© The Association of Anaesthetists of Great Britain and Ireland
Edited By: Dr A. A. Klein, Cambridge, UK
Impact Factor: 3.794
ISI Journal Citation Reports © Ranking: 2015: 5/31 (Anesthesiology)
Online ISSN: 1365-2044
NIH Public Access Mandate
For those interested in the Wiley policy on the NIH Public Access Mandate, please visit our policy statement
WHY PUBLISH IN ANAESTHESIA?
As a new or established author you are looking for the best place to submit your work. We recognise the wide range of specialty journals that currently exist, and are determined to be at the top of the list when authors make their decision. Click here to read the main reasons why we feel that authors should consider publication of their best work in Anaesthesia.
NOTICE TO CONTRIBUTORS
Anaesthesia is the official journal of the Association of Anaesthetists of Great Britain and Ireland and is published monthly. It is international in scope and comprehensive in coverage. It publishes original, peer-reviewed articles on all aspects of general and regional anaesthesia, intensive care and pain therapy, including research on equipment. Although primarily a clinical journal, we welcome submissions of animal or basic science papers if the authors can demonstrate their clinical relevance.
The Editorial Board of Anaesthesia supports the statement on Geopolitical Intrusion on Editorial Decisions, by the World Association of Medical Editors and is a member of the Committee on Publication Ethics.
All authors must meet the requirements of authorship as set out in the guidelines of the International Committee of Medical Journal Editors, i.e. all have made a substantial contribution to the acquisition of data and its interpretation AND been involved in drafting the manuscript or revising it. All proposed changes in authorship after submission must be explained, and any changes can only occur with the explicit permission of the Editor-in-Chief. Authors are advised that all submissions are checked for redundant publication and plagiarism using specific software.
TYPES OF MANUSCRIPT
Anaesthesia has the following regular sections: Editorials, Original Articles, Reviews and Correspondence. Case Reports, Historical Articles or Special Articles may also be included. Editorials are often commissioned but authors are encouraged to contact the Editor-in-Chief if they wish to discuss potential topics. Authors seeking to submit official Clinical Guidelines, Consensus Statements, etc. should refer to specific guidance here.
Most editorials are commissioned by the editorial team, but some unsolicited editorials are accepted. Our editorials are primarily opinion pieces, although they should be backed up by evidence where available. The word count is usually around 2000 words excluding references. A figure or table (or even more than one) may be included, and most editorials are written by one or two authors; more than two would be unusual (but not unheard of).
Most original articles are between 3000 and 4000 words, and up to 30 to 40 references. It is very rare that we publish articles longer than this. For further information about layout, format and style, please see below. We are predominantly a clinical journal, however we do occasionally publish laboratory and animal research, but only where there is a clear clinical focus. We also occasionally publish articles describing quality improvement exercises or audit cycles.
Most reviews are not commissioned; the editorial team is willing to discuss suggestions of topics for reviews if contacted (firstname.lastname@example.org).
Anaesthesia welcomes both narrative and systematic reviews of potential interest to our readers. Even a narrative review should be a structured assessment of the literature, and should include a description of how articles have been selected, and if appropriate a full search strategy. It would also need some analysis and comment, not just a listing of the literature and reporting the results. It should also include an analysis of the quality of the literature. It would usually be around 4000-5000 words of text, excluding references.
Systematic reviews should ideally be presented according to the PRISMA statement and prospectively registered (e.g. on PROSPERO). Larger, more inclusive reviews (not, for instance, limited by the type of surgery) may be preferable to smaller ones with a small number of studies. Subgroup analyses may be performed to explore group differences, but only if there are sufficient studies. Scoring of methodological quality should be performed with the Cochrane Collaboration risk of bias tool rather than numerical scores (e.g. Jadad score). Authors should consider how excluding low quality studies might change the overall results. Heterogeneity should be explored by consideration of individual studies, by appropriate sensitivity analysis, or by meta-regression if the number of included studies allows. For more information, please see Smith AF, Carlisle J. Reviews, systematic reviews and Anaesthesia. Anaesthesia 2015; 70: 644-50.
