eg, an abstract) is eligible for consideration for publication. Authors considering presenting or planning to present the work at an upcoming scientific meeting should indicate the name and date of the meeting on the manuscript submission form. For accepted papers the editors may be able to coordinate publication with the meeting presentation, or publish it online ahead of print. Authors who present information contained in a manuscript that is under consideration by JAMA Internal Medicine 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 JAMA Internal Medicine, publication of full reports in proceedings or online, issuing detailed news releases reporting the results of the study, or participation in formal news conferences will jeopardize chances for publication of the submitted manuscript in JAMA Internal Medicine.15 Media coverage of presentations at scientific meetings will not jeopardize consideration, but direct release of information through press releases or news media briefings may preclude consideration by JAMA Internal Medicine.15 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.

Embargo Policy

All information regarding the content and publication date of accepted manuscripts is strictly confidential. Unauthorized prepublication release of accepted manuscripts may result in rescinding the acceptance and rejecting the paper. This policy applies to all categories of articles, including Original Investigations, Reviews, Editorials, Viewpoints, Letters, 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 article is published (typically 3 pm CST on a Monday or other specified embargo release date for the cases in which articles are released early).15

Depositing Research Manuscripts With an Approved Public Repository

All JAMA Network articles reporting original research are made freely available 12 months after publication, from 1998 forward, subject to certain conditions. The JAMA Network editors and publishers believe that the public is best served by accessing the freely available research articles on the journal website, to ensure access to the final published version, any corrections, and related web features. However, some funding organizations require that authors of manuscripts reporting research deposit those manuscripts with an approved public repository, such as PubMed Central. Authors have the JAMA Network’s permission on the following conditions:

  • 1. Permission is granted only for manuscripts reporting research funded by not-for-profit organizations to be deposited in not-for-profit, publicly available repositories.
  • 2. Permission is granted to post only the manuscript reporting research that was submitted and accepted for publication but not the final, edited, formatted, and published article.
  • 3. Authors must ensure that the posted manuscript links back to the published article on the JAMA Network website to provide readers with access to the final reviewed and edited version plus any corrections and letters, as well as the article-related features only available on the JAMA Network website.
  • 4. Authors who submit their manuscripts to an approved public repository, such as PubMed Central, must indicate that the manuscript may not be made available to the public sooner than 12 months after publication in the JAMA Network. If authors adhere to these requirements, they may submit the final accepted version of the manuscript to the repository, if and only if the repository ensures that the deposited manuscript will not be made available to the public during the 12-month embargo following publication in the JAMA Network.

The published article is protected by copyright at the time of publication and thereafter (see the JAMA Network Conditions of Use). This research access policy does not include permission to use the JAMA Network logo and trademarks. The JAMA Network article of record is the final published version; the JAMA Network assumes no responsibility for earlier versions because substantive changes and corrections may occur during the postacceptance editing process. Authors may contact the JAMA Network with any questions at jamainternalmed@jamanetwork.org.

Unauthorized Use

Published manuscripts become the permanent property of the American Medical Association (AMA) and may not be published elsewhere without written permission. Unauthorized use of the JAMA Network 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.

Editorial Review and Publication

Authors will be sent notifications of the receipt of manuscripts and editorial decisions by e-mail. During the review process, authors can check the status of their submitted manuscript via the online manuscript submission and review system.

JAMA Internal Medicine receives more than 2500 submissions per year, of which approximately 13% are accepted. Manuscripts undergo rigorous peer review and careful statistical assessment within 2 to 3 weeks of submission; the interval between acceptance and publication ranges from 72 days for articles published online first to 167 days for articles published simultaneously in print and online.

Editorial and Peer Review

All submitted manuscripts are reviewed initially by a JAMA Internal Medicine editor. 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 medical interest. 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. Peer reviewer identities are kept confidential, but author identities are made known to reviewers. The existence of a manuscript under review is not revealed to anyone other than peer reviewers and editorial staff. Peer reviewers are required to maintain confidentiality about the manuscripts they review and must not divulge any information about a specific manuscript or its content to any third party without prior permission from the journal editors. Information from submitted manuscripts may be systematically collected and analyzed as part of research to improve the quality of the editorial or peer review process. Identifying information remains confidential.

Reviews and decisions on submitted manuscripts in which the editor or one of the associate editors is a coauthor, or has a conflict of interest, are managed independently by an associate editor from another institution, in conjunction with a member of the editorial board. If needed, the final editorial decision will involve a member of the editorial board who does not have such a potential conflict.

