Hey {{first_name}}

I am freshly back from a great week in Boston, catching up with friends and clients old and new, including PatientsLikeMe, Cognito Therapeutics and Alden Scientific—pictures towards the end of this email!

Boston has always been a second home. I lived in the Massachusetts suburbs as an expat British tween in the early 1990s, and in Back Bay as an urban tech hipster from 2008 to 2011. Since 2006 I've flown in and out about 80 times, by my own back-of-an-envelope count. I flew so much I even wrote a paper on whether people really cry more at films on planes (email me for a copy).

This trip was special for two reasons. It was 20 years since I first started working with PatientsLikeMe, back when Kendall Square had far fewer high-rises. And it was my first visit representing the whole ProofStack team and our mission to move fast and prove things.

I'll be spending a lot more time there over the next few years. If you're building something in Boston that needs evidence behind it, let's talk.

Previous edition: L2 Analysis

My first research paper took seven years to go from idea to print.

About three of those years were science itself. I won the grant, collected the data and ran the analysis for my PhD. The next three and a half went on writing it up and trying to get it published.

We aimed for the highest-impact journal we could. It sat in peer review for a long time and came back rejected. We tidied it up and sent it to another journal, waited, and got rejected again. Then again. That paper was rejected six times before it was finally accepted in 2009, four years after I'd finished my PhD.

My study was in ALS. By the time it was published, none of the patients who took part were alive to read it.

That left me with a deep-seated frustration at how slowly research moves. Ever since, I've wanted to build systems that close the gap.

Proof assets are the tangible things that turn your data into something people can read and cite. They include conference abstracts and the posters you print once you get there, preprints and the peer-reviewed papers they become, editorials and opinion pieces in scientific journals, and the content on your own estate, like your website and blog.

They are the currency of clinical proof.

When I laid out every step of those seven years on a chart, I realised the time hadn't gone the way seven years goes when you're learning a skill or training for a marathon. I would spend some focus time on it, wait, and get feedback. Then a little more focus time wait, and get feedback again. Most of the elapsed time was not spent on focussed thinking and writing, it was spent waiting. Waiting on collaborators, on journal editors, on IRBs, and on whoever was running the analysis.

So we put our effort into shortening the gaps in between.

After over more than 200 peer-reviewed publications, we've turned those lessons into templates, guidance, rules of the road and processes. At ProofStack we aim for 90 days from idea to submission, and 90 days from submission to acceptance.

Seven years, down to under seven months. That's where our > 10x claim comes from.

Opening a blank Word document and typing is the worst way to start a proof asset. That way lies madness! You've given yourself no guardrails and no constraints, and in our experience it's the number one reason publications stall.

Instead, we set up what we call an “Evidence Council”. Once a month, people from leadership, marketing and the science team meet to prioritise which proof assets to develop and which narrative points they want to land. The scientists leading each piece come with a two-page publication brief, which we help them write. It sets out the objective of the asset, the audience, some suggested journals, a RACI chart showing who is Responsible, Accountable, Consulted and Informed for each element, a timeline and a budget.

People forget the budget. Many journals now charge you to publish and bringing in outside expertise needs resources so your CFO doesn’t query the invoice.

A manuscript can swell to 50 pages while 20 people layer comments on top of each other, all disagreeing about what story the paper is telling. A clear brief gives everyone the same story to write to, which raises the odds of acceptance and cuts the rework of moving between journals.

Part of the reason my first paper kept bouncing is that we aimed too high for the kind of study it was. It's a very common mistake. Everyone wants the credit of the highest impact factor they can get, and the cost of chasing it is time.

So now we use pre-submission inquiries. Once you know roughly where you want to go, we write to the editors of three journals with a set of questions we've refined over the years, designed to draw out how well the work fits before anyone submits it.

A rejection for a full paper from a busy editor can take weeks or months to arrive. By then you may have spent days or weeks formatting the manuscript and preparing all the appendices a given high-impact journal demands. If the paper was always going to be turned away for being out of scope, not high-impact enough, off the journal's current emphasis, or better suited to a sister journal, that effort was wasted before you began.

A pre-submission inquiry only tells you whether the venue is willing to receive the paper, before you've spent a week formatting it for them.

We've catalogued plenty of recurring patterns. Here are two that come up the most.

One is working with external partners without a clear agreement on who writes what, and who is responsible for herding the cats through revisions. Things drift, and occasionally a partner publishes something without telling you. This year one of our clients waited months to hear from a partner on a joint paper. When the partner finally got in touch, they gave my client less than one business day to read and review it. Nobody can review a scientific paper properly in that time. We now give clients templates and advice for working with every kind of partner, from drug companies to their own customers.

Another is refusing to submit until the paper is perfect. Perfect is the enemy of published. Submit when it's ready for peer review, not when your inner critic is fully appeased.

Many journals carry a front section, left over from their print days, that holds editorials, opinion pieces, perspectives and letters to the editor. Getting published there is much easier than getting a data paper accepted.

You do need something to say, and it can't be an advert for your company. Done well, it's an excellent example of credible thought leadership, and a way to take part in the wider debates in your field. We work with senior leadership teams and their scientific advisors, sometimes board members, to find the issues worth raising and the counterintuitive lessons a company has learned that the wider literature would benefit from. Sometimes that means sharing battle scars, warts and all, about a part of the research only they could describe. Sometimes it's a letter to the editor responding to, or correcting, someone else's work.

Review can take days or weeks instead of months or years. At a top journal, the chance of acceptance can be around ten times higher than for a data paper. We've helped clients publish this way in Nature Medicine and JAMA. Those pieces have gone on to be cited and have built our clients' credibility without them waiting years for the data to come through. Get in touch for some examples.

Many of the best papers started off as conference posters. An accepted abstract is your entry point and the constraint of 250 words with a deadline is a magnificent forcing function. Our conference tools do three jobs. First, they scout which meetings are worth a look. Next, they help you choose the ones that fit your objectives and budget. Then, they help you plan who to meet, based on the speakers, sponsors, agenda and partners.

An accepted abstract also earns you a poster. We produce those in your company's brand guidelines, so your scientists can stand in front of it and use it as a reason to go and meet people (We walked through a real example on Page 5 of How Much Evidence is Enough?). Finally, we work with your marketing team to ensure it gets the attention it deserves on LinkedIn and is properly archived so that others can find it in the future and perhaps even cite it in their own work.

Once your evidence starts to pile up, the last piece is the one that keeps it consistent. We build clients a claims bank: a reviewed, vetted database of every claim you can make in public, each one traced back to the proof asset behind it. Anything your marketing team writes has provenance behind it, however large your body of proof grows. We can even maintain it for you.

We can also review your competitors' claims monthly or quarterly and map them against the evidence you have and the evidence on your roadmap. The claims bank will get its own issue later in this newsletter series.

Next issue: L4 — Distribution.