My approach to writing a manuscript

Purpose
I describe my process of writing clinical original research manuscripts.

Generally:

• I  load my papers on google doc. This way I can have access at anytime and can add my information and content on the go.  
• I started sharing the documents with my colleagues so that we can edit simultaneously.
• Set a deadline: having some hard time stop has allowed me slowly but surely tackle the paper.
• Upload my tables directly to google doc: by having access to my tables, I can have the data to write about. I can also copy and paste my graphs to google doc.
• When I can, I use Dictation system so that the manuscript is done faster. 

Writing order:

• Tables & Graphs: First, I create the tables.
• this sets the template of the paper for me
• I usually find discrepancies in the data during this step, so I'll re-review the medical records to resolve any issues.
• Typically, I have about 4 tables
• Graphs and figures are must have. They help explain the key points in visual way and help the reader navigate the paper. 
• Results: Then, I write out into words what I have produced in the tables. This is usually the straight forward.
• Methods: straight forward.  I refer to published studies to understand what I should describe and how to organize it. 
• Discussion:
• This section requires planning.
• The first paragraph summarizes the study findings. Start with the specific findings and then, connect the findings to a larger important clinical implication.
• Then, I have three paragraphs:
• I focus on three major findings of the study.
• The structure of each paragraph proceeds like this: 
• How is my findings similar: Similar to published studies, we have shown....
• How is my results different: Unlike those published studies, our data is different because....
• Resolve these two issues: The similarities and differences between is likely due to .
• The fifth paragraphs makes up the the limitations of the study.
• Lastly, I bring it all together in the conclusion.
• Introduction
• I write this section last after I finish the discussion so that I know how to frame the introduction.
• First, I write a very general introduction of the topic
• Then, I narrow down into the existing need/problem
• Lastly, I introduce the hypothesis of the manuscript to address the need.
• Citations
• I use MyEndNote software (free). See EndNote blog.
• I work on the references last. 
• I do annotate the Pubmed ID number, which makes it easier to insert the references later when I'm ready to do the citations.
• I copy and paste my manuscript to Word document and finish my references there. 
• When done:
• I have a few people proofread it
• Hopefully, one of my reviewers is very good in English grammar to catch the subtle grimmer (or sometimes gross spelling) errors. 
• Check all the numbers: I reference all the numbers in the tables and make sure they match with what I wrote in the paragraphs. 
• Hyperlink
• I proofread papers and I like suing hyperlink function to link to the reference paper directly. This helps me pull up the original reference paper and helps me save time writing the manuscript.  Commonly, small mental hurdles (ie. not wanting to pull the original articles, etc) can delay progress so I'm a huge fan of whatever it takes to mitigate these mental barriers.
• Here is a video to demonstrate how to hyperlink articles:

When the draft is completed :

In the past when I was email the word document to the co-authors, there is often a email exchange of up to 20 emails of edits back and forth. In addition, some co-authors may take a few months to submit their edits. 

Recently,  I took a different approach. I forward the hyperlink of  the draft in Google document  to my co-authors and give them a four week time frame, stating the exact date that the edits are due. This provides a fair time interval and keeps everyone on track, so that the manuscript submission is not delayed.  I specify that edits should be done directly on the Google document and / or email to me directly to avoid the back and forth emails that everyone gets. This has made the review experience significantly more facile and efficient. In addition, editing directly in the Google document allows everyone to see everyone's comments and edits.

I send an email reminder to the authors two weeks, one week and a few days before the deadline for final edit submission. This ensures that everyone is aware and have an opportunity to edit.

Once everyone has submitted their edits,  I transfer the Google document to a Microsoft Word and work on the references. I use the PMID that I enter in Google document to quickly format the references using my End Note. The references take me about 10 - 15 minutes. I do this at the very end so that  I only need to do it once. 

Additional resources:

• HHMI Making the Right Moves
• use project management software; I signed up for Trello to help me manage and track my progress and recognize my challenges.
• set specific time to get work done without distractions until you develop a habit.
• Preparing your first draft--Some Dos and Don'ts by Dr Angel Boria