Editing

Accepted manuscripts are edited in accordance with the AMA Manual of Style, 10th edition,2 and returned to the corresponding author (or his/her 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. If an author wishes to receive page proofs for approval, he or she must contact the manuscript editor assigned to the manuscript within 2 days of receiving the typescript.

Corrections

Requests to publish corrections should be sent to the editorial office. Corrections are reviewed by editors and authors, published promptly, and linked online to the original article.

Reprints/e-prints

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

Categories of Articles

JAMA Internal Medicine publishes Original Investigations, Reviews, Case Report/Case Series, Special Communications, Viewpoints, and other categories of articles. Topics of interest include all subjects that relate to the practice of medicine and the betterment of public health worldwide. The most frequently published types of articles are described herein.

Original Investigations

These reports typically include randomized clinical trials (see Clinical Trial), intervention studies, studies of screening and diagnostic tests (see Reports of Diagnostic Tests), cohort studies, cost-effectiveness analyses and decision analyses (see Reports of Cost-effectiveness Analyses and Decision Analyses), case-control studies, and surveys with high response rates (see Survey Research). 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; any deviation from the trial protocol; details regarding patient consent; 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). A structured abstract is required; for more information, see instructions for preparing structured Abstracts for Reports of Original Data. Maximum length: 3000 to 3500 words of text (not including acknowledgment, abstract, tables, figures, references, and online-only material) with no more than a total of 5 tables and/or figures.

Clinical Trial

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. Interventions include but are not limited to drugs, surgical procedures, devices, behavioral treatments, process-of-care changes, and the like. All manuscripts reporting clinical trials must include a copy of the trial protocol including the complete statistical analysis plan (see Protocols), a flow diagram (Figure), and a completed trial checklist (see CONSORT Flow Diagram and Checklist). All clinical trials must be registered at an appropriate online public registry (see Trial Registration requirements).

For additional guidance on preparing manuscripts reporting cluster trials, noninferiority and equivalence trials, and pragmatic trials, see Extensions of the CONSORT Statement. Each manuscript should clearly state an objective or hypothesis; the 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 main outcome measures; the main results of the study; a discussion section placing the results in context with the published literature and addressing study limitations; and the conclusions. A structured abstract is required, and trial registration information (name, number, and URL) must be listed at the end of the abstract; for more information, see instructions for preparing structured Abstracts for Reports of Original Data. Maximum length: 3000 to 3500 words of text (not including acknowledgment, abstract, tables, figures, references, and online-only material) with no more than a total of 5 tables and/or figures.

Meta-analysis

These manuscripts are systematic, critical assessments of literature and data sources pertaining to clinical topics, emphasizing factors such as cause, diagnosis, prognosis, therapy, or prevention. All articles or data sources should be searched for and selected 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. A structured abstract is required; for more information, see instructions for preparing structured Abstracts for Meta-analyses. Maximum length: 3000 to 3500 words of text (not including acknowledgment, abstract, tables, figures, references, and online-only material), with no more than a total of 5 tables and/or figures and no more than 50 to 75 references.

Reviews

Systematic reviews 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. Reviews should include the clinical question or issue and its importance for general medical practice, specialty practice, or public health; description of how the relevant evidence was identified, assessed for quality, and selected for inclusion; synthesis of the available evidence such that the best-quality evidence (eg, well-conducted clinical trials, meta-analyses, and prospective cohort studies) should receive the greatest emphasis; and discussion of controversial aspects and unresolved issues. The specific type of study or analysis, population, intervention, exposure, and tests or outcomes should be described for each article or data source. A structured abstract is required; for more information, see instructions for preparing structured Abstracts for Reviews. Maximum length: 3500 words of text (not including acknowledgment, abstract, tables, figures, references, and online-only material), with no more than a total of 4 tables and/or figures and no more than 50 to 75 references.

Case Report/Case Series

These unique, first-time reports of a clinical case series must be of unusual quality and special interest to merit publication, and must have no more than 5 authors. A structured abstract is required with the following headings: Importance, Observations, Conclusions and Relevance; for more information, see instructions for preparing structured Abstracts for Case Reports/Case Series. Maximum specifications: 1000 to 1200 words, 10 to 15 references, no more than a total of 4 tables and/or figures.

Viewpoint

Viewpoints provide expert analysis of and perspective on a specific article or series of articles in the journal, or on a topic of special interest to practitioners in general internal medicine and internal medicine subspecialties. Viewpoints should be well focused, scholarly, clearly presented, and must have no more than 3 authors. 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. Viewpoints not meeting these guidelines will not be considered.

