Criteria for Publication Appropriateness 

MSMR is dedicated to reporting evidence-based estimates of the incidence, distribution, impact, or trends of illness and injuries among members of the United States Armed Forces and other beneficiaries of the Military Health System (e.g., family members, retirees, civilian employees).

MSMR reports generally focus on data or public health information directly relevant to the health, safety, and well-being of MHS beneficiaries or military members’ operational readiness. Submissions with a focus beyond the U.S. Armed Forces may be considered if relevant and generalizable to a current military health issue. 

Quality

Reports must be based on analyses that use standardized, validated, or accepted scientific methods and should include sufficient data samples to adequately address the aim of the report. Results should yield actionable public health information or recommendations. Recommendations presented in the Discussion should reflect the quality and nature of the study design. Any major limitations resulting from data quality should be included for transparency. Reports primarily descriptive in nature, i.e., not testing a proposed hypothesis, should have a limited Discussion section. Use of active voice, in addition to succinct language, are strongly encouraged for clarity and reports should be logically organized for ready comprehension by MSMR readers

Originality

Reports must be submitted exclusively to MSMR, should be original, and otherwise unpublished in the peer-reviewed literature, either previously or in the future. As part of the submission package, all prior related publications and presentations must be disclosed, including presentations (oral or poster) at scientific conferences and technical publications internal to a governmental agency. Updates of surveillance summaries previously published in MSMR will be considered if they add significant new information.

Timeliness

Reports should employ the most current data available from surveillance systems or analyses of electronic health records, surveys, case reports, or other studies. Data from emergency response or outbreak investigations should be no older than 12 months at time of submission. Generally, data presented as a Full or Brief Report should include a surveillance period within the last five years.

Full Reports

Full Reports present the verified results of a completed epidemiologic investigation or study that answers a question of military health importance. All Full Reports are submitted to two voluntary, independent reviewers for peer review.

The Introduction, Methods, Results, and Discussion sections of a Full Report should not exceed 2,000 words. Full Reports exceeding 2,000 words may be considered if a supported justification is presented to the editor. Cited references in a Full Report are limited to 25, and data tables and figures should complement the text succinctly and logically. Recommendations presented in the Discussion of a Full Report should reflect the quality and nature of the study design.

Full Report submissions comprise 10 elements or sections, in the following order:

1.  Title: Brief and descriptive, indicating major result(s) in as few words as possible.

2.  Authorship and Affiliations: List all authors and affiliations immediately after title, according to MSMR authorship guidelines (see Submission Formats below). MSMR policy requires all authors satisfy all International Committee of Medical Journal Editors authorship criteria:

• Substantial contributions to the conception or design, or acquisition, analysis or interpretation of data.
• Drafting and critical revision of important intellectual content.
• Final approval published version.
• Agreement to accountability for all aspects to ensure accuracy or integrity questions are appropriately investigated and resolved.

3.  Military Relevance: In 100 words maximum, convey succinctly what is novel about the findings and describe how they can inform decisions and actions supporting readiness and force health protection: MSMR aims to disseminate actionable medical surveillance information to military medical and public health professionals to enhance health, fitness, and readiness. This information is presented in a text box with two key questions: What are the new findings? and What is the impact on readiness and force health protection? 

• For the new findings statement, in 50 words or less describe, in plain English, the findings of the analysis or report that either are new or provide confirmation of earlier reports.
• For the impact on readiness and force health protection statement, in 50 words or less describe, in plain English, how the findings can be applied to decisions or actions for military operational readiness or force health protection. (See MSMR November 2018, volume 25 issue 11.)

4.  Structured Abstract: In 175 words maximum, summarize the report, with a focus on the main findings, in sections labeled Introduction, Methods, Results, and Discussion. 

5.  Background: Include contextual information (e.g., brief, relevant literature review) and relevance to U.S. military populations or operations. Conclude with objective or specific question(s).

