Clinical medical paper writes a point

Basic Medical Pathology: Neoplasis I

The structure of clinical medical paper is shown 1 times like the graph, among them summary part has fixed pattern commonly, namely " purpose, method, result, conclusion " , summary part is begged only simple and compendious, not detailed analytic with the analysis. Accordingly, discuss mainly below from the back 4 much.

1. Foreword

Foreword common is called " opening remarks " , have main effect to judging the value of the article. It not only give a reader, often also give reader and periodical editorial office " first impressions are strongest " impression. Is the first of outline of clinical document judge asked about [1] " what is the purpose that the author studies? Whether be solve a certain (some) research problem or test and verify a certain hypothesis? If be if, you whether induce from inside the article the issue that gives this research or hypothesis? This research problem or hypothesis whether about a certain interpose (if treat) the effect, causal or the intensity that decides a certain healthy issue? " the end that the most serious content in foreword wants to will study clearly namely tells a reader, want to explain the setting of research and the basis that establish a problem at the same time. General requirement first from introduce research setting on the whole, narrow gradually basis establishing a problem, center research purpose again. Like the graph so 1 is shown, foreword part shows echelon structure.
There is periodical of a few medicines on international, the requirement introduces research in detail in foreword part setting and basis establishing a problem, but more international and domestic medicine periodical, it is to ask to introduce research crisply in foreword part setting and basis establishing a problem, center research purpose next. Setting of such a few research and the content of basis establishing a problem, need to be described in discuss. A fine introduction should be to use a few words wraparound and previous the research of this domain, show the necessity of this research then, the research that must elaborate you according to the facts is better than foregoing research where be, where be newly.

