what is an integrated summary in writing research

Relatively static data (e.g., name) appears in the upper-left panel. Thus, the values entered in the flowsheet section reflect the effects of the medications and dosages listed directly above them in the medication list section. Past medical history. For many student writers, deciding on what source material to use in your research paper can be a daunting task. For returning patients, I can quickly refresh my memory of their health status, review my prior plan and make a preliminary task list for today’s appointment, usually in less than a minute. Creation of clear links between the objectives of the research and the results from the raw data. The Integrated Summary: A Documentation Tool to Improve Patient Care. It can be easily and inexpensively implemented with nothing other than a photocopier and handwritten entries, or programmed as a component of an electronic medical record (EMR). When the right side becomes full, you can overlay a blank copy of the template, cutting off the three panels on the left and binding the new page to the chart. Making it your own. It eases documentation. Reading and writing became … Return to clinic in one month. The problem list is expanded to annotate the results of major quantifying hospital tests including head computed tomography scan (CT), echocardiogram (ECHO) and adenosine thallium cardiac perfusion scan (AdThal). The past medical history (PMH) section is filled in from her history, and the immunizations heading helps to remind me that (now that she has been diagnosed with COPD) she is a candidate for pneumococcal polysaccharide (PPS), which is given. Change to angiotensin receptor blocker per IS. The patient follows up. Understand attribution and alignment methodologies in value-based payment arrangements to know which patients are assigned to you. I also encode the number of months supply (M) and number of refills (RF) in an abbreviated fashion “M+RF” (e.g., “1+5” indicates a one-month supply with five refills). Being too brief; Excluding data that do not support the effectiveness conclusions An example of an integrated summary template useful for most adult patients in the author’s family practice can be viewed and downloaded below. Quanticate's Medical Writing Team have summarized tips for the preparation of comprehensive, well-written, and focused integrated summary documentation.. The increase in her age shown in the demographic section reminds me in my review of the screening section that she is now a candidate to begin annual fecal occult blood testing and cards are given, with results later appended. In the nineteenth century, students did not typically write analyses of what they read, but instead wrote themes on prescribed topics, such as Vanity, Democracy, Ethics, and so on. At each visit, the physician enters dynamic data into the integrated summary as follows: First, newly available outside test results for tests drawn at the previous visit are entered into the previous visit column. She is on half a dozen medications, as documented on integrated summary (IS). The middle panel on the left is the problem list, where problems are organized by disease or organ system following some sensible order (see the box). Her problem of smoking is expanded to document the intervention of cessation counseling. When dictating admission notes, I often do so from just this one page without the need to resolicit information from the patient or search through the chart. DM: Suboptimal control. Writing a summary of research paper involves becoming very familiar with the topic – sometimes, it is impossible to understand the content without learning about the current state of knowledge, as well as key definitions, concepts, models. this is usually a rule to write a research paper. Immediate, unlimited access to all FPM content. ISS and ISE stand for integrated summary of safety and integrated summary of effectiveness, respectively. Get Permissions, Sign up to receive FPM's free, weekly e-newsletter, "Quick Tips & Insights.". All rights Reserved. More importantly, however, it is integrated in that the relationships between problems, medications and measured flowsheet parameter results are evident on a single page, and their changes (compensated or decompensated, improving or progressing) are readily apparent over time. Integrating the problem and medication lists to the flow sheet, I choose the parameters of blood pressure (BP), basic metabolic panel (BMP) and heart rate as appropriate to monitor, and the new diagnosis of COPD suggests adding metered dose inhaler (MDI) frequency and peak flow. Use strong and positive language. Her flow sheet is modified by adding new monitoring parameters for rhythm, digoxin level and International Normalized Ratio (INR). Other normal findings on exam were …. Copyright (c) 2003 Michael Stelman, MD. This content conforms to AAFP CME criteria. In writing a research paper it is needed to have the skill of summarizing more than two sources. Integrated Summary Tips:. The integrated summary organizes problems, medications and flowsheet parameters by disease or organ system and makes their relationships more evident over time. Integrative reviews of research are a valuable part of the process of creating and organizing a body of literature. One of the common mistakes in writing a research is publishing an unclear and unpolished summary. The integration of her flow sheet helps point out that her improved BP after last month’s medication augmentation is not adequate for the new target of 130/80 for DM, and the next column of the medication list shows that the angiotensin-converting-enzyme inhibitor (ACE-I) captopril is substituted for her HCTZ, a statin is added for her newly diagnosed suboptimal lipids and a hypoglycemic agent has been prescribed. I update her medication list to reflect that digoxin was started in the hospital for rate control, warfarin was substituted for aspirin for anticoagulation, and that metformin was added for her yet suboptimal glucometer readings. When she subsequently reports congestive heart failure, I can add this to the list above. The statistical analy… It offers a template that can be altered to accommodate the work styles and preferences of any physician. / Vol. Its organized structure allows drugs to be grouped vertically by organ system and horizontally by temporal order of initiation. I also list the suggested reassessment frequency for a stable, compensated patient, where needed. Integrated Summary Tips:. The summary is integrated in that it includes data on one page from multiple (and now unnecessary) parts of a traditionally organized chart. It takes only a few seconds during my interview to record today’s data into the flow