Practice

We welcome submissions for this section, and also commission some contributions.

Types of article for this section include:

• Interactive Case Reports
• Evidence based case reports
• Lesson of the week
• Patient's journeys

Interactive Case Reports

Interactive case reports are presented in three parts, published in the LJPC over five weeks with open debate from readers on the web through rapid responses on www.londonjournalofprimarycare.org

We ask several people, including clinical and educational experts and the patient, to comment on the case. We also invite them to moderate and stimulate the web debate as the story unfolds.

Here is our detailed guidance on producing an interactive case report for the LJPC:

• The case should describe a real patient who presented initially in primary care or the accident and emergency medicine department
• The case should have subsequently involved secondary care specialists in mainstream departments such as obstetrics, gastroenterology, haematology
• The case should be sufficiently complex to raise interesting clinical, investigative, diagnostic, and management issues but not so rarefied that it is only likely to appeal to a minority of LJPC readers. Cases, which stimulate debate, air uncertainties and controversies in management, and raise ethical questions, are particularly welcome
• Please include brief details of the social circumstances of the patient with some indication of the (possible) impact of their illness on them and their family. This information is as important as the medical information, because it will help commentators to remember the patient’s perspective of illness. We hope that patients will be willing to use their real first names and will not mind that they are potentially identifiable. Of course, patients can opt for anonymity if they wish, in which case the personal information in the report will have to be quite limited
• Please provide 3-4 clinical illustrations so that there is a at least one illustration for each of the three parts of the case report (such as radiographs, CT scans, ultrasound scans, ECGs – preferably relating to this patient, though library illustrations will do). Other material such as boxes, figures and tables are welcome but may have to be published only on www.londonjournalofprimarycare.org if there isn't enough space in the print LJPC. This material may help to generate further questions for readers. We do not need references for any part of your case report
• The case report should conclude with a clear outcome that we can publish 4-5 weeks after the initial case history and questions. This would usually be the definitive diagnosis (but not inevitably: it may be a presumptive one) and some clear management endpoint
• Please note that the patient needs to be involved closely in this interactive learning. You will have to obtain the patient’s written and informed consent to publication using the LJPC consent form at /collections/informed_consent/draft_f.shtml
• Please also invite the patient to comment on his or her own case and on the experience of seeing the debate unfold in the rapid responses on www.londonjournalofprimarycare.org. Our advice to patients is copied below. This involvement means that the patient will have to have access to email and the web and to feel reasonably confident in using them. If he or she does not want to or is unable to do this, please explain that we would invite a patient advocate to comment on their case instead
• Please provide for each of the first two parts of the case report a list of key questions/topics/management issues that the case raises. These questions should be written in plain language such as “if you were the doctor managing this case, what diagnoses would you consider?”…”what tests would you order?”…”is there anything else you would ask the patient?”… “what would you say to the patient at this time? The questions should prompt rapid responses to the case on bmj.com as well as giving a focus to the invited commentators
• The case presentation should comprise approximately 1100 words with at least 3 illustrations overall. It should be structured in three parts for publication over five weeks:
• Initial presentation. For publication on its own in the first week. Please describe here any first line investigations or immediate management. The text should be approximately 350 words with one or more illustration(s) and 3 or 4 questions. Readers and invited commentators would be urged to debate the case in rapid responses on bmj.com in the week after publication
• Case progression. For publication in week 2, one week after the first part of the case report. Again, this should be approximately 350 words with one or more illustrations and questions as above, and rapid responses would be invited. Please say here what happened next to the patient’s clinical condition and mention any treatments, further tests and referrals to specialists
• Case outcome. For publication in week 5. This should comprise up to 400 words with one or more illustrations, covering the management and outcome of the case. This part would be accompanied by several invited commentaries – at least by one or more clinical specialists, a GP/family practitioner, the patient or a patient advocate and, when appropriate, an education expert. Each of these commentaries would discuss the case (with references as appropriate) and would also mention how the open debate developed on www.londonjournalofprimarycare.org

Evidence Based Case Reports

These reports show how evidence can be applied at all stages of patient care. They should not exceed 1200 words.

Please define the clinical question in four parts; patient, intervention, comparison, and outcome. The report should show that you have searched for, cited, and summarised studies of appropriate relevance, design, and quality, and should state which bibliographic databases you have used.

Finally, the report should answer the research question or state that there is no answer available.

See Applying research evidence to individual patients

Lessons of the week

These are usually case reports or case series alerting readers to potential clinical problems. They should be less than 1200 words long and accompanied by a single sentence of up to 15 words stating the lesson. We welcome illustrations.

The lesson should be as specific as possible and aimed at general readers. The LJPC's editors and peer reviewers use the following questions to assess lessons of the week:

• How common is the condition? (It should not be so rare that it is irrelevant to most LJPC readers).
• How commonly is the condition missed?
• How serious is it if missed?
• Will this report contribute to preventing missed cases?

Patient's Journeys

This intermittent series describes patients’ experiences of living with chronic disease. Please see;

The patient's journey: travelling through life with a chronic illness

Journey articles should encompass how it feels to face a difficult diagnosis and what that does to relationships and quality of life. But these articles should not simply give one or more personal accounts of coping with illness: we want them also to provide reliable and widely available practical information and advice. Articles should underline the need to treat patients, rather than diseases, and to understand the impact such journeys may also have on patients’ carers and families. Above all, these articles should tell doctors what really matters to patients and what help they need to make the most of their lives.

We will be happy to consider articles describing life with rare disorders, but may give priority to those on common disorders because we want the articles to be useful to as many readers as possible. Try to focus on day to day problems faced by the individual, rather than issues arising directly from local health care services: please remember that the LJPC is an international journal with readers all round the world. We hope you will try to highlight any general lessons that you have learned about coping with a chronic disorder.

Patients and carers must be actively and directly involved in the preparation of the articles; we do not believe that doctors and journalists acting only as proxies for patients will be able to tell sufficiently convincing stories. We will be happy to consider articles co-written by any combination of patients, patient advocates, carers, and clinicians (although doctors will need to be reminded that we are less interested in the unusual medical facts and want to know about their reactions to and relationships with patients).

Please provide a title page, giving the names, addresses, and email addresses of all authors, including any patients. For any patient who is not an author but is mentioned or quoted in the article, please send us their signed consent to publication using the LJPC consent form (coming soon)

Patients may remain anonymous if they prefer. We will not use partial or fictitious names, however: please state each patient’s full name and age in the piece (given and family names) if they do not wish to be anonymous.

Articles should have no more than 2000 words of main text and no formal references. They should, however, include one or more boxes listing resources such as books, leaflets, and particularly websites. Please list any web addresses (URLs) and describe each website in a sentence or two. We welcome photographs and other illustrations.

We will be pleased to consider different formats and styles for journey articles. We suggest, however, that you cover these points:

• the map: an outline of the natural/typical course of the disease
• the good and bad news: what's wrong? what's going to happen? how is it going to end?
• travelling alone: losing independence and dealing with changing relationships and social roles
• companions on the journey: friends and family, professionals, support organisations ways of coping
• what’s needed along the way: information, help, and treatment: what has really made a difference?
• losing the path: other problems that may arise over time; what have been the most taxing, stressful, and difficult parts of the journey?
• travellers' tales: one or more brief stories and quotes from real patients - highlighted by one 300 word personal account
• journey's end: what has happened to date? what are your hopes and fears for the future? what have you learnt from your journey?