2. Material and method

The reflects a lot of basic level hospitals doctor of sex of 2.1 articles science and effectiveness and the doctor that do not have concept of abide card medicine, when reading a paper, often not quite notice its research technique. However the scientific sex that the content of this one part often reflects an article and effectiveness, accordingly it is periodical of affirmatory paper accept or reject the most crucial place. In 9 outline of clinical document judge, having 7 is to be mirrorred in " material and method " part.
Because doctor of domestic rheumatism family is medium the person that had accepted epidemic knowledge to groom is very little, add a lot of people when reading document at ordinary times, often jump over " material and method " part, the paper that causes rheumatism to learn puts generally in such problem: Jie of accept of Quan  scoop up with a dust pan is dark the method that? of Han of a surname of exterminate of Qi of the flute that receive Xing puts major length in descriptive lab, and oversight the content; of the scientific sex that reflects an article and effectiveness if the paper does not involve the content that has a lab, do not know what this part should write, many clinical papers are in " material and method " in the part, use a few words only, because " it is good to do not have a thing write " . Actually discretion of quality of a paper, often reflect in this one part. Accordingly, want to raise rheumatism to learn the quality of the paper, need from here proceed with.
The doctor of young rheumatism family that suggests to annals composes ability at raising oneself paper, from inside the advanced periodical such as Lancet, NewEngl JMed, BMJ, JAMA, search 10 ～ 20 treatise that oneself are interested in a domain, read in detail (the key is put in " material and method " partial) , choose among them 3 ～ 5, read by what judge outline has judge sex. After finishing, write to your clinical research and paper will have great progress surely. The author in international clinical epidemiology works net, of Australia groom during central study, each country student feels generally, going up " Criticalappraisal " class and finish " Critical AppraisalExercise " after exercise, have " suddenly see the light " feeling.
The content that 2.2 need clarify is not little of the sexual distinction of paper general case of illness, average age, average course of diseases, base line wait quite " result " partial content is written in ahead of schedule " material and method " in, this is impertinent. "Material and method " basically be the plan that describes this research, basically include 6 fields. 2.2.1 research are politic: Core of greedy for food of  of  of male Ping of scoop up with a dust pan pits Yu 2] , OK and direct, OK also and indirect, but must let a reader very the strategy that knows this research explicitly. Because the reader needs to judge, this research strategy is used at solving a problem of a research appropriate. In the paper that rheumatism learns, experimental sex studies (random and clinical trial) with the analysis the gender studies (alignment research and case of illness contrast research) less, most paper is descriptive sex, perhaps cannot realize an its research strategy from inside the paper at all. Accordingly, when emphasizing writing an article, need is advertent research strategy is explained was clear about. Because do not have the thesis that researchs strategy, the data is again good, also can be in a state of disunity only. 2.2.2 research example: Core of Qiu feel ashamed health origin of example of? of ∪ of dispatch of  of Tao of difficult  bureau must be clarified. Studying case had better be the successional patient inside some period of time, if not be successional patient, be necessary to clarify how to choose research example from inside the patient of big group. In the paper that rheumatism learns, many only simple when introducing research boy or girl friend ground are mentioned " exemple of × of × × ill × , all accord with × × to diagnose a standard " , as to research example comes from He Fang, it is the patient of which time, how to sample etc, entirely does not say. Such paper, the reader cannot judge the exterior effectiveness of this research at all, be accepted by abide card medicine hard. The selected standard that researchs sample book and eliminate a standard to also must be described in detail. Contrast in case of illness in research, contrast of the group form and it is clear that origin must be explained, because contrast the affirmatory problem of the group, create bias easily.
2.2.3 research element: Banter flute Yue circles core excessive head treats triangular bream to circle core fears? studying the factor is very main, often be the core content of this research. Because this must explain research element and the method that measure these research factors clearly. In experimental sex research, in group random, if not be random, the remedial method of group of interpose of whether basic identical; and blame interpose group has the base line that must compare two across block why to be distinguished, except interpose, other treatment is same, it is clear that remedial method must be explained. In analysing a gender to consider, research element exists, it is a patient when entering research, had existed, is not the apiration according to investigator undertakes in group. Accordingly, what need explains is its measurement technique, is not in group. When go over a manuscript or draft, had seen a few thesises erroneously will kind the patient of rheumatism arthritis " group of positive of factor of rheumatism of random ground classification and feminine form " . In alignment research, those who study a factor is affirmatory and prevenient, the judgement of ending is in hind, the subjective bias; when producing research element lesser to measure commonly but contrast in case of illness research, because decide group of case of illness is mixed first,contrast group, reviewing when exposing an element appear easily subjective bias, the article must be explained here avoid deflective method, if use blind method,wait.