6.  Methods: Specify, as appropriate, target population, time period, definitions, exposures, outcomes or endpoints, other characteristics of interest, sources and methods of data collection, and data summary and statistical analysis methods. The Methods must have sufficient detail to allow study reproduction or verification. If analysis involved databases or methods already published, limited text should be devoted to information available elsewhere, referenced. For descriptive studies, the Methods must describe how data were obtained, including source(s), case and covariate definitions, and most recent date(s) data sources were refreshed.

7.  Results: Communicate, logically and concisely, findings and analysis results. Excepting emphasis on important or significant observations, do not repeat numerical data in tables and graphs; limit tables and figures to those required to explain and support the argument and report key outcomes identified. Descriptive studies should limit analyses to those appropriate for hypothesis-generating submissions.

8.  Discussion: Provide interpretive com­ments that address the importance of the study findings. Contextualize the main findings within broader military or general public health conditions or concerns, including previously published comparative studies, as applicable. Articulate both study strengths and limitations, including likely impacts of the limitations (e.g., shortcomings of data sources, sources of bias). Propose specific strategies for future studies or changes in practice. Descriptive (hypothesis-generating) studies should limit their discussions to new or noteworthy trends, strengths and limitations, and suggestions for future work. Analytic (hypothesis-testing) studies should include comparisons to published literature (if any) and whether the new findings confirm or refute those studies.

Acknowledgements (optional): Recognize contributors who do not qualify as authors.

Disclaimers (optional): Disclose any necessary legal, service-specific, or DOD disclaimers. Submissions from within any DOD service or agency must have legal and public affairs review.

9.  References: Cite a maximum of 25, directly related to the topic. All references must be cited in the text, in superscript. List references in AMA style. (See Submission Formats.)

10. Tables and figures: Submit in a separate Excel file. The number of tables and figures should complement the text succinctly and logically. (See Submission Formats.)

Brief Reports 

Brief Reports condense 8 of the 10 elements of a Full Report—Military Relevance and Structured Abstract are not required—to 1,000 words maximum. Brief Reports are generally more descriptive and suitable for most descriptive (hypothesis-generating) studies, due to their simplified and limited Methods and Discussion sections. All Brief Reports are peer-reviewed. Brief reports are generally limited to one or two tables and figures, to focus the scope of the report, with a maximum of 10 references. 

TIP: Simplicity expedites the review of a Brief Report, which only summarizes an analysis of data or prior reporting.  

Outbreak Reports 

Outbreak Reports detail the chronology of an epidemiologic investigation with a surveillance period of 12 months preceding report submission. Outbreak Reports include all 10 elements of Full Reports and should not exceed 2,000 words. The Methods should summarize the full investigation with case definitions, case-defining activities, and epidemiologic study design. The Results should describe case characteristics (e.g., clinical characteristics) as well as person, place, and time measurements. The Discussion may include a brief summary of public health interventions, interpretation of results, implications for public health practice, and recommendations for future prevention and control. All Outbreak Reports are peer-reviewed. 

TIP: This type of report may include clusters of disease where no specific etiology was discovered after a thorough investigation.

Case Reports 

Case Reports, limited to 1,000 words, describe a disease occurrence to share timely, pertinent, and potentially actionable information for medical, scientific, or educational purposes. Case Reports should clearly establish a relevance to matters of public health importance. Case Reports should include a Summary of each case(s) followed by a Discussion, and may contain images, as appropriate. Specific section headers may be proposed by authors. Acknowledgements, Disclaimers, and References should be included, when applicable. All Case Reports are peer-reviewed.

Surveillance Snapshots 

Surveillance Snapshots depict the incidence or distribution of disease within a single chart and can include one or two paragraphs of text (with no section heading), limited to 500 words. Surveillance Snapshots are not peer-reviewed but are subject to editorial review that may include consultation with other AFHSD staff. Acknowledgements, Disclaimers, and References should be included, as applicable.

