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BMJ Surgery, Interventions, & Health Technologies is an online-only, peer-reviewed, open access journal that aims to operate a fast submission process with continuous publication online to that ensure timely, up-to-date research is available worldwide. The journal adheres to a rigorous and transparent peer-review process and all papers will be considered on the basis of ethical and methodological soundness rather than their novelty, significance, or relevance to any particular group.



Editorial Policies

BMJ Surgery, Interventions, & Health Technologies adheres to the highest standards concerning its editorial policies on publication ethics, scientific misconduct, consent and peer review criteria. The journal follows guidance produced by bodies that include the Committee on Publication Ethics (COPE), the World Association of Medical Editors (WAME) and the International Committee of Medical Journal Editors (ICMJE). To view all BMJ Journal policies, please refer to the BMJ Author Hub policies page.

We take seriously all possible misconduct. If an editor, author, or reader has concerns that a submitted article describes something that might be considered to constitute misconduct in research, publication or professional behavior, they should forward their concerns to the journal. The publisher will deal with allegations appropriately.

As an open access journal, BMJ Surgery, Interventions, & Health Technologies adheres to the Budapest Open Access Initiative definition of open access. Any articles accepted by the journal are published under an exclusive license or non-exclusive license for UK Crown employees or where BMJ has agreed CC BY applies. For US Federal Government officers or employees acting as part of their official duties, the terms are as stated in accordance with our license terms. Authors or their employers retain copyright. Such open access articles can be reused under the terms of the relevant Creative Commons license (CC BY-NC or CC-BY) to facilitate reuse of the content. Authors should refer to the latest BMJ Surgery, Interventions, & Health Technologies Author License for more information.

As the author, you may wish to post your article in a pre-print service, institutional or subject repository or a scientific social sharing network. For more information on author self archiving and rights to reuse content – which are dependent on the license you have obtained – please refer to the BMJ author self archiving and permissions policies page.



Peer Review

Articles submitted to BMJ Surgery, Interventions, & Health Technologies are subject to peer review. The journal operates single blind peer review whereby the names of the reviewers are hidden from the author; this is the traditional method of reviewing and is the most common. For more information on what to expect during the peer review process, please refer to BMJ Author Hub – after submitting.

BMJ requests that all reviewers adhere to a set of basic principles and standards during the peer-review process in research publication; these are based on the COPE Ethical Guidelines for Peer Reviewers. Please refer to our peer review terms and conditions policy page for further information.

BMJ is committed to transparency. Every article we publish includes a description of its provenance (commissioned or not commissioned) and whether it was internally or externally peer reviewed.

Plagiarism is the appropriation of the language, ideas, or thoughts of another without crediting their true source and representation of them as one’s own original work. BMJ is a member of CrossCheck by CrossRef and iThenticate. iThenticate is a plagiarism screening service that verifies the originality of content submitted before publication. BMJ runs manuscripts through iThenticate during the peer review process. Authors, researchers, and freelancers can also use iThenticate to screen their work before submission by visiting www.ithenticate.com.



Article Processing Charges

BMJ Surgery, Interventions, & Health Technologies is an open access journal and levies an Article Processing Charge (APC) of $2,800 (exclusive of VAT for UK and EU authors), with several exceptions:

  • Data sources and analysis papers are subject to a lower APC of $1,500 (exclusive of VAT for UK and EU authors).
  • Perspectives are subject to a lower APC of $1,000 (exclusive of VAT for UK and EU authors).
  • Regulatory and policy corner papers are subject to a lower APC of $600 (exclusive of VAT for UK and EU authors).

There are no submission, color, or page charges. Associate editors and authors who have completed a review for the journal in the previous year are eligible for a 25% discount on the full APC; qualified authors should contact the Editorial Production Assistant for additional information after their papers have been accepted. All papers that are subject to a lower APC are not entitled to this discount.

Please see our Author Hub for detailed information on discounts and waivers. Applications for waivers or discounts should be made during initial submission and not after an article has been accepted. Editors are not involved in this process and the ability to pay has no bearing on editorial decisions. Payment will not be required unless your article is accepted. Accepted articles will not be published until payment has been received. BMJ does not refund APCs once paid.

As one of the founding members of the HINARI Access to Research in Health Programme, we provide free access to all of our journals and our journals archive to local, not-for-profit institutions in low income countries. In addition, we appreciate that some authors do not have access to funding to cover publication costs and we offer waivers through our Open Access Waiver Fund. We will accept part payment where only limited funds are available, and we offer waivers to authors in exceptional circumstances, on request.