2.2.4 research ending: Core beat Xun is worth Guang of discharge daughter-in-law box already the method that lobar Ga? needs to explain judgement to study final result accordingly. If the judgement of ending gets student the influence of subjective element, if arthritic radiology is damaged, must explain whether to use blind method. In along with visit research (include random and clinical trial and alignment research) in, if He Gui is belonged to,break the precedent that visit disease, reach its to follow visit time how to decide, it is clear to all need to explain. To not be the research of ending in order to die, if why handle the material of the person that die, calculating cutout to break still is terminal, how is time waited a moment certainly.
2.2.5 control are jumbly with deflective measure: Gao of Qiong of earnestly of Quan  core takes off core beat Xun to plant? of right Qiong of stir-fry before stewing of joke of Bi of Jiao of provide for of  Xu zinc must have measure to go the bias that place of corrective and jumbly element brings about. To the causal derivation of much element, must use multivariate recursive method is corrective between each element mutual and jumbly. The analysis of the relevant factor that has seen hip joint of rachitis of sex of a rigidity is damaged, the data that establishs problem and place to collect is very good, use ｔ only simply to examine regrettablly with χ 2 examine undertake only factor is analysed, not corrective between each element mutual and jumbly, when if the author is in,paper book is written, have " jumbly " a such concepts, oneself or ask statistical teacher, spend time of a few minutes again, undertake much element is analysed, the quality of the paper and but abide card sex will have substantially rise, only a momentary slip and make paper quality fails to rise further, how regrettablly. Decrease or avoid deflective measure to need to explain, in if be followed longerly in time,visitting research, how to decrease break visit. Blind law applies at experimental sex research only not simply, in analysing a gender to consider, research element decides with what study final result and judge, often also need to use blind method. Can bring about deflective sort a lot of, this print had one lecture 2000 " in how identify and dominating clinical research jumbly with bias " already detailed introduction.
2.2.6 statistical methods: Head of flute Yue courtyard treats? of scoop up with a dust pan of  of cellar of bursa of triangular bream predestined relationship to all must explain statistical method explicitly. Come for years, rheumatism learns the problem that statistical method exists in the paper relatively outstanding.
Many papers did not explain statistical method, it is those articles that contain a lab to study content more, because spent the flow of many length introduction lab, make " material and method " the part appears " contented " , be omited accordingly or omited the description of statistical method, make an article not complete with defective and scientific sex. Some articles are in " statistical method " in one column, used 5 words only: Software of SPS8.0 of San of  of Xi of  thirsty  undertakes plinth of suddenly of ┲ of travel of Can of thin R of Luo of forge of Shou of the boundless and indistinct that install take along sth to sb statistical processing " . Did not explain specific statistical method. Let a person feel, this is the fill that handling form " be short of " , wrote be equal to did not write.
Although ｔ examines with χ 2 examining is basic statistical method, but be not " universally applicable " . In rheumatism paper, because apply ｔ blindly,often examine and χ 2 examine, bring about quality not tall. The statistical analysis that is not all data above all all can examine with ｔ and χ 2 examine, case load is mixed less the data that is not normal school must use method of nonparametric check proved recipe, if order is mixed,examine to wait with mathematical probability law. The comparison of much across block may need to use variance analysis; to follow seek a data (if random and clinical trial, alignment studies,wait) with live analytic method may be much better; existence is much the causal analysis of the element (like prognostic element analysis, pathogeny learns to consider to wait) need is multivariate recursive analysis is waited a moment. When many papers are explaining statistical method, say generally to use multivariate recursive method, it is which kind of regression methods did not explain after all, from " result " in also do not look to gave its data to whether use recursive method. Analysis and the phenomenon that return to point-blank are very common also related abuse. Actually, the statistical analysis method that relevant analysis is a kind of low administrative levels, basically use in descriptive sex to consider (if cross section studies) data analysis, and the data analysis that need not study at experimental sex and analytic sex commonly. Because relevant analysis has statistical sense,be not a delegate correlativity of existence of two groups of data. Because be in the statistical education that returns to an analysis, it is commonly return to to Logistic from linear regression, return to to Cox again, because this returns to analytic principle and spirit, undertake explaining in linear regression more, the impression that graduate students are opposite the medicine that makes study statistical generally to be returned to point-blank is deeper. Actually linear regression analysis is applied rarely study at medicine, the most extensive regression analysis that uses in medical research is Logistic regression and COX regression.
Additional, rheumatism learns a paper in, what seldom mention sample size is computative. Of sample size computative and main it is to make the result of research avoids to make statistical Ⅱ kind mistake. Ⅱ kind the mistake is to because sample size is insufficient,point to, make original discrepant two groups, carry cipher out does not have the result of difference. Of sample size push the level that is the difference value that expects according to investigator, check to give a sense (α is worth) the effect with research (1- β is worth) . β value is to allow to make Ⅱ kind wrong probability. General requirement α is worth =0.05, research effect is in 0.8 or 0.9. The P of the existence in studying a result that becomes you is worth > 0.05 when, what ask the article has sample size is computative, or provide research effect.