There are two routes for sending correspondence:
- Please submit all responses to material published in Anaesthesia via the dedicated correspondence website; do not send them to the Editorial Office. Responses should be submitted following the guidance on the website and using the online form provided, not uploaded as a Word file.
- Please submit all correspondence that is not in response to material published in Anaesthesia to the Editorial Office (see below), clearly indicating that it is a letter to the Editor-in-Chief.
Please note that work previously published or submitted as a conference abstract must not be submitted as correspondence without prior discussion with the Editor-in-Chief.
Case reports cannot be submitted directly to Anaesthesia. Authors wishing to submit a case report for publication should do so via theAnaesthesia Cases website, which is hosted by the AAGBI and may be reached at www.anaesthesiacases.org. Case reports will be considered for publication online at the website, and a proportion will be passed to Anaesthesia for possible publication in the Journal. Those not published by Anaesthesia will be passed back toAnaesthesia Cases for publication there. (N.B. case reports Anaesthesia Cases published in Anaesthesia Cases will not appear in Anaesthesia, and they may not be submitted for publication elsewhere).
Abstracts presented at specialist society meetings
Please note that the Journal no longer publishes abstracts from specialist society meetings. Abstracts presented at the AAGBI Winter Scientific Meeting, AAGBI Annual Congress and AAGBI Group of Anaesthetists in Training Annual Scientific Meeting will continue to be published as online supplements .
All other material
All other material should be submitted via email to the address below as an attachment (Word for Windows or rich text format - see below for information regarding Figures).
SUBMISSION OF MATERIAL
The Editors regret that failure to comply with the following requirements may result in a delay in publication of accepted papers, and strongly urge authors to use the following Checklist before submitting their work.
Before submitting your manuscript or item of correspondence, please check that you have:
Please do not attach files in .bmp, .docm or .rar format – these files will be filtered and/or rendered unreadable.
Submission in any other format may slow down the review/publication process but is possible for those authors who do not have access to the appropriate technology; if this applies, please contact the Editor-in-Chief in advance at the journal’s Editorial Office:
Dr A Klein
Association of Anaesthetists of Great Britain & Ireland
21 Portland Place
W1B 1PY, UK
Covering letter/Declaration Form
No covering letter is required but all manuscripts must be accompanied by an Authors’ Declaration Form, which may be downloaded here.
The maximum number of authors is nine; if there are additional contributors, the journal will acknowledge them in an Appendix to the published paper and their names will be indexed appropriately on PubMed.
We will not accept any submission that is not accompanied by a fully completed form, and failure to follow these Author Guidelines will significantly delay processing of your manuscript for review.
For papers that are subsequently accepted for publication, all authors are required to sign against their entry on the final page of the declaration form to signify their agreement to inclusion in the authorship list. This can be by way of hand-written or digital/electronic signature.
REVIEW AND PUBLICATION PROCESS
All papers, editorials and letters are reviewed by the Editor-in-Chief and at least one Editor, plus external reviewers as deemed appropriate. The Editor-in-Chief’s verdict on acceptance or rejection is final. Papers submitted with one of the Editorial Board members as an author require an additional external review before acceptance. The median time from submission to preliminary verdict is under a week; the time from full acceptance to online publication is usually 1-2 months and to print publication is usually 2-3 months.
When a paper is accepted, the author identified as the formal corresponding author for the paper will receive an email prompting him/her to login into Author Services, where he/she can complete a copyright form or licence agreement on behalf of all authors on the paper via the Wiley Author Licensing Service (WALS). The type of licence/agreement will depend on whether the paper is to be published Open Access, and whether (and by whom) the study has been funded. More details can be obtained here .
Once accepted for publication, the manuscript will be sub-edited by an Editor; this usually involves some alterations to clarify points and maintain house style. Rather than be excessively prescriptive, the Editorial team tries to be as helpful as possible at this stage – with the aim of improving your paper and its readability. The article is then sent to the publishers who will send a set of proofs to the author, Editor and finally the Editor-in-Chief. Changes by the authors at proof stage should be kept to a minimum; authors may be charged for excessive alterations.