For more information on open access, funder compliance, discounts and waivers, please refer to the BMJ Author Hub open access page.



Patient and Public Involvement

BMJ encourages active patient and public involvement in clinical research as part of its patient and public partnership strategy. To support co-production of research, we request that authors provide a Patient and Public Involvement statement in the methods section of their papers.

We appreciate that patient and public involvement is relatively new and may not be feasible or appropriate for all papers. We therefore continue to consider papers where patients were not involved.  Please note that this practice is only applicable for Research Articles and Registry Reports.

The Patient and Public Involvement statement should provide a brief response to the following questions, tailored as appropriate for the study design reported (please find example statements here):

  • At what stage in the research process were patients/the public first involved in the research and how?
  • How were the research question(s) and outcome measures developed and informed by their priorities, experience, and preferences?
  • How were patients/the public involved in the design of this study?
  • How were they involved in the recruitment to and conduct of the study?
  • Were they asked to assess the burden of the intervention and time required to participate in the research?
  • How were (or will) they be involved in your plans to disseminate the study results to participants and relevant wider patient communities (e.g. by choosing what information/results to share, when, and in what format)?

If patients were not involved, please state this.

In addition to considering the points above, we advise authors to look at guidance for best reporting of patient and public involvement as set out in the GRIPP2 reporting checklist.

If the Patient and Public Involvement statement is missing in the submitted manuscript, we will request that authors provide it.



Data Sharing

BMJ Surgery, Interventions, & Health Technologies adheres to BMJ’s Tier 2 data policy. We strongly encourage that data generated by your research that supports your article be made available as soon as possible, wherever legally and ethically possible. We also require data from clinical trials to be made available upon reasonable request. To adhere to ICMJE guidelines, we require that a data sharing plan must be included with trial registration for clinical trials that begin enrolling participants on or after January 1, 2019. Changes to the plan must be noted in the Data Availability Statement and updated in the registry record. All research articles must contain a Data Availability Statement. For more information and FAQs, please see BMJ’s full Data Sharing Policy page.



ORCID Policy

BMJ Surgery, Interventions, & Health Technologies mandates ORCID IDs for the submitting author at the time of article submission; co-authors and reviewers are strongly encouraged to also connect their ScholarOne accounts to ORCID. We strongly believe that the increased use and integration of ORCID iDs will be beneficial for the whole research community. Please find more information about ORCID and BMJ’s policy on our Author Hub.



Submission Guidelines

Please review the below article type specifications including the required article lengths, illustrations, table limits and reference counts. The word count excludes the title page, abstract, tables, acknowledgements, contributions and references. Manuscripts should be as succinct as possible.

For further support when making your submission please refer to the resources available on the BMJ Author Hub. Here you can also find general formatting guidelines across BMJ and a formatting checklist.

You may also wish to use the language editing and translation services provided by BMJ Author Services. If your article is accepted, you can take advantage of BMJ’s partnership with Kudos, a free service to help you maximize your article’s reach.

Key Messages

All articles submitted to BMJ Surgery, Interventions, & Health Technologies must include a short summary explaining the significance of the study. It should contain answers to the following questions:

  • What is already known about this subject?
  • What are the new findings?
  • How might these results affect future research or surgical practice?

Please add this section in your manuscript following the abstract. All of the headings listed above must be used, and each should contain no more than two short sentences.

The Key Messages box for analysis papers differs slightly. If you are submitting an analysis paper, you should summarize your article in three bullet points, each of which consists of no more than two short sentences. The headings requested in the Key Messages box for other article types should be omitted.

Note that this requirement applies only to original research, reviews, analysis papers, and registry reports. Regulatory and policy corner items, perspectives, data sources, protocols and research design plans, and editorials do not require a Key Messages box.



Original research

Original research articles are the products of a structured inquiry into a clearly defined question or problem. They should clearly articulate the researcher’s objective, thoroughly outline the methods used, assess the outcomes with reference to the established methodology, and elaborate on the greater clinical significance of the results.

THE IDEAL FORMAT

The subject matter of this journal dictates that it will attract articles describing research and evaluation on interventions and devices throughout their life cycle. While randomized controlled trials are well accepted as the best method for studying comparative effectiveness amongst treatments, a great deal of important research relates to questions that arise before or after the point at which comparative effectiveness is appropriately studied. For treatment evaluations at these other points in the life cycle, we encourage using the study formats described in the IDEAL Recommendations. This section explains how to report such studies.

