Manuscript Submission

Author Resource Center
Information for Authors

Submission Process
Previous Publication and Simultaneous Submission
Article Categories
Manuscript Preparation
Peer Review and Publication Process

These guidelines for contributors to The Journal of the American Osteopathic Association (JAOA) are in accordance with the "Uniform Requirements for Manuscripts Submitted to Biomedical Journals: Writing and Editing for Biomedical Publication" established by the International Committee of Medical Journal Editors (ICMJE). These guidelines are also in accordance with the 10th edition of the AMA Manual of Style: A Guide for Authors and Editors (2007). Manuscripts submitted to the JAOA can be prepared using the JAOA's, the ICMJE's, or the AMA's guidelines.

The Journal gives priority to original research, systematic reviews, and meta-analyses.

Submission Process

To submit a manuscript to the JAOA, log on to our web-based manuscript tracking system. Authors can upload manuscripts and accompanying materials to the site and will receive all correspondence regarding their submissions through the site. During the submission process, authors must upload all manuscript components. Failure to do so will result in the manuscript being temporarily unsubmitted. The JAOA will consider the manuscript after all items are submitted.

Please note that our submission process is designed for original contributions. If you feel that a specific question or text box (eg, abstract, IRB approval) does not apply to the manuscript you are submitting, please enter "NA" (not applicable). Shortly after submission, authors will receive an e-mail through the system prompting them to sign and return a copyright release form. 

Authors can check the status of their submissions online at any time. A description of the statuses are below.

Awaiting Reviewer Invitation/Assignment - the manuscript has not been sent to the minimum number of peer reviewers yet.
Awaiting Reviewer Scores - the manuscript has been sent to the minimum number of peer reviewers, but reviews have yet to be received.
Overdue Reviewer Scores - peer review deadlines have passed, but reviews have yet to be received.
Awaiting OE Recommendation - the oversight editor is reviewing the manuscript and making a recommendation to the editor in chief.
Awaiting Pre-Acceptance Editorial Review - journal staff is completing editorial review.
Awaiting EIC Decision/Awaiting Decision Approval - the editor in chief has made a decision, and authors can expect to know the next step within a few days.

All manuscripts should be submitted as Microsoft Office Word documents or in Rich Text Format. Submissions received as PDFs will be returned. All manuscripts should be formatted in 12-point standard font (eg, Times New Roman).

For specifications regarding electronically generated graphic elements, consult the section titled "Graphic Elements" in these guidelines.

Authors are encouraged to use the JAOA's "Manuscript Checklist" as a reference for required materials when preparing manuscripts for submission.

Previous Publication and Simultaneous Submission

The JAOA accepts manuscripts for consideration with the understanding that they have not been published elsewhere in print or online and that they are not simultaneously under consideration by any other print or electronic publication. Any duplicate materials (eg, an abstract, material published using the same or similar data, graphic elements) should be described in the cover letter and identified as such in the submitted materials.

Because the JAOA's volunteer peer reviewers invest a considerable amount of time in the peer review process, manuscripts must be withdrawn from consideration at the JAOA if they (1) have already been published in any print or online medium or (2) are currently under review by another biomedical journal or other publication.

Article Categories

Authors submitting original contributions and reviews are encouraged to follow the guidelines of Annals of Internal Medicine. Links to this journal's guidelines are provided where applicable. However, please note that the word limits and abstract requirements of Annals of Internal Medicine are not applicable to JAOA submissions. The JAOA's abstract requirements are described later in this document.

Recommended limits on word count, number of references, and number of tables or figures are listed below for each JAOA section. These limits are provided to help guide authors as they prepare their submissions. Manuscripts that exceed these limits may be considered for publication; however, an author may be asked to shorten his or her manuscript. Lengthy graphic elements and supplemental material may be published online only. Authors are encouraged to submit other online-only content such as videos.

The JAOA welcomes submissions in the categories listed below. Requirements for each section are also listed in the JAOA's "Manuscript Checklists."

