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ACADEMIA & CLINfC Uniform Requirements for Manuscripts Submitted to Biomedical Journals INTERNATIONAL COMMITTEE OF MEDICAL JOURNAL EDITORS* IN JANUARY 1978 a group of editors from some major biomedical journals published in English met in Vancou- ver, British Columbia, and decided on uniform technical requirements for manuscripts to be submitted to their journals. These requirements, including formats for bibli- ographic references developed for the Vancouver group by the National Library of Medicine, were published in three of the journals early in 1979. The Vancouver group evolved into the International Committee of Medical Journal Editors (ICMJE). At the October 1981 meeting the requirements were revised slightly and published in a second edition in 1982. Since then the group has issued several separate statements, and these have been incorpo- rated into the main part of this, the third, edition. Over 300 journals have agreed to receive manuscripts prepared in accordance with the initial, previously pub- lished, requirements. It is important to emphasize what these requirements imply and what they do not. Firstly, the requirements are instructions to authors on how to prepare manuscripts, not to editors on publication style. (But many journals have drawn on these require- ments for elements of their publication styles.) Secondly, if authors prepare their manuscripts in the style specified in these requirements, editors of the partic- ipating journals will not return manuscripts for changes in these details of style. Even so, manuscripts may be *Edward J. Huth, M.D.; Annals of Internal Mcdicine; Kathleen King, M.R.C.Path.; The Mcdical Journal ofAustralia; Stephen P. Lock, M.D.; British Medical Journal; George D. Lundberg, M.D.; Journal ofthe Ameri- can Medical Association; Ian Munro, M.B.; The Lancet; Magne Nylenna, M.D.; Tidsskrift for Den Norske Laeg°forening; Roy Rada, M.D.; Index Medicus; Arnold S. Rdman, M.D.; New England lournal ofMadicinr Povl Riis, M.D.; Journal ofthe Danish Medical Association and Danish Medical Bulletin; Richard G. Robinson, Ch.M.; New Zealand Medical Journal; Bruce P. Squires, M.D.; Canadian Medical Association Journal; Dr. Ilkka Vartiovaara; Finnish Medical Journal; Malcolm S. M. Watts, M.D.; The Western Journal ofMedicine. This document is not covered by copyright; it may be copied or reprinted without permission. Anyone in North America who wishes to obtain a single reprint in booklet form may do so by sending a stamped (U.S: postage stamps), self-addressed envelope (no smaller than 105 mm by 220 mm or 4 1/8 in. by 8 3/4 in.) to the Circulation Manager, Annals of Internal Medi- cine, 4200 Pine Street, Philadelphia, PA 19104. There is no charge for a single reprint. Rates for bulk orders ofSO or more reprints are a vailable from the Circulation Manager (toll free: 800-523-1546.• or 215-243-1200,• ext. 1650). • Citations of this document should be to one of the sources listed befow: INTER- NATIONAL COMMITTEE OF MEDICAt. JOURNAL EDITORS. Uniform requlre• ments for manuscripts submitted to biomedical journal.. .4nn lntern M<d. 1988;108:258-265. INTER.•:ATIONAl. COmmiTiEf: OF MEDICAt. JOURNAL EDITORS. Uniform re- quirements for manuscripts submitted to biomedical journals. Br Mcd !. I988;296. [In press.] 258 Annals of Internal Medicine. 1988;108:258-265. altered by journals to conform with details of their own publication styles. Thirdly, authors sending manuscripts to a participat- ing journal should not try to prepare them in accordance with the publication style of that journal but should fol- low the "Uniform Requirements for Manuscripts Sub- mitted to Biomedical Journals." Nevertheless, authors must also follow the instructions to authors in the journal as to what topics are suitable for that journal and the types of papers that may be submit- ted (for example, original articles, reviews, case reports). In addition, the journal's instructions are likely to con- tain other requirements unique to that journal, such as number of copies of manuscripts, acceptable languages, length of articles, and approved abbreviations. Participating journals are expected to state in their in- structions to authors that their requirements are in ac- cordance with "Uniform Requirements for Manuscripts Submitted to Biomedical Journals" and to cite a pub- lished version. This document will be revised at intervals. Inquiries and comments from Central and North America about these requirements should be sent to Edward J. Huth, M.D., Annals of Internal Medicine, 4200 Pine Street, Philadelphia, PA 19104, USA; those from other regions should be sent to Stephen P. Lock, M.D., British Medical Journal, British Medical Association, Tavistock Square, London WC1H 9JR, United Kingdom. Note that these two journals provide secretariat services for the Interna- tional Committee of Medical Journal Editors; they do not handle manuscripts intended for other journals. Papers intended for other journals should be sent directly to the offices of those journals. Summary of Requirements Type the manuscript double spaced, including title page, abstract, tt:xt, acknowledgments, references, tables, and legends. Each manuscript component should begin on a new page, in the following sequence. Title page Abstract and key words Text Acknowledgments References Tables: each table, complete with title and footnotes, on a separate page Legends for illustrations Illustrations must be good-quality, unmounted glossy UMI Article Clearinghouse has reproduced this material with permission of the copyright owner. Further reproduction is prohibited.