The IDEAL Recommendations [1] describe ways of designing and reporting research on surgical innovations that are appropriate to the stage that knowledge on the subject has reached. If you are not sure which IDEAL stage your study fits into, please consult Pennell et al [2]. Briefly, Idea (Stage 1) reports are for first in-human experiences. Stage 2a (Development) studies deal with procedures or devices that are in the process of being perfected or stabilized or have just reached this point. Stage 2b (Exploration) studies are for stable procedures that require more information to help decide whether a randomized controlled trial can or should be done. Stage 3 (Assessment) is the stage for doing such trials – or other pivotal comparative trials if an RCT is not feasible. Stage 4 (Long-term study) is for studies of late or rare outcomes, changes in use over time, and surveillance of performance. Registries and opportunistic analysis of real-world data are the standard study designs in this stage. For additional information on IDEAL Recommendations, please consult Sedrakyan et al [3].

GENERAL RECOMMENDATIONS

IDEAL format studies should be reported in the standard IMRAD (Introduction, Methods, Results, and Discussion) format. There are a small number of additional requirements, which apply to all types of IDEAL study, and others to specific stages. The general recommendations for all stages are:

  • data in IDEAL studies collected prospectively will be considered much more robust;
  • protocols for prospective studies should be developed and registered before data collection begins (recommended); and
  • standard, well recognized and widely accepted measures and definitions should be used to record outcomes, patient characteristics and other confounders, and interventions. The use of core outcome sets such as those produced by the COMET initiative is strongly recommended for this purpose.

STAGE-SPECIFIC RECOMMENDATIONS

For stage-specific recommendations, please see here. These relate only to articles about devices or procedures which are at a specific IDEAL stage in their life cycle.

STAGE 1 Recommendations. Stage 1 is reserved for reports of first-in-human experiences of new treatments.

STAGE 2A Recommendations. In Stage 2a, the intervention is not yet stable, but is still in a phase of purposeful iterative modification. The Prospective Development Study format is recommended for this stage. This is a small prospective case series with sequential reporting of results and complete transparency about any changes which take place during the series. Once the procedure or device has reached a stage of stability where no further improvements are envisaged, Stage 2a is completed.

STAGE 2B Recommendations. In Stage 2b, intentional iterative improvements to the intervention have ceased, but a number of issues typically need to be clarified before a randomized controlled trial is likely to be successful. These include definition of acceptable variations in the intervention, of the patient population most likely to

benefit and of the quality with which the intervention is delivered, and exploration of the values and attitudes of both clinicians and patients relevant to the design of a trial. IDEAL recommends the Prospective Exploration Study format for this stage; this is a collaborative prospective cohort study with specific characteristics.

STAGE 3 Recommendations. At Stage 3, the innovation is compared with current best practice, preferably in a randomized controlled trial.

STAGE 4 Recommendations. Stage 4 studies are observational studies of outcomes after treatments have become well-established. These studies should be focused investigations that follow the standard PICO format. The principal designs used are registries and prospective databases, and, increasingly, opportunistic studies of “Real World Evidence” (i. e. data collected for other purposes such as administration, billing or clinical care), but these studies are different from the broader Registry Reports that we also consider for publication. Registries may begin at any point in the life cycle of innovation.

STRUCTURED ABSTRACTS

Abstracts should be 250 to 300 words long. They should include the following headings, but they may be modified for abstracts of clinical trials or systematic reviews and meta-analyses according to the requirements on the the CONSORT extension for abstracts and the PRISMA extension for abstracts, respectively.

  • Objectives – a clear statement of the main aim of the study and the major hypothesis tested or research question posed
  • Design – including factors such as prospective, randomisation, blinding, placebo control, case control, crossover, criterion standards for diagnostic tests, etc.
  • Setting – include the level of care, eg primary, secondary; number of participating centres. Be general rather than give the name of the specific centre, but give the geographical location if this is important
  • Participants (instead of patients or subjects) – numbers entering and completing the study, sex, and ethnic group if appropriate. Give clear definitions of how selected, entry and exclusion criteria.
  • Interventions – what, how, when and for how long. This heading can be deleted if there were no interventions but should normally be included for randomised controlled trials, crossover trials, and before and after studies.
  • Main outcome measures – those planned in the protocol, those finally measured (if different, explain why).
  • Results – main results with (for quantitative studies) 95% confidence intervals and, where appropriate, the exact level of statistical significance and the number need to treat/harm. Whenever possible, state absolute rather than relative risks.
  • Conclusions – primary conclusions and their implications, suggesting areas for further research if appropriate. Do not go beyond the data in the article. Conclusions are important because this is often the only part that readers look at.
  • Trial registration – registry and number (for clinical trials and, if available, for observational studies and systematic reviews).