Authors requesting to withdraw their manuscript at any stage after submission are required to provide a letter or email to the Editor-in-Chief, stating the reason for the request. All authors will be asked to confirm that they agree with the request, and with the stated reason. Please note that a manuscript can only be considered as no longer under consideration by Anaesthesia when this has been confirmed by the Editor-in-Chief.
For FAQs and tips about preparing and submitting manuscripts and more, and for services like automated email tracking for your article through production, please visit the Author Services website.
This is available to authors of primary research articles who wish to make their article available to non-subscribers on publication, or whose funding agency requires grantees to archive the final version of their article. With OnlineOpen the author, the author’s funding agency, or the author’s institution pays a fee to ensure that the article is made available to non-subscribers upon publication via Wiley Online Library, as well as deposited in the funding agency’s preferred archive. For the full list of terms and conditions, click here. Before acceptance, there is no requirement to inform the Editorial Office that you intend to publish your paper OnlineOpen if you do not wish to. All OnlineOpen articles are treated in the same way as any other article. They go through the Journal’s standard peer-review process and will be accepted or rejected based on their own merit. Any authors wishing to send their paper OnlineOpen will be required to complete the payment form.
Material storage policy
Please note that unless specifically requested, Wiley will dispose of all hard copy or electronic material submitted two months after publication. If you require the return of any material submitted, please inform the Editorial Office or Production Editor as soon as possible if you have not yet done so.
The Publisher, Editorial Board and Editors cannot be held responsible for errors or any consequences arising from the use of information contained in this journal. The views and opinions expressed do not necessarily reflect those of the Publisher, Editorial Board or Editors, neither does the publication of advertisements constitute any endorsement by the Publisher, Editorial Board and Editors of the products advertised.
PREPARATION OF MATERIAL
A typical manuscript will have the following sections in the following order:
The name and full postal address of the corresponding author should appear in the top left-hand corner. The rest of the page should follow this example:
Title of paper that does not state the conclusion or pose a question*
A. B. Author,1 C. D. Author2 and E. F. Author3
1 Position/designation of 1st author, primary institution, city, country.
2 Position/designation of 2nd author, primary institution, city, country.
3 Position/designation of 3rd author, primary institution, city, country.
Correspondence to: Dr Corresponding Author (incl. e-mail address)
*footnote if presented in part at any national or international meetings, with details including location and date.
Short title of up to 60 characters suitable for a running header
N.B. Place the superscript number after the commas in the list of authors. Please do not include authors’ qualifications. Please note that statements such as 'Author XX and Author YY both contributed equally to this work' are not used.
Each manuscript should have 3 to 5 keywords identified on the title page. Please only use keywords from this list here.
The title should describe the purpose and contents of the paper as well as possible; in general, this should not exceed 20 words. Include relevant key-words e.g. randomised controlled trial, prospective, observational, etc.
The Summary should follow the sequence of the main body of the text, i.e. introduction, methods, results, discussion, but should not be structured. It should briefly state the purpose of the study or investigation; basic procedures; important results (giving numbers studied, values for results with p values) including relevant findings from Results, Tables and Figures; and principal conclusions.
Use the same sequence when presenting the methods and results as in the main body of the text, always mention the groups in the same order, and ensure that the numbers in the Summary exactly match those in the main body; it may be preferable to write the summary after having finished writing the main paper, in order to ensure that these features match.
The Summary should only exceed 250 words in exceptional circumstances. Abbreviations should not be used except for units of measurement.
The Introduction should give a concise account of the subject’s background. Previously published work should only be quoted if it has a direct bearing on the present study. The Introduction should clearly and explicitly state the aims of the project.
A statement confirming Local Research Ethics Committee approval and written informed consent should be at the beginning of this section (see Ethical Considerations, below).
