Use of a VISUAL ABSTRACT
to Disseminate
Scientific Research
Version 4 | January 2018
Editor
Andrew M. Ibrahim MD, MSc
University of Michigan
@andrewmibrahim
www.SurgeryRedesign.com
#VisualAbstract 2
Preface
Dear Reader,
Since the first visual abstract in July of 2016, more than 50 journals and
institutions have adopted its use in their social media strategy to
disseminate scientific research. Equally exciting as the widespread
adoption has been the community that has developed to share the best
tips, tricks and problem-solving required to create a visual abstract. I
am incredibly grateful to each of contributors who have taken time to
openly share their experience and best practices here, in the 4th Version
of the Visual Abstract Primer. More than a collection of ideas and
recommendations, it reflects the earnest desire to disseminate and
share scientific knowledge. It is my hope that every subsequent
versions continues to grow with the same spirit and mission.
Sincerely,
Andrew M. Ibrahim
Ann Arbor, Michigan
January 2018
#VisualAbstract 3
Contributors
Mohammed Ali Abbass MD | @AbbassMohd
Mohammed is a surgical resident in General Surgery at the Cleveland Clinic and founding CoVisual
Abstract Editor at the World Journal of Surgery.
Patricia Anderson, MILS | @PFAnderson
Patricia (PF) is the Emerging Technologies Informationist at the University of Michigan Taubman
Health Sciences Library, and serves on Mayo Clinic Social Media Network External Advisory
Board. You can learn more about her work here: https://www.lib.umich.edu/users/pfa
Rebecca E. Berger, MD| @RebeccaEBerger
Rebecca is a hospitalist at Massachusetts General Hospital. From 2016-2017 she worked as an
editorial fellow at the New England Journal of Medicine.
Justin B. Dimick, MD, MPH | @JDimick1
Justin is the George D. Zuidema Professor of Surgery at the University of Michigan and an
Associated Editor at the Annals of Surgery. You can learn more about his work here:
http://surgery.med.umich.edu/general/patient/faculty/jdimick.shtml
Chelsea Harris MD, MS | @CAHarrisMD
Chelsea is the current Creative Director at the Annals of Surgery and a surgical resident at
University of Maryland.
Andrew M. Ibrahim MD, MSc | @AndrewMIbrahim
Andrew was the inaugural Creative Director at the Annals of Surgery and founder of the
#VisualAbstract. You can learn more about his work here: www.SurgeryRedesign.com
Hari Keshava MD, MS | @Hari_Keshava
Hari is a surgical resident in General Surgery at the Cleveland Clinic and founding Co-Visual
Abstract Editor at the World Journal of Surgery.
Bon Ku, MD, MPP | @BonKu
Bon is an Emergency Medicine physician and Dean for Design & Health at the Jefferson
University. You can learn more about his work here: http://design-health.com/
Joel Topf MD | @Kidney_Boy
Joel is a nephrologist, co-creator of the Nephrology Social Media Cooperative Internship,
#NephMadness, and #NephJC. He is on the Visual Abstract editorial team for the Clinical Journal
of the American Society of Nephrology. More about his work here: https://about.me/joeltopf
#VisualAbstract 4
Thomas Varghese MD | @TomVargheseJr
Tom is Thoracic Surgeon at the University of Utah and author of numerous publications on
disseminating research through social media. You can learn more about his work here:
https://healthcare.utah.edu/fad/mddetail.php?physicianID=u6001828
Emily Smith MA | @EZarack
Emily is the inaugural Multimedia Designer at the University of Michigan Institute for
Healthcare Policy and Innovation, and former visual communication adjunct faculty and graphic
designer for the communications and marketing department at Ohio University. You can learn
more about her work at: http://www.emilyzarack.com/
#VisualAbstract 5
TABLE OF CONTENTS
INTRODUCTION & ADOPTION OF THE VISUAL ABSTRACT 6
WHAT IS A VISUAL ABSTRACT? 7
EMERGING EVIDENCE ON VISUAL ABSTRACT IMPACT 11
CREATING A VISUAL ABSTRACT 15
PRINCIPLES OF DESIGN THINKING 16
CREATING A VISUAL ABSTRACT 20
MAKING YOUR ABSTRACT VISUAL 26
LEVERAGING THE VISUAL ABSTRACT FOR DISSEMINATION 30
DISSEMINATING YOUR VISUAL ABSTRACT ON SOCIAL MEDIA 31
USE OF VISUAL ABSTRACTS & LIVE TWEETING AT ACADEMIC MEETINGS 34
USE OF VISUAL ABSTRACTS & ONLINE JOURNAL CLUBS 40
VISUAL ABSTRACT: VIEWS FROM THE JOURNAL 44
IMPLEMENTATION OF VISUAL ABSTRACTS AT YOUR JOURNAL 45
AFTER ADOPTION – AVOIDING VISUAL ABSTRACTS MISTAKES AT YOUR JOURNAL 48
FUTURE OF VISUAL ABSTRACTS 52
LIBRARIANS & VISUAL ABSTRACTS 53
MOVING FORWARD TOWARD BETTER VISUAL ABSTRACTS 56
#VisualAbstract 6
INTRODUCTION & ADOPTION
OF THE VISUAL ABSTRACT
#VisualAbstract 7
What Is a Visual Abstract?
ANDREW M. IBRAHIM MD, MSC
#VisualAbstract 8
WHAT IS A VISUAL ABSTRACT?
Simply put, a visual abstract is a visual summary of the information usally found within the
abstract portion of an article. Similar to the actual text abstract of a research article, it is meant
to convey the key the findings of the article in a shorter format.
Use of visuals to summarize scientific articles have a long history, with notable examples in such
as the “Central Illustration” in cardiology or the “Graphical Table of Contents” in basic science
dating back to the 1980s.