Word Count: up to 5,000 words
Abstract: up to 300 words
Tables/Figures: up to 6 tables or figures
References: up to 75
Authors: up to 20 (no more than 8 from a single institution)
APC: $2,800

1 Hirst A, Philippou Y, Blazeby J, et al. No Surgical Innovation Without Evaluation. Ann Surg 2019;269:211–20. https://doi.org/10.1097/SLA.0000000000002794

2 Pennell CP, Hirst AD, Campbell WB, et al. Practical guide to the Idea, Development and Exploration stages of the IDEAL Framework and Recommendations. Br J Surg 2016;103:607–15. https://doi.org/10.1002/bjs.10115

3 Sedrakyan A, Campbell B, Merino JG, Kuntz R, Hirst A, McCulloch P. IDEAL-D: a rational framework for evaluating and regulating the use of medical devices. BMJ 2016;353:i2372. https://doi.org/10.1136/bmj.i2372



Review

Systematic reviews document the selection, discovery, critique and synthesis of evidence relevant to well-defined research questions. They should be accompanied by a structured abstract that addresses the background, objectives, data sources, study eligibility criteria, participants and interventions, study appraisal and synthesis methods, results, limitations, and conclusions and implications of key findings.

Word Count: up to 4,000 words
Abstract: up to 300 words
Tables/Figures: up to 4 tables or figures
References: up to 80
Authors: up to 5
APC: $2,800



Analysis

Analysis papers contribute to relevant clinical and ethical debates among today’s practitioners, policy makers, and researchers.  Offering clearly articulated arguments supported by by an even-handed look at the evidence, they clearly convey a definitive message on a pressing issue to the entire field. Unless it is experimentally tested by their authors, they are not intended to set out a hypothesis.

Word Count: up to 2,000 words
Abstract: not required
Tables/Figures
: up to four tables or figures
References: up to 80
Authors: up to six
APC: $1,500



Registry report

Registry reports should document specific registry findings that have the potential to improve modern healthcare; examples include results of outlier physician or technology/device analysis, specific quality of care improvement achievements, successful and sustainable implementation of unique device identification, and data linkages leading to long-term outcome assessments. Please review the International Medical Device Regulatory Forum’s essential registry principles document for more information.

More specific studies using registry infrastructure (e.g., IDEAL stage 1-4 studies) should be submitted as research articles.

All registry reports should include the following:

The article title should be short and informative. Titles should not declare the results of the study.

Unstructured abstract/executive summary should be no longer than 350 words and include a crisp summary of the report, including methods and specific registry findings.

Manuscripts should be divided into the following sections:

  • Background
  • Purpose of the Registry
  • Aims of the Report
  • General Methods (Data Collection Process, Data Validation)
  • Main Findings with Discussion
    We recommend that your main findings section be no longer than eight paragraphs; we also recommend that you use at least several subheadings. This section should include discussion of results, possible explanations of each finding, implications for clinicians and policymakers, and future research plans.
  • Funding Statement, preferably worded as follows:
    “This work was supported by [name of funder] grant number [xxx]. You must ensure that the full, correct details of your funder(s) and any relevant grant numbers are included. This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
  • Competing Interests Statement
    See the BMJ Author Hub for details on what to include as competing interests.
  • Articles should list each author’s contribution individually at the end.
    This section may also include contributors who do not qualify as authors. Please visit the ICMJE website for more information on authorship.
  • Data Sharing Statement, such as:
    “Technical appendix, statistical code, and dataset available from the Dryad repository, DOI: [include DOI for dataset here].”

Supplementary and raw data can be placed online alongside the article. We may request that you separate out some material into supplementary data files to make the main manuscript clearer for readers.

Following the lead of The BMJ and its patient partnership strategyBMJ Surgery, Interventions, & Health Technologies is encouraging active patient involvement in setting the research agenda. As such, we require authors to add a Patient and Public Involvement (PPI) statement in the Methods section. Please see our FAQs regarding PPI statements.