The Methods section must describe in sufficient detail the techniques and processes used so that the investigation can be interpreted and repeated by readers. Any modification of previously published methods should be described and the appropriate reference given. If the methods are commonly used, only a reference to the original source is required. If special equipment is used, then the manufacturer’s details (including town and country) should be given in parentheses. Drugs should be identified by their recommended international non-proprietary names (NB adrenaline and noradrenaline are used in preference to epinephrine and norepinephrine). Label groups in a way that is easy to follow; thus ‘propofol group’ and ‘thiopental group’ instead of ‘Group P’ and ‘Group T’. (Occasionally, abbreviated group titles may be better, e.g. ‘Group BLAB’ instead of ‘bupivacaine-lidocaine-adrenaline-bicarbonate group’). Remember to include inclusion/exclusion criteria and a justification of sample size. For randomised controlled trials, sufficient detail should be given on the following to allow readers to properly judge the risk of bias in the study: random sequence generation, allocation concealment, blinding (of patients, investigators, clinical staff, observers/assessors as appropriate) and handling of dropouts/withdrawals (intention to treat principle). Selective reporting bias will be assessed by comparison of the report with its protocol/trial registry entry (see above). The statistical methods used to investigate data should be given at the end of the Methods section (see below).
Express results as mean (SD), median (IQR [range]) or number (proportion) as appropriate. Results (including actual p values) must be presented for all measurements detailed in the Methods section, and in the same order. Results should not be repeated unnecessarily. For example, if a graph is used, do not also present the same information in the text or in a Table. Results should not be given to an unwarranted number of decimal places and 95% confidence intervals should be used where possible (see Statistics, below).
In randomised trials, baseline data (age, ASA physical status, duration of operation, etc.) should not be subjected to statistical comparison, since it is already known that the subjects were randomly allocated and that any difference is therefore due to chance. Describe characteristics and, if possible, allow for differences in the analysis and discussion.
When reporting the effect of an intervention, absolute risk (AR), relative risk (RR) and ‘number needed to treat’ (NNT) are more easily understood by readers and may be preferable to odds ratio (OR).
Graphs and tables should be appropriate for the data to be displayed. Tables usually convey more precise numerical information; graphs should be reserved for highlighting changes over time or between treatments.
Avoid judgemental terms such as ‘very’ or ‘highly’ significant.
Report actual p values, rather than ranges or limits (e.g. p=0.032, rather than p<0.05).
- Use ‘survival’ curves for outcomes that are time e.g. ‘time to extubation‘ or ‘time to hospital discharge’, particularly if it is the primary outcome
- Means should be expressed to a sufficient precision that they are different, with a minimum of three significant digits e.g. 372, 37.2, 3.72, 0.372 etc.
- Means should be followed by the standard deviation, not the standard error.
- Standard deviations do not need to be different and should be a minimum of two significant digits.
- Rates should be followed by proportion if the denominator exceeds 100, e.g. 90/200 (45%) but 9/20.
The Discussion should not merely recapitulate the results but should present their interpretation against a background of existing knowledge. Any conclusions must be warranted by the results. In general, avoid a paragraph headed ‘Conclusions’ that merely repeats a summary of the results. Also avoid ending with ‘further work is needed’ (it almost always is) unless you have specific areas of research to suggest.
The authors should acknowledge those who have made substantial contributions to the study or preparation of the manuscript but whose contributions do not fulfil the requirements for authorship (see above). For Case Reports, a statement ‘Published with the written consent of the patient(s)’ should be included. The trial registration site and number should be included in this section.
A statement should be made at the end of all manuscripts, stating any funding obtained and any potential competing interests. For example: ‘No external funding and no competing interests declared’ or ‘Funded by the XXXX Association, grant no. yyyy. Author AB has received payments from ZZZZ Ltd for consultancy work’, etc. as appropriate.
Information or data not directly a result of the study but necessary for the reader to understand the manuscript should be included as an Appendix. Examples might include copies of questionnaires used, recognised mathematical processes used to generate results or previously published and validated classification systems. All should be appropriately referenced and the authors must obtain permission from the copyright holders if the contents have been previously published.
References must be numbered sequentially as they appear in the text. References cited in figures or tables (or in their legends and footnotes) should be numbered according to the place in the text where that table or figure is first cited. Reference numbers in the text should be inserted after punctuation and one space, e.g. .