The first #VisualAbstract for social media was introduced by the Annals of Surgery in July of
2016. It differs from previous visual summaries of research by using a triptych layout, single
color icons, and direct reporting of primary outcomes. It by no means replaces the article, but
serves an adjunct to help readers quickly find the content most relevant to them that they want
to pursue further and read.
#VisualAbstract 9
COMPONENT OF AN EFFECTIVE VISUAL ABSTRACT
When first introduced, visual abstracts followed the general layout show here with attention to
specific components:
Key components of the visual abstract include:
Summarize Key Question Being Addressed: This usually comes from the title of the article or a
heading of key figure.
Summary of Outcomes: Most articles have many more than 3, but the visual abstract will focus
on 1-3 that the primary findings of the article.
Author, Citation: Typically including the first author’s name, journal, and year of publication.
State Outcome Comparison: A short phrase that clearly states the outcome with some
directionality. For example, “Decreased Need for Blood Transfusions” is used rather than
simply, “Blood Transfusions.” As much as possible, the language used should use the same
prose and interpretation used in the article for consistency.
Visual Display of Outcome: A simple, single colored icon that represents the outcome. (More on
this below – “Making it Visual.”)
Data of Outcome (Units): In addition to stating the outcome, visual abstracts give the numeric
representation with clear labeling of the units.
#VisualAbstract 10
Who Created the Visual Abstract: This is often the journal, but may be individual author. It is
important not to use the logo of the journal without their permission.
A VISUAL ABSTRACT IS NOT A SUBSTITUTE FOR READING THE ARTICLE
It is important to state here up front what the visual is NOT. A visual abstract is not a substitute
for reading the article and does not contain all the details of an article. The goal of a visual
abstract is to inform a potential reader of the key findings in an article to help them decide if
they want to proceed in reading the entire article. It is similar to the “trailer” of a movie. Just as
any single article should not change one’s practice, a visual abstract alone should not influence
clinical decision making or opinion about the paper.
#VisualAbstract 11
Emerging Evidence on
Visual Abstract Impact
JUSTIN B. DIMICK MD, MPH
#VisualAbstract 12
To those of us following the #VisualAbstract on social media, its impact has seemed selfevident.
The visuals are intuitive, eye-catching and easy to share. Importantly, the visual
abstract impact on dissemination has been tracked and measured through two important
metrics: how many journals have adopted them and how far articles with visual abstracts
spread.
INCREASING ADOPTION OF THE VISUAL ABSTRACT
Since the first Visual Abstract in July of 2016, there has been a steady increase in adoption.
Individual researchers as well as institutes quickly recognized their value and encouraged their
adoption.
To date, more than 50 journals, organizations and institutions have adopted the visual abstract
into their social media dissemination strategy including the New England Journal of Medicine,
JAMA Surgery and Heart BMJ.
An updated and running list of journals and institutions who have adopted the visual abstract
are listed here.
#VisualAbstract 13
INCREASED DISSEMINATION WITH USE OF A VISUAL ABSTRACT
From July of 2016 to December of 2016, the Annals of Surgery carried out the following
prospective cross-over study to compare the extent of article dissemination using text-alone
tweets versus visual abstracts. The full article can be downloaded here:
https://twitter.com/AnnalsofSurgery/status/858036253773660161
Ibrahim, AM, Lillemoe K, Klingensmith ME, Dimick JB.. "Visual Abstracts to Disseminate Research
on Social Media: A Prospective, Case-control Crossover Study." Ann Surg. 2017 Apr 26. doi:
10.1097/SLA.0000000000002277.
In short, the journal shared 44 original research articles on social media twice; once with a
visual abstract and once without. To minimize exposure and content bias, they implemented a
cross-over design with a four-week washout period in between each dissemination method.
#VisualAbstract 14
The trial demonstrated that compared to title only tweets, those with a visual abstract had 7
fold higher impressions, 8 fold higher retweets and nearly a 3-fold higher article visits on the
publisher website.
At present, at least two additional trials from other journals are underway measuring the
impact of the visual abstract on their ability to disseminate articles.
ADDITIONAL VISUAL ABSTRACT PUBLICATIONS
Additional Publications about the Visual Abstract are listed here:
Ibrahim AM, Lillemoe KD, Klingensmith ME, Dimick JB. “Visual Abstracts to Disseminate
Research on Social Media: a prospective, case-control crossover study” Ann Surg. 2017
Apr 26. Link to Article
Wray CM, Arora VM. “#VisualAbstract: A Revolution in Communicating Science?” Ann
Surg. 2017 Dec;266(6):e49-e50. Link to Article.
Ibrahim AM, Bradley SM. “The Adoption of Visual Abstracts at Circulation CQO: why and
how we’re doing it” Circ Cardiovasc Qual Outcomes. 2017 Mar;10(3). Link to Article
Ibrahim AM. "Seeing is Believing: Using Visual Abstracts to Disseminate Scientific
Research." Am J Gastroenterol. 2017 Sep 19. Link to Article
Nikolian, V, Ibrahim AM. “Visual Abstracts and the Future of Scientific Journals” Clinics in
Colon and Rectal Surgery.” Clinics in Colon and Rectal Surgery. 2017 Sep;30(4):252-
25. Link to Chapter
Aungst, T. “Visual Abstracts are Changing How we Share Studies.” Doximity. July 2017. OpEd.
Link to Article
#VisualAbstract 15
Creating a Visual Abstract
#VisualAbstract 16
Principles of Design Thinking
BON KU MD, MPP
#VisualAbstract 17
EMBRACING SOME DESIGN PRINCIPLES
An effective visual abstract has a clear message. You will want to embrace some principles of
design when creating your visual abstract. These include:
Focus on the user experience. The process of design starts and always returns to
the user experience. Always keep in mind, “What does my audience on Twitter
want to know about scientific research?”
Clarity of Purpose. Particularly within complex articles, you want to spend time
narrowing the key message down to what you want to deliver. Some simplification
of presentation may be necessary to establish a clear focus.