Word Count: up to 4,500 words
Abstract: up to 350 words
Tables/Figures: up to 8 tables or figures
References: up to 75
Authors: up to 20 (no more than 8 from a single institution)
APC: $2,800



Data source

Data sources are descriptions of a particular data source that can be used by surgeons and interventional professionals for research and surveillance. They might include registry data, various administrative data sources, cohort or clinical trial data and others designs. Ideally, these data sources are of national or international importance. The article should consist of the following sections:

  • Purpose and Goals of Original Data Collection
    Some data sources are related to on-going major cohort study, previously conducted study, national or regional quality improvement efforts or to understand costs of care. This section will help researchers better understand the scope, costs, and possible limitations and advantages for their research needs.
  • Title
    Include the full name of the resource followed by relevant acronyms.
  • List of Authors
    Writing groups are acceptable and individual members can get authorship on PubMed. Please upload the names of these authors as an appendix and refer to it in your cover letter to the editor.
  • Data Collected
    Include a brief description of any support structures and any sampling done. Include special section on data access and funding sources. Data coverage and completeness is important. It should be clear if individual level data is available and
    all privacy protections are in place including the process of de-identification. Describe all elements available to researchers, including any biospecimens. If data linkages are performed, provide validation data on linkages if any. This is the most important section of the article and clarity in presentation is important. Tables and figures are encouraged.
  • Data Resource Use
    Where applicable, please provide examples of data use or data from relevant publications (with permissions). Please include a list of up to 10 relevant citations of conducted studies using this particular data source.
  • Strengths and Limitations
    Please include brief and relevant descriptions of strengths and limitations from a surgical, interventional, or health technology perspective. Include any issues with generalization in this section.

Word Count: up to 2,000 words
Abstract: not required
Tables/Figures: up to 6 tables or figure
References: up to 10
Authors: up to 6
APC: $1,500



Protocols and research design plans

BMJ Surgery, Interventions, & Health Technologies will publish protocols and study design plans for studies relevant to the subject matter of the journal. Protocols should clearly set out the aims of the study, the proposed methods, measures and interventions in sufficient detail to allow readers to determine whether the protocol was followed in any subsequent publications reporting study outcomes.

Protocols that have formal ethical approval and funding from a recognized, open access advocating research-funding body (such as those listed by the JULIET project) may be published without peer review. Please provide proof that these criteria are met when uploading your protocol. Any protocols that do not meet both these criteria will be sent for external peer review. Reviewers will be instructed to review for clarity and sufficient detail. The intention of peer review is not to alter the study design. Reviewers will be instructed to check that the study is scientifically credible and ethically sound in its scope and methods, and that there is sufficient detail to instill confidence that the study will be conducted and analyzed properly.

Format

Please include an Abstract, Introduction, and Study Description. This should incorporate: description of the population or subjects being studied and how they are to be selected; data to be collected about subjects, how it will be acquired, stored and

analyzed, and measures to be employed; interventions or tests (diagnostic, therapeutic or prognostic) to be evaluated; study design or format; primary outcome measure and outline statistical analysis plan where relevant.

A brief Discussion should explain choices or decisions which the authors feel need justification, discuss any likely limitations of the study and describe what further research or changes in practice the authors hope the study may stimulate.

Please include statements about intentions or progress on obtaining ethics approval, funding sources, role of the sponsor, author conflicts of interest and trial registration where relevant.

Supplementary material may be submitted as online Appendices by agreement with the Editor.

Word Count: up to 3,500 words
Abstract: up to 250 words
Tables/Figures
: up to 6 tables or figures
References: up to 30
Authors: up to six
APC: $2,800



Regulatory and policy corner

Regulatory and Policy Corner reports should cover major developments in regulation and policy-making relevant for health technologies and interventional care. Examples include specific technology-related alerts, summary of device recalls, summary of reported adverse events related to specific technology, new regulatory pathways, major healthcare laws passed by governments, major decisions and policy implications of new coverage decisions by payers and other relevant news and information that is appealing to our international readership of technology experts, practicing doctors and patients.

Word Count: up to 600 words
Abstract: not required
Tables/Figures: 1 table or figure
References: up to 5
APC: $600



Perspectives

Perspectives are highly readable and compelling commentaries that appeal to our international readership of practicing doctors. We also publish opinion pieces authored by patients.

Word Count: up to 1,000 words
Abstract: not required
Tables/Figures: 1 table or figure
References: up to 10
APC: $1,000



Editorial

Editorials for BMJ Surgery, Interventions, & Health Technologies are strictly commissioned, but suggestions for papers are welcome.

Word Count: up to 1,000 words
Abstract: not required
Tables/Figures: 2 tables or figures
References: up to 10
APC: None