prints usually 127 by 173 mm (5 by 7 in.) but no larger than 203 by 254 mm (8 by 10 in.). Submit the required number of copies of manuscript and figures (see journal's instructions) in a heavy-paper envelope. The submitted manuscript should be accompa- nied by a covering letter, as described under "Submission of Manuscripts," and permissions to reproduce previous- ly published materials or to use illustrations that may identify human subjects. Follow the journal's instructions for transfer of copy- right. Authors should keep copies of everything submit- ted. Prior and Duplicate Publication Most journals do not wish to consider for publication a paper on work that already has been reported in a pub- lished paper or is described in a paper submitted or ac- cepted for publication elsewhere. This policy does not usually preclude consideration of a paper that has been rejected by another journal or of a complete report that follows publication of a preliminary report, usually in the form of an abstract. When submitting a paper, an author should always make a full statement to the editor about all submissions and previous reports that might be re- garded as prior or duplicate publication of the same or very similar work. Copies of such material should be in- cluded with the submitted paper to help the editor decide how to deal with the matter. Multiple publication-that is, the publication more than once of the same study results, irrespective of whether the wording is the same-is rarely justified. Sec- ondary publication in another language is one possible justification, provided the following conditions are met. (a) The editors of both journals concerned are fully informed; the editor concerned with secondary publication should have a photocopy, reprint, or manuscript of the primary version. (b) The priority of the primary publication is re- spected by a publication interval of at least two weeks. (c) The paper for secondary publication is written for a different group of readers and is not sim- ply a translated version of the primary paper; an abbreviated version will often be sufficient. (d) The secondary version reflects faithfully the data and interpretations of the primary version. (e) A footnote on the title page of the secondary version informs readers, peers, and document- ing agencies that the paper was edited, and is being published, for a national audience in par- allel with a primary version based on the same data and interpretations. A suitable footnote might read as follows: "This article is based on a study first reported in the [title of journal, with full reference] ". Multiple publication other than as defined above is not acceptable to editors. If authors violate this rule, they may expect appropriate editorial action to be taken. Preliminary release, usually to public media, of scien- tific information described in a paper that has been ac- cepted but not yet published is a violation of the policies of many journals. In a few cases, and only by arrange- ment with the editor, preliminary release of data may be acceptable, for example, to warn the public of health haz- ards. Preparation of Manuscript Type the manuscript on white bond paper, 216 by 279 mm (8'/Z by 11 in.) or ISO A4 (212 by 297 mm), with margins of at least 25 mm (I in.). Type only on one side of the paper. Use double spacing throughout, including title page, abstract, text, acknowledgments, references, tables, and legends for illustrations. Begin each of the following sections on separate pages: title page, abstract and key words, text, acknowledgments, references, indi- vidual tables, and legends. Number pages consecutively, beginning with the title page. Type the page number in the upper or lower right-hand corner of each page. TITLE PAGE The title page should carry 1) the title of the article, which should he concise but informative; 2) first name, middle initial, and last name of each author, with highest academic degree(s) and institutional affiliation; 3) name of department(s) and institution(s) to which the work should be attributed; 4) disclaimers, if any; 5) name and address of author responsible for correspondence about the manuscript; 6) name and address of author to whom requests for reprints should be addressed, or statement that reprints will not be available from the author; 7) the source(s) of support in the form of grants, equipment, drugs, or all of these; and 8) a short running head or footline of no more than 40 characters (count letters and spaces) placed at the foot of the title page and identified. AUTHORSHIP All persons designated as authors should qualify for authorship. Each author should have participated suffi- ciently in the work to take public responsibility for the content. Authorship credit should be based only on substantial contributions to (a) conception and design, or analysis and interpretation of data; (b) drafting the article or re- vising it critically for important intellectual content; and on (c) final approval of the version to be published. Con- ditions (a), (b), and (c) must all be met. Participation solely in the acquisition of funding or the collection of data does not justify authorship. General supervision of the research group is also not sufficient for authorship. Any part of an article critical to its main conclusions must be the responsibility of at least one author. A paper with corporate (collective) authorship must specify the key persons responsible for the article: others contributing to the work should be recognized separately (see Acknowledgments and Other Information). Editors may require authors to justify the assignment of authorship. fJ ABSTRACT AND Kta' \VORDS 0 The second page should carry an ab>tract of no more ~ t*) Uniform Requirements for Manuscripts 259 ~ t4~ $ f.~ -0