Note: The JAOA no longer considers opinion pieces (formerly "In My View"), personal essays (formerly "In Your Words"), special reports, book reviews, or "Still Relevant" essays for publication. However, authors are encouraged to submit personal essays and perspectives to The DO, the AOA's online magazine, at

Original Contributions
Manuscripts in this category document original clinical or applied research. Original contributions include controlled trials, observational studies, diagnostic test studies, cost-effectiveness studies, and survey-based studies. The JAOA will accept basic scientific research only if the work has clear clinical applications. For randomized controlled trials, study flow diagrams must be submitted. For all other types of original contributions, flow diagrams are encouraged. Original contributions should be 3000 words with no more than 50 references and 5 tables or figures.

The JAOA will consider quality improvement studies that may be valuable to its readership; however, the authors of such studies must obtain a statement of exemption from the institutional review board at the author’s institution. Quality improvement studies without exemption status will not be considered.

If the manuscript includes OMT protocols, the JAOA encourages the inclusion of an accompanying video that demonstrates the OMT protocols. The JAOA will give priority to submissions with video accompaniment. 

Brief Reports
Submissions in this category substantively but briefly document clinical information, early-phase investigations and small pilot studies, clinical "pearls," and similar scholarly insights.

Brief reports should be structured as original contributions and should include at least the following sections: (1) a brief introduction to the topic, (2) an outline of study methods, (3) a description of results, (4) a discussion of the implications of the findings, and (5) a conclusion. Brief reports should be 2500 words with no more than 35 references and 4 tables or figures.

Manuscripts of this type are detailed, critical surveys of published research relevant to clinical problems. Systematic reviews and meta-analyses are preferred and will receive a higher publication priority than other reviews. Systematic reviews should have a clear objective, a description of the data-selection and -exclusion process, and a discussion of the research implications.

Narrative reviews should include a clear objective, a description of the condition being reviewed, a summary of common problems in diagnosis and treatment, and a discussion of new theories in the medical literature for improving patient care.

Reviews are limited to 3500 words with no more than 75 references and 4 tables or figures.

Clinical Review
Manuscripts of this type are brief reviews summarizing evidence on a specific clinical question. Manuscripts in this category should consist of the following 3 sections: introduction to the topic, summary of the evidence, and conclusion. They should also include a box that summarizes the main points by answering the following questions: (1) What is the clinical question? (2) What does the evidence say? and (3) What is the take-home message for clinicians? Clinical reviews should be kept to 1500 words and 25 references. No abstract is needed for this section.

Reviews in Musculoskeletal Medicine
Alterations in the musculoskeletal system have systemic consequences that affect human health and well-being. Manipulation of this system through manual techniques, exercise, regenerative and surgical techniques, dietary changes, and lifestyle modifications may assist in the management of complex multisystem disorders such as obesity, cardiovascular disease, diabetes, and other metabolic disorders. Understanding how these disorders affect population health and how chronic diseases impact musculoskeletal health are key research questions for osteopathic medicine.

Submissions in this section should briefly but critically review and update the contemporary research focused on the musculoskeletal system’s relationship to health and disease and generate hypotheses for future research needed in the field. Submissions should introduce the problem or clinical question (1-2 paragraphs); discuss what is already known and the state of the current research on the question (1-2 paragraphs); assess the recent literature, pointing out limitations and the need for further research in the field (3-5 paragraphs); and provide a definitive conclusion as to the meaning of the articles reviewed and future directions.

Submissions are limited to 1500 words and 20 references. Authors must translate the evidence so that it is relevant to clinicians.

Clinical Practice
Manuscripts in this category consist of expert critical viewpoints with practical applications for osteopathic physicians. Although often similar to review articles in both content and structure, clinical practice articles emphasize findings and recommendations based on the authors' clinical experience. Clinical practice submissions should be 3000 words with no more than 50 references and 4 tables or figures.

Art and Science of Osteopathic Medicine
This new section is meant to enhance our readers' understanding of the pathogenesis of common problems seen by generalist physicians. These manuscripts should begin with a brief clinical vignette followed by an up-to-date review of the pathogenesis of the condition. Authors should make every effort to link the discussion to osteopathic principles, and the conclusion should be hypothesis generating to stimulate further work in the area.

Submissions to "Art and Science of Osteopathic Medicine" should have no more than 2500 words and consist of an abstract (<200 words), clinical vignette (<300 words), pathogenesis (<2000 words), conclusion (<200 words), references (<30), and 1-2 figures, if helpful.