Where more than one reference is cited, these should be separated by a comma, e.g. [1, 4, 39]. For sequences of consecutive numbers, give the first and last number of the sequence separated by a hyphen, e.g. [22-25]. Please note that if references are not cited in order, the manuscript may be returned for amendment before it is passed on to the Editor for review.
Abstracts may be quoted as references so long as they have been published in peer-reviewed journals. Internet sites may be quoted as references by listing them in the normal way in the text (using Arabic numerals). Unpublished observations, personal communications and abstracts published only in proceedings of meetings should be quoted within the text of the manuscript, in parentheses. Please submit copies of any articles accepted for publication but not yet published. Information from manuscripts submitted but not yet accepted should be cited in the text as unpublished observations. References cited for the first time in Tables or Figures should be numbered in the sequence established by the first mention of the particular Table/Figure in the text. All references (including those in press) should be listed at the end of the text in the order they are quoted. For internet sites, please include the date accessed in parentheses. List all authors unless there are seven or more, in which case give the first three followed by ‘, et al.’ The journal title should be written out in full and in italics, followed by a semi-colon then a space followed by the edition number in bold (no sub-edition numbers please) then a colon then a space and finally the page numbers.
- Author AB, Author CD. Title of paper. Journal Title Written Out in Full in Italics 2010; 12: 123-4.
- Author AB, Author CD. Title of paper published as 'ePub ahead of print'. Journal Title Written Out in Full in Italics 2010 Dec 15; doi xx.xxxx/xxx.xxxxxx.
- Author AB, Author CD, Author EF, et al. Seven or more authors – what’s the point? (chapter title). In: Editor GH, Editor IJ, eds. Title of Book. Place: Publisher, 2010: 345-67.
- Author AB. Book Title, 5th edn. Place: Publisher, 2010.
- Author(s) of website. Title of document/page, 2010. www.URL.co.uk/link.pdf (accessed 01/01/2010).
The International Committee of Medical Journal Editors has stated that: "Authors are responsible for checking that none of the references cite retracted articles except in the context of referring to the retraction. For articles published in journals indexed in MEDLINE, the ICMJE considers PubMed the authoritative source for information about retractions. "Retracted articles can be identified by using the following search strategy in PubMed, e.g. for an author J. Smith enter "Smith*J AND retracted publication[pt]".
Include the Tables in the same file as the text, but after the References not in the middle of the text. Each Table should be on a separate page. Number the Tables consecutively with Arabic numerals. Each Table should have a brief Caption immediately above it; the Caption should provide enough information for readers to follow it without having to look through the text (e.g. ‘Characteristics of patients receiving vecuronium or rocuronium for caesarean section’ rather than just ‘Patients’ characteristics’). The Caption should explain whether the values refer to mean (SD), number (proportion), etc. Abbreviations should not be mentioned in the Caption without explanation. Abbreviations used in the body of the Table should be explained as footnotes in the order in which they are first mentioned.
For adults: age, weight, height and BMI should be expressed as mean (SD).
For children: age, weight, height and BMI should be expressed as median (IQR [range]).
The study groups should form the columns rather than the rows. If statistical comparisons are being made, a separate column with exact p values should appear.
Please supply each Figure as a separate file, rather than embed them within the body of the Word document or in the covering email, and preferably in TIFF or high-resolution JPEG format. We ask that they are both supplied at a resolution of 300 pixels per inch for photographs and 600 pixels per inch for line art or a combination of photograph and labelling. Please do not send image files larger than 10MB.
Please ensure related graphs have the same format (fonts, use of symbols, etc.), and that the groups are presented in the same order in each graph (and in the same order as in the rest of the manuscript). The same requirements for abbreviations and units apply as for those in the text. The title, plot frame, gridlines and legend box within the graph itself should be removed, with symbols and error bars explained in the Caption. Avoid the use of 3-D unless absolutely necessary. Please note that colour Figures (e.g. photographs, complex flow diagrams, etc.) may be used without charge.
Captions for Figures
Each Figure Caption should include an explanation of the symbols used to provide enough information for readers to follow it without having to look through the text.
