Getting Published Gavin Leslie Judy Currey Andrea Marshall Leanne 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 Message Dwivedi 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