Medical Education
Manuscripts in this category focus on osteopathic undergraduate, graduate, and continuing medical education.

Medical education submissions may be structured as original contributions, review articles, or special communication articles. They should focus on curricular developments, standardized tests, or programs specific to osteopathic medical education. Generally, medical education submissions should be 3000 words or less with no more than 50 references and 5 tables or figures.

Empathy in Medicine
"Empathy in Medicine" is a series of articles in the JAOA pertaining to teaching and measuring empathy in medical education and to the role of empathy in patient care and health outcomes. Articles in this section do not follow a unique format or guidelines. Research studies on empathy should follow the guidelines for original contributions, reviews of empathy in medicine should follow the guidelines for review articles, and so on.

Special Communication
Articles in this section cover various biomedical topics of interest to osteopathic physicians, especially unique perspectives and hypotheses related to health care, career development, and the application of osteopathic manipulative treatment. Special communication manuscripts should be 2500 words with no more than 35 references and 3 tables or figures.

Case Reports
To be considered for publication in the JAOA, case reports MUST describe clinical presentations that have strong relevance to osteopathic medicine. These manuscripts must also include results of osteopathic structural examinations and a relevant literature review. Case series are strongly encouraged.

Case reports should follow the CARE guidelines and include the following: (1) a brief narrative abstract; (2) an introduction to the topic (eg, prevalence, implications, differential diagnoses); (3) a description of the patient's presentation, medical history, treatments, and outcomes; (4) a discussion of the case in the context of relevant medical literature; and (5) a conclusion. Case reports should be 1500 words with no more than 20 references and 2 tables or figures.

Clinical Images
This section showcases medical conditions that osteopathic physicians encounter. "Clinical Images" is intended to provide meaningful learning opportunities but is not meant to be an outlet for case reports.

Manuscript submissions to this section should include the following: (1) up to 2 original images of a condition that the authors encountered in the clinical setting, (2) a title and short paragraph of no more than 150 words that describes the patient presentation and resolution of the condition, (3) a maximum of 2 authors, and (4) a few references, if appropriate. Images submitted for this section must be associated with the described case.

The JAOA’s SURF section seeks to engage Students, Residents, and Fellows in scholarly publications. Manuscripts published in this section should be written by trainees and provide their unique perspectives. Osteopathic medical students, residents, and fellows are encouraged to share their research projects, evidence reviews, and other submissions related to issues important to them. Research-based SURF submissions should focus on treating the whole patient and may be related to student-driven community initiatives. They should be structured as original contributions but may be more narrative and less data driven than the JAOA’s original contributions. These types of studies should be limited to 2000 words with no more than 2 tables or figures and 20 references. The JAOA has prepared a manuscript template to help novice investigators document their research. All other SURF submissions should follow the submission guidelines for each of the manuscript types as noted previously. The JAOA welcomes SURF submissions that do not fit under current JAOA sections; these submissions will be evaluated on a case-by-case basis.

Editorials are commentaries on articles published in the current or a recent issue of the JAOA. The JAOA also publishes editorials written by the editor in chief or associate editors describing important changes to The Journal and its processes. Editorials are typically solicited, although unsolicited editorials may be considered. Editorials are typically 1000 words with 10 references and 1 table or figure, if appropriate.

Health Policy
Manuscripts for this section should provide clear overviews of public policy, legislative proposals, or other issues related to health care cost, quality, and accessibility that may impact osteopathic medicine. Health Policy manuscripts should consist of the following 5 sections: (1) a 1-2 paragraph introduction to the topic with key statistics, ending with an objective statement; (2) a 1-2 paragraph history and background of the issue being discussed; (3) a summary of the stakeholders’ arguments for and against actions related to the issue (including the AOA's position, when applicable); (4) recommendations of the author; and (5) references.

Health Policy submissions do not require abstracts. Authors should limit submissions to approximately 1500 words with no more than 20 references and 1 table or figure, if appropriate. Because these types of submissions are time sensitive, the JAOA will consider these to be high priority for publication once they are accepted by the editor in chief for publication.