sheet, write any medication adjustments into the medication list and record an abbreviated plan. Keys to High-Quality, Low-Cost Care: Empanelment, Attribution, and Risk Stratification “Practical” flow sheet. What do ISS and ISE mean? The lab results that have returned are entered into the preceding column, including the preceding elevated fasting glucose unbeknownst at the time steroids were prescribed. Copyright © 2020 American Academy of Family Physicians. The patient presents with hemiparesis and is found to be in atrial fibrillation (a-fib) with a rapid ventricular rate and is admitted to the hospital. Statisticians need to be involved in the planning stages of integrated summaries, Ideally, statisticians should attend pre-submission meetings with regulatory authorities to discuss the statistical analysis aspects of the integrated summary including sample size and trial design. The integrated summary template presented here may not suit every physician’s work style or approach to primary care. To understand how a physician would use the integrated summary in practice, consult the text in this box and the example below, both of which are color coded to facilitate understanding. Physicians may find it useful to expand upon each element of the problem list, adding date of onset, diagnostic criteria, extenuating circumstances at the time of diagnosis and dates of major quantifying test results (e.g., echocardiogram or computed tomography). HTN: Now compensated but intolerant of ACE-I. Patient notes a cough since starting captopril. A document, prepared for inclusion in a new drug application (NDA) or biologics license application (BLA) in the United States, which includes a detailed set of integrated analyses of all relevant data from the clinical study reports. Choose a single article, issue, or full-access subscription. Combination of varied secondary data in a brief summary. See FPM CME Quiz. Worst practices for producing an integrated summary. Use empanelment and risk stratification to better understand where to expend your practice's care management and care coordination resources. Finally, new medications or dosage changes and newly ordered lab or imaging tests are entered into the column for the next visit (again, with colons to indicate that results are pending). The screening section shows that an unremarkable general physical exam (PEx) including a normal breast exam was done, and colons (“:”) show pending results of her ordered BMP, mammogram, Pap smear cytology, cholesterol (chol) and triglycerides (tg), and diabetes screen. Listing problems in the temporal order of their diagnosis requires more mental integration of the data than ordering problems by disease or organ system. This is often performed while reading the literature review. The problem list is further expanded to show that the patient heeded my recommendation to quit smoking. Hospital admission lab results are added to the preceding column, and colons mark the pending results of tests ordered today. Integrated Summary of Effectiveness Guidance for Industry U.S. Department of Health and Human Services Food and Drug Administration Center for Drug Evaluation and Research (CDER) Not providing one! To see the full article, log in or purchase access. The integrated summary simplifies the progress note; it does not duplicate it. Bear in mind that your readers are likely reading about the topic of your research for the first time, avoid unclear and uncertain explanations and a disorganized summary. She gives a history of hypertension (HTN), familial risk for coronary artery disease (CAD) and smoking (all of which are added to the problem list), and her exam shows wheezing leading to a new diagnosis of chronic obstructive pulmonary disease (COPD). The right side captures six visits’ worth of key data per page. The integrated flow sheet shows the home glucometer readings are suboptimal in response to the glyburide dose recorded above, and an augmented twice-daily dose is recorded in the next column. Colleagues covering acute office visits in my absence have a quick summary to guide them as they care for my patients. Maternal Immunization Task Force for Pregnant Women: A Call to Action The summary is integrated in that it includes data on one page from multiple (and now unnecessary) parts of a traditionally organized chart. A physician must review multiple pages to find what he or she needs. Its major benefits include the following: It summarizes and replaces the patient’s demographic data, problem list, past medical history, immunization list, medication list and flow sheets, and it provides an abbreviated plan both for today and for future visits all on a single page. The integrated summary requires minimal data entry at each visit, and it simplifies progress note documentation. Also, make those links clear to others and how those links will fulfill the research objective. “Expanded” problem list. Patient demographic data is recorded across the top of the integrated summary. The clinical example on page 36 describes the case of a hypothetical middle-aged female patient with a fairly complicated set of problems and shows how the integrated summary would be completed over several visits. Problem list is updated accordingly. Patients’ charts are overflowing with information – problem lists, medication lists, disease-oriented flow sheets, laboratory flow sheets, preventive screening flow sheets, immunization lists, and previous histories and physicals. To save space and time, I enter only changes to medications, rather than rewriting the prescription information for each visit. Demographic data that might change more frequently is entered on the right side of the integrated summary and includes the patient’s age and insurance. Integrating Reading and Writing. Requiring only a little practice, the integrated summary is a valuable tool that can help physicians improve the quality and efficiency of patient care. Simplifies the progress note ; it does not duplicate it relatively static data e.g...., compensated patient, where needed ( e.g., name ) appears in the temporal order initiation. And preferences of any physician tips for the preparation of comprehensive, well-written and! In writing a research paper added to the preceding column, and focused integrated summary stand integrated! A rule to write a research paper can be altered to accommodate the work styles and of... The preparation of comprehensive, well-written, and Risk stratification to better understand where to expend your 's! Visits in my absence have a Quick summary to guide them as they care for patients. To High-Quality, Low-Cost care: Empanelment, attribution, and focused integrated summary..... 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