than 150 words. The abstract should state the purposes of the study or investigation; basic procedures (selection of study subjects or experimental animals, observational and analytic methods); main findings (give specific data and their statistical significance, if possible); and the principal conclusions. Emphasize new and important as- pects of the study or observations. Below the abstract, provide, and identify as such, 3 to 10 key words or short phrases that will assist indexers in cross-indexing your article and that may be published with the abstract. Use terms from the Medical Subject Headings (MeSH) list of Index Medicus; if suitable MeSH terms are not yet available for recently introduced terms, present terms may be used. TEXT The text of observational and experimental articles is usually-but not necessarily-divided into sections with the headings Introduction, Methods, Results, and Dis- cussion. Long articles may need subheadings within some sections to clarify their content, especially the Results and Discussion sections. Other types of articles such as case reports, reviews, and editorials are likely to need other formats. Authors should consult individual jour- nals for further guidance. Introduction: State the purpose of the article. Summa- rize the rationale for the study or observation. Give only strictly pertinent references, and do not review the sub- ject extensively. Do not include data or conclusions from the work being reported. 1llethods: Describe your selection of the observational or experimental subjects (patients or experimental ani- mals, including controls) clearly. Identify the methods, appacatus (manufacturer's name and address within pa- renthesis marks [round brackets] ), and procedures in sufficient detail to allow other workers to reproduce the results. Give references to established methods, including statistical methods (see below); provide references and brief descriptions for methods that have been published but are not well known; describe new or substantially modified methods, give reasons for using them, and eval- uate their limitations. Identify precisely all drugs and chemicals used, including generic name(s), dose(s), and route(s) of administration. Ethics: When reporting experiments on human sub- jects, indicate whether the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional or regional) or with the Helsinki Declaration of 1975, as revised in 1983. Do not use patients' names, initials, or hospital numbers, especially in any illustrative material. When reporting experiments on animals indicate whether the institution's or the National Research Council's guide for, or any national law on, the care and use of laboratory animals was followed. Statistics: Describe statistical methods with enough de- tail to enable a knowledgeable reader with access to the original data to verify the reported results. When possi- ble, quantify findings and present them with appropriate indicators of measurement error or uncertainty (such as confidence intervals). Avoid sole reliance on statistical hypothesis testing, such as the use of P values, which fails to convey important quantitative information. Discuss el- igibility of experimental subjects. Give details about ran- domization. Describe the methods for, and success of, any blinding of observations. Report treatment complica- tions. Give numbers of observations. Report losses to ob- servation (such as dropouts from a clinical trial). Refer- ences for study design and statistical methods should be to standard works (with pages stated) when possible rather than to papers where designs or methods were originally reported. Specify any general-use computer programs used. Put general descriptions of methods in the Methods section. When data are summarized in the Results sec- tion, specify the statistical methods used to analyze them. Restrict tables and figures to those needed to explain the argument of the paper and to assess its support. Use graphs as an alternative to tables with many entries; do not duplicate data in graphs and tables. Avoid non-tech- nical uses of technical terms in statistics, such as "ran- dom" (which implies a randomizing device), "normal," "significant," "correlation," and "sample." Define statis- tical terms, abbreviations, and most symbols. Results: Present your results in logical sequence in the text, tables, and illustrations. Do not repeat in the text all the data in the tables, illustrations, or both; emphasize or summarize only important observations. Discussion: Emphasize the new and important aspects of the study and the conclusions that follow from them. Do not repeat in detail data or other material given in the Introduction or the Results section. Include in the Dis- cussion section the implications of the findings and their limitations, including implications for future research. Relate the observations to other relevant studies. Link the conclusions with the goals of the study but avoid unqualified statements and conclusions not completely supported by your data. Avoid claiming priority and al- luding to work that has not been completed. State new hypotheses when warranted, but clearly label them as such. Recommendations, when appropriate, may be in- cluded. ACKNOWLEDGMENTS At an appropriate place in the