Letters to the Editor 

Letters to the Editor offer timely and concise opinions or interpretations of articles published in the MSMR. Letters should not include unpublished data and should be submitted within one year of publication of the referenced article. They are not peer-reviewed, but it is customary for the editorial team to send each letter to the author(s) of the original work for an opportunity to reply; the authors’ response is generally published as a companion to the letter. Text for a letter to the editor is limited to 1,000 words, with references limited to five. Tables and figures are discouraged but may be considered on an individual basis. Acknowledgements, Disclaimers, and References should be included, as applicable. Letters are subject to abridgement and editing for style and content. 

Historical Perspectives 

Historical Perspectives discuss the historical impact(s) of a disease or condition on a specific military operation or the military overall, limited to 2,000 words and one or two images. Section headers can be proposed by the authors; Acknowledgements, Disclaimers, and References should be included, as applicable. Historical Perspectives may be peer-reviewed by historians or relevant subject matter experts.  

Notices to Readers 

Notices to Readers announce changes in recommended public health practices (e.g., vaccine recommendations) or the availability of clinical or surveillance resources (e.g., laboratory testing), in 500 words or less. Notices to Readers are not peer-reviewed. MSMR does not publish meeting announcements or summaries of past meetings. 

Images in Health Surveillance 

Images in Health Surveillance illustrate militarily relevant public health information with photographs, drawings, or other images, with accompanying text limited to 500 words, with no section headers. Acknowledgements, Disclaimers, and References should be included, as applicable. 

Guest Editorials 

Editorials are usually invited but may be proposed. An editorial may serve as an opinion piece, or a comprehensive narrative relevant to public health professionals serving MHS beneficiaries. This may include a narrative review of literature or knowledge base, an update on the current understanding and state-of-the art of the topic, theory, and practice of epidemiology and/or military public health sciences. Editorials are generally limited to 2,000 words and may contain up to 2 tables or figures. The section headers of this report may be proposed by the authors. Acknowledgements, Disclaimers, and References should be included, as applicable. 

Other article types

May be proposed to the editor.

Submission Formats

MSMR follows the American Medical Association Manual of Style, 11th edition as well as the MHS Editorial Style Guide. Please refer to the AMA manual if you have questions about formatting or structure not addressed in these instructions. Submissions should be sent to the MSMR editor.

Required for submission:

• a Microsoft Word document of the manuscript text of the proposed article
• a completed Authorship Submission Form
• a Microsoft Excel file containing any associated tables and figures, or associated images, as applicable. 

Manuscript Text 

All manuscript text should be submitted in one Microsoft Word file, using the structure and section headers (applicable) noted for each type of report. Please submit all Word documents in 12-point Times New Roman font, with text double-spaced, and leave right margins unjustified (ragged). Do not embed tables or charts in the Word document (see Tables and Figures). A title page is not required. 

Word limits only apply to the body of the text, which include 2,000 words for Full Reports, Outbreak Reports, Topical Reviews, and Historical Perspectives; 1,000 words for Brief Reports and Case Reports; and 500 words of text may accompany Surveillance Snapshots, Images in Health Surveillance, and Notices to Readers.

Submissions longer than these suggested word counts will be considered individually and must be justified by the authors in their submission e-mails.

References

References should be listed in accordance with AMA style.

• List authors by last name and initials with no punctuation other than commas separating authors. When listing more than 6 authors, list only the first 3 followed by “et al.”
• Only proper nouns are capitalized for article or chapter titles.
• Use journal title abbreviations as listed in PubMed and italicize journal title abbreviations and book titles.
• Journal issue citations should include no spaces after year of publication, followed by a semicolon; then volume number with issue number in parentheses, followed by a colon with page number(s) immediately after.
• Online updates and dates of access should precede the URL.
• Do not include URLs for references indexed in PubMed. 

