Getting Published

Gavin Leslie Judy Currey

Andrea MarshallLeanne Aitken

Workshop Outline

• Update on ACC

• Preparing a case study for publication

• Update on electronic publishing

Case Studies - Purpose

• Informative critique of patient care • Facilitates learning from past

experiences • Allows clinicians to share management

plans for challenging patients • Develops problem solving skills • Facilitates development of practice

guidelines

Educational Message

• Essential component of case study

• Might include: – Raising awareness of issue – Outlining new understanding of

condition, complication or treatment – Clarifying previously unclear aspect of

pathophysiology or care

Educational Message

Patterson et al Successful Outcome in Severe Traumatic Brain Injury: A Case Study. J. Neuroscience Nursing 2005; 37(5): 236 – 42:

• Abstract - “This case study explores the potential benefit of combining multimodality monitoring and TBI guidelines in the management of severe TBI”

• Conclusion – “This case study demonstrates how neurocritical care management with MMM can control ICP, maximize CPP and prevent devastating secondary injury.”

Educational MessageDwivedi et al Interactive Care Report: A 28 year

old post partum woman with right sided chest discomfort. BMJ 2006; 332: 406, 471, 643

• Presented in 3 sections: – Case presentation – Case progression – Case outcome

• “highlights the importance of ruling out coronary artery disease …. The exercise test is truly diagnostic in only 40% of patients …. Stress echocardiography is a reliable and cost effective method for diagnosis and risk assessment ….”

Principles

• Describe a real patient who required significant and challenging care

• No intention to generalise care beyond this specific case

• Sufficiently complex to raise interest care issues

• Not so rare that few readers will care for a similar patient

Categories of Case Reports

• Totally original condition / new disease

• Rare and previously sparsely reported condition

• Unusual presentation of a common disease

• Unexpected association between two relatively uncommon symptoms / signs

• Impact of one disease process on another

• Unexpected event in the course of observing or treating a patient

• Impact of a treatment regime of one condition on another disease

• Unexpected complication of treatment or procedure

• New and unique treatment • Honest mistakes in

management

Chelvarajah R & Bycroft J Writing and publishing case reports, Acta Neurochir, 2004; 146: 313-6

Principles cont.

• All aspects of background that impact on care should be described

• Outcome should be included • Incorporate relevant illustrations • Maintain privacy of patient • Critically appraise care • Incorporate literature where

appropriate

Format

• Abstract

• Introduction

• Case description

• Discussion

• Conclusion

Abstract

• Format dependent on journal

• Describe clinical problem or care

• Clearly state what the educational message is

Introduction

• Set the scene

• Identify how common the situation / condition is

• What makes this case interesting?

• Reference this to the known literature so readers can refer

Case Description

• Include all relevant background, e.g.: – Past health history – Social history – Current problem

• Do not provide unnecessary / irrelevant information

• Consider how to sequence information

Case Description cont.

• Aspects of care to incorporate: – Assessment information – Treatment information– Care of the family – Interpersonal care

Discussion

• Provides a critique of the care

• Commentary on care that was not effective and possible reasons

• Incorporate relevant literature and comments on the consistency of this case with the literature

Conclusion

• Links to the introduction

• Emphasises the educational message

• Outline implications for practice and recommendations for future research

Style of a Case Study

• Combination of ways of providing information, e.g.: – Essay style – ‘text boxes’ with clinical details

• Ensure ease of reading

Summary

• Need to be interesting

• Must have educational message

• Follow a structured format