Invited Commentary

Invited Commentaries, written by experts in the topic discipline, are insightful and objective articles that frame the content and clinical implications of a specific article in a context that will help clinicians interpret the relevant findings. Maximum specifications: up to 1200 words of text, or 1000 words of text with 1 small table or figure; up to 7 references, up to 2 authors.

Evidence to Practice

These articles aim to make high-quality evidence reports accessible to clinicians and to describe the impact of the findings on clinical care. Evidence to Practice manuscripts should be focused, brief, and organized under the following headings: Source of Review, Background, Summary of Findings, Limitations on the Evidence, Conclusions, References. Maximum specifications: 3 authors; 1000 words of text with no more than 1 table and/or figure; 1200 words of text if no table or figure; and no more than 6 to 8 references. In general, inclusion of 1 table or figure is preferred.

Editorials

Editorials are commentaries written by the editors or by their invitation that focus on 1 or a series of articles in the JAMA Internal Medicine or on topics of special importance to our readership. Maximum specifications: 1200 to 1500 words (excluding title, byline, and references), and no more than 1 table and/or figure with reduction in word count; 10 to 15 references; 1 to 2 authors.

Special Communication

These in-depth, scholarly communications describe in a scholarly, thorough, well-referenced, systematic or evidence-based manner any important topic in internal medicine, public health, research, ethics, health policy, or health prevention that is of interest to our readership and the wider health care community. A narrative (unstructured) abstract of 200 words or fewer is required. Maximum length: 3000 words of text (not including acknowledgment, tables, figures, or references) with no more than a total of 4 tables and/or figures and no more than 50 references.

Less Is More

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

Perspectives

These brief “Less Is More” articles present patients’ and physicians’ perspectives on their health care experiences, with special emphasis on examples when more care is not always better, even to the point where it is perceived as harmful. Maximum specifications: up to 1200 words of text—or 1000 words with 1 small table and/or figure (excluding title, byline, and references); no more than 7 references; up to 3 authors.

Teachable Moments

The Teachable Moments series is a subsection of Perspectives and is designed to encourage trainees at all levels to submit articles that bring attention to the harms that can result from medical overuse and from underuse of needed medical interventions. Our long-term aim is to promote appropriate medical care. Each Teachable Moments manuscript should include a clinical vignette headed “Story From the Front Lines” (an engaging story with enough clinical information for JAMA Internal Medicine readers to understand the clinical issues) and a summary of the clinical issues headed “Teachable Moment” (a succinct summary of the clinical issues, stating the evidence for over-testing or under-testing or treatment and suggesting an alternative approach). The manuscript should be submitted as a Perspective and should be given a title that reflects the specific focus and a subtitle of "A Teachable Moment." The first author must be a trainee (professional student, intern, resident, fellow, masters or doctoral student, or postdoctoral student). Articles should not exceed 800 words and 5 references, and should have a maximum of 3 authors. A signed Patient Permission form must be included at the time of initial submission.

Challenges in Clinical Electrocardiography

These peer-reviewed articles demonstrate challenges and pitfalls in electrocardiography (ECG) interpretation for practitioners in the office, hospital, and prehospital setting. Examples include misinterpreted ECG findings, artifacts, limitations of computer interpretations, and controversies. The goal is educational, and the focus is on presentations and findings that represent a risk of potential misdiagnosis or treatment. Each submission should include a brief text introduction, 1 ECG image, 1 or 2 pertinent questions, and an anonymized case discussion and patient course, if applicable. Maximum specifications: 1000 words, consisting of no more than 200 words for the case presentation and no more than 800 words for the case discussion and patient course, if applicable; 5 bulleted summary points; no more than 10 references; no more than 3 authors. Images: Minimum 5 inches wide and 350 dpi. Labels should be added to electronic images only on a separate layer or by importing into applications such as Word, PowerPoint, or Illustrator; however, original image files must also be submitted. (For additional information, see Technical Requirements for Figures.)

Letter to the Editor

Letters discussing a recent JAMA Internal Medicine article should be submitted within 4 weeks of the article’s publication in print.16 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 JAMA Internal Medicine article. No figures will be considered. They should be double-spaced and a word count should be provided. 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 e-mail 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 will be published at the discretion of the editors and are subject to abridgement and editing for style and content. Alternatively, comments on papers can be submitted using the Comments tab on the online article. Comments promote discussion among readers and authors but are not indexed in PubMed.

