MEMO TO: Author FROM: Lauren Montemurri DATE: March 28, 2011 RE: CAM utilization study edits

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1 MEMO TO: Author FROM: Lauren Montemurri DATE: March 28, 2011 RE: CAM utilization study edits The purpose of this memo is to discuss the developmental edits needed for the CAM utilization study article. In order to better facilitate the reader and to follow principles that the target publication requires, I have suggested a number of edits in structure and on the line level that are addressed below. Copyediting changes will be made at a later date. If you have any questions or concerns please contact me. IMRAD Principles: For quick reference, major requirements for IMRAD style are: Titles are concise and include keywords in order to make searching easy. Articles have introduction, methods, results, and discussion sections. Introduction defines terms, provides background and states objectives Methods describes participants including explanation of exclusion and inclusion principles Results list information by importance, using tables to show findings, with a written summary of key findings. Discussion emphasizes the important aspects of the result, discusses limitations of the study, and suggests future studies. Purpose/Thesis/Audience: Purpose: The purpose of this article is to inform the readers of the Journal of the American Medical Association (JAMA) about the use of complimentary therapy medicine (CAM) through a study done on breast cancer patients. This purpose is clear, except when talking about other studies. It is important that other study information facilitates this study s results. Therefore the explanations should be brief and tie into the thesis. Audience: This article is aimed at academic medical professional. As such, many should be well versed in medical jargon. This magazine is also peer reviewed, which means that those who read it also have some say in its content. The magazine is very interested in exact values and stating importance clearly as is demonstrated in its own about section. Keep this all in mind when deciding what to include. Thesis: The thesis of this article is unclear. What do you believe the study proved? It seems that CAM therapies had some effect and there usage was affected by a few different variable. I believe that you are trying to talk about the use of CAM to improve the quality of life, however, you also talk a lot about CAM decisionmaking, which takes strength away from your other points. Write a statement or two to put

2 at the end of the introduction section so that readers will know where the paper is going and what the study is looking to prove. Structure The structure of this article should follow the IMRAD principals stated above. For more specific line restructuring, see Paragraph edits and Line edits below. Intro: The first couple paragraphs should be the introduction section and should be labeled accordingly. This section should include line 2 thru line 46, though with some rearrangements. The definition of CAM therapies and the 5 principal should come first. The paragraph that starts with line 13 should be moved after line 46. Line 47 through line 69, which talks about the parent study should also be included in the introduction section. Methods: Line 47 should start this section. The rest of the section can be restructured as follows. For example, the paragraph that starts at line 70 should be rearranged for clarity in the following ways. Since there are two hypotheses and many questions each can be grouped separately, as shown below: The research questions investigated were: 1. Which major CAM categories and specific therapies were most frequently used, and to what extent (behavior)? 2. Do different major CAM categories and specific therapies reflect different decision-making values about CAM options, as indicated by the amount of money spent per major CAM category and/or specific therapy? 3. Is the use of different major CAM categories and specific therapies (behavior) associated with differences in contextual variables, including quality of life, employment, education, income, surgery type, and age? Hypotheses tested were: 1. That there would be differences in spending among major CAM categories. 2. That there would be an association between the extent of CAM use and contextual variables. The rest of the Methods section should follow a similar structure, with the inclusion of subheadings for each major section. This includes a restructuring of the sample, measure and data sections. The recruitment and procedure section currently talks a lot about the sample, and therefore should be moved to be apart of this section. Results: Line 143 starts the results section. To better facilitate IMRAD consider rearranging line 197 through 233. For the results section, do not separate by question but by findings. The technical can be presented in graph or table format in an appendix. IMRAD principles also suggest that findings be rated by importance, with the most important first. This creates a flow for the results section, suggesting that you look at results in terms of importance, rate each finding, and order them from most to least important in your article.