Figure 1 Itching after surgery in patients receiving saline ( ) or chlorphenamine ( ). No significant difference between groups.
Is preferable to this:
Figure 1 Itching after surgery.
See notes below for ethical considerations relating to photographs.
Supporting Information (online only)
Additional material such as video clips, lengthy Appendices (e.g. extensive reference lists or mathematical formulae/calculations), etc. that are relevant to a particular article but not suitable or essential for the print edition of the Journal, may also be considered for publication. Please refer to all supporting information in the manuscript using Table S1, Figure S1, etc. and supply such information as separate files (i.e. not embedded within the main manuscript). Further information on suitable file formats, etc. may be found here.
Please note that Anaesthesia uses UK English spelling e.g. “ise” not “ize”, “anaes” not “anes”, etc. In general, we prefer a clear, precise style to jargon. Please avoid long, complicated sentences and the passive voice when the active is more appropriate (e.g. ‘We chose epidural anaesthesia because...’ instead of ‘Epidural anaesthesia was chosen by the authors because...’). Remove unnecessary clutter and focus on the actual message of each sentence; thus ‘Hypotension is important because...’ instead of ‘It would be remiss of us not to mention hypotension because...’). Remember that lungs are ventilated, not patients (nor are they intubated – their tracheas are).
Similarly, patients are not induced – anaesthesia is – or put on ventilators. Correct terms are tracheal (not endotracheal) tube and neuromuscular blocking drugs (not muscle relaxants). Please refer to recent issues of the Journal for preferred wording/spelling, e.g. “manikin” is preferred to “mannequin”, and “supraglottic airway device” is preferred to “extraglottic airway device”.
The abbreviation LMA is only to be used if referring to a specific device made by The Laryngeal Mask Company Ltd, and with the first mention in the Summary and in the main text highlighted by (R) and ‘LMA is a registered trade mark of The Laryngeal Mask Company Ltd, an affiliate of Teleflex Incorporated’ as a footnote. If used, the correct format is ‘LMAâ laryngeal mask’ for the first mention (n.b. not just ‘LMAâ’) and ‘LMA laryngeal mask’ thereafter. The same to apply to LMAâ Classic, LMAâ Flexible, LMAâ Fastrach (n.b. previously labelled ILMAâ), LMAâ ProSeal, LMAâ Supreme, LMAâ Unique (n.b. ‘cLMA’ not to be used). The generic term of ‘laryngeal mask’ should be used for describing inflatable-cuff supraglottic airways in general.
In general, the Journal does not encourage the use of abbreviations, especially in the Summary, since their frequent use makes papers cluttered and difficult to read. However, we will accept abbreviations in the following circumstances:
- Universal abbreviations that do not need to be written out in full when first mentioned in the text. These include abbreviations that appear in a large proportion of the articles published in the Journal, e.g. ASA, BMI, ECG, ICU, HDU, SD, SEM, 95% CI, IQR, ANOVA, SpO2, FIO 2, pH.
- Acceptable common abbreviations that can be used but should be written out in full at their first mention, e.g. CNS, CSF, HME, PEEP, PCA, SCBU, CTG, EEG, BIS, CVP, PAP, PCWP, ECT – unless they’re only mentioned a few times, in which case please spell them out throughout. Please do not use abbreviations that are clumsy or will be unfamiliar to the majority of readers, e.g. DI (difficult intubation), TTFB (time to first breath), etc.
- Acceptable abbreviations that do not need to be written out in full when first mentioned but whose use should be restricted to situations where space is limited, such as in formulae or in Tables and Figures, e.g. O2, CO2, N2O, HCO3-, Na+, K+, Mg2+.
Numbers and units
Numbers should be spelled out in full when they start a sentence, and when they are less than 10 (unless they are followed by units of measurement). Thus: ‘Thirteen days later, five patients each received 7 ml solution...’ Commas are used to indicate thousands above 10,000: thus, 2000 and 20,000. Please give costs in sterling (£) with equivalent Euros and US dollars (€/$) in brackets.
