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撰写病例报告可改善临床推理的七个要素。

Writing Case Reports Can Improve Seven Components in Clinical Reasoning.

作者信息

Nishizawa Toshinori, Ishizuka Kosuke, Otsuka Yuki, Nakanishi Toshiyuki, Kawashima Akira, Miyagami Taiju, Yamashita Shun

机构信息

Department of General Internal Medicine, St Luke's International Hospital, Tokyo, Japan.

Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan.

出版信息

Int Med Case Rep J. 2024 Mar 21;17:195-200. doi: 10.2147/IMCRJ.S449310. eCollection 2024.

Abstract

Case reports provide scientific knowledge and opportunities for new clinical research. However, it is estimated that less than 5% of cases presented by Japanese generalists at academic conferences are published due to various barriers such as the complex process of writing articles, conducting literature searches, the significant time required, the reluctance to write in English, and the challenge of selecting appropriate journals for publication. Therefore, the purpose of this opinion paper is to provide clinicians with practical tips for writing case reports that promote diagnostic excellence. In recent years, clinical practitioners have been striving for diagnostic excellence and optimal methods to accurately and comprehensively understand the patient's condition. To write a case report, it is essential to be mindful of the elements of diagnostic excellence and consider the quality of the diagnostic reasoning process. We (the authors) are seven academic generalists who are members of the Japanese Society of Hospital General Medicine (JSHGM) - Junior Doctors Association, with a median of 7 years after graduation and extensive experience publishing case reports in international peer-reviewed journals. We conducted a narrative review and discussed ways to write case reports to promote diagnostic excellence, leveraging our unique perspectives as academic generalists. Our review did not identify any reports addressing the critical points in writing case reports that embody diagnostic excellence. Therefore, this report proposes a methodology that describes the process involved in writing diagnostic excellence-promoting case reports and provides an overview of the lessons learned. Based on our review and discussion, we explain the essential points for promoting diagnostic excellence through case reports categorized into seven components of clinical reasoning. These strategies are useful in daily clinical practice and instrumental in promoting diagnostic excellence through case reports.

摘要

病例报告为新的临床研究提供了科学知识和机会。然而,据估计,日本全科医生在学术会议上展示的病例中,由于诸如文章撰写过程复杂、进行文献检索、所需时间长、不愿用英文撰写以及选择合适的期刊发表等各种障碍,只有不到5%得以发表。因此,本观点论文的目的是为临床医生提供撰写有助于提高诊断水平的病例报告的实用技巧。近年来,临床医生一直在努力追求卓越诊断以及准确全面了解患者病情的最佳方法。要撰写病例报告,必须留意卓越诊断的要素,并考虑诊断推理过程的质量。我们(作者)是日本医院普通医学学会(JSHGM)初级医生协会的七名学术全科医生,毕业中位数时间为7年,在国际同行评审期刊上发表病例报告经验丰富。我们进行了一项叙述性综述,并利用我们作为学术全科医生的独特视角,讨论了撰写有助于提高诊断水平的病例报告的方法。我们的综述未发现任何涉及体现卓越诊断的病例报告撰写关键点的报告。因此,本报告提出了一种方法,描述了撰写有助于提高诊断水平的病例报告所涉及的过程,并概述了经验教训。基于我们的综述和讨论,我们解释了通过病例报告促进卓越诊断的要点,这些要点分为临床推理的七个组成部分。这些策略在日常临床实践中很有用,有助于通过病例报告促进卓越诊断。

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