Letter in Reply

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

Research Letter

Research Letters reporting original research should not exceed 600 words of text (not including acknowledgment, table, figure, or references) and 6 references and may include up to 2 tables or figures. Online supplementary material is not allowed. Research letters may have no more than 7 authors. The text should include the full name, academic degrees, and a single institutional affiliation for each author and the e-mail 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: To the Editor (which serves as an introduction), Methods, Results, and Discussion. Research Letters should be double-spaced and a word count should be provided with each letter. They should not include an abstract, but otherwise should follow all of the guidelines in Manuscript Preparation and Submission Requirements. Letters not meeting these specifications are generally not considered.

Images From Our Readers

We welcome the submission of images from members of the health care community that have special significance to them and that would be of interest and relevance to our readers. Each image should carry with it a short, descriptive caption. We limit submissions to 8 per calendar year and no more than 4 in any one month. The permission form, which applies to this section only, is available here.

Manuscript Preparation and Submission Requirements

Presubmission inquiries will not be considered. Manuscript submission for initial review ensures the thoughtful assessment by the editors of its appropriateness for JAMA Internal Medicine, and this determination is made within 5 to 7 days.

Manuscript Submission

Manuscripts should be submitted online via the online manuscript submission and review system. At the time of submission, complete contact information (affiliation, postal/mail address, e-mail address, telephone and fax numbers) for the corresponding author is required. First and last names, e-mail addresses, and institutional affiliations of all coauthors are also required. Manuscripts submitted through the online system should not also be submitted by mail or e-mail. 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 Letters to the Editor and Invited Commentaries will be sent an Authorship Form to complete and submit (see sample Authorship Form). All authors of all other manuscripts will receive an Authorship Form at the time of request for/receipt of a revision to their manuscript. See Manuscript Checklist, Manuscript Preparation and Submission Requirements,1,2 and other details in these instructions for additional requirements.

Cover Letter

Include a cover letter and complete contact information for the corresponding author (affiliation, postal/mail address, e-mail address, and telephone and fax numbers) and whether the authors have published or submitted any related papers from the same study (see Duplicate/Previous Publication or Submission). The cover letter should also include the intent of the manuscript and why it is suitable for publication in JAMA Internal Medicine and a list of author contributions. The cover letter should not be a duplication of the title page of the manuscript or of the author response letter.

Manuscript Style

Manuscripts should be prepared in accordance with the AMA Manual of Style, 10th edition,2 and/or the Uniform Requirements for Manuscripts Submitted to Biomedical Journals.1

Manuscript Components

Include in the manuscript file a title page, abstract, text, acknowledgments, references, and appropriate figure legends and tables. Start each of these sections on a new page, numbered consecutively, beginning with the title page. Include figures as separate files.

Recommended File Sizes

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).

Manuscript File Formats

For submission and review, acceptable manuscript file formats include Word. 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). All copy must be typed double-spaced with 1-inch margins, numbered consecutively, beginning with the title page. Do not use line numbering. Double-space throughout, including title page, abstract, text, acknowledgments, references, legends, and tables.

Title Page

Titles should not exceed 75 characters, including punctuation and spacing. Avoid using declarative sentences or questions as titles. Avoid abbreviations in the title, abstract, and text.

The title page should be the first page of your main 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; authors’ contributions and conflict of interest disclosures; and word count (not including title, abstract, acknowledgments, references, tables, and figure legends); and financial disclosure information as a footnote. Specify the address to which requests for reprints should be sent.

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

Title

Titles should be concise, specific, and informative and should contain the key points of the work.2(p8) Please limit the length of titles to 150 characters for reports of research and other major articles and 100 characters for Editorials, Viewpoints, Commentaries, and Letters. For scientific manuscripts, overly general titles are not desirable and questions and declarative sentences should be avoided. 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.

Abstracts

Include a structured abstract of no more than 350 words for reports of original data from clinical or basic science investigations and reviews (including meta-analyses). Abstracts should be prepared in JAMA Network style—see instructions for preparing structured abstracts below. Original Investigations, Reviews, and Special Articles require abstracts (abstracts for Special Articles should be unstructured, no more than 200 words, and summarize the objective, main points, and conclusions of the article). Abstracts are not required for other types of articles (see the Categories of Articles section).