Rapid Prototyping. There are infinite ways to visually display research. Your 1st, 2nd
or 10th visual abstract won’t be your best one. You will improve significantly by
rapidly trying new formats and seeing what works!
Iterative Improvement. Rather than ask, "Is it perfect?" design thinking focuses on,
"What is the next step to make it partially better?" You will significantly improve by
soliciting feedback and studying other designs.
Thoughtful Restraint. Prioritize the key message over completeness. Sure, having
every secondary endpoint and every limitation of the article in the visual abstract is
ideal to give context, but this can significantly distract from the key message. In the
case of visual abstracts, more is not always better.
Relevant Creativity. Thinking outside the box can be valuable, but ultimately needs
to be grounded in the desired outcome. Experimenting “just to be different” isn’t
always effective. You should frequently balance your design creativity with
thoughtful restraint and clarity of purpose.
#VisualAbstract 18
DEVELOPING YOUR DESIGN SKILLSET
There are countless resources available to help you develop your design skillset. Here are a few
options to consider:
Online Toolkits
Stanford d-School Virtual Crash Course
Researchers and designers travel from all over the
world to train and learn from the experts at the dschool.
Here is a 90-minute virtual crash course in
design thinking from them that you can access for
free: https://dschool.stanford.edu/resources-
collections/a-virtual-crash-course-in-design-thinking
IDEO Design Kit
IDEO is the among the world leaders in design
thinking. They have made their tool-kit open source
that you can use to help apply design principles into
your day to day problem solving.
http://www.designkit.org/methods
In-Person Workshops
Visual Abstract Workshops
Periodically, you will find design workshops pop-up.
Many of the authors in this primer have run them,
including ones specifically targeted for visual
abstracts. Ask around your institution or to authors in
this primer to find out if any of them are near you.
#VisualAbstract 19
Collaborating with Designers
Improving your ability to design is like many other skills that improve with deliberate practice
and exposure. There’s no substitute for simply spending time with designers. You will be
surprised how close they may be!
Consider the DHW lab, situated on within Auckland City Hospital. Clinical providers frequently
rotate through the lab to trouble shoot ideas they see in real life practice and learn from the
designers about to address them. Similar healthcare design labs exist at Thomas Jefferson
University and the University of Virginia.
#VisualAbstract 20
Creating a Visual Abstract
ANDREW M. IBRAHIM MD, MSC
#VisualAbstract 21
STARTING WITH A SOFTWARE
While the work can be done with expensive software (e.g. Adobe Photoshop Suite),
most (or even all of it) can be done in Microsoft PowerPoint or Keynote. In fact, to
facilitate the “thoughtful restraint” mindset as a core design principle, I almost
exclusively stick to Power Point.
If you have a higher end design taste and want to create images more
sophisticated than Paint allows, try Pixlr (https://pixlr.com/editor/ ) a free
online image editor.
STEP BY STEP PROCESS OF CREATING A VISUAL ABSTRACT
The following steps in this order can help you create a simple visual abstract:
Step 1: Choose an Article. Choose an article and spend time identifying the key message is that
you want you convey. Pull out the key outcomes. While most articles have several key points, it
is difficult to convey more than 2 or 3 in a visual abstract.
Step 2: Create Your Visual Fields. There are many ways to do this, but colored boxes can be
quite easy and helpful.
#VisualAbstract 22
Step 3: Add Author, Journal and Title. Starting filling in some of the essential information.
Step 4: Layout Your Outcomes. Describe the outcomes across the top in short phrases with
comparative phrases inside of text boxes.
#VisualAbstract 23
Step 5: Add in Values for Each Outcome. Add in the numeric values of each outcome, including
the units.
Step 6: Add Visuals. This is arguably the hardest part for most people, and an entire section
(“Making It Visual”) is dedicated to it below. It is CRUCIAL that you do not use images for which
you do not have permissions or rights.
Step 7: Export your File. You will want to save the file as a JPEG of other image file to make it
easily usable for social media. Be sure to proof read and double check all your outcomes so that
they are consistent with the article. If the methods (e.g. randomized trial, retrospective review)
are not clear in the visual abstract, be sure to include it in the text of the Tweet.
#VisualAbstract 24
SHORT VIDEO SUMMARY ON CREATING A VISUAL ABSTRACT
The key steps described above are summarized in a two-minute video here:
https://twitter.com/AndrewMIbrahim/status/839642707089899520
ALTERNATIVE LAYOUTS
Below are additional visual abstracts layouts shown in their template form (blue) and their final
form (yellow) as used at the Annals of Surgery.
#VisualAbstract 25
Here are more examples from the New England Journal of Medicine using similar templates but
with their own branding and color schemes:
#VisualAbstract 26
Making Your Abstract Visual
EMILY SMITH, MS
#VisualAbstract 27
MAKING IT VISUAL
Many researchers encounter design challenges with developing effective visual abstracts for lay
audiences. Even with a simple message and only the necessary facts, researchers may face
practical difficulties selecting effective images and designing an effective layout. Below are
some common challenges and solutions.
Finding Images. There are a number of image banks on the internet (e.g. Google image search),
some of which are free to use. Researchers who frequently prepare visual presentations
may benefit from purchasing a subscription to access higher end icons (e.g. Shutterstock, Getty
Images, Noun Project.)
In some cases, the researcher may need to create the icon or collaborate with a graphic
designer.
Finding the Right Images. When choosing an image, people often choose the wrong one.
Researchers should plan to “rapidly prototype” multiple iterations of their visual abstract with
different audiences of their peers before choosing the final lay out and images. Audiences are a
great resource to help identify if the visuals best depict the information.
More on Choosing the Right Images. There is no clear “visual style” for academic journals,
however, solid colored “icons” have the strongest professional appeal over cartoon-like images.
While ultimately up to the researcher, it is highly encouraged to stick with solid color icons.
Copyright Issues. Just because an image is on the internet, does not mean it is free to use. A
researcher MUST make sure that they have copyright permission to use the images. This point
#VisualAbstract 28
cannot be overemphasized enough. To avoid this problem, either use the copyright filter during
an image search or subscribe to an icon image bank.