Example references:

1. Stahlman S, Oetting AA. Mental health disorders and mental health problems, active component, U.S. Armed Forces, 2007–2016. MSMR. 2018;25(3):2-11. 
2. Armed Forces Health Surveillance Division. Armed Forces Reportable Medical Events Guidelines and Case Definitions. October 2022. Accessed April 6, 2023. https://www.health.mil/Reference-Center/Publica­tions/2022/11/01/Armed-Forces-Report­able-Medical-Events-Guidelines 
3. O’Connor FG, Sawka MN, Deuster P. Disorders due to heat and cold. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:692-693.

Authorship and Affiliations 

The Microsoft Word file submission must include a list of all authors and affiliations, immediately below the title. For each author list first name, middle initial, last name, highest academic degree(s). Examples: John Snow, MD, MPH; Mary L. Archer, MD. If an author holds two doctoral degrees (e.g., MD and PhD), either or both may be used, in the author’s preferred order. List academic degrees below the highest degree only when representative of a specialized field or other than highest degree (e.g., MPH, BSN). List each author’s current assignment and/or affiliation. Examples: U.S. Naval Medical Research Unit 3, Cairo, Egypt (Dr. Archer); Department of Surgery, University of Chicago, Chicago, Illinois (Dr. Snow, Dr. Smith, Dr. Jones).

Only authors with substantive contributions qualifying for authorship credit according to ICMJE guidelines may be listed; listing authors who do not meet ICMJE authorship criteria is considered a serious breach of scientific ethics. The primary author is solely responsible for verifying the academic contributions of each co-author. Each co-author must approve the final version of the article prior to publication. An author must satisfy all of the following criteria:

• Substantial contributions to the conception or design of the work; or the acquisition, analysis or interpretation of data. For contributions to be substantial, the work could not have proceeded without that author’s contributions. Granting authorship to a senior individual solely by virtue of position, e.g., department head, commander, is prohibited. MSMR may request additional information to verify contributions.
• Drafting and critical revision for important intellectual content: Each author should provide substantive comments during reviews—authors should record comments during reviews so each author’s contributions to the final product can be verified.
• Final approval of the version published.
• Agreement to accountability for all aspects of the work, ensuring that questions of accuracy or integrity for any part are appropriately investigated and resolved: Scientific misconduct, e.g., falsifying or intentionally presenting misleading data is a serious offense. All authors are expected to fully cooperate in any investigation where scientific misconduct is alleged.
• The primary author must be able to identify which co-authors are responsible for specific parts of the work. This information should be included in the initial submission packet.

Tables and Figures 

Tables and figures should adhere to AMA style and must be submitted as a Microsoft Excel file, i.e., not embedded in the text. Microsoft Excel is the preferred software for generating tables and figures. Figures generated with other software (e.g., SAS, SPSS) will be considered individually.   

Each table or figure should constitute one worksheet tab. The data used to create a figure in Excel must be included in tabular form and link to the figure. Number each table and figure, with a descriptive title.

Every table and figure should be cited in the text. Verify that data are consistently reported within all text, tables, and figures. 

Place legends within the figure—line labels for graphs are preferred—and titles above the figure. Do not use pie charts or 3-D graphs. Format all tables and figures with Arial font 8-point. Use lowercase superscripted letters (e.g., a,b,c) for footnotes in tables and figures.

TIP: Authors should study tables in the example and previously published reports for specific style guidance.

Photographs that illustrate a prevention intervention, risk factor, or outbreak setting are encouraged. Only submit photographs within the public domain; if a photo credit is required, submit the name.

Submission and Acceptance

Submit via email at dha.ncr.health-surv.mbx.msmr@health.mil. Consult the Submission Formats section for all formatting requirements and instructions. Submit the Microsoft Word report document, Excel tables/figure file (or photographs, if applicable), and authorship submission form as separate attachments.

Publication Timeline

Accepted reports are typically published within 60 days of acceptance.

Information on Clearance and Consent, as well as Ethics and Publication Malpractice should be reviewed at the Instructions for Authors page.