All reports of original data, systematic reviews, and meta-analyses should be submitted with structured abstracts as described below. No information should be reported in the abstract that does not appear in the text of the manuscript. The following is adapted from “More informative abstracts revisited.”17

Because abstracts are the most visible part of a manuscript, special attention will be paid to the quality of abstract. Authors are expected to adhere to the quality criteria for abstracts, as outlined in “The Need for Concrete Improvement in Abstract Quality”18 and “Writing Informative Abstracts for Journal Articles.”19 These criteria are summarized in the following tabulation (adapted from JAMA18):

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

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. State the years of the study and the duration of follow-up. 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, general community, a primary care or referral center, private or institutional practice, or ambulatory or hospitalized care.

Participants: State the clinical disorders, important eligibility criteria, and key sociodemographic features of patients. The numbers of participants and how they were selected should be provided (see below), including the number of otherwise eligible individuals who were approached but refused. 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. In intervention studies, the number of patients withdrawn because of adverse effects should be given. 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.

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(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 measurements unfamiliar to a general medical readership.

Results: The main outcomes of the study should be reported and quantified, including baseline characteristics and final included/analyzed sample. Include absolute numbers and measures of absolute risks (such as increase/decrease or absolute differences between groups), along with confidence intervals (for example, 95%) or P values. Approaches such as number needed to treat to achieve a unit of benefit may be included when appropriate. 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, and all surveys should include response 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, the name of the trial registry, registration number, and URL of the registry must be included.

Abstracts for Meta-analyses:

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 review question.

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.

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, abstract booklets, 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 used for abstracting data and assessing data quality and validity (such as criteria for causal inference) and whether data were pooled using a fixed-effects or random-effects model. The method by which the guidelines were applied should be stated (for example, independent extraction by multiple observers).

Main Outcome(s) and Measure(s): Indicate the primary study outcome(s) and measurement(s) as planned before data collection began. If the manuscript does not report the main planned outcomes of a study, this fact should be stated and the reason indicated. State clearly if the hypothesis being tested was formulated during or after data collection. Explain outcomes or measurement unfamiliar to a general medical readership.

Results: State the main quantitative results of the review, including baseline characteristics and final included/analyzed studies and/or sample(s). Include absolute risks whenever possible (such as increase/decrease or absolute differences between groups), along with confidence intervals (for example, 95%) or P values. . Meta-analyses should state the major outcomes that were pooled and include odds ratios or effect sizes and, if possible, sensitivity analyses. Numerical results should be accompanied by confidence intervals, if applicable, and exact levels of statistical significance. 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 Reviews:

Review articles should include an abstract of no more than 300 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 heath.

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 informatio sources used, including the search strategies, years searched, and other sources of material, such as subsequent reference searches of retrieved articles. Methods used for quality assessment and inclusion of identified articles should be explained.

Findings: The major findings of the review of the clinical issue or topic should be addressed in an evidence-based, objective, and balanced fashion, with the highest quality evidence available receiving the greatest emphasis.

Conclusions and Relevance: The conclusions should clearly answer the questions posed if applicable, be based on available evidence, and emphasize how clinicians should apply current knowledge.

Abstracts for Case Report/Case Series:

Abstracts that accompany publication of Case Report/Case Series should be no longer than 200 words and described under 3 headings.

Importance: An overview of the topic and discuss the main objective or reason for this report. Why was this manuscript submitted for publication and how is the information included unique?

Observations: The principal observations, findings, or results. Numerical results should include confidence intervals and levels of statistical significance if applicable. The Observations section would include an explicit description of the “design” (case report or case series), information about setting and dates of collection of observations (for example, a report of a single case… or a report of a series of xxx consecutive patients at xyz institution….from 2008-2013”), key demographic information, and a brief summary of the observations.

Conclusions and Relevance: The conclusions of the report that are supported by the information, along with clinical applications, avoiding overgeneralization. The need for further studies or additional research may be suggested.

Style of Writing

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

Statistics

Authors are encouraged to consult “Reporting Statistical Information in Medical Journal Articles.”20 Describe statistical methods with enough detail to enable a knowledgeable reader with access to the original data to reproduce the reported results. When possible, quantify findings and present them with appropriate indicators of measurement error or uncertainty (such as confidence intervals). Avoid relying solely on statistical hypothesis testing, such as the use of P values, which fails to convey important quantitative information. Give details about randomization. Describe the methods for and success of any blinding of observations. Report complications of treatment. Give numbers of observations. Report losses to observation (such as dropouts from a clinical trial). For multivariate models, report all variables included in models, and report model diagnostics and proportion of variance explained by both individual variables and the complete model.

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

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

Abbreviations

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.

