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P Values, Educational Studies, and Reporting Guidelines: Updates to the Prehospital and Disaster Medicine Instructions for Authors

Published online by Cambridge University Press:  05 February 2025

Jeffrey M. Franc*
Affiliation:
Research Director, Department of Emergency Medicine, University of Alberta, Alberta, Canada
*
Correspondence: Jeffrey Michael Franc, MD, MS (Stats), M.Sc. (DM), FCFP(EM), Dip Sport Med Research Director Department of Emergency Medicine University of Alberta, Alberta, Canada 736c University Terrace, 8203-112 Street NW Edmonton, AB, Canada, T6G 2T4 Email: jeffrey.franc@ualberta.ca
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Abstract

For 2025, three new additions will be made to the instructions for authors. This includes an updated policy on P values, more detailed instructions for educational studies, and the use of existing reporting guidelines for many study designs.

Type
Editorial Comments
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of World Association for Disaster and Emergency Medicine

As a researcher, I have frequently found that following the instructions for authors of some journals is a painful experience. Often the instructions lack details and are spread across several web pages. Given the lack of detail, specific instructions often arrive only after the submission during the review process. This can lead to rounds of time-consuming revisions. Upcoming changes to Prehospital and Disaster Medicine’s (PDM’s) instructions for authors will provide more concise detail of requirements and make it easier for authors to view and follow the instructions.

Additions to the Instructions for Authors

For 2025, three new additions will be made to the instructions for authors. This includes an updated policy on P values, more detailed instructions for educational studies, and the use of existing reporting guidelines for many study designs.

P Value Policy

P values, while an indispensable method for hypothesis testing, have become increasingly problematic and increasingly controversial. Many manuscripts continue to use many P values and rely on the fact that several were positive to form the findings of the study. Unfortunately, this type of analysis is strongly discouraged as it creates a high risk of Type 1 error. Many journals, including the New England Journal of Medicine, have issued updates on the use of P values. Reference Harrington, D’Agostino and Gatsonis1 Primarily, these updates are designed to avoid many of the pitfalls associated with P values, including issues of multiplicity, magnitude of effect, and reporting. The updated P value policy for PDM will include the following instructions for authors:

  1. 1. Significance tests should always be accompanied by a confidence interval for effect size;

  2. 2. In general, P values should be limited to the primary outcome of the study;

  3. 3. If multiple P values are reported, the methods must describe the statistical controls for Type 1 error, such as the Bonferroni adjustment or a specified hierarchical procedure;

  4. 4. If no adjustment for multiplicity is used, researchers must limit P values to the primary outcome and report secondary or exploratory effects with a confidence interval; the methods should state explicitly that the confidence intervals were unadjusted and should not be used for hypothesis testing; and

  5. 5. Explicit instructions to reaffirm that P values should never be used to compare the distribution of baseline variables between randomized groups.

Educational Studies

While not primarily an educational journal, PDM does occasionally publish educational studies. The new instructions for authors will give additional clarification of which type of educational studies are appropriate for PDM and how to best format these studies.

Generally, PDM does not publish educational studies unless they: (1) introduce an innovative educational technique not previously published; and (2) are widely generalizable to many settings.

Educational studies should explicitly state in the introduction how the research was grounded in or framed within educational theory or principles. Educational studies at the higher levels of the Kirkpatrick hierarchy are strongly preferred. Reference Kirkpatrick and Kirkpatrick2 Submissions showing groups of learners doing better on tests after training than they did before training, or reporting on their satisfaction with a specific training program, are of little generalizable value.

Reporting Guidelines

PDM has long required reporting guideline checklists for several study types. Generally, authors are required to attach the checklist as supplemental material when the manuscript is submitted. This has included guidelines for randomized controlled trials, diagnostic studies, systematic reviews, and others. The new instructions for authors will include these guidelines and further expand the scope of reporting checklists:

  1. 1. Randomized Controlled Trials: CONSORT checklist;

  2. 2. Observational Epidemiologic Studies: STROBE checklist;

  3. 3. Diagnostic Accuracy: STARD checklist;

  4. 4. Meta Analysis/Systematic Reviews: PRISMA checklist;

  5. 5. Scoping Reviews: PRISMA-SCR checklist;

  6. 6. Quality Improvement: SQUIRE checklist;

  7. 7. Qualitative Studies: COREQ or SRQR checklist; and

  8. 8. Conference Reports: STROBE checklist.

Authors are encouraged to use the reporting checklists in a formative fashion - reworking and amending the manuscript to ensure that all issues in the checklist are explicitly addressed in the manuscript.

Clarifications to the Instructions for Authors

In addition to the three new topics above, additional clarifications will be added to the instructions for authors around several of the journal’s existing policies. These clarifications are focused on several areas that are common causes for article rejection, such as:

  1. 1. Outcome data should be presented as means, percentages, and proportions with accompanying 95% confidence intervals; medians must have interquartile range reported.

  2. 2. All real or potential conflicts of interest must be reported; authors should disclose all conflicts of interest, not just those specifically related to the submission.

  3. 3. Each author must meet all four criteria for authorship based on the International Committee of Medical Journal Editors (ICMJE), including: (1) conception and design; (2) drafting or reviewing; (3) final approval of the document; and (4) agreement to be accountable for all aspects of the work. 3 When the number of authors appears unusually high given the nature of the research, the article may be returned to the authors for additional clarification of each authors’ contribution.

  4. 4. Regardless of the submission category, all research that includes human or animal subjects (including survey research, educational studies, disaster reports, or analysis of patient databases) must be submitted to an independent research ethics review committee for approval. Authors must provide either (A) the name of the research ethics board providing the approval and the identification number in the manuscript text, or (B) the name of the research ethics board providing the exemption and a copy of the exemption letter (uploaded as a supplementary file).

  5. 5. PDM reserves the right to refuse publication of any submission that in the editor’s opinion duplicates a previous publication. PDM uses iThenticate (TurnitIn LLC; Oakland, California USA) to assist in this decision. Note that plagiarism includes the excessive copying of the author’s own previously published manuscripts.

  6. 6. PDM prioritizes clarity in manuscript formatting, following the ICMJE guidelines. 4 An excellent step-by-step guide to formatting a manuscript is available from Stiell, et al. Reference Stiell and Canadian5

Summary

Prehospital and Disaster Medicine’s new instructions for authors will provide additional clarity to authors, peer reviewers, and editors. It is hoped that these instructions - in combination with compact checklists - will simplify and standardize the submission process for contributors.

Conflicts of interest

JMF is the CEO and founder of STAT59, an employee of the University of Alberta, and the Editor-in-Chief of Prehospital and Disaster Medicine.

References

Harrington, D, D’Agostino, RB Sr, Gatsonis, C, et al. New guidelines for statistical reporting in the journal. N Engl J Med. 2019;381(3):285286.CrossRefGoogle ScholarPubMed
Kirkpatrick, JD, Kirkpatrick, WK. Kirkpatrick’s Four Levels of Training Evaluation. Alexandria, Virginia USA: Association for Talent Development; 2016.Google Scholar
Stiell, IG, Canadian, EMWG. Guide to writing and publishing a scientific manuscript: Part 1-the structure. CJEM. 2022;24(2):117119.CrossRefGoogle ScholarPubMed