3 Discussion: Line 233 starts this section. This section should order findings in terms of importance. It can also be separated into three subheadings; main ideas, limitations and future research. Paragraph line 290 starts the limitations section. Paragraph line 324 starts the future research section. Edits: Things to add: Title: According to IMRAD principals, the title of the article should reflect the main content by using keywords. It should also be clear and concise to aid searching. The current title does not fulfill any of these requirements. First, abbreviations should be abandoned for clarity, so CAM should become Complementary Alternative Medicine. Some keywords to consider are: breast cancer, quality of life, treatments, decision making, therapy, demographics, values, and behavior. With all of these things considered, some example titles are: 1. Complementary Alternative Medicine s use in Breast Cancer Patients. 2. Values that effect the use of Complementary Alternative Medicine in Cancer Patients. 3. How Complementary Alternative Medicine improves Quality of Life. When talking about other studies, be sure to give a brief background so that the user can follow why this study is important when interpreting the presented data. For example, why is the Molenaar study on line 17 relevant to the data of this study? The procedure section currently talks a lot about the sample and not much about what was actually done. Expand on the actual procedures. Things to delete: Though information on the parent study is important to set the stage for the study, it is a little lengthy and the actual study being reviewed gets lost. Instead, cut down on this section and expand on the study being reviewed. Abbreviations are used inconsistency throughout the article. Decide if you are going to use them or not. If you are, the first time you mention something spell it out with the abbreviation in parenthesis. For example, Complimentary alternative medicine (CAM) or Quality of life (QOL). Paragraph Edits: Paragraph line 26: Should be moved to right after line 20 in the introduction. When defining the different categories of CAM therapies, consider either providing all general examples or all examples from the current study in order to create consistency. If not all are included in the study, then group the ones that are together. Another possibility is to include a list of all the different examples first and then talk about the ones that are used in the study.

4 Paragraph line 80: Besides stating the sample, explain why you decided to use these people. For example explain why only participants of certain ages were included or why most of the women were Caucasian. Why do you exclude other groups? Paragraph line 91: Recruitment information should be included with paragraph 80, under sample (especially line ). This would help explain why you choose certain groups. Paragraph line 117: Demographic Variables are mentioned here. If these are being considered they should be in the Sample section and explained for importance. Paragraph line 197: The purpose of this paragraph is very important but needs to be expanded on. Why are these finding important? Focus more on why they are important instead of simply stating what was found. Explain what these findings mean. Paragraph line 169: This paragraph is currently very confusing; consider representing in a table instead of writing out. Paragraph line 315: It is unclear whether this paragraph is talking about a limitation or a finding. If it is a finding, the paragraph should be grouped with the other findings under main ideas. If it is a limitation, clarify why the sample could be inaccurate. Paragraph line 342: what leads you to believe that they will increase in the future? Support your statement with an expanded explanation. If you cannot expand, remove. Line Edits and Queries: Line 4: Since this is in an academic journal the audience should be educated enough to understand what decisionmaking is, making the definition unnecessary. Line 13: What is the significance of the Molenaar study? Either expand to talk more about what its findings say and how they were measured, or it needs to be taken out. Line 17: National Institute s opinion is important and should be moved to after the first sentence, but what are the consequences of this statement? What has been done besides the Molenaar study? Line 20: This is an introductory sentence and should be moved to the first paragraph. Line 42, Line 64: Expand information about the instrument and why it is still effective and relevant in measuring in order to prevent people from dismissing the rest of the article as irrelevant because you claim that the 5 principals are not followed. Also expand your explanation of how the old measurements are applied and effectively used with the new principals. This instrument is also talked about on line 64. Line 66: Earlier you stated that the 5 categories were not used making this sentence inconsistent with that statement and therefore should either be removed or expanded on. Where they used or weren t they?

5 Line 70, Line 80: consider using a subheading for your questions, hypothesis and sample and using a bulleted or numbered list. See changes in Structure for an example. Line 9699: Why is the information about supportive services relevant? It is unclear what this has to do with CAM. If it is important, consider expanding and linking to the thesis. Otherwise this section should be removed. Line 128: What do you mean by Testretest reliability correlations? Will this be clear to your audience? Explain why this is important to data collection. Line 129: Explain the significance of Cronbach s alpha values and why it is important to this study. Line 136: Content validity is not related to this study, so delete this sentence. Line : This information is hard to follow in the current format and does not follow IMRAD. Consider presenting it in graph format in an appendix Line 284: The findings of Vickers and Cassileth in this instance do not support the findings of this study, so all information about this study in this paragraph are unimportant and should be removed. Line 293: Delete this sentence because it is irrelevant to the thesis. Line : Starts to again present a finding, move under main ideas.