Units of Measure

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

Names of Drugs, Devices, and Other Products

Use nonproprietary names of drugs, devices, and other products, unless the specific trade name of a drug is essential to the discussion.2(pp567-569)

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

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

Gene Names, Symbols, and Accession Numbers

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

Reproduced Material

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

References

Authors are responsible for the accuracy and completeness of the references and for their correct text citation. Cite all references in the text or tables. 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 style2(pp39-79) 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:

  • 1. Garbutt JM, Banister C, Spitznagel E, Piccirillo JF. Amoxicillin for acute rhinosinusitis: a randomized controlled trial. JAMA. 2012;307(7):685-692.
  • 2. Steinbrook R, Ross JS. “Transparency reports” on industry payments to physicians and teaching hospitals [published online February 14, 2012]. JAMA. doi:10.1001/jama.2012.211.
  • 3. 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.
  • 4. 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.

Unpublished data and personal communications should not be listed as references. Authors who name an individual as a source for information in a personal communication, be it through conversation, a letter, e-mail message, or telephone call, should obtain written permission from the named individual.

The reference numbers in the reference list (if any) should be keystroked. Do not let the word-processing program generate the reference numbers, using such features as automatic footnotes or endnotes.

Web References

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

Tables

Number all tables in the order of their citation in the text. Include a succinct title for each table (a brief phrase, preferably no longer than 10-15 words). Include all tables at the end of the manuscript file. Refer to Categories of Articles because there may be a limit on the number of tables for the type of manuscript. If a table must be continued, repeat the title on the second page, followed by “(continued).” Tables should be original work and only rarely should they be reproduced material.

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

Title all tables and number them in order of their citation in the text. Make certain each item in the table is in its own table cell. Do not use paragraph returns (to start new rows) or tabs (to start new columns) to format the table.

Instructions for Table Creation

These instructions are available here.

Figures

Number all figures (graphs, charts, photographs, and illustrations) in the order of their citation in the text. Include a legend for each figure and illustration. Figures and illustrations should be original work and only rarely should they be reproduced material. For initial manuscript submissions, figures must be of sufficient quality for editorial assessment and peer review. Figures should be submitted as individual digital files. If the manuscript is accepted, authors will be asked to provide figures that meet the Technical Requirements for Figures. Online-only figures will not be edited or re-created (see Online-Only Supplements and Multimedia).

  • • For original drawings or illustrations, provide a signed copyright transfer (see box on the Authorship Form) from the illustrator(s). The illustrator will be contacted with instructions for completing the copyright transfer at the appropriate time.
  • • For images and illustrations originally created digitally, see Technical Requirements for Figures.

Image Integrity

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

When inappropriate image adjustments are detected by JAMA Internal Medicine 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 these standards.

Guidelines for Figures in Accepted Manuscripts:

These guidelines are available here.

Acceptable Figure File Size

To reduce the time that it takes to upload files to the JAMA Internal Medicine submission site and for reviewers to download files from the site, we recommend that the file size of figures be compressed before uploading them. This can be done by using compression software or by decreasing the resolution of individual files.

Acceptable Figure File Formats

At submission, the following file formats are acceptable: AI, BMP, DOC, EMF, EPS, JPG, PDF, PPT, PSD, TIF, WMF, or XLS. Figures must be uploaded as separate files, not embedded in the manuscript text file, for submission purposes.

Figure Titles and Legends

At the end of the manuscript, include a title and legend for each figure. The figure title should be a brief descriptive phrase, preferably no longer than 10 to 15 words. The figure legend can be used for a brief explanation of the figure or markers if needed (preferred maximum length, 40 words) 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.

Number of Figures

Refer to Categories of Articles as there may be a limit on the number of figures for the type of manuscript.

Online-Only Supplements and Multimedia

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

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

Online-only material should be submitted in a single Word document (Supplement) with pages numbered consecutively. Each element included in the online-only material should be cited in the text of the main manuscript (eg, “see eTable 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 Supplement.

Online-Only Text

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

Online-Only References

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

Online-Only Tables

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

Online-Only Figures

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

eAppendixes

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

Video

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

  • Acceptable file formats: .mov, .wmv, .mpg, .mpeg, .mp4, or .avi
  • Maximum file size: 25 MB
  • Minimum dimensions: 320 pixels wide by 240 pixels deep 480 pixels wide; height may vary
  • Desired aspect ratio: 4:3 (standard) or 16:9 (widescreen)
  • Maximum length: 5 minutes
  • Verify that the videos are viewable in QuickTime or Windows Media Player.