Letters to the Editor
Osteopathic physicians, faculty members at osteopathic medical colleges, osteopathic medical students, and others in the healthcare professions are encouraged to submit comments related either to articles published in the JAOA or to the mission of the osteopathic medical profession. The JAOA's editors are particularly interested in letters that discuss recently published original research. Letters are limited to 400 words. Unsigned letters will not be considered for publication in the JAOA.

Manuscript Preparation

For additional guidance in scholarly activity and manuscript preparation, visit the JAOA's Author Resource Center. All manuscripts and tables should be submitted as Microsoft Word documents.

Public Registration
For manuscripts on phase 3 clinical trials, the trials must have been registered with at least 1 public registry before subject enrollment in the study. Other prospective trials involving human subjects, including pilot studies, must meet this requirement, regardless of whether a prospectively assigned concurrent control or comparison group is used.

Authors must provide the JAOA with the name of the public registry they used. The registry listings for research submitted to the JAOA must include information on the 20 items that the World Health Organization identified in 2004 as the minimal registration data set.

Manuscript Components

Authors must submit each of the components listed below, either as separate Word files or as a single Word file.

  • Cover letter—A cover letter addressed to AOA Editor in Chief Robert Orenstein, DO, must accompany each submission. The cover letter should provide the corresponding author's full name and contact information, including that author's full professional titles and affiliations, preferred mailing address, preferred e-mail address, day and evening telephone numbers, and preferred fax number.

    The cover letter should specify the type of article being submitted for consideration (eg, original contribution), all of the relevant practice focus areas addressed in the manuscript (eg, gynecology, oncology, gynecologic oncology, gynecologic surgery), and the name of the institution from which the work initiated.

    Finally, authors are encouraged to suggest reviewers for the AOA editor in chief and the JAOA's associate editors to consider.

  • Title page—The title page should include the title; full author names, professional titles, and affiliations; author contributions; and financial disclosures. Authors' names should appear according to the authors' preferred usage and include all doctoral and master degrees in the order in which they were earned. For authors without doctoral or master degrees, their highest earned academic degrees or relevant certifications should be listed. The names of osteopathic medical students should include the OMS designation with the year of training in Roman numerals (eg, "OMS IV" should appear after the names of fourth-year osteopathic medical students). In addition, the full professional titles and affiliations of all of the manuscript's authors should be included on the title page.

    Any manuscript submitted by osteopathic medical students, interns, or residents must include at least one trainer's name in the byline. The trainer should be a clinician or basic scientist who has a thorough understanding of the research or other work associated with the manuscript.

    Each author's contributions must be identified using language provided by the International Committee of Medical Journal Editors, as follows: "[Author(s)] provided substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; [Author(s)] drafted the article or revised it critically for important intellectual content; [Author(s)] gave final approval of the version of the article to be published; and [Author(s)] agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved." Each author must meet each of the 4 criteria. Individuals who do not meet all 4 of the requirements should be listed in the acknowledgments.

    The title page should describe any financial support provided for the work on which the manuscript is based, and grant numbers should be provided. For each author, the title page should also include a financial disclosure statement (eg, employment, funding, or stock ownership with the manufacturer of the product studied) and a conflict of interest statement (eg, any nonfinancial affiliation with a group that may benefit from the study, such as serving on a formulary committee). In the event that authors do not have any potential conflicts to disclose, a statement to that effect must be made on the title page. A list of potential conflicts of interest is included in the "Manuscript Checklist" page.

  • Abstract—The JAOA requires structured abstracts for original contributions, systematic reviews, meta-analyses, and brief reports. Unstructured abstracts are acceptable for all other article types. Structured abstracts are limited to 350 words. Unstructured abstracts are limited to 150 words.

    Structured abstracts for original contributions and brief reports should include at minimum the following four sections: context, objective, methods, results, and conclusions. Structured abstracts for systematic reviews and meta-analyses should consist of at least the following 6 sections: objective, data sources, study selection, data extraction, data synthesis, and conclusions.

  • Introduction—Authors should briefly introduce the topic of their manuscript. Introductions should generally consist of 3 paragraphs: (1) background describing the previous work that led to the research, (2) the research question and domain of the inquiry (eg, therapy, diagnosis, quality), and (3) goals of the study.

