Writing Case Reports Can Improve Seven Components in Clinical Reasoning

Toshinori Nishizawa, Kosuke Ishizuka, Yuki Otsuka, Toshiyuki Nakanishi, Akira Kawashima, Taiju Miyagami, S. Yamashita
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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.
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撰写病例报告可提高临床推理能力的七个组成部分
: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,日本普通医生在学术会议上发表的病例报告只有不到 5%得以发表,原因是存在各种障碍,如撰写文章、进行文献检索的复杂过程、所需的大量时间、不愿用英语撰写以及选择合适期刊发表的挑战。因此,本意见书旨在为临床医生提供撰写病例报告的实用技巧,以促进卓越诊断。近年来,临床医生一直在努力追求卓越的诊断效果和最佳的诊断方法,以准确、全面地了解患者的病情。撰写病例报告时,必须注意卓越诊断的要素,并考虑诊断推理过程的质量。我们(作者)是日本医院全科医学会(JSHGM)--初级医生协会的七名学术型全科医生,毕业后的工作年限中位数为 7 年,在国际同行评审期刊上发表病例报告的经验丰富。我们进行了叙述性回顾,并讨论了如何撰写病例报告以促进卓越诊断,充分利用我们作为学术全科医生的独特视角。我们的综述没有发现任何报告论述了撰写体现卓越诊断的病例报告的关键点。因此,本报告提出了一种方法,描述了撰写促进卓越诊断的病例报告的过程,并概述了所吸取的经验教训。在回顾和讨论的基础上,我们将通过病例报告促进卓越诊断的要点归纳为临床推理的七个组成部分。这些策略在日常临床实践中非常有用,有助于通过病例报告促进卓越诊断。
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