For each video, provide a citation in the appropriate place in the manuscript text and include a title (a brief phrase, preferably no longer than 10-15 words) and a caption at the end of the manuscript. In the video caption, specify the video file format and briefly describe the content of the video. The same title and caption must be entered in the designated fields on the web-based 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 with the manuscript the Patient Permission form completed and signed by the patient. See also Identification of Patients in Descriptions, Photographs, Video, and Pedigrees.

If the author does not hold copyright to the video, the author must obtain permission for the video to be published in JAMA Internal Medicine. This permission must be for unrestricted use in all print, online, and licensed versions of JAMA Internal Medicine. (See Permission to Reproduce Copyright-Protected Material Guidelines.) Submit the completed form to the editorial office.

Postacceptance requirements: If the manuscript and accompanying video(s) are accepted for publication, journal staff will contact you to request the original full-size video without superimposed text, labels, arrows, logos, or other graphical elements. As needed, video files may be edited according to journal style. Note: There is no minimum file size requirement once it has been accepted.

Please see Additional Guidelines and Considerations for Optimal Video Quality.

Audio

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

  • Audio files may be submitted as an mp3 file, no larger than 10 MB.
  • Acceptable file formats: .mp3, .wav, or .aiff
  • Maximum file size: 10 MB
  • To achieve the best quality, when saving audio files as an mp3, 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 a citation in the appropriate place in the manuscript text and include a title (a brief phrase, preferably no longer than 10-15 words) and a caption at the end of the manuscript.

Postacceptance requirements: If the manuscript and accompanying audio file(s) are accepted for publication, journal staff will contact you to request the original uncompressed audio file. Note: There is no minimum file size requirement once it has been accepted.

Manuscript Checklist

  • 1. Cover letter (see Cover Letter), including complete contact information for the corresponding author and whether the authors have published or submitted any related papers from the same study (see Duplicate/Previous Publication or Submission). The cover letter should also include the intent of the manuscript and why it is suitable for publication in JAMA Internal Medicine and a list of author contributions.
  • 2. On the title page, include a word count for text only, exclusive of title, abstract, acknowledgments, references, tables, and figure legends.
  • 3. On the title page, designate a corresponding author and provide his or her complete address, telephone and fax numbers, and e-mail address.
  • 4. Include statement signed by corresponding author that written permission has been obtained from all persons named in the acknowledgment.
  • 5. For clinical trials, add trial registry name, registration number, and the URL for the registry. Include the CONSORT Checklist and flow diagram for randomized trials.
  • 6. For systematic reviews, include the PRISMA flow diagram and checklist.
  • 7. Provide an abstract that conforms to the required abstract format (see specific Categories of Articles).
  • 8. Double-space manuscript (text and references) and leave right margins unjustified (ragged). Do not use line numbering.
  • 9. For reports of original data, include statement from at least 1 named author, but no more than 2 named authors, that she or he “had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis” in the Acknowledgment section at the end of the manuscript.
  • 10. Include all authors’ potential conflicts of interest, including relevant financial interests, activities, relationships, and affiliations in the Acknowledgment section of the manuscript. The corresponding author is responsible for ensuring that the disclosure information in the Acknowledgment section of the manuscript is consistent with that reported in each author’s Authorship Form or attachment to the Authorship Form.
  • 11. Include all sources of financial and material support and assistance (eg, grant identification, transfer agreement) along with detailed information on the roles of each sponsor or funder in each of the following: “design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript” in the Acknowledgment section of the manuscript.
  • 12. In the Acknowledgment section of the manuscript, include the names, academic degrees, affiliations, and specific contributions of all persons who have contributed to the work reported in the manuscript (eg, data collection, analysis, writing or editing assistance, review of manuscript) but who do not fulfill authorship criteria, and also indicate whether any compensation was received for such contributions. Written permission must be obtained from all persons named in the Acknowledgment section and the corresponding author must confirm that such written permission has been obtained (see also the Acknowledgment statement in the Authorship Form that must be signed by the corresponding author).
  • 13. Include written permission from each individual identified as a source for personal communication.
  • 14. Include informed consent forms for identifiable patient descriptions, photographs, and pedigrees.
  • 15. If appropriate, include information on institutional review board/ethics committee approval or waiver and informed consent.
  • 16. The reproduction of material (including tables and figures) that was previously published is discouraged. Original material should be provided, except under extraordinary circumstances.
  • 17. Include written permission from publishers (or other copyright owner) to reproduce or adapt previously published content (eg, tables, figures, substantial portions of text) in JAMA Internal Medicine (in print, online, and licensed versions) (see Permission to Reproduce Copyright-Protected Material Guidelines).
  • 18. Figures uploaded as separate file (to be merged by the system); tables included in the main manuscript file; online-only material uploaded as 1 separate supplemental file..
  • 19. Check all references for accuracy and completeness. Put references in proper format in numerical order, making sure each is cited in sequence in the text. It is advised not to use auto-numbering reference software.
  • 20. Include for each table and figure and all online-only material a succinct title (a brief phrase, preferably no longer than 10-15 words) and an explanatory legend as needed.
  • 21. Review more detailed instructions for specific Categories of Articles.