Follow Design Rules. To create a strong visual abstract, it is important to respect design
conventions including attention to contrast, repetition, alignment, and proximity. For example,
to create hierarchy with information, use contrast techniques such as bold, color, and size.
Following design rules will help create a consistent visual abstract that allows audiences to
easily understand the key findings of the article.
COLLABORATING WITH A DESIGNER
If creating a visual abstract is more than a one-off effort, you might find it helpful to start
collaborating with a designer. Here is some practical advice on making that collaboration
productive.
How to Find a Designer
Start Local. When looking for a designer to assist with a visual abstract, first
determine if your company, department, or unit employs a staffed designer. We are
always surprised how often they are underutilized because employees simply don’t
know about them. Contact your communications or marketing staff to help you
determine if there is a designer available.
Ask Colleagues. You probably learned about the visual abstract because you saw it in
the work of a colleague online or at a meeting. They may be best to point you
toward a designer who is familiar with visual abstracts and with whom they have a
good track record.
Go the Internet. If your institution does not house a designer then head to the
internet and start search for a local graphic designer or through online design
resources (e.g. DesignCrowd, Upwork).
#VisualAbstract 29
Making Your Designer Relationship Productive
Once you have a designer in place, here are a few suggestions to help you make the most of
your collaboration to create a visual abstract:
Meet Early. Before getting too carried away with your project, meet with a designer
early. The more time you have to co-create the project, the more satisfied you’ll be
with the result.
Focus Your Message. Designers won’t know your research as well as you do. Take
time to really craft and simplify your message to focus what you want to
communicate. Ideally put this into 2-3 short bullets.
Provide Examples. If the designer has never created a visual abstract, explain the
goals of visual abstracts, share some examples, and recommend the appropriate
visual abstract layout structure (this primer can serve as good start, and can be
downloaded free here: https://www.surgeryredesign.com/resources).
Embrace Mutual Feedback. The first (or even third draft) of the visual abstract won’t
be perfect. If the designer finds your content confusing, you may need to revisit
your message. Expect and embrace iterative feedback both ways.
On a practical note, creating a visual abstract has a learning curve. If you find a designer that
you enjoy working with, you may find it easiest to stick with them so they can learn your style
and preferences, and thereby expedite the timeline of future project.
#VisualAbstract 30
Leveraging the Visual
Abstract for Dissemination
#VisualAbstract 31
Disseminating Your
Visual Abstract on Social Media
TOM VARGHESE MD
#VisualAbstract 32
Once you have created your visual abstract, you will need a plan to disseminate it. Social media
has emerged as an enormous tool to improve dissemination of research. Many platforms
exist— Facebook, Twitter, LinkedIN,SnapChat— and each have their own benefits and
drawbacks. Our experience has primarily been on Twitter, and we will focus on it here.
As a start, if you’re not familiar
with Twitter, consider this
excellent introduction from
the American College of
Surgeons.
Improving Your Dissemination and Reach on Twitter
Once you have created a visual abstract, you will want to maximize how far it disseminates.
Here are four suggestions to help you improve your reach.
Contact the Journal. Many journals have dedicated public relation or social media
personnel. Let them know you’ve created a visual abstract and share it with
them. They may be able to share it, possibly after some modifications, through
their social media network.
Tag the Authors & Institutions. Twitter allows you to “tag” photos with other
Twitter accounts. By tagging authors, institutions or key thought leaders on the
topic, they will be alerted to the post and more likely to share it within their
network.
Make it Reusable. Visual abstracts have a shelf life well beyond their initial post.
They recycle themselves into grand round slides, conference presentations and
press releases. To help make the image reusable, take extra effort to make the
message clear as a stand-alone image & release it in a high quality image format.
Watch for Important Events. While most authors and journals release the visual
abstract when the article comes into press, additional follow-up opportunities
also exist when a similar topic is discussed at a national meeting or in the news.
Stay abreast of them and consider re-posting the visual abstract in that context.
You should also ask around at your institution if a social media team exists that may also help
you improve the dissemination of your visual abstract and research.
#VisualAbstract 33
Measuring Your Social Media Reach
Hopefully creating a visual abstract is not a one off project for you, and you plan to do it a few
times. If that is the case, you will want to make an effort to track how well your content is
disseminating. This may be particularly important if you need to justify a budget or time spent
creating one.
Twitter itself will allow you to follow dissemination statistics. Common “outcomes” used to
follow tweets include:
Impressions. The number of times a tweet is seen on Twitter. This is largely a
measure of exposure and influenced by the number of followers each account has
that shares the tweet.
Retweets. The number of times a tweet is shared. This reflects how interesting
people find the content as it passed their threshold to pass it along to their network
of followers.
Link Clicks. The number of times the link in the tweet is clicked. For most visual
abstracts this will be a link to the article, and therefore serves as a surrogate for
article visits. This best represents engagement in the actual content of the article.
Many additional consulting groups and websites will allow you to track additional measures of
how your visual abstract is disseminating. For most users, however, these three metrics serve
as a good initial foundation.
Read Thrice, Tweet Once
Although social media may seem less formal that other forms of communication, it should be
taken with the utmost seriousness. Each tweet shared on social media has enormous potential
to spread quickly to a broad audience. As such, take time to really revaluate your work before
sharing it to ensure that it reflects the professionalisms and brand you want you associated
with your work.
#VisualAbstract 34
Use of Visual Abstracts &
Live Tweeting at Academic Meetings
CHELSEA HARRIS MD, MSC
#VisualAbstract 35
WHAT IS LIVE VISUAL ABSTRACTING?
Live Visual Abstracting (LVA) is the latest frontier in research dissemination. This concept
combines the principles of a standard visual abstract (using compelling images to relay the key
aspects of a topic ) with live tweeting (provide a running, publically available window into a
conference or speech). In much the same ways that standard visual abstracts increase article
downloads and improve dissemination, LVA helps raise the visibility of speakers, their research,
and the conference itself.
