臨床藥師的病例分析選題與寫作

1、整理ppt第二屆“?？婆R床藥師藥學服務技能及病例分析論壇”臨床藥師的病例分析臨床藥師的病例分析選題與寫作選題與寫作衛(wèi)生部臨床藥師（師資）培訓基地國家臨床藥學重點?？疲ㄜ婈牻ㄔO）中國人民解放軍全軍臨床藥學中心整理pptl臨床藥學病例分析l病例分析的選題l病例分析的寫作l病例分析的評價整理pptCase ReportlA report of a single case of a disease, usually with an unexpected presentation, which typically describes the findings, clinical course, and

2、prognosis of the case, often accompanied by a review of other cases previously reported in the biomedical literature to put the reported case in context.http:/medical- reportlIn medicine, a case report is a detailed report of the symptoms, signs, diagnosis, treatment, and follow-up of an individual

3、patient. Case reports may contain a demographic profile of the patient, but usually describe an unusual or novel occurrence.lTypes of case reportslMost case reports are on one of six topics1:lAn unexpected association between diseases or symptoms. lAn unexpected event in the course of observing or t

4、reating a patient. lFindings that shed new light on the possible pathogenesis of a disease or an adverse effect. lUnique or rare features of a disease. lUnique therapeutic approaches. lA positional or quantitative variation of the anatomical structures. /defin

5、itions/Case%20report?cx=partner-pub-0939450753529744%3Av0qd01-tdlq&cof=FORID%3A9&ie=UTF-8&q=Case%20report&sa=Search#922整理pptlUsefulness and validitylA case report is a type of anecdotal evidence. As such, it is less scientifically rigorous than controlled clinical data involving a larger sample size

6、. Proponents argue that case reports have value within scientific method:lThey permit discovery of new diseases and unexpected effects (adverse or beneficial) as well as the study of mechanisms, and they play an important role in medical education. Case reports and series have a high sensitivity for

7、 detecting novelty and therefore remain one of the cornerstones of medical progress; they provide many new ideas in medicine. (Vandenbroucke, 2001) 整理pptlFamous scientific case reportslSigmund Freud reported on numerous cases, including Anna O., Dora, Little Hans, Rat Man, and Wolf Man lFrederick Tr

8、eves reported on The Elephant Man Proteus綜合征lPaul Broca reported on language impairment following left hemisphere大腦左半球lesions in the 1860s. lJoseph Jules Dejerine reported on a case of pure alexia失讀癥. lWilliam MacIntyre reported on a case of multiple myeloma多發(fā)性骨髓瘤(described in the 1840s). 整理pptlPubl

9、ishing case reportslMany international journals will publish case reports, however there are very few that are devoted to publishing case reports alone. Journal of Medical Case Reports 1 and Cases Journal 2 are two such journals, publishing Open Access peer reviewed case reports in all areas of medi

10、cine. Another is Radiology Case Reports, an open-access peer-reviewed journal focusing on medical imaging.lUse of term outside sciencelThe term is also used to describe non-scientific reports usually prepared for their educational value.整理pptlEditoriallA case report provides important and detailed i

11、nformation about an individual, which is often lost in larger studies. Moreover, case reports can serve as an early warning signal for the adverse effects of new medications, or the presentations of new and emerging diseases. Although a number of medical journals publish case reports, these articles

12、 are underrepresented in the literature, and there has not been a journal specifically devoted to these valuable reports. Journal of Medical Case Reports fills this void. It is an online, open access journal dedicated to the publication of high quality case reports, and aims to contribute to the exp

13、ansion of current medical knowledge.lSince antiquity, clinicians have learnt from their more experienced peers as well as from their own work with their individual patients 1. Accurate recounting of clinical experience continues to be essential to the progress of medicine. In recent years, however,

14、case reports have become a casualty of the pursuit of the impact factor. Case reports tend to have low citation value and therefore can negatively affect a journals impact factor, and prevalence of these articles in high impact journals has been reported as being in decline 2. With Journal of Medica