3. Result

Writing the purpose with the mainest thesis is the result that shows research to the reader, the core of the paper and marrow basically are reflected in " result " part. Because be in " foreword " part, the question that you raise, all can be in " result " the part finds the solution. This part asks to have objective state to studying a result, both neither suffers the effect of other document, also do not get a writer the left and right sides of subjective apiration. Place to in an attempt to is shown 1 times, "Result " the structure that is a square partly, hint it does not need to extend, just want objective state.
One good " result " , must let a reader the thinking down you, one pace ground achieves the result. Tell a reader through the character this research discovered what; passes form to develop specific data systematically reader; to make through the graph the reader can understand the outcome of research intuitionisticly.
Although the description of base line of 3.1 research data has some of author to will study the description of data base line is put in " material and method " in, but actually the description of base line is put in " result " in more exact. Because " material and method " basically be the plan that explains research, how much does how old, male occupy as to the age in collects case of illness, how long is course of diseases waited a moment, it is when the data after the end studies is analysed ability knows. If be in group research, the base line that needs to compare each across block is same. Whether to have the data that does not await analytic case of illness at inter block along with the base line that visits research to break the person that visit or midway to eliminate case of illness quite even, let a reader know to break visit or the bias that midway eliminates case of illness to whether bring about research.
Sex of experiment of result of 3.2 statistical operation and the result that analyse sexual research are the result that comes from statistical operation for the most part very. Rheumatism is united in wedlock a few years this to learn a paper here " result " a few errors with common share (do not be in certainly this print) undertake discussion, continue in order to reduce the paper henceforth to appear similar problem.
3.2.1 P are worth a problem: " Pie thanks fleabane of  cellar Щ  of dam of nose Kang Ao of extensive of old reel silk from cocoons] ? of idle of Mi Mo elder brother of to instruct of Chinese alligator of  of provide for lofty but the paper that rheumatism learns is useful " < " or " > " the person that will express still holds great majority. Ever to coming careful manuscript is mixed a few already published a paper, the data that provides according to the place in the article (like case load, all number, standard deviation) undertake answer calculate, discover many errors or be deficient in. For example some of P value is in 0.05 ～ 0.1 between, in be being written into <0.05; to express however, the comparison of many combination, the author is used " <0.05 of the value that it is P, be worth <0.01 for P " , be worth <0.001 for P " , answer the result that calculate is " " some P value is to fall in 0.01 ～ in numerical value the occasional of 0.001 0.001 the following. Since already clarified in the article,statistical operation is to use statistical software, the result of computer operation is particular P value for certain, because this paper does not have reason,not be worth to specific P. Be worth when P only very small, the P value that computer operation result indicates is 0 " when, mark of the ability in the paper " P is worth <0.001 " .
Intensity reachs his related 3.2.2 attentions the expression of 95% authentic interval:  of Mao of Kang Mu of core of Qiu feel ashamed 3 I Jie is dark relatively? of Song of head of magpie of rostellum She Kang is the most commonly used is OR value and RR value. Have some of paper that already published, the author says to use in statistical method obviously Logistic returns together or COX is returned to, but OR value or RR value cannot be found however in the result. Relevant intensity reachs his the operation of 95% authentic interval and meaning oneself is advanced face a few in telling, discuss, here does not repeat. Be worth what carry is, the OR in many articles is worth or the 95% authentic interval of RR value were included 1, p is worth however <0.05, the computer won‘t carry for certain calculate a such result.
3.2.3 data must agree with research data: Data of? of  of Mao of admire of male of Ji  scoop up with a dust pan and research data differ too big. Exemple study for a long time along with what visit like, in " material and method " in make clear " to came in January 1985 December 2000 " , and " result " live 3 times medium graph, all show curvilinear right end arrives 25 years, be which segment gives an issue after all?
The 3.2.4 data that avoid to disobey science: Emperor goes straight towards? of  of neon of У of pure cattail of シ of ┪ of  Jie Huang to make the paper is become " rubbish " . For example nephritis of sex of a lupus follows the paper that seek for a long time, two ending 1 group of patients (person survival rate and nephritic survival rate) live 2 times draw of music line drawing is on a coordinate, apply Logrank to examine, unexpectedly can " computation " give 2 values of its χ and P value. The computer is impossible to make this kind of operation, because these two curves make otherness impossibly,examine.
The issue that 3.3 comprehensive descriptions study originally always can have the data of statistical processing, answer to apply statistical processing as far as possible. But some data need to have detailed state. Should say, all sorts of final result that should study the data can be mirrorred should be stated. For example, fall into disuse or break the amount that seeks case and main reason; all sorts of curative effect and all sorts of problems that all sorts of side-effect; appear in research, the discovery that includes an accident is waited a moment. Although the happening of some accident is not certain have direct connection with this research, but also must describe according to the facts, be in next " discuss " in undertake an analysis, him statement is right the viewpoint of this accident. Allegation must objective, not far-fetched, also do not discuss and subjective conclude. Discuss and conclude must put " discuss " in go.

4. Discuss


The graph is shown 1 times, discussion part shows echelon structure, hint this one part needs the result that the basis studies, combine the reviewing of document, develop spreads out come analytic discussion, the conclusion that studies in order to reach originally.
If length of foreword part be confined to, cannot introduce a setting of a research and basis of make a point in detail, the first paragraph of complement that can discussing is described. Those who need an attention is, do not appear easily in the paper " initiate " , " banner " or " did not appear in the newspaper in the past " word. If be such truly, should state objectively: ? of fawn on male ┐ is like armour ammonia butterfly Ling and adult Still disease) retrieve which database (like Medline or PubMed) , retrieval result how. Because seek the document that be less than from inside these databases, do not be equal to a whole world to had reported without the person. Objectively allegation retrieval result, be accepted easily by the family, and the reader also can use same strategy when necessary, repeat undertake retrieval.
In discussing must closely around wear oneself research result, analyse other learned man‘s congener on international research, what is identical, what is different, contrary perhaps, analyse mix differently contrary reason. If your data is true, research designs be science to mix reasonable, should dare to believe, hold to oneself viewpoint. Scientific thing, always can put in different point of view. Of course, be necessary to analyse its reason in the article, in be like example of racial diversity, research inferior model different etc. The need in discussing avoids to leave his research result, discuss too far, bring about excursive. Last of outline of clinical document judge are asked about [1] , "The result that whether the quote of conclusion analyses according to research to study? Be aimed at the problem of research, what conclusion did the author make? According to this research, whether did the author put forward new hypothesis again? " paper of a clinical medicine, often be around move these problems delimit on of full stop.