Live visual abstracts share many of the same core design principles as standard visual abstracts,
but there are unique elements in both their creation and circulation that prospective
abstracters should consider before embarking. It is important to note that because LVA is a
relatively new paradigm, some procedural issues remain unresolved; we will highlight these
areas where relevant.
PRE-CONFERENCE PREPARATION
Understanding The Context
Creating live visual abstracts at an academic meeting works best if you can understand the
context and your role beforehand.
Don’t Work in a Silo. Deciding to make your own Live Visual Abstract may not engender a lot of
enthusiasm if you are seen to be encroaching on someone else’s domain or if you are producing
duplicate work. This is particularly important if you plan on using conference iconography
(society logos etc.) as this may give the false impression that you are associated with an
organization in an official capacity.
Work with the Conference Planners. Currently, there are no regulations regarding who can and
should make Visual Abstracts. However, if the overarching goal is to produce succinct, visually
appealing messages, knowing if the conference organizers have a Live Visual Abstracting
procedure in place (including templates, designated designers, and review strategies) is
prudent.
Keep Presenters in the Loop. Finally, if you are a presenter, you clearly have more latitude to
make your own than an audience member. However, contacting the organizers may still be
beneficial as they may be able to provide you with templates or icons that will maintain a
consistent, professional aesthetic. If you’re not the present, be sure to inform them beforehand
– they may help provide content and also keep you from surprising them during the talk.
#VisualAbstract 36
Creating Live Visual Abstract Templates
Once you have clarified your LVA role, you should begin preparing your templates. One of the
key differences between live and standard visual abstracts is the timeframe for creating live
visual abstracts is much shorter. For maximal impact, the time between the conference session
and the abstract dissemination should be very short. Thus, abstractors should aim to have a
nearly complete product by the time each session ends. There are several strategies to facilitate
timely and effective LVA production.
Make templates ahead of time. Decide on color schemes, enter in session title, conferences
logos, and authors names/credentials prior to the session. The fast pace potentiates small
mistakes like typos, so pre-filling whatever information you have a priori will give you more
time to proofread your final product.
Customize Your Icon Color Scheme: Both Power Point and subscription icon services allow you
to make customized colors, so if you plan on using a non-standard palate, take a few minutes to
save those in ahead of time. The eyedropper function which is available in newer version of
Power Point is a great tool as it allows you to match your colors to conference logos exactly,
and can ensure your text matches as well.
Have Multiple Candidate Templates per Talk: For example, if you are planning on making an
LVA for a panel, have several pre-filled options. You can consider making templates with all the
authors on a single slide, individual slides for each author, or some combination. Similarly, you
can prepare templates that emphasize quotations or include a range in panel numbere. At
some point fairly early on you will have to make a judgement call regarding how much space
Example of Fixed Template
Components:
 Pre-filled Title, Key
points, Author name &
credentials,
Conference logos,
Abstractor attribution
 High Panel Count,
rapidly collapsible
 Widescreen 16:9 ratio
 Pre-set Icon color
scheme
#VisualAbstract 37
you want to give each speaker, but being able to expand or condense your template quickly is
key.
ADJUSTING YOUR TEMPLATES
Conferences are inherently different than research papers. They are often more fluid, include
multiple presentations in quick succession, and may include opinion as well as references. To
accommodate these nuances, abstractors may want to adjust their templates to include
quotation-anchored and non-linear formats.
Examples shown here from the recent Women in Surgery Leadership Development Conference:
Non-linear FormatsQuotation-Anchored Formats
#VisualAbstract 38
Expand template to include more findings: instead of the increasingly common 3-panels
structure seen in standard visual abstracts, consider a layout that can accommodate 4-8
findings. Changing slide size in Power Point from a standard 4:3 ratio to a widescreen 16:19 can
provide more space. As always, abstractors must balance thoroughness with readability, so you
should be judicious in what you ultimately include.
Anchor to a quotation: speakers often frame their talks with pithy quotations so using these as
a starting point is a great way to attract attention. If the quotation is glib or somewhat
controversial, making sure to attribute it to the original source is also a good strategy to ensure
you are not putting words in the speakers’ mouth.
Employ non-linear formats: unlike scientific papers which are formulaic, conferences follow a
looser format so you can be creative in how you display your information. Test out new formats
beforehand with your colleagues to weed out ones that are boring or too busy.
Final Checks
Time pressure will inevitably make Live Visual Abstracts error prone, so make sure you review
your draft in full screen and ideally enlist a second reviewer before sending out the final
product. Pay special attention to authors’ names and credentials as these are more important
than small typos.
COMMONLY ASKED QUESTIONS ABOUT LIVE VISUAL ABSTRACTING
If there is no pre-existing plan for LVA at a session I’m attending can I try my hand at it alone?
Yes, but would not recommend it. The short answer is no one can stop you, but there are
several things to keep in mind. First, if you haven’t practiced with standard visual abstracts, this
is probably not a great first step. As noted earlier, creating quality visual abstracts is an iterative
process, and there is not much time to edit in the live setting. In addition, if you are attending a
session given by a paid consultant, you should be cognizant of whether broad dissemination of
the key points will undermine their business model, or if the information is proprietary. You will
be most effective (and avoid creating enemies) by working with the conference planners and
speakers on a pre-arranged plan.
How can we ensure the message is correct?
Engage the conference planners and speakers. This is probably the biggest controversy in LVA.
To date, most previous abstracting has had some quality control built in either through a
dedicated review process at the journal promoting the VA, or because the author created their
#VisualAbstract 39
own and could therefore control the message. Similarly, as live tweeting often includes pictures
of slides, the author still retains primary control and citations are displayed prominently to give
context and validity. Because conference speakers are often moving on to the next session
quickly, it may be difficult to obtain permission or get them to review the live visual abstract in
a timely manner. We recommend several strategies to address this tension. First, a prior clear
agreement with conference organizers about who will be performing LVA, informing speakers
of its occurrence, and potential review is best. In the absence of existing structures,
approaching the moderator prior to the session’s start to inquire if they would be willing to
spot check your work is another viable approach. Finally, if you don’t have access to any of
these things, asking a fellow attendee to review and confirm your draft may also work.