  • Methods—For prospective clinical trials, including pilot studies, the methods section must state the name of the public registry in which the trial was listed before subject recruitment began (see "Public Registration").

    For a human or experimental animal investigation, the methods section must identify the institutional review board that approved the project. It must also state the manner in which informed consent was obtained from human subjects.

    Authors must also clearly describe the basic study design, list measurement instruments and other tools used for independent and dependent variables, and clearly identify any modified or novel interventions that did not comply with approved or standard use.

    In addition, authors must define the masking or blinding protocol and any statistical methods used, providing the full name of each method at first mention (eg, "Pearson's product moment correlation coefficient" rather than "Pearson's correlation coefficient").

    As a general guideline, the methods should be written with enough detail that another researcher can replicate the study.

  • Results—Authors must report all outcome data and other results as they relate to the study's objectives and to the manuscript's "Methods" section. Where appropriate, authors should discuss the relevance and importance of their findings specific to osteopathic medicine.

  • Discussion—Authors should interpret the significance of the findings as they relate to other relevant literature, describe any limitations of the study, and make recommendations for future research. The discussion should also comment on the study's importance in relation to the tenets of osteopathic medicine.

  • Conclusion—Authors should identify the study's major findings as they relate to the study's purpose and the clinical applications of those findings, if appropriate. They should not consist of a summary of the study. Conclusions should be limited to 1 paragraph.

  • Acknowledgments—Authors should limit acknowledgments to people who substantially contributed to either the study or the preparation of the manuscript. Acknowledgments should list contributors' full names; highest earned academic degrees, including all doctoral and master degrees; and professional titles at academic and other institutions. Acknowledgments of osteopathic medical students should include their OMS designation.

    Authors are required to obtain permission to name in print for all individuals listed in the acknowledgements section. Failure to submit permission to name individuals acknowledged in print may result in manuscript processing delays until permissions are received.

  • References—References are required for all material derived from the work of others and should follow the guidelines described in the 10th edition of AMA Manual of Style: A Guide for Authors and Editors (2007). References should include direct, open-access URLs (uniform resource locators) to full-text versions of the referenced articles. A URL to an abstract in the National Library of Medicine's PubMed database does not meet this requirement.

    For journal articles that are not accessible online for free, authors must send photocopies via e-mail, fax or mail, if requested, once their manuscripts are accepted for publication. For additional requirements and examples of reference style, click here.

    When comparing the work of the manuscript with published studies, authors must refer to original documents rather than secondary sources.

  • CME quiz questions—Authors should submit 1 to 4 multiple-choice questions (not true/false) for the continuing medical education quiz and brief discussions of the correct answers. Questions must pertain to the manuscript being submitted, and answers should be apparent from the text. Readers should not have to consult outside sources to determine the correct answer. For examples, please review our January 2017 CME quiz.

Graphic Elements
Research-based submissions should include at least 1 graphic element. All accompanying tables and figures should be numbered, and they should be cited sequentially in the text. Labeled captions for all figures should be provided at the end of the manuscript. A full bibliographic citation should be provided in each caption for reprinted or adapted graphic elements.

  • Tables should consist of 3 or more interrelated columns and rows and should present only information that is relevant and of interest. Primary comparisons should be presented horizontally, left to right. Tables should be able to stand on their own, without reference to the text; thus, table titles must provide the context to help readers interpret the data presented. Read the JAOA's tips for preparing tables for additional guidance. Tables should be submitted as Word files.

  • Statistical figures are best used for communicating trends or relationships in a study's findings. Bar graphs are best for showing magnitude, line graphs for trends over time, or dot plots for quantitative data on a single axis (eg, time series, ranking, and nominal-comparison relationships), and scatterplots for correlations. Graphs must depict findings fairly and accurately. For instance, authors should not alter the scales used to make findings appear more meaningful. Once manuscripts are accepted for publication, JAOA staff must recreate charts before publication to ensure that the images are of reproduction quality. Authors, therefore, must provide data points for each graph. Failure to provide data points on request may result in unsubmission. Read the JAOA's tips for preparing figures for additional guidance.