15、l Case Reports we intend to create a dedicated home for these articles, which have the potential to contribute to and change clinical practice.整理ppt藥學病例分析藥學病例分析l臨床醫(yī)學病例分析以疑難疾病、罕見疾病的臨床診治得失總結(jié)為主要內(nèi)容l臨床藥學病例分析以具體病例藥物治療得失及其相關問題的分析總結(jié)為主要內(nèi)容整理ppt病例分析的選題病例分析的選題l來源于臨床藥學實踐l反映臨床藥師工作得失l圍繞藥物治療各類問題（藥學診斷）l重點討論一個問題整理ppt

16、l定義（定義（Culbertson et alCulbertson et al）：）：“用來鑒定病人特定的藥物相用來鑒定病人特定的藥物相關問題的、以問題為中心的認識過程關問題的、以問題為中心的認識過程。”l處方問題處方問題l藥物治療評價相關問題藥物治療評價相關問題l藥物治療的不良反應問題藥物治療的不良反應問題l監(jiān)測相關問題監(jiān)測相關問題l病人相關因素病人相關因素l病人教育問題病人教育問題整理ppt整理ppt整理ppt整理ppt整理ppt整理ppt病例分析的寫作病例分析的寫作l文體l篇幅l基本結(jié)構(gòu)整理ppt整理ppt病例報告病例分析病例討論病例數(shù)5多例1例特點在臨床診治中的極為特殊的情況，或極為罕

17、見的病例，往往容易造成誤診甚至延誤治療以一組相同疾病進行統(tǒng)計分析、對照比較以尋求其共同規(guī)律是以臨床診治較為疑難的病例為對象，從病例的實際資料出發(fā)，應用現(xiàn)代醫(yī)學理論對其進行深入系統(tǒng)的討論，把討論過程記錄、整理撰寫成為病例討論文章結(jié)構(gòu)一般情況、檢查治療結(jié)果及預后等討論一般資料、臨床表現(xiàn)、實驗室檢查等一一加以分析、對比、歸納，總結(jié)共同規(guī)律和特征+總結(jié)+文獻病例摘要+討論（含討論過程及結(jié)論，也可按問題歸納）整理ppt整理ppt整理ppt整理ppt整理pptl病例分析的基本結(jié)構(gòu)l題目l前言l病史摘要l分析討論l小結(jié)l參考文獻整理ppt題題 目目l突出重點問題，言簡意賅l注意題目的適用范圍l注意結(jié)論的嚴謹

18、性和可靠性l盡可能反映臨床藥師的作用整理ppt前前 言言l交待主要背景l(fā)引出討論話題l說明寫作目的l做到前呼后應整理ppt病史摘要病史摘要l介紹患者基本資料l簡要介紹與所討論問題相關的疾病情況l重點介紹與所討論問題相關的藥物治療l介紹臨床藥師的參與及干預處置過程l重點注意客觀、全面、準確l必要時可以利用一些圖表輔助整理ppt分析討論分析討論l圍繞選定問題重點討論l結(jié)合理論與患者實際情況分析對比l體現(xiàn)藥師的推理邏輯與分析思路l注意文獻的引用和分析l注意相關因素的全面甄別整理ppt小小 結(jié)結(jié)l總結(jié)問題結(jié)論l歸納規(guī)律性問題l評價藥師工作得失l提出相關缺陷與不足整理ppt參考文獻參考文獻l引用全面準確l注意文獻新穎與權威l盡量國內(nèi)外文兼顧l著錄格式規(guī)范整理ppt病例分析的評價病例分析的評價l基本評價點l病例選擇適宜l討論的問題選擇適宜l病史摘要簡明扼要l分析討論證據(jù)充分l心得體會深刻l文字用語規(guī)范整理pptl質(zhì)量缺陷評價表l基本要求: l字跡潦草難以辨認、不能通讀（重度缺陷）l有證據(jù)證明系拷貝行為導致的原則性錯誤（重度缺陷）l專業(yè)用語不規(guī)范（5）l藥物名稱未使用通用名（重度缺陷）l未針對明確的藥物治療事件展開討論（重度缺陷）l主要參考文獻未注明（2）整理ppt質(zhì)量缺陷評價表質(zhì)量缺陷評價表l病史摘要: l病史介紹內(nèi)容與討論問題要點不能緊密結(jié)合（5）l疾病發(fā)展變化過程描述不清（5）l相關