article (title-page foot- note or appendix to the text; see the journal's require- ment) one or more statements should specify: (a) contri- butions that need acknowledging but do not justify au- thorship, such as general support by a departmental chairman; (b) acknowledgments of technical help; (c) acknowledgments of financial and material support, spec- ifying the nature of the support; (d) financial relation- ships that may pose a conflict of interest. Persons who have contributed intellectually to the pa- per but whose contributions do not justify authorship may be named and their function or contribution de- scribed, for example, "scientific adviser," "critical review of study proposal," "data collection," "participation in clinical trial." Such persons must have given their per- mission to be named. Authors are responsible for obtain- 260 February 1988 0 Annals of Internal Medicine • Volume 108 0 Number 2

ing written permission from persons acknowledged by name because readers may infer their endorsement of the data and conclusions. Technical help should be acknowledged in a paragraph separate from those acknowledging other contributions. REFERENCES Number references consecutively in the order in which they are first mentioned in the text. Identify references in text, tables, and legends by arabic numerals within paren- thesis marks. References cited only in tables or in legends to figures should be numbered in accordance with a se- quence established by the first identification in the text of the particular table or illustration. Use the style of the examples below, which are based on the formats used by the U.S. National Library of Medicine in Index Medicus. The titles of journals should be abbreviated according to the style used in Index Medi- cus. Consult List oFJournals Indexed in Index Medicus, published annually as a separate publication by the Li- brary and as a list in the January issue of Index Medicus; also see the list of journal titles and abbreviated titles at the end of this document. Try to avoid using abstracts as references; "unpub- lished observations" and "personal communications" may not be used as references, although references to written, not oral, communications may be inserted (with- in parenthesis marks) in the text. Include among the ref- erences papers accepted but not yet published; designate the journal and add "in press" (within parenthesis marks). Information from manuscripts submitted but not yet accepted should be cited in the text as "unpublished observations" (within parenthesis marks). The references must be verified by the author(s) against the original documents. Examples of correct forms of references are given be- low. Journals 1. Standard Journal Article (List all authors when six or less; when seven or more, list only first three and add et al.) You CH, Lee KY, Chey RY, Menguy R. Electro- gastrographic study of patients with unexplained nausea, bloating and vomiting. Gastroenterology 1980;79:311-4. 2. Corporate Author The Royal Marsden Hospital Bone-Marrow Trans- plantation Team. Failure of syngeneic bone-marrow graft without preconditioning in post-hepatitis mar- row aplasia. Lancet 1977;2:242-4. 3. No Author Given Anonymous. Coffee drinking and cancer of the pan- creas [Editorial]. Br Med J 1981;283:628. 4. Journal Supplement Mastri AR. Neuropathy of diabetic neurogenic blad- der. Ann Intern Med 1980;92(2 Pt 2):316-8. Frumin AM, Nussbaum J, Esposito M. Functional asplenia: demonstration of splenic activity by bone marrow scan [Abstract]. Blood 1979; 54(Suppl 1):26a. 5. Journal Paginated by Issue Seaman WB. The case of the pancreatic pseudocyst. Hosp Pract 1981;16(Sep):24-5. Books and Other Monographs 6. Personal Author(s) Eisen HN. Immunology: an introduction to molecu- lar and cellular principles of the immune response. 5th ed. New York: Harper and Row, 1974:406. 7. Editor, Compiler, Chairman as Author Dausset J, Colombani J, eds. Histocompatibility testing 1972. Copenhagen: Munksgaard, 1973:12-8. 8. Chapter in a Book Weinstein L, Swartz MN. Pathogenic properties of invading microorganisms. In: Sodeman WA Jr, Sodeman WA, eds. Pathologic physiology: mecha- nisms of disease. Philadelphia: WB Saunders, 1974:457-72. 9. Published Proceedings Paper DuPont B. Bone marrow transplantation in severe combined immunodeficiency with an unrelated MLC compatible donor. In: White HJ, Smith R, eds. Proceedings of the third annual meeting of the International Society for Experimental Hematology. Houston: International Society for Experimental Hematology, 1974:44-6. 10. Monograph in a Series Hunninghake GW, Gadek JE, Szapiel SV, et al. The human alveolar macrophage. In: Harris CC, ed. Cul- tured human cells and tissues in biomedical re- search. New York: Academic Press, 1980:54- 6.(Stoner GD, ed. Methods and perspectives in cell biology; vol 1). 11. Agency Publication Ranofsky AL. Surgical operations in short-stay hos- pitals: United States-1975. Hyattsville, Maryland: National Center for Health Statistics, 1978; DHEW publication no. (PHS)78-1785, (Vital and health statistics; series 13; no 34). 12. Dissertation or Thesis Cairns RB. Infrared spectroscopic studies of solid oxygen [Dissertation]. Berkeley, California: Univer- sity of California, 1965. 156 p. Other Articles 13. Newspaper Article Shaffer RA. Advances in chemistry are starting to unlock mysteries of the brain: discoveries could help cure alcoholism and insomnia, explain mental ill- ness. How the messengers work. Wall Street Journal 1977 Aug 12:1(col 1), 10(col 1). 14. Magazine Article Roueche B. Annals of medicine: the Santa Claus cul- ture. The New Yorker 1971 Sep 4:66-81. TABLES Type each table double spaced on a separate sheet. Do not submit tables as photographs. Number tables consec- utively in the order of their first c;tation in the text and supply a brief title for each. Give each column a short or abbreviated heading. Place explanatory matter in foot- notes, not in the heading. Explain in footnotes all non- Uniform Requirements for Manuscripts 261