What happens if I tweet out a LVA and realize there is an error?
Acknowledge it and repost the correct version. Time and severity are the two biggest
considerations here. If you notice immediately and it has not been widely shared, delete your
tweet, correct the abstract and try again. If you noticed a typo after the abstract has been
widely shared, acknowledge your mistake repost a corrected version but leave the original—the
message is likely more important than spelling. If you make a message error—meaning you
mispresent the content—we recommend working with the original speaker to make
corrections. This may entail deleting the original tweet, issuing a retraction, or other remedial
efforts. This ties back in to the creative control issue: because visual abstracts reach wide
audiences, retracting the message is impossible. Ultimately, having established LVA practices
are ideal.
What should I do if someone has made a visual abstract that I don’t like or misrepresents my
work?
Contact the person who made it. Contacting the abstractor is a good first start. Misrepresenting
your work is obviously a more serious transgression than creating a product that is simply
unattractive, but working together to correct the mistake will be most successful. There may
be little you can do to reign in spread once its public, but you can issue corrections. As is often
the case in medicine, prevention is probably most helpful—designating someone to create your
abstract and announcing this or preparing yours ahead of time will avoid this issue altogether.
How can I use the Visual Abstract to drive traffic to the relevant journal articles?
Tweet in tandem. The best way is to leverage a friend. Depending on the pace of the
conference you may not have time to thoroughly reply to or augment your initial tweet.
Therefore having a second person who can link article to the abstract or tie in other information
is very useful.
#VisualAbstract 40
Use of Visual Abstracts &
Online Journal Clubs
Joel Topf MD
#VisualAbstract 41
Critics of visual abstracts are concerned that they provide a superficial understanding of the
article and oversimplify the work. In my experience, they have been just the opposite. Visual
abstracts serve as a gateway to deeper conversations about the articles as we use them to draw
attention to our online journal clubs.
In this section I will give an overview of how we organize our online journal clubs and have
subsequently integrated the visual abstracts to improve our engagement and broaden our
reach.
ABOUT NEPHROLOGY JOURNAL CLUB ( #NephJC )
Nephrology Journal Club was established in 2014 as
a means to bring together the online nephrology
community to discuss the articles that are driving
nephrology forward. NephJC discusses two articles
a month.
Our monthly cycle for #NephJC includes the following components:
Blog Post Introduction. The cycle begins with a blog post that summarizes the key
points of the article.
Patient Essay. On the same page, we also include an essay by a patient discussing
how the disease, test, or treatment affects them.
Visual Abstract. To bring attention to the blog post, the patient essay, and the
upcoming journal club, we create a visual abstract for the article that is shared it on
social media and through our newsletter.
Online Twitter Chat. The primary event that these efforts are supporting are two 1hour
Twitter chats, one timed for North America and one for Europe. Thirty to one
hundred people participate in each chat. The conversation is lively and is similar in
content to a face-to-face journal club with discussions of previous work, methods,
results, and the implications and next steps for the field.
Summary of Discussion. After the discussion is complete a summary of the chat is
created and links to the discussion are added in a comment to the PubMed listing
using PubMed Commons
A more detailed summary of our work and process has been published in the American Journal
of Kidney Disease.
#VisualAbstract 42
USING VISUAL ABSTRACTS FOR JOURNAL CLUBS
In 2017 NephJC began creating visual abstracts for each article we discussed. The visual
abstracts were published to promote the Twitter chat and to get more people to participate
and clarify the subject of the discussion. Nearly a year later we find visual abstracts to be
particularly helpful in three core areas:
1. Lower Engagement Audiences
2. Studies where a Prior Article is Critical for Context
3. Complex Studies
Low Engagement Audience. Like many on-line activities, the audience for NephJC has various
levels of commitment. While we have a strong cohort of people who read the article, editorials,
and every supplement, we also have many people who come to the journal club chat without
reading the article. For the latter group having a visual abstract of the study orients them so
they can follow and understand the discussion. While visual abstracts are not intended to
replace the entire manuscript for some people it is enough for them to understand and get
useful information from the chat.
Studies where a prior article is critical for context. Another place visual abstracts are
particularly helpful is describing the research landscape that has already been written. For
example, when discussing the TESTING trial for IgA, it was helpful to review the visual abstract
for the STOP-IgAN trial because one could only understand the importance of the latter trial if
you were familiar with the former. Posting them together for the journal club quickly provided
context and enriched the discussion. The ability of a visual abstract to allow people to quickly
digest the prior literature allowed people to quickly grasp how the current study fit into the
scientific discussion.
#VisualAbstract 43
Complex Studies. We sometimes
review studies with complex
methods involving multiple trial
arms and interventions (seen at
right.) Even for people who have
read the article thoroughly, it can
be difficult to keep them all
straight. Having a visual abstract
allowed people to better
understand the methods and refer
to specific aspects fo the article.
ADOPTION BEYOND JOURNAL CLUBS
Perhaps the best testament to the visual abstract
experience at #NephJC has been the subsequent broad
uptake within the nephrology community. Over the last
year, several of our leading journals have adopted the
visual abstract. JASN has gone even further to create a
visual abstract editor section on editorial board.
#VisualAbstract 44
Visual Abstract:
Views from the Journal
#VisualAbstract 45
Implementation of Visual
Abstracts at Your Journal
Rebecca E. Berger MD
#VisualAbstract 46
This section is dedicated to academic journal editors and editorial staff who want to integrate
visual abstracts into their dissemination strategy. It builds directly on my experience
implementing the process at the New England Journal of Medicine in 2017 while working there
as an editorial fellow.
