临床药师的病例分析选题与写作

1、整理ppt第二届“专科临床药师药学服务技能及病例分析论坛”临床药师的病例分析临床药师的病例分析选题与写作选题与写作卫生部临床药师（师资）培训基地国家临床药学重点专科（军队建设）中国人民解放军全军临床药学中心整理pptl临床药学病例分析l病例分析的选题l病例分析的写作l病例分析的评价整理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综合征lPaul Broca reported on language impairment following left hemisphere大脑左半球lesions in the 1860s. lJoseph Jules Dejerine reported on a case of pure alexia失读症. lWilliam MacIntyre reported on a case of multiple myeloma多发性骨髓瘤(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药学病例分析药学病例分析l临床医学病例分析以疑难疾病、罕见疾病的临床诊治得失总结为主要内容l临床药学病例分析以具体病例药物治疗得失及其相关问题的分析总结为主要内容整理ppt病例分析的选题病例分析的选题l来源于临床药学实践l反映临床药师工作得失l围绕药物治疗各类问题（药学诊断）l重点讨论一个问题整理ppt

16、l定义（定义（Culbertson et alCulbertson et al）：）：“用来鉴定病人特定的药物相用来鉴定病人特定的药物相关问题的、以问题为中心的认识过程关问题的、以问题为中心的认识过程。”l处方问题处方问题l药物治疗评价相关问题药物治疗评价相关问题l药物治疗的不良反应问题药物治疗的不良反应问题l监测相关问题监测相关问题l病人相关因素病人相关因素l病人教育问题病人教育问题整理ppt整理ppt整理ppt整理ppt整理ppt整理ppt病例分析的写作病例分析的写作l文体l篇幅l基本结构整理ppt整理ppt病例报告病例分析病例讨论病例数5多例1例特点在临床诊治中的极为特殊的情况，或极为罕

17、见的病例，往往容易造成误诊甚至延误治疗以一组相同疾病进行统计分析、对照比较以寻求其共同规律是以临床诊治较为疑难的病例为对象，从病例的实际资料出发，应用现代医学理论对其进行深入系统的讨论，把讨论过程记录、整理撰写成为病例讨论文章结构一般情况、检查治疗结果及预后等讨论一般资料、临床表现、实验室检查等一一加以分析、对比、归纳，总结共同规律和特征+总结+文献病例摘要+讨论（含讨论过程及结论，也可按问题归纳）整理ppt整理ppt整理ppt整理ppt整理pptl病例分析的基本结构l题目l前言l病史摘要l分析讨论l小结l参考文献整理ppt题题 目目l突出重点问题，言简意赅l注意题目的适用范围l注意结论的严谨

18、性和可靠性l尽可能反映临床药师的作用整理ppt前前 言言l交待主要背景l引出讨论话题l说明写作目的l做到前呼后应整理ppt病史摘要病史摘要l介绍患者基本资料l简要介绍与所讨论问题相关的疾病情况l重点介绍与所讨论问题相关的药物治疗l介绍临床药师的参与及干预处置过程l重点注意客观、全面、准确l必要时可以利用一些图表辅助整理ppt分析讨论分析讨论l围绕选定问题重点讨论l结合理论与患者实际情况分析对比l体现药师的推理逻辑与分析思路l注意文献的引用和分析l注意相关因素的全面甄别整理ppt小小 结结l总结问题结论l归纳规律性问题l评价药师工作得失l提出相关缺陷与不足整理ppt参考文献参考文献l引用全面准确l注意文献新颖与权威l尽量国内外文兼顾l著录格式规范整理ppt病例分析的评价病例分析的评价l基本评价点l病例选择适宜l讨论的问题选择适宜l病史摘要简明扼要l分析讨论证据充分l心得体会深刻l文字用语规范整理pptl质量缺陷评价表l基本要求: l字迹潦草难以辨认、不能通读（重度缺陷）l有证据证明系拷贝行为导致的原则性错误（重度缺陷）l专业用语不规范（5）l药物名称未使用通用名（重度缺陷）l未针对明确的药物治疗事件展开讨论（重度缺陷）l主要参考文献未注明（2）整理ppt质量缺陷评价表质量缺陷评价表l病史摘要: l病史介绍内容与讨论问题要点不能紧密结合（5）l疾病发展变化过程描述不清（5）l相关