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The major pulmonary and critical care journals publish more than 5,000 articles every year. To read these would require more than 25 hours each week. Despite the surfeit of information, the average physician is starving for wisdom. The aim of scholarship is to increase understanding, not just accumulate discrete facts. A stack of papers no more conveys wisdom than a pile of bricks makes a house.
If new research is to improve patient care, reports need to be fitted into the mosaic of existing knowledge. General medical journals, such as the New England or Annals, publish a much higher proportion of review articles than do subspecialty journals. But the audience for a subspecialty journal is different from a general medical journal. The first rule of writing is to identify your audience. Review articles that appeal to general physicians are unlikely to satisfy subspecialists, who are expected to have a more detailed and nuanced understanding of subjects in their field.
The first step in writing a review article is selecting a suitable subject. Authors of a review article in AJRCCM may pick a broad field suited to a comprehensive overview in a State-of-the-Art (1-14), encapsulate a surge of rapid progress in a Pulmonary Perspective (15-30), turn a searchlight on an overlooked subject in a Critical Care Perspective (31-40), capture advances in related fields in an Update in Nonpulmonary Critical Care (41-53), convey practice pearls in a Clinical Commentary (54-63), share the secrets of scientific discovery in a How it Really Happened (64-78), or comment on a social conundrum in an Occasional Essay (79-83). By definition, a review article does not include original data. Yet, the perspective should be fresh and the synthesis unique. Authors must avoid a rehash of views expressed in existing reviews.
When writing a state-of-the-art review, the author needs to amass and synthesize a huge number of original reports. The skill is akin to that of a landscape artist. When ranging over a great sweep of scenery, the naked eye takes in millions of shapes, shades, and textures. The painter reduces this complexity to a few hundred brush strokes through ruthless selection, intensifying some contours, ignoring others, and reordering and harmonizing the relationships between elements. Great compositional skill is needed to place the...