MAKING THE PITCH TO THE EDITORIAL BOARD
You may have encountered the visual abstract and wondered, “Why doesn’t my journal do
this?” Before you approach the editorial board of a journal, you will want to think through
some important questions:
 Can the results of the typical manuscript published in my journal be translated into the
visual abstract format?
 Would my readers benefit from seeing the journal content in the visual abstract format?
 How should I “sell” the idea of visual abstracts to the editors and editorial staff? Is the
goal to improve the number of readers, number of page views, number of subscriptions
for our journal? How would using visual abstracts meet any of these goals?
 Who would be responsible for creating and disseminating visual abstracts? Will you be
asking the editorial staff or authors to create and disseminate visual abstracts, or will
the process involve a collaboration of the two?
 How will I address anticipated challenges or criticisms of using this format at my
journal? The more common concerns include the risk of over-simplification of
complicated content and logistical considerations regarding accuracy, the review
process, formatting, and dissemination.
 How will we pilot visual abstracts for our journal?
 What will be our plan to test and improve our process and outputs?
Being prepared to answer these questions will help you better engage a journal editorial board
on whether or not to adopt the visual abstract. It is also helpful to talk to other journals who
have adopted the visual abstract to learn how they worked through the common hurdles listed
above. As evident by this primer, the visual abstract community is full of people openly sharing
their advice and experience.
#VisualAbstract 47
GETTING STARTED
Once your editorial board has agreed to adopt the Visual Abstract, here are some practical tips
to help you get started:
Start Small. A modest goal of one visual abstract a month is appropriate as your start
to figure out your templates, patterns and work flow. Plan to pilot 2-3 visual abstracts
before re-grouping with your editorial team to troubleshoot any challenges in the
process and output.
Choose Wisely. Some articles lend themselves to a visual abstract better than others.
Especially early on, choose articles with straight forward methods and clearly
reported outcomes. Decide with your editorial team how much content you want to
highlight on each visual abstract.
Dedicate a Point Person. Creating a visual abstract has a learning curve. Start by
identifying a single person (or perhaps 2) to create the first 10 visual abstracts, rather
than “spreading the work out” and having 10 people each make one.
Engage Key Team Members. If your journal has a staff member responsible for social
media, make sure they are involved in the process as they will likely be the ones
responsible for disseminating your work. If your journal has a business or marketing
team, they may have approved logos and branded images that they prefer you use.
Commit to Your Brand. Another reason to limit the early phases to a single person is
to maintain a style and consistency that can be recognized as part of the journal.
Standardizing simple design elements such as lay out, font, and color schemes can go
a long way to make your visual abstracts easy to produce and instantly recognizable.
Measure What Matters. Decide in advance with your team how you want to
measure success in your visual abstract pilot. Do you want to measure click-through
rates, or solicit feedback from a group of readers? If so, make sure you have the
mechanisms to collect this information in advance of releasing your first visual
abstract.
Growth Mindset. Even if you do not formally collect feedback from readers, make
sure you get feedback from your editorial team and colleagues including from other
journals. Iterative improvements can help further define the scope of your visual
abstracts and make each one better than the last. Most of the improvements we
made over the last year came directly from suggestions by our readers or colleagues.
#VisualAbstract 48
After Adoption – Avoiding
Visual Abstracts Mistakes at Your Journal
Hari Keshava MD, Mohamed Abbasi MD
#VisualAbstract 49
While creating visual abstracts has plenty of
upside for dissemination of research, it also
has many potential pitfalls. We outline here
some common mistakes made by those
creating visual abstracts and strategies to
mitigate them. As a start, we recommend
taking time to look through this primer as well
as examples of visual abstracts – e.g. search
the hashtag #VisualAbstract on social media –
to learn different styles and approaches.
A recent publication in Nature AJG (figure
from article show to the left) outlines some
guidelines to standardize the quality of visual
abstracts. These are not meant to be
restrictive rules, but rather safeguards meant
to guide you away from common mistakes.
We build on those here using our own experience working within a large international journal.
KEEP THE GOAL OF A VISUAL ABSTRACT IN PERSPECTIVE
The experience of creating a visual abstract should involve some tension. You don’t want it to
be so simplistic that you “dumb down” the research and offend the authors. You also do not
want to make the visual abstract so complex that it fails to engage potential readers. Even
worse, in either circumstance you do not want to misrepresent the actual research.
To take off some of the tension, we frequently give ourselves a couple reminders:
It’s Not About You, It’s the Article. You may find yourself stressed out that you have injected
too much of our own opinion in interpreting the article or that the findings are controversial.
Remember, this isn’t about you. The visual abstract should simply reflect the actual article
itself. Comments and critiques often apply to the article itself and not you.
It’s Just a Preview, Not A Substitute. Most good articles that catch your attention have multiple
important findings as well as specific caveats. It is impossible to capture all the nuance in a
visual abstract, and it’s rarely done in the actual text abstract. Although you should try to be
thorough, remember that the visual abstract is just preview and not designed to be a substitute
for the article.
#VisualAbstract 50
STRATEGIES TO LIMIT VISUAL ABSTRACT MISTAKES
Below are some strategies we have found helpful to reduce and even limit common visual
abstract mistakes.
Stick to the Prose of the Article. Try your best to use the same language that the
original author used in the article to minimize confusion and limit your own bias in
interpreting the findings.
Include the Methods. While visual abstracts usually feature a key outcome of
findings, remember to include the methods. At a minimum, we recommend
including the study design (e.g. randomized controlled trial, survey, etc) and sample
size to help give the reader context.
Clearly State the Authors Conclusion. Although the visual abstract is compared to a
“movie trailer” in that it’s just a snap shot of the article, a visual abstract should
include the conclusion. Avoid the “cliff-hangers” and click-bait, and simply state the
conclusion.
Include Measures of Significance. If the abstract or article has measures of
significance (e.g. p-value) for the main finding you’re showing the in visual abstract,
then include that measure. This will help give validity and again help the reader
interpret the findings.