REFERENCES

  • 1. International Committee of Medical Journal Editors. Recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals. http://www.icmje.org. Updated 2013. Accessed December 20, 2013.
  • 2. Iverson C, Christiansen S, Flanagin A, et al. American Medical Association Manual of Style: A Guide for Authors and Editors 10th ed. New York, NY: Oxford University Press; 2007. http://www.amamanualofstyle.com
  • 3. Flanagin A, Fontanarosa PB, DeAngelis CD. Authorship for research groups. JAMA. 2002;288(24):3166-3168. Medline
  • 4. DeAngelis CD, Fontanarosa PB, Flanagin A. Reporting financial conflicts of interest and relationships between investigators and research sponsors. JAMA. 2001;286(1):89-91. Medline
  • 5. Fontanarosa PB, Flanagin A, DeAngelis CD. Reporting conflicts of interest, financial aspects of research, and role of sponsors in funded studies. JAMA. 2005;294(1):110-111. Medline
  • 6. DeAngelis CD, Drazen JM, Frizelle FA, et al; International Committee of Medical Journal Editors. Clinical trial registration: a statement from the International Committee of Medical Journal Editors. JAMA. 2004;292(11):1363-1364. Medline
  • 7. Deangelis CD, Drazen JM, Frizelle FA, et al; International Committee of Medical Journal Editors. Is this clinical trial fully registered? A statement from the International Committee of Medical Journal Editors. JAMA. 2005;293(23):2927-2929. Medline
  • 8. Moher D, Schulz KF, Altman D; CONSORT Group (Consolidated Standards of Reporting Trials). The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomized trials. JAMA. 2001;285(15):1987-1991. Medline
  • 9. Standard Definitions: Final Dispositions of Case Codes and Outcome Rates for Surveys. 6th ed. Lenexa, KS: American Association for Public Opinion Research; 2009. http://www.aapor.org/Standard_Definitions/1481.htm. Accessed October 21, 2009.
  • 10. Winker MA. Measuring race and ethnicity: why and how? JAMA. 2004;292(13):1612-1614. Medline
  • 11. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191-2194. http://jama.jamanetwork.com/article.aspx?articleid=1760318. Accessed January 2, 2014.
  • 12. Weatherall D. The use of nonhuman primates in research. December 2006. http://www.acmedsci.ac.uk/more/news/the-use-of-non-human-primates-in-research/. Accessed February 11, 2011.
  • 13. Kilkenny C, Browne WJ, Cuthill IC, Emerson M, Altman DG. Improving bioscience research reporting: the ARRIVE guidelines for reporting animal research. PLoS Biol. 2010;8(6):e1000412. doi:10.1371/journal.pbio.1000412. Medline
  • 14. Atlas R, Campbell P, Cozzarelli NR, et al; Journal Editors and Authors Group. Statement on scientific publication and security. Science. 2003;299(5610):1149. http://www.sciencemag.org/site/feature/data/security/statement.pdf. Accessed July 12, 2011.Medline
  • 15. Fontanarosa PB, Flanagin A, DeAngelis CD. Update on JAMA’s policy on release of information to the public. JAMA. 2008;300(13):1585-1587. Medline
  • 16. Golub RM. Correspondence course: tips for getting a letter published in JAMA. JAMA. 2008;300(1):98-99.
  • 17. Haynes RB, Mulrow CD, Huth EJ, Altman DG, Gardner MJ. More informative abstracts revisited. Ann Intern Med. 1990;113(1):69-76. Medline
  • 18. Winker MA. The need for concrete improvement in abstract quality. JAMA. 1999;281(12):1129-1130. Medline
  • 19. Cummings P, Rivara FP, Koepsell TD. Writing informative abstracts for journal articles. Arch Pediatr Adolesc Med. 2004;158(11):1086-1088. Medline
  • 20. Cummings P, Rivara FP. Reporting statistical information in medical journal articles. Arch Pediatr Adolesc Med. 2003;157(4):321-324. Medline

Last updated July 17, 2014.