Question

You are working as a health care provider, and have started prescribing a new medication for difficult to manage seizures as part of the treatment of epilepsy. Several of your patients start to develop unusual previously not reported side effects in the clinical trials for that drug. The side effects include peripheral vision blindness and skin turning blue. In addition to alerting the FDA, you want to publish your patient observations so that other doctors are made aware. using this scenario, describe the process you would take to write these cases into a paper and describe the peer review process of medical journals from start to finish. Describe any obstacles or challenges in getting your observations published.

( Pease write enough so I can understand it more ) at least 380 words

There is no statistical data here. It's basically asking that if You were the healthcare provider what will you be doing in this situation. It's basically your opinion there is no such thing as wrong or right answer.

Answer 1

The process I would take to write these cases into a paper:

Case reports usually describe an unusual or novel occurrence and as such, remain one of the cornerstones of medical progress and provide many new ideas in medicine.

The most common reasons for publishing a case are the following:

• Unusual observations
• Adverse response to the new medication
• Illustration of a new theory
• Personal impact.

The case report that I would work on includes the following components: an abstract, an introduction, a case, and a discussion. Some journals might require literature review.

Abstract

The abstract that summarize the case, the problem it addresses, and the message it conveys. Abstracts of case studies are usually very short, preferably not more than 150 words.

Introduction

The introduction gives a brief overview of the problem that the case addresses, citing relevant literature where necessary. The introduction generally ends with a single sentence describing the patient and the basic condition that he or she is suffering from.

Case

This section provides the details of the case in the following order:

• Patient description

• Case history

• Physical examination results

• Treatment plan ( Medication administered)

• Expected outcome of the treatment.

• Actual outcome.

I must ensure that all the relevant details are included and unnecessary ones excluded.

Discussion

This is the most important part of the case report; the part that will convince the journal that the case is publication worthy. This section should start by expanding on what has been said in the introduction, focusing on why the case is noteworthy and the problem that it addresses.

This is followed by a summary of the existing literature on the topic.

This part describes the existing theories and research findings on the key issue in the patient's condition. The review should narrow down to the source of confusion or the main challenge in the case.

Finally, the case report should be connected to the existing literature, mentioning the message that the case conveys.

Conclusion

A case report ends with a conclusion or with summary points, depending on the journal's specified format. This section should briefly give readers the key points covered in the case report. Here, I can give suggestions and recommendations to clinicians, teachers, or researchers.

Notes on patient consent

Informed consent in an ethical requirement for most studies involving humans, so before I start writing my case report, I must take a written consent from the patient as all journals require that I provide it at the time of manuscript submission. In case the patient is a minor, parental consent is required. For adults who are unable to consent to treatment, consent of closest family members is required. Patient anonymity is also an important requirement. Remember not to disclose any information that might reveal the identity of the patient.

Peer review helps prevent the publication of flawed medical research papers.

Flawed research includes:

• made-up findings and hoax results that do not have a proven scientific basis.
• dangerous conclusions, recommendations, and findings that could harm people.
• plagiarized work, meaning that an author has taken ideas or results from other researchers.

For medical journals, peer review means asking experts from the same field as the authors to help editors decide whether to publish or reject a manuscript by providing a critique of the work.

Peer review process of medical journals are as follows:

1. When a manuscript is first submitted to a medical journal, at first, the topic and scope of the manuscript and its contribution to the existing literature is checked. This is done by the editor-in-chief, typically in consultation with the associate editor. This process usually takes less than one month.

2. For a manuscript deemed appropriate, editors will send it to an average of two to three reviewers for peer review. Editors decide the reviewers for a particular manuscript based on their expertise and availability. If the reviewer accepts an email invitation to the review, full text manuscript can be accessed via the online submission system. Usually reviewers are asked to send their comments back within two to four weeks of receipt of the manuscripts. After finishing the review, reviewers should upload their review results on the submission system.

3. The manuscripts and reviews are discussed at the editorial board's meetings. These discussions, along with the responses from reviewers, help the board members make a final decision on each manuscript. When differences of opinion between reviewers occur, the editorial board weighs all comments and arrives at a balanced decision based on these comments. Reviewers whose opinion differs from the final board decision should not be discouraged, for their hard work is nonetheless fully appreciated. The editorial board is the final decision maker on publication.

4. The decision letter of the editorial board and reviewers' comments are sent to authors via email. The medical journals usually notify reviewers of the ultimate decision to accept or reject a manuscript and allow them to share the review of co-reviewer(s) of the same paper so that they learn from each other in the review process.

There are various obstacles and challenges in getting the observations published:

lack of time to fulfill the commitment that is required for publishing a journal. Very frequently journal-related tasks are needed to be carried out along with all the routine work of patient care, teaching, and research. Therefore, passion and sheer determination are the essential prerequisites

Another challenge that is faced is of getting articles. Initially, personal contacts are required to get the articles for publication in a new journal but authors are hesitant to submit their manuscripts to new/unheard of journals that are not indexed.

Another issue regarding the manuscripts that are submitted is the substandard English expression. At times, both reviewers and the editorial staff have to correct the grammar and the English expression which is very time-consuming and often articles tend to be rejected in the initial evaluation itself; however, due to this, a new journal cannot afford to do so.

The third challenge is regarding peer reviewers and the editorial board. Getting the manuscripts peer reviewed by experts is essential for maintaining standards of the academic content and to improve the credibility of the journal. Getting peer reviewers for a new journal is a very tough task and most of the times, especially during the initial years, the peer reviewers have to be individually requested to do the needful; the one who agree is usually a close acquaintance. In addition, the reviewers get no recognition, academic acknowledgment, or any financial reimbursements for a task which if done correctly is very time-consuming.

An equally important challenge is the cost factor. The cost involved in bringing out a hard copy of the journal and the money required on postage tend to be a headache for the chief editor. The online issues are cheaper, but certain medical councils do not accept publications in net-based journals as criteria for academic achievements.

Furthermore, it is not easy to find audience/readers for a new journal. It is worthwhile that the first few issues of printed journals can be provided to libraries of medical institutions at a free of cost. Similarly, such issues could be distributed as part of conference kits for bringing about awareness regarding the journal. Once a couple of issues of the journal have been brought out, the challenges which are faced are regarding duplicate submission, duplicate publication, and plagiarism.