standard abbreviations that are used in each table. For footnotes, use the following symbols, in this sequence: ', t,t, §, II.Ti,",tt,.... Identify statistical measures of variations such as stan- dard deviation and standard error of the mean. Do not use internal horizontal and vertical rules. Be sure that each table is cited in the text. If you use data from another published or unpublished source, obtain permission and acknowledge fully. The use of too many tables in relation to the length of the text may produce difficulties in the layout of pages. Examine issues of the journal to which you plan to sub- mit your paper to estimate how many tables can be used per 1000 words of text. The editor, on accepting a paper, may recommend that additional tables containing important back-up data too extensive to publish be deposited with an archival service, such as the National Auxiliary Publication Service (NAPS) in the United States, or made available by the authors. In that event, an appropriate statement will be added to the text. Submit such tables for consideration with the paper. ILLUSTRATIONS Submit the required number of complete sets of figures. Figures should be professionally drawn and photo- graphed; freehand or typewritten lettering is unaccept- able. Instead of original drawings, roentgenograms, and other material, send sharp, glossy black-and-white photo- graphic prints, usually 127 by 173 mm (5 by 7 in.) but no larger than 203 by 254 mm (8 by 10 in.). Letters, num- bers, and symbols should be clear and even throughout, and of sufficient size that when reduced for publication each item will still be legible. Titles and detailed explana- tions belong in the legends for illustrations, not on the illustrations themselves. Each figure should have a label pasted on its back indi- cating the number of the figure, author name, and the top of the figure. Do not write on the back of the figures, or scratch or mar them using paper clips. Do not bend fig- ures or mount them on cardboard. Photomicrographs must have internal scale markers. Symbols, arrows, or letters used in the photomicrographs should contrast with the background. If photographs of persons are used, either the subjects must not be identifiable or their pictures must be accom- panied by written permission to use the photograph. Figures should be numbered consecutively according to the order in which they have been first cited in the text. If a figure has been published, acknowledge the orig- inal source and submit written permission from the copy- right holder to reproduce the material. Permission is re- quired, irrespective of authorship or publisher, except for documents in the public domain. For illustrations in color, ascertain whether the journal requires color negatives, positive transparencies, or color prints. Accompanying drawings marked to indicate the region to be reproduced may be useful to the editor. Some journals publish illustrations in color only if the author pays for the extra cost. LEGENDS FOR ILLUSTRATIONS Type legends for illustrations double spaced, starting on a separate page, with arabic numerals corresponding to the illustrations. When symbols, arrows, numbers, or letters are used to identify parts of the illustrations, iden- tify and explain each one clearly in the legend. Explain internal scale and identify method of staining in photomi- crographs. Units of Measurement Measurements of length, height, weight, and volume should be reported in metric units (metre, kilogram, li- tre) or their decimal multiples. Temperatures should be given in degrees Celsius. Blood pressures should be given in millimetres of mer- cury. All hematologic and clinical chemistry measurements should be reported in the metric system in terms of the International System of Units (SI). Editors may request that alternative or non-SI units be added by the author before publication. Abbreviations and Symbols Use only standard abbreviations. Avoid abbreviations in the title and abstract. The full term for which an ab- breviation stands should precede its first use in the text unless it is a standard unit of measurement. Submission of Manuscripts Mail the required number of manuscript copies in a heavy-paper envelope, enclosing the manuscript copies and figures in cardboard, if necessary, to prevent bending of photographs during mail handling. Place photographs and transparencies in a separate heavy-paper envelope. Manuscripts must be accompanied by a covering letter. This must include (a) information on prior or duplicate publication or submission elsewhere of any part of the work; (b) a statement of financial or other relationships that might lead to a conflict of inrerest; (c) a statement that the manuscript has been read and approved by all authors; and (d) the name, address, and telephone num- ber of the corresponding author, who is responsible for communicating with the other authors about revisions and final approval of the proofs. The letter should give any additional information that may be helpful to the editor, such as the type of article in the particular journal the manuscript represents and whether the author(s) will be willing to meet the cost of reproducing color illustra- tions. The manuscript must be accompanied by copies of any permissions to reproduce published material, to use illus- trations or report sensitive personal information of identi- fiable persons, or to name persons for their contributions. PARTICIPATING JOURNALS The journals listed in Table I are those that notified the ICMJE of their willingness to consider for publica- tion manuscripts prepared in accordance with the guid- 262 February 1988 0 Annals of Internal Medicfne 6 Volume 108 0 Number2

