Purpose: Each article in the Symptoms to Diagnosis series should contribute to the Journal’s educational mission by providing a brief, case-based question-and-answer discussion of an important, timely, or difficult clinical question commonly encountered by internists and cardiologists. Provide clinical details that would be usual and appropriate in the evaluation, based on the patient’s presentation. Avoid including results of tests that would not be cost-effective or that might have been ordered in a teaching hospital to be “complete.”
Format:
- Begin with a case presentation that can include signs, symptoms, and results of the physical examination and initial laboratory testing. Include relevant reference ranges for laboratory testing results. A question about further evaluation may be appropriate at this point.
- The body of the paper should consist of a series of 3 or 4 multiple-choice questions, each relating to a particular aspect of the case, such as the differential diagnosis, testing options, and treatment options.
- After each multiple-choice question, explain not only why the correct answer is correct, but also why the wrong answers are wrong. Avoid “all of the above” and “none of the above” options.
- Conclude the article with a summary of the salient points.
The format can be adapted to fit the specific case.
Style: Each article should present a structured, stepwise approach to the problem. Use plain language as much as possible, with a minimum of technical jargon.
Length: Articles should be about 2,500 words long (not counting references, tables, and figures), with about 30 key references. No abstract is required.
When citing study results: When discussing the results of clinical studies, the absolute risk value and the number needed to treat should be included whenever possible, rather than only the relative risk and hazard ratio.
Authorship: Every person listed as an author must have contributed substantially to the paper according to the authorship criteria of the International Committee of Medical Journal Editors. The criteria are as follows:
- Each author listed must have contributed to the conception or design of the paper, or to the acquisition, analysis, or interpretation of data.
- Each author listed must have participated in drafting the paper or revising it critically for important intellectual content.
- Each author listed must have given final approval of the version to be published.
- Each author listed must have agreed to be accountable for all aspects of the paper, ensuring that questions related to the accuracy or integrity of any part are appropriately investigated and resolved.
Example of a Symptoms to Diagnosis article (formerly Internal Medicine Board Review).