Use the format mg.kg-1 not mg/kg for all units. Use SI units throughout the text except for vascular pressure measurements (mmHg or cmH 2O) and haemoglobin concentration (g.l-1). Litres are indicated by lower case ‘l’ not upper ‘L’. Use the 24-hour clock for times.
Whatever their other merits, manuscripts will only be considered for publication in Anaesthesia if they adhere to the highest ethical standards. These are detailed in two editorials published in the journal, that are available here and here and which potential authors are strongly advised to consult.
The Editorial Board takes all cases of possible publication misconduct seriously and will investigate these according to the recommendations of the Committee on Publication Ethics (COPE). Further guidance can be found in our Editorial Policies.
All clinical trials that prospectively assign human subjects to intervention or comparison groups to study the cause-and-effect relationship between a medical intervention and a health outcome should be registered before the time of first recruitment. There are several public registries now available which meet the requirements of the ICMJE and these are listed on the WHO International Clinical Trials Registry Platform (ICTRP). The registry, registration number and date of registration must be stated in the Acknowledgements section of the manuscript. This should have been done before patient recruitment commenced. Reports of original research that were not registered before the study was carried out should include separate submission of the original protocol for the study. If the submitted report differs from the protocol, an explanation of the reason for this should be provided. Authors should be willing and able to submit their raw study data to the journal, if requested, after submission.
Anaesthesia supports and encourages the use of the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network guidelines to ensure the transparent and accurate reporting of research studies. The authors of clinical intervention studies are advised to review the CONSORT statement regarding the reporting of randomised trials prior to manuscript submission.
We strongly encourage authors to register systematic review protocols on a similar database (for instance, PROSPERO http://www.crd.york.ac.uk/PROSPERO/).
All clinical trails should be conducted in accordance with the ethical principles as set out in the Declaration of Helsinki. In brief, the minimum ethical standards for Anaesthesia include:
- Approval by a Research Ethics Committee (REC) or equivalent Institutional Review Board (IRB) must be obtained prospectively for all studies on human subjects, including studies in which participants’ skills are tested using manikins. Some studies involving audit and epidemiological surveys, assessments of medical equipment or analysis of previously collected, non-identifiable information from a database may be exempt from this stricture if participants are appropriately protected against coercion and there is due regard to confidentiality. Publication of the results, however, would usually still require informed consent and assurances regarding confidentiality (including approval by the Caldicott Guardian or equivalent for patient data and the relevant Research and Development department), even if the REC/IRB has indicated that formal submission is unnecessary.
- While an essential preliminary step, REC/IRB approval does not guarantee that the ethical standards of a study will meet the requirements of the Editorial Board of Anaesthesia. If authors have any concerns that ethical issues might compromise publication, they are invited to contact the Editor-in-Chief before embarking on the study.
- The Editorial Board supports the view of the ICH Harmonised Tripartite Guideline for Good Clinical Practice that full prospective written informed consent should be obtained from all subjects of clinical trials, including participants in manikin studies (see above). This would normally comprise provision of written information to potential research participants, allowance of adequate time for them to consider their involvement and ask questions, and the use of specific consent forms (for the study, not just for routine surgery/anaesthesia) that should be signed by the participants to indicate their consent and then stored in case they require examination later.
- Submission of a case report requires the written consent of the subject to publication, using a specific form. Please do not submit this document together with your manuscript but note that authors may be asked to provide the signed form as evidence, should a complaint result in a subsequent investigation. While the Editorial Board recognises that it might not always be possible to seek such consent (or the assent of the next-of-kin if the patient has died), the onus will be on the authors to demonstrate that this exception applies in their case. Please state in an Acknowledgement at the end of the text: ‘Published with the written consent of the patient(s)’ or similar, as appropriate.
- Studies of novel treatments, in particular drug studies where the agent used is given via unlicensed routes (especially neuraxial or perineural), may have received approval from the REC/IRB, but the Editorial Board is likely to reject such studies if it considers that the risks posed outweigh the potential benefits. Such a conclusion is more likely to be reached if the drug in question is not widely used in routine practice (as evidenced by inclusion in standard textbooks), if the study participants are especially vulnerable (e.g. children, women in labour), if there are questions over consent, or if only modest improvements in outcome are expected where other, well established methods already exist.