ance given in the second (1982) edition of the Uniform Requirements for the Submission of Manuscripts to Bio- medical Journals. Their listing here does not imply that they endorse this present version (3rd) of "Uniform Re- quircments ...". The Index Medicus abbreviations for journal titles are given within square brackets. Table 1. Journals Participating in the Uniform Requirements Agreement Acta Medica Colombiana [Acta Med Colomb] Acta Orthopaedica Scandinavica [Acta Orthop Scand] Acta Paediatrica Japonica (Acta Paediatr Jpn (Overseas) ] Acta Paediatrica Scandinavica [Acta Paediatr Scand] Acta Pharmacologica Sinica [Acta Pharmacol Sin] Activox [Activox] AIDS.•An International BimonthlyJournal [AIDS] American Family Physician [Am Fam Physician] TheAmerican Journal of Cardiology [Am J Cardiol] The American Journal ofClinical Nutrition (Am J Clin Nutr] American Journal of Diseases of Children [Am J Dis Chi1dJ The American Journal of Emergency Medicine [Am J Emerg Med] American Journal ofEpidemiology [Am J Epidemiol] American Journal ofHospital Pharmacy [Am J Hosp Pharm] The American Journal ofHuman Genetics [Am J Hum Genet] The American Journal of Medicine (Am I Med] American Journal of Obstetrics .-tnd Gynecology [Am J Obstet Gynecol] American Journal ofOpiometry and Physiological Optics [Am J Optom Physiol Opt] The American Journal ofPathology [Am J Pathol] The American Journal ofPsychiatry [Am J Psychiatry] The American Journal ofPublic Health (Am J Public Health] AJR: American Journal of Roentgenology [AJR] The American Journal ofSurgery [Am I Surg] American ReviewofRespiratoryDisease [Am Rev Respir Dis] The American Surgeon [Am Surg] Anaesthesia [Anaesthesia] Anaesthesia and Intensive Care [Anaesth Intensive Care] Anesthesia and Analgesia [Anesth Analg] Annals of Clinical Biochemistry [Ann Clin Biochem] Annals of Clinical and Laboratory Science [Ann Clin Lab Sci] Annals oflnternal Medicine [Ann Intern Med] The Annals of Otology, Rhinology and Larynogology [Ann Otol Rhinol Laryngol] Annals of the Rheumatic Diseases [Ann Rheum Dis] The Annals of the Royal College of Physicians and Surgeons of Canada [Ann R Coll Physicians Surg Can] Annals of the Royal College of Surgeons of England [Ann R Coll Surg Engi] Annals ofSurgery [Ann Surg] The Annals of Thoracic Surgery [Ann Thorac Surg] Annals of Tropical Paediatrics [Ann Trop Paediatr] Archives ofDermatology [Arch Dermatol] Archives of Disease in Childhood (Arch Dis Child] Archives of General Psychiatry [Arch Gen Psychiatry] Archives oflnternal Medicine [Arch Intern Med] Archives of Neurology [Arch Neurol] Archives of Ophthalmology [Arch Ophthalmol] Archives of Otolarynogology-Head and Neck Surgery [Arch Otolaryngol] Archives of Pathology and Laboratory Medicine [Arch Pathol Lab Med] Archives of Surgery [Arch Surg] Archivos de Investigacion Medica [Arch Invest Med (Mex)] Arizona Medicine [Ariz Med] Arteriosclerosis: A Journal of Vascular Biology and Thrombo- sis [Arteriosclerosis] Australasian Journal of Dermatology [Australas J Dermatol] Australian and New Zealand Journal of Medicine [Aust NZ J Med ] Australian and New Zealand Journal of Ophthalmology [Aust NZ J Ophthalmol] The Australian and New Zealand Journal ofSurgery [Aust NZ J Surg] Australian Family Physician (Aust Fam Physician ) Australian Journal of Hospital Pharmacy [Aust J Hosp Pharm] Australian Orthoptic Journal [Aust Orthopt J] Australian Paediatric Journal [Aust Paediatr JJ Bangladesh Journal of Child Health [Bangladesh J Child Health] Bibliothek for Laeger [Bibl Laeger] Biomedical Bulletin [Biomed Bull] Boletin de la Asociacion Medica de Puerto Rico [Bol Asoc Med PR] Boletin Medlco de/ Hospital Infantil de Mexico [ Bol 'vfed Hosp Infant MexJ Bordeaux Medical [Bord Med] Brain and Development [Brain DevJ British Denta/Journal [Br Dent J] British Heart Journal [Br Heart J] British HomoeopathieJournal [Br Homoeopath JJ British Journal ofAnaesthesia [Br J Anaesth] British Journal ofIndus•trial Medicine [Br J Ind Mcd] British Journal of Occupational Therapy [Br J Occup Ther] British Journal of Ophthalmology [Br J Ophthalmol] British Journal of Pain [Br J Pain] British Journal ofRheurnatology [Br J Rheumatol] British Journal ofSurgery (Br J Surg] British Medical Bulletin [Br Med Bu11] British Medical Journal [Br Med JJ Bulletin of the Medical Library Association [Bull 'vled Libr AssocJ British Osteopathic Journal [Br Osteopath J] Bulletin of the World Health Organization [Bull WHO] Canadian Family Physician [Can Fam Physician] Canadian Journal ofAnaesthesia [Can J Anaesthes] Canadian Journal of Comparative Medicine [Can J Comp Med ] Canadian Journal ofPublic Health [Can J Public Health] Canadian Journal ofSurgery [Can J Surg] Canadian Medical Association Journal [Can Med Assoc J] Canadian Veterinary Journal (Can Vet JJ Cardiovascular Research [Cardiovase Res] Central African Journal ofMedicine [Cent Afr J Mcd] Cephalagia [Cephalalgia] Chest [Chest] Chinese Journal ofAnesthesiology [Chin J Anesthesiol] Chinese Journal of Cardiovascular Disease [Chin J Card;'ovasc Dis] Chinese Journal of Dermatology [Chin J Dermatol] Chinese Journal of Digestion [Chin J Dig] Chinese Journal of Endocrinology and Metabolism [Chin J En- docrinol Metab] ] Chinese Journal of Epidemiology [Chin J Epidemio] Chinese Journal ofExperimental Surgery [Chin J Exp Surg] Chinese Journal of Geriatology [Chin J Geriatol] Chinese Journal of Hematology [Chin J Hematol] Chinese Journal of Hospital Administration [Chin J Hosp Adm] Chinese Journal of Industrial H}•giene and Occupational Dis- ease [Chin J Ind Hyg Occup Dis] Chinese Journal oftnfectious Diseases [Chin J Infect Dis] Chinese Journal oflnternal.Yledicine [Chin J Intern N1edJ Chinese Journal ofllledical History [Chin J Med Hist] Chinese Journal of Medical Laboratory Technologr (Chin J Med Lab Technol] Chinese Journal of Microbiology and Immunolo~r [Chin J ti1i- crobiol Immunol] Chinese Journal ofNephrology [Chin J tiephroi] Un;formRequlre-nents'ort.,.--;v-`:;:<_ 263

Table 1. (Continued) Chinese Journal of Neurology and Psychiatry [Chin J Neurol Psychiatr] Chinese Journal ofNeuauurgery (Chin J Neurosurg) Chinese Journal of Nucl{ar Medicine (Chin J Nucl Med] Chinese Journal ofObstetrics and Gynecology (Chin J Obstet Gynecol] Chinese Journal ofOnc,ology (Chin J Oncol] Chinese Journal ofOphthalmology [Chin J Ophthalmol] Chinese Journal of Organ Transplantation (Chin J Organ Transplant] Chinese Journal of Orthopedics (Chin J Orthop] Chinese Journal ofOtolaryngology [Chin J Otolaryngol] Chinese Journal ofPathology [Chin J Pathol] Chinese Journal of Pediatric Surgery [Chin J Pediatr Surg] Chinese Journal of Pediatries (Chin J Pediatr] Chinese Journal ofPhysical Medicine [Chin J Phys Med] Chinese Journal of Physical Therapy (Chin J Phys Ther] Chinese Journal of Plastic Surgery and Burns [Chin J Plast Surg Burn] Chinese Journal ofPreventive Medicine [Chin J Prev Med] Chinese Journal of Radiological Medicine and Protection [Chin J Radiol Mcd] Chinese Journal ofRadiology [Chin J Radiol] Chinese Journal ofStomatology [Chin J Stomatol] Chinese Journal ofSurgery [Chin J Surg] Chinese Journal of Tuberculosis and Respiratory Diseases (Chin J Tuberc Respir Dis] Chinese Journal of Urology [Chin J Urol] Chinese Medical Journal (Chin J Med] Chronic Diseases in Canada [Chronic Dis Can] Circulation [Circulation] Clinica Chimica Acta [Clin Chim Acta] Clinical Chemistry [Clin Chem] Clinical and Experimental Optometry [Clin Exp Optom] Clinical Diabetes [Clin Diabet] Clinical and Investigative Medicine [Clin Invest Med] Clinical Pediatrics [Clin Pediatr (Phila) ] Clinical Pharmacology and Therapeutics [Clin Pharmacol Ther] Clinical Pharmacy [Clin Pharm] Clinical Preventive Dentistry [Clin Prev Dent] Community Dentistry and Oral Epidemiology (Community Dent Oral Epidemiol] Community Medicine [Community Med] Cuadernos del Hospital de Clinicas [Cua Hosp Clin] Danish Dental Journal [Dan Dent J] Danish Medical Bulletin [Dan Med Bull] Diabetes [Diabetes] Diabetes Care [Diabetes Care] Diabetes Journal [Diabetes J] Diabetologia [Diabetologia] Diagnostic Cytopathology [Diagn Cytopathol] Drug Intelligence and Clinical Pharmacy [Drug Intell Clin Pharm] Environmental Medicine [Environ Med] European Heart Journal [Eur Heart J] European Journal of Cancer and Clinical Oncology [Eur J Cancer Clin Oncol] European Journal ofClinicalInvestigation [Eur J Clin Invest] European Journal ofRespiratory Diseases [Eur J Respir Dis] European Journal of Rheumatology and InAammation [Eur J Rheumatol Inflamm] Family Medicine [ Fam Med ] Family Practice Research Journal [Fam Pract Res J] The Finnish AIedical Journal [Finn Med J] Gastroenterology [Gastroenterology] Gastrointestinal Endoscopy (Gastrointest Endosc] Genitourinary Medicine [Genitourin Med] Geriatrics [Geriatrics] Gut [Gut] Hau•aii Medical Journal [Hawaii Med J] Health Trends [Health Trends] Nellenike Chcirourgike (Hell Chcir] Helleniki latrike [Hell Iatr] Ilong Kong Medical Technology Association Journal [Hong Kong Med Technol Assoc J] Hospital Pharmacy (Hosp Pharm] latrike (Iatrike] Indian Journal of Dermatology, Venereology and Leprology [Indian J Dermatol Venereol Lepr] Indian.lournal of Gastroenterology [Indian J Gastroenterol] Indian Journal of Urology [Indian J Urol] International Disability Studies [Int Disabii Stud] International Journal of Epidemiology [Int J Epidemiol] International Journal of Pediatric Nephrology [Int J Pcdiatr Nephrol] International Surgery [Int Surg] Israel Journal of Psychiatryand Related Sciences [ Isr J Psychi- atry Relat Sci] JAMA (Chicago) [JAMA] The Journal of Allergy and Clinical Immunology [J Allergy Clin Immunol] Journal of the American College of Cardiology [J Am Coll Cardiol] Journal of the American Medical Association (see JAMA) The Journal ofApplied Nutrition [J Appl Nutr] Journal of Biological Standardization [J Biol Stand] Journal of the British Association for Immediate Care [J Br Assoc Immed Care] Journal of the Canadian Association of Radiologists [J Can Assoc Radiol] Journal of the Canadian Chiropractic Association [J Can Chi- ropr Assoc] Journal of Cardiovascular Surgery [J Cardiovasc Surg] Journal ofChronic Diseases [J Chronic Dis] Journal of Clinical Gastroenterology [J Clin Gastroenterol] Journal of Clinical Pathology [J Clin Pathol] Journal of the Danish Medical Association (see Ugeskrift for Laeger) The Journal of Diabetic Complications [J Diabetic Compl] Journal ofDiarrhoeal Disease Research [J Diarrhoeal Dis Res] Journal