How to Write and Structure Clinical Articles

Having a standardised approach to writing articles ensures that readers have a consistent experience and that the website, as a whole, feels cohesive. As a result, we’ve created some guidelines to assist you when writing your clinical article.

Each article needs to provide a succinct overview of the relevant clinical condition. You should avoid including an excessive amount of detail and try to convey only the key points. These articles need to be pitched at the level of a final year medical student who is wanting to revise topics that they already have some knowledge of.

You should also read our guide to appropriately formatting your article, to increase the chances of it being published on the Geeky Medics website.


Introduction

Your article should begin with a brief explanation of the condition or topic that the article is covering. If the article is about a specific condition (e.g. acute pancreatitis), you should begin by defining what the condition is.

Example

An ectopic pregnancy is one that occurs anywhere outside of the uterus. The most common location for ectopic pregnancy to occur is in one of the fallopian tubes.


Aetiology and Risk Factors

The next section should cover aetiology and risk factors of the condition.

Example

There is often no identifiable cause for ectopic pregnancy, however, the following risk factors are associated with an increased risk of ectopic pregnancy:

  • Assisted reproduction techniques (e.g. in-vitro fertilisation)
  • History of pelvic inflammatory disease (resulting in tubal occlusion due to adhesions)
  • Endometriosis

Clinical Features

The clinical features section should provide a succinct summary of how the condition can present, including symptoms and clinical signs. You should break this section down into the following subsections:

  • History (most common symptoms and less common symptoms)
  • Clinical Examination (most common findings and less common findings)

Example

History

The most common symptoms include:

  • Abdominal pain
  • Pelvic pain
  • Amenorrhoea or a missed period
  • Vaginal bleeding (with or without clots)

 

Less common symptoms include:

  • Dizziness, fainting or syncope
  • Shoulder tip pain
  • Breast tenderness
  • Dysuria
  • Passage of products of conception

Clinical Examination

Most common findings:

  • Pelvic or abdominal tenderness
  • Adnexal tenderness

Less common findings:

  • Rebound tenderness
  • Cervical tenderness
  • Tachycardia
  • Hypotension
  • Abdominal distension

 


Differential Diagnoses

This section should briefly summarise what other diagnoses can present in a similar way and therefore should be considered.

Example

The clinical presentation of ectopic pregnancy is similar to several other conditions including:

  • Threatened miscarriage
  • Appendicitis
  • Pelvic inflammatory disease

Investigations

This section should provide a succinct summary of the important investigations that should be carried out if this condition is suspected.

You should break down this section into sub-sections based upon the type of investigation:

  • Bedside investigations (e.g. capillary blood glucose, ECG)
  • Laboratory investigations (e.g. blood tests, bacterial cultures)
  • Imaging (e.g. CT abdomen, echocardiogram)
  • Other investigations  (e.g. cardiac exercise stress test, risk scoring systems)

Example

Bedside investigations

  • Urine pregnancy test (hCG urine dipstick)
  • Urinalysis (to rule out urinary tract infection)

Laboratory investigations

  • Baseline blood tests (FBC, U&E, Coagulation, CRP)
  • Serum hCG
  • Group and Save (as may require a blood transfusion)

Imaging

  • Transvaginal ultrasound scan – the most accurate method of confirming the presence of a tubal ectopic pregnancy

Management

This section needs to provide a brief overview of management options for the condition.

Example

Medical management

NICE recommends systemic methotrexate as the first-line option for women who meet the following criteria:

  • Able to return for follow-up
  • No significant pain
  • Unruptured ectopic pregnancy with an adnexal mass <35 mm and no visible heartbeat
  • No intrauterine pregnancy is seen on the ultrasound scan
  • Serum hCG <1500 IU/L

The serum hCG level is monitored to ensure it is declining and not continuing to rise. If serum hCG levels continue to rise, a further dose of systemic methotrexate may need to be administered.

Surgical management

Surgical management involves the surgical removal of the ectopic pregnancy.

Surgery should be offered to those women who meet any of the following criteria:

  • Unable to return for follow-up
  • Significant pain
  • Adnexal mass ≥35 mm
  • Fetal heartbeat visible on the scan
  • Serum hCG level ≥5000 IU/L

In cases of tubal ectopics, a laparoscopic salpingectomy is usually performed, removing both the ectopic pregnancy and the tube that it is implanted within.


Complications

This section needs to provide a brief summary of the potential complications of the condition.

Example

If an ectopic pregnancy is not diagnosed and treated promptly, complications can include:

  • Fallopian tube or uterine rupture
  • Secondary massive haemorrhage and disseminated intravascular coagulation
  • Death

Complications of surgical management can include:

  • Bleeding
  • Infection
  • Damage to local structures (bladder, bowel, vasculature)

 


Key Points

The section needs to provide a summary of the important points a student should take away from the article.

Example

Key Points

  • An ectopic pregnancy is one that occurs anywhere outside of the uterus.
  • The most common location for ectopic pregnancy to occur is in one of the fallopian tubes.
  • The most common symptoms include abdominal pain, pelvic pain, amenorrhoea and vaginal bleeding (with or without clots).
  • The most common clinical findings include pelvic or abdominal tenderness and adnexal tenderness.
  • Medical management involves the administration of systemic methotrexate, with ongoing monitoring of serum hCG levels.
  • Surgical management involves the surgical removal of the ectopic pregnancy (most commonly a laparoscopic salpingectomy)
  • Complications can include fallopian tube rupture, haemorrhage and death.