- Animal studies will only be considered for publication if they have ethical and governmental approval, and have been conducted under appropriate standards of care. Researchers will be expected to follow the ARRIVE guidelines for experimentation in animal research.
It is difficult to provide generic guidance on statistics, since statistics are designed to test a hypothesis in a quantitative way and hypotheses differ across studies. Nevertheless, the following guidelines may help authors present their work in a better and more rigorous way that avoids common statistical errors that frequently lead to rejection. This should not be regarded as an exhaustive list and, of course, the Editorial Board and reviewers of manuscripts may ask authors for revisions that are not detailed here. However, adherence to these guidelines in a paper that is otherwise acceptable will provide authors with a good footing.
Randomisation methods should be made explicit (e.g. coin toss, random numbers, etc.). Please describe if stratification of the allocation system in a randomised controlled trial is performed (e.g. by age or recruiting centre) or block (permuted sequence or otherwise). For instance, most anaesthetic RCTs have exactly the same number of patients in each group but don't mention any blocking method (which would include putting equal numbers of folded pieces of paper for each group in an urn). Blinding must be as good as possible within constraints of clinical practice.
Where there are several outcomes to be reported, the most important (primary) outcome should be clearly stated, along with any secondary outcomes. Beware of reporting as ‘significant’ or ‘important’ a positive result of a secondary outcome, when the study was in fact powered (sample sized) to a different primary outcome.
Some justification of sample size is always necessary for all observational studies, randomised or non-randomised controlled trials, or other types of study. Justification may be quantitative or qualitative (e.g. a ‘convenience sample’), although the latter may be regarded as weaker than the former. Details provided (for continuous variables) should include the power level; the significance level at which a result is sought; and the expected control and study group proportions or mean and pooled SD, in order to allow reviewers and readers to follow the calculation. The method used to justify power should be referenced and enough detail provided, so that the calculation can be repeated by readers. Conventionally, the power of study should be at least 80% but where different should be stated and justified. The ‘clinically important difference’ that the study is designed to detect should indeed be clinically relevant. Beware of setting an unreasonably large ‘clinically important difference’ to justify small sample size, as reviewers will recognise this is done simply to facilitate a small study.
- Use mean (SD) unless data are discrete (e.g. Apgar scores, sedation scores) or grossly non-normally distributed: use median (IQR [range]) or you are interested in the ‘true’ value for the population (use SEM).
- Visual analogue scores (VAS) for pain may be treated as continuous data and be subjected to parametric tests as long as the sample size is large (> 50) and the data appear normally distributed. VAS for other modalities (nausea, drowsiness) have not been so extensively validated and are best treated as ordinal data.
- Scales of measurement can be problematic (e.g. Cormack-Lehane scale, VAS, etc.) because a value of say 2 on the scale does not imply something twice the value of 1, etc. So they cannot logically be regarded as linear, continuous scales. It is safer to regard them as ordinal scales. However, for some scales such as VAS for pain it appears established norm that this may be regarded as continuous, especially for large sample sizes (e.g. >50).
- Use simple statistical tests where possible.
- Avoid multiple comparisons, or correct for them if used.
- Reference unusual tests; and assume that the more unusual the test used, the more likely will a specialist statistical referee review the paper.
- Include details of any computer package/version used.
- When looking for relationship between variables, use correlation to describe a simple descriptive association between two variables.
- Use regression to describe a quantitative relationship between two or more variables, especially where one is predictive and other(s) dependent. Non-linear regression may be appropriate. Regression methods yield a formula to relate the variables being described.
- Use the Bland-Altman method to describe the performance of two different methods used in measurement, analysis or diagnosis.
All conclusions should be warranted by the results and not extend beyond the confines of the study conditions. A negative result does not mean that there is definitely no difference (confidence in the conclusion is dependent upon the power of the study), and a positive result does not mean that there definitely is a difference (confidence in the conclusion is dependent upon the alpha error).