Ask Dr. Austin: Explaining your country’s medical system as it affects your research

When writing a manuscript, you need to research your target journal, anticipate any potential points of confusion, and add short clarifying descriptions where needed. This is particularly true when government medical systems are involved. The Japanese medical system includes unique elements, and many of your readers will be unfamiliar with that system, so you have to briefly explain the essential points. 

       For example, let’s consider a study that uses a Japanese insurance database to determine the prevalence of a certain disease by looking at findings from specific screening tests. You write a paper describing that study, and you submit your paper to a United States medical journal. The reviewers immediately ask questions about the methodology, including, “Why did the doctor run this test?” “How were these data obtained?” “Did the patients agree to be part of this study?” You have to rewrite part of the Methods to briefly describe:

  • the Japanese national disease register
  • the fact that this type of study does not require patient consent because the information is anonymized before it was made available to you
  • the fact that many Japanese workers receive a very thorough in-hospital health exam every year as part of their health insurance coverage
  • the fact that the applicable Japanese guideline recommends running certain screening tests in specific patients  

This kind of background information helps the reader (and the reviewers and journal editor!) to understand and appreciate your paper. It may also speed up the review process.