Link to the Article. Remember, the goal is here is to preview the article, not be a
substitute. Be sure that when sharing the visual abstract, you clearly link to the
actual article. This will make it easier for readers to know where the information is
derived.
Make the Visual Abstract Searchable. At present there is not a repository for visual
abstracts, but most journal use the hashtag #VisualAbstract on social media to
readers find them. Some also post them on their site with the article itself.
Use the Right Images. Only use images that you either have a copyright to use, or
that you’ve purchased through a subscription that allows you to use them.
Copyright violations will deeply threaten your journal’s credibility in this space.
#VisualAbstract 51
IMPROVING THE VISUAL ABSTRACT PROCESS AT YOUR JOURNAL
While visual abstracts can be created by individual authors and one-off projects, we strongly
advocate that journals commit resources to a create a dedicated team. Many journals now have
made “Visual Abstract Editor” or a “Creative Director” position on their editorial board to spear
head visual abstract creation.
After your journal has gotten started, here are some tips to help improve your process:
Maximize the Learning Curve. Creating a visual abstract has a learning curve. It is
best to have one or two people create the first ten, rather than ten people each
creating one. Quality and consistency from your journal will go a long way to
establish brand and credibility.
Establish Internal/External Review. Many mistakes in transcription or unconscious
bias can be detected before the visual abstract is disseminated by having another
person at the journal and/or someone outside the journal review it.
Be Responsive & Transparent. Even the best of us will make a mistake. If there is an
error (e.g. incorrect value, mislabeled outcome) detected in your visual abstract
after it has been shared, own it. Make the correction and re-post it.
Commit to a Dissemination Plan. Make sure you have a dedicated account that will
be used for the purpose of disseminating the visual abstract. From our standpoint,
tweeting the abstract is always done through the journal’s twitter account with the
goal of 4-6 abstracts per month.
A final word of advice-- do not hesitate to ask for help. This primer brings together a dozen of
us who have never been in the same room together, but all share tips and tricks together on
how to create a better visual abstract.
#VisualAbstract 52
Future of Visual Abstracts
#VisualAbstract 53
Librarians & Visual Abstracts
Patricia Anderson, MILS
#VisualAbstract 54
Visual abstracts have gained enormous traction over the last year. From the view of a librarian,
they have several benefits, drawbacks and future issues that need to be considered.
BENEFITS, DRAWBACKS OF VISUAL ABSTRACTS
Benefits
The benefits of a visual abstract are numerous. In addition to the evidence that articles with
visual abstracts are read more often, they also have potential for broad application. A visual
abstract lends itself to plain language explanations of concepts, clarity for funding agencies and
policy makers, and as a tool for public outreach and education. The visual abstract may be more
accessible to people with cognitive disabilities or who prefer visual learning (albeit while being
less accessible to those with visual disabilities.) There are powerful benefits, especially in this
era of publicly contested science findings.
Drawbacks
Visual abstracts are not without draw backs. Although never the intent, there appears to be
some temptation to have them replace written abstracts. Another challenge is that they
currently are not searchable in databases, and the issue of how to include and discover visual
abstracts in MEDLINE remains to be addressed by the National Library of Medicine. Personally,
I’m not sure that it replaces the full functionality of the traditional abstract, but rather
supplements it, which I suspect is the intent of most users. Offering both strongly empowers
science communicators and educators, especially if the images are licensed to promote use and
dissemination. It would be ideal if the standard of practice for visual abstracts would be to
make them Creative Commons licensed.
What is the Role of a Librarian?
Visual abstracts have generated discussion amongst librarians because of its potential to
efficiently organize and communicate a broad body of scientific research. Librarians and
libraries can provide useful expertise and resources in support of developing visual abstracts.
Specifically, librarians can help in the discovery of royalty-free and Creative Commons images
appropriate for use; training, acquisition, and licensing of image manipulation software and
image databanks; as well as development and management of visual media, infographics, and
image creation services.
#VisualAbstract 55
FUTURE QUESTIONS ABOUT THE VISUAL ABSTRACTS
Over the last two years several important considerations have been raised regarding the future
of visual abstracts.
1. Should the Visual Abstract be part of the actual article? The original intent of the visual
abstract was as an adjunct on social media to highlight key findings from an article. They have
become, however, valuable resources that readers download and integrate into their lectures
and presentations to reference the paper. At least one journal, Annals of Thoracic Surgery, has
included the visual abstract alongside the article itself.
2. Who should create the Visual Abstract? Do authors get academic credit? While the spirit of
the visual abstract has been to open source creation and make it available to researchers,
journals and institutions will likely shoulder the responsibility of facilitating that they are done
at a high quality (i.e. provide resources, edit them, etc). At present there is no formal
recognition for creating a visual abstract. However, several authors, having spent hours and
multiple revisions creating one have started to list them on their CV.
3. Should Visual Abstracts be required from authors? While creating a visual abstract was
initiated as a purely voluntary activity, demand for them has grown. In April of 2017, Stroke was
first to announce that it will require visual abstracts for basic science manuscripts accepted to
the journal. Other journals have followed suit, but it is unclear to what extent these
requirements will be enforced.
4. Should there be a central repository for Visual Abstracts? At present, most visual abstracts
only exist on social media platforms. Ideally they should be integrated in the MEDLINE or the
publisher website so they can be readily included with the article itself. Efforts to create a
central repository of visual abstracts have been discussed, but not formally implemented yet.
#VisualAbstract 56
Moving Forward
Toward Better Visual Abstracts
ANDREW M. IBRAHIM MD, MSC
#VisualAbstract 57
If the past year is any indication, our ability to create better visual abstracts will only grow.
Particularly as journals make investments to professionalize the practice, it will become more
common place.
If you have ideas and content you want to see in the next version of the visual abstract primer,
please share them with us (email: iandrew@umich.edu) and we’ll work to incorporate it into
the next edition.