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Detailed guidance for writing a PLOS Medicine Learning Forum article

The Learning Forum section

The aims of this section are (1) to present a case in which there are clear teaching points and (2) to guide medical readers (who can be at any stage of their career and in any country in the world) to an understanding of the best clinical approach to the problem. Learning Forum articles will usually include an analysis of the key points in history, examination, and relevant investigations, leading to a differential diagnosis and management plan. The ideal Learning Forum article will be well illustrated (figures, photos, tables, and boxes) and even show how to do common procedures (i.e., with attached video files). All subspecialties will be covered, but the articles should be pitched at a general audience (including residents, medical students, and family doctors). It is important that any recommendations you give, particularly on diagnostic tests and on treatment, are based on the best available evidence and that they represent standard best practice. We are particularly keen to feature common clinical cases from low and middle income settings.

PLOS Medicine no longer publishes isolated Case Reports. If you would like to submit a case-based article, the only available format is the Learning Forum.

Format

The standard format is:

  1. Give a short clear presentation of the case—that is, the salient points in the history, examination, and investigations. This opening section is called "Description of Case."
  2. Then take the readers through a series of steps that you went through in making the diagnosis and treating the patient.
  3. Introduce each new step with a suitable sub-heading. Some examples:
    • At this stage, what was our differential diagnosis?
    • Why did we think that condition X was most likely?
    • Which tests would now be helpful?
    • What is the meaning of this test result?
    • What else could have caused this test result?
    • What is the next step in managing this condition?
    • What is the standard treatment for this condition?
    • What are the complications of this condition?
    • What was the outcome of this case?
  4. Finally, please end with a short section called "Discussion" in which you discuss the disease itself and the take home messages of the case.

If the case was managed in a developed world setting, we encourage you to insert a box/sidebar into the discussion on management of this type of problem in a resource poor environment.

We ask authors of all articles to include a box at the end of the paper called “Key Learning Points.” This box should have a bulleted list of the 5 major take home messages of the article.

The text should ideally be 2000 words maximum (excluding references, figures, boxes, tables).

Here are some examples of previous Learning Forum cases to give you a better idea of the format:

Fever, Headache, and Visual Blurring in a 17-Year-Old Woman Lynn W, Lightman S PLOS Medicine Vol. 1, No. 1, e7, http://dx.doi.org/10.1371/journal.pmed.0010007

A 52-Year-Old Female with a Hoarse Voice and Tingling in the Hand Razvi S, Perros P PLOS Medicine Vol. 4, No. 3, e29, http://dx.doi.org/10.1371/journal.pmed.0040029

A 69-Year-Old Female with Tiredness and a Persistent Tan Perros P PLOS Medicine Vol. 2, No. 8, e229 http://dx.doi.org/10.1371/journal.pmed.0020229

A Gambian Infant with Fever and an Unexpected Blood Film Howie S, Guy M, Fleming L, Bailey W, Noyes H, et al. PLOS Medicine Vol. 3, No. 9, e355 http://dx.doi.org/10.1371/journal.pmed.0030355

Please give your article a title that summarizes the presentation but also leaves the diagnosis a mystery (see the three examples above).

Patient Consent

We cannot publish your Learning Forum article unless you have obtained consent from the patient, or the parent/guardian of a child, or from the next-of-kin if the patient has died. Authors must download the Consent Form for Publication in a PLOS Journal (http://www.plosmedicine.org/static/guidelines#supporting) from our site, which the patient, parent or guardian must sign once they have read the paper and been informed about the terms of PLOS open-access license. (This license means that the images and text we publish online become available for any lawful purpose). Once authors have obtained the signed consent form, it should be filed securely in the patient’s case notes and the article submitted to PLOS journal should include this statement indicating that specific consent to publication was obtained: "The patients in this manuscript have given written informed consent (as outlined in PLOS consent form) to publication of their case details."

Please avoid "fictionalised" or composite cases based on real patients—since there have been occasions where real patients have identified themselves.

Making Learning Forum Articles Evidence-based

We are keen to ensure that these learning materials are not "anecdotal" but represent standard best practice. The articles are aimed at medical students, residents, and practising doctors around the world and it is clearly important that any advice/recommendations are based on best practice.

We would like you to cite the key evidence in numbered references as you go through the piece, ideally from systematic reviews (such as those in the Cochrane Library; see http://www.cochrane.org/). We are not suggesting that authors do exhaustive reviews—just that these pieces be grounded in the key evidence.

Please feel free to contact Jocalyn Clark (jclark [at] plos.org) if you want help in finding evidence.

The Open Access License

PLOS Medicine requires all authors to agree to its open access license (see http://www.plosbiology.org/plosonline/?request=get-static&name=license). This license permits unrestricted use, distribution, and reproduction of the article in any medium, provided the original work is properly cited.

Peer Review

All articles, with the exception of some perspectives will be peer reviewed before a final decision can be made about publication.

Please use the following PLOS house style for references: (a) please number them at the end of the relevant sentence (e.g. "Inflammatory bowel diseases (IBD), characterized by chronic or recurrent relapsing gastrointestinal inflammation, are broadly grouped by clinical and pathological features into two groups—Crohn's disease and ulcerative colitis (UC) [6–8]."), and (b) In the numbered reference list at the end of the piece, the house style is "First five authors et al, year in parentheses, title, journal citation" (e.g. "Fadok VA, Bratton DL, Konowal A, Freed PW, Westcott JY, et al. (1998) Macrophages that have ingested apoptotic cells in vitro inhibit proinflammatory cytokine production through autocrine/paracrine mechanisms involving TGF-beta, PGE2, and PAF. J Clin Invest 101: 890–898.")

Finally, please include two statements with your article:

(a) Funding: Please state whether you received any specific funding to write your piece. If you did, please state whether the funder played any role in the article's preparation.

(b) Competing interests: Please state whether you have any competing interests related to the article (see http://www.plosmedicine.org/static/competing).