  • Nonstatistical figures are visual representations of information that do not included data, such as clinical images, illustrations, and diagrams. All images must be submitted as separate high-resolution JPEG or TIF files. The minimum resolution that the JAOA can accept is 8 inches width at 72 dpi. All patient information must be removed from or blocked out of graphic elements. Radiologic images in particular should be checked for patient information before being submitted to the JAOA. Read the JAOA's tips for preparing figures for additional guidance.

Video Submissions
All videos must be submitted as .mpg, .mpeg, .mov, .avi, or .wmv files. The maximum file size that the JAOA can accept is 20 MB. While the JAOA can be flexible with the length of the video submission, a length of 90 seconds or less is preferred. Please consider the tips in the following graphic when preparing your video.

Supplemental Material
For manuscripts based on survey data, copies of the original surveys and the cover letters that accompanied the surveys must be included with the other manuscript components at the time of submission.

For randomized controlled trials, authors must submit study flow diagrams.

Authors are responsible for obtaining written permission from publishers and authors to adapt or reprint previously published tables, illustrations, and other graphic elements. Authors must specifically obtain permission to reprint or adapt graphic elements for both the JAOA's print and online versions. The JAOA has prepared a template reprint permission request form for this purpose.

Authors must also obtain written permission from patients to use their photographic images if those patients are identifiable in the images. If a patient is younger than 18 years, authors must obtain permission from one of the patient's parents or guardians. Authors are encouraged to use the JAOA's patient-model release form for this purpose.

Authors must submit signed permissions from publishers, authors, and patients once their manuscripts are accepted for publication in the JAOA. Likewise, authors must submit signed permission from anyone explicitly named in their studies, including named sources for unpublished data and individuals listed in the acknowledgments.

Authors serving in the US military must obtain armed forces' approval for their manuscripts and provide military or institutional disclaimers when submitting manuscripts.

Failure to submit appropriate permission forms may result in unsubmission.

Peer Review and Publication Process

All manuscripts submitted to the JAOA are first reviewed by the AOA's editor in chief. Submissions are then reviewed by 2 or more experts in specialties or subspecialties relevant to the manuscripts. To learn more about the peer review process and the JAOA's expectations of its peer reviewers, all reviewers and authors are invited to complete the JAOA's peer review module.

The JAOA usually notifies authors of manuscript acceptance, revision requests, or rejection within 1 month of acknowledging receipt of manuscripts. Authors are encouraged to contact the JAOA if they have not received a status update in that period.

As a means of maintaining editorial and other quality standards, all accepted manuscripts are subject to editing and abridgment. Such editing takes place after manuscripts undergo peer review and author revision. During this editing process, the JAOA's staff editors revise all accepted manuscripts for clarity, organization, grammar, conformity to house style and format, and adherence to AOA-preferred terminology, nomenclature, and spelling. Staff editors also conduct basic fact checking, including verifying referenced statements. As a consequence, they may request copies of referenced materials that were not provided on submission. As noted under "Manuscript Submission," failure to provide copies of referenced material upon request may result in delayed publication.

Corresponding authors will receive edited manuscripts for review and comment before publication. Corresponding authors are responsible for responding to peer reviewers' comments and concerns, as well as staff editors' queries. Corresponding authors are also responsible for verifying all statements in their articles, including confirming the accuracy of changes made by the JAOA's staff editors. Failure to respond fully to peer reviewers' comments and concerns before manuscript acceptance, to address staff editors' queries, or to verify statements may result in publication delay.

Accepted manuscripts are scheduled for publication according to (1) article type (eg, original contributions are assigned the highest priority followed by systematic reviews and meta-analyses), (2) the timeliness of the topics the manuscripts address, and (3) the priority assigned by the AOA's editor in chief and the JAOA's associate editors.

Authors who would like their manuscripts considered for rapid review should justify that request in their cover letters.

Authors who are considering submitting multiple manuscripts that will convey the progression of a study or that are part of a series of articles intended to be published at the same time are strongly encouraged to contact JAOA staff before submitting such articles.

Although tentative publication dates are provided to corresponding authors in advance as a courtesy, those dates are subject to change with due notice based on changes in priority made by the editor in chief, the associate editors, and the JAOA Editorial Advisory Board.

[Updated July 2018]

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