of Epidemiology and Community Health [J Epidemiol Community Health] Journal of the Faculty of Medicine Baghdad [J Fac Med Bagh- dad] Journal of the Institute ofMedicine [J Inst Med] Journal of the Irish Colleges of Physicians and Surgeons [J Ir Coll Physicians Surg] The Journal of Laboratory and Clinical Medicine [J Lab Clin Mcd ] The Journal of Maternal and Child Health [J Maternal Child Health ] Journal ofManipulative and Physiological Therapeutics [J Ma- nipulative Physiol Ther] Journal of Medical Ethics [J Med Ethics] Journal of Medical Genetics [J Med Genet] Journal ofthe National t.;ancer Institute [JNCI] Journal of Neurology, Neurosurgery and Psychiatry [J Neurol Neurosurg Psychiatry] Journal of Neuropathology and Experimental Neurology [J Neuropathol Exp Neurol] The Journal of Nuclear Medicine [J Nucl Med ] Journal of Nuclear Medicine Technology [J Nucl Med Tech- nol] The Journal ofPalliative Care [J Palliat Care] Journal ofPat.5ology [J Pathol] Journal of Pharmacy Technology [J Pharm Technol] Journal of Psychosomatic Research [J Psychosom Res] Journal of the Royal Army Medical Corps [J R Army Med Corps] Journal ofthe Royal College of Physicians of London [J R Coll Physicians Lond] Journal of the Royal College of Surgeons of Edinburgh [J R Coll Surg Edinb] 264 February 1988 0 Annals of Internal Medicine 0 Volume 108 0 Number 2

Table 1. (Concluded) Journal of the Royal Naval Medical Service [J R Nay Med Serv] Journal of the Vivekananda Institute of Medical Sc•ic•nces [J Vivekananda Inst Med Sci] Lakartidningen [Lakartidningcn] The Lancet [Lancet] Leprosy Review [Lepr Rev] Malaysian Journal of Pathology [Malays J Pathol] Manedsskrift for Praktisk Laegegerning [Manedsskr Laegegern] Medicina Intensiva [Med Intensiv] Medical Care [Med Care] Medical and Pediatric Oncology [Med Pediatr Oncol J TheMedicallournal ofAustralia [Med J AustJ Medical Laboratory Sciences [Med Lab SciJ Mediclna Clinica [Med Clin (Bare)] Medicine (Oxford) [Medicine (Oxford) ] MilitaryMedicine [Milit Med] Prakt The Mount Sinai Journal of Medicine [Mt Si na i J Med ( N Y)] National Medical Journal of China [Chung Hua I Hsuch Tsa Chih] Nederlands Tijdschrift voor Geneeskunde [Ned Tijdschr Gen- eeskd] Neurology [Neurology] Netv Doctor [N Doctor] The New England Journal of Medicine [N Engl J Med] New York State Journal of Medicine [NY State J Med] New Zealand Family Physician [NZ Fam Physician] New Zealand Journal of Medical Laboratory Technology [NZ J Med Lab Technol] New Zealand Medical Journal [NZ Med J] Newfoundland Medical Association Journal [Newfoundland Med Assoc J] Nigerian Medical Journal [Niger Med I] No To Hattatsu [No To Hattatsu] Nordisk Medicin [Nord Med] North Carolina hledical Journal [NC Med J] Nosokomaka Chronica [Nosokom Chron] Nursing [Nursing] Obstetrics and Gynecology [Obstet Gynecol] Ophthalmology [Ophthalmology] Otolaryngology and Head and Neck Surgery Head Neck Surg] [Otolaryngol Papua New Guinea Medical Journal [Papua New Guinea Med J] Pharmacy Management Combined with the American Journal of Pharmacy [Pharm Manage Comb Am J Pharm] Pathology [Pathology] Pediatric Emergency Care [Pediatr Emerg Care] Peritoneal Dialysis Bulletin [Perit Dial Bull] Pharmaceutisch Weekblad [Pharm Weekbl] Pharmaceutisch Weekblad. Scientific Edition [Pharm Weekbl (Sci) ] Commun j Phurmacolhcr.upy [PharmacotherapyJ The I'hysician und Sports Medicine [Physician Sports Med J Postgruduute Doctor-Africa [Postgrad Doctor AfrJ Postgruduatc Doctor-Asia [Pcntdrad Doctor AsiaJ Postgraduatc Medical Journal [Postgrad Med J J Po.stgraduate Medicine [Postgrad MeriJ Psychiatria Fennica [Psychiatr FennJ Public Health [Public Health] Puerto Rico Hea/th Sciences Journal [PR Health Sci J] Quarterly Journal of Medicine [Q I Mcd J Radiology [Radiology] Revista Chilena de Pediutria [Rev Chil Pediatrj Revista Clinica Espanola [Rev Clin Esp] Revista de Gastrocnterologia de Mcxico [Rev Gast roen terol Mex ] Revista E.spanola de Reumato%gia [Rev Esp Reumatol] Revista Medica de Chile [Rev Med Chil] Revista Medic•a del Instiluto Mexicano del Seguro Socivl [ Res Med Inst Mex Seguro SocJ Revisla Mexicana de Anestesiologia [Rev Mex Aneste5iol J Revista Mexicana de Radiologia [Rev Mex Radiol J Salud Publica de Mexico [Salud Publica 'vlex] Saudi Medical Journal [Saudi Med JJ Scandinavian Journal ofDental Research [Scand I Dent Res ] Scandinavian Journal ofHaematology [Scand J Haematol] Schumpert Medical Quarterly [Schumpert Med Q] Schweizerische Medizinische Wochenschrift [SchKeiz Med Wochenschr] Sexually Transmitted Diseases [Sex Transm DisJ Shinkci Byorigaku [Shinkei Byorigaku] South African Medica/Journal [S Afr'vled JJ Southern Medical Journal [South Med J] The Springfield Clinic Medical Bulletin [Springfield Clin Med Bull] Sri Lankan Family Physician [Sri Lankan Fam Physician] Thorax [Thorax] Tidsskrift for den Norske Laegeforening [Tidsskr tior Laegeforen] Transactions-American Socicty Ibr Artificial Internal Organs [Trans Am Soc Artif Intern Organs] Transfusion [Transfusion] Tropical Gastroenterology [Trop Gastroenterol] UgeskriR for Laeger [Ugeskr Laeger] Ulster Medical Journal [Ulster Med J] Undersea Biomedical Research [Undersea Biomed Res] Veterinary Radiology [Vet Radio]] The West Virginia Medical Journal [W Va Med IJ The Western Journal ofMedicine [West J`vlcd] WHO Chronicle [WHO Chron] World Health Statistics Quarterly [World Health Stat Q] World Medical Journal [ WorJd Med J] Yale Journal ofBiology and Medicine [Yale J Biol Med] Pharmacological Research Communications [Pharmacol Res Un,torm P.eawre-~~ts'or'• 265