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Aims & Scope: Defining the scholarship of Clinical Decision Science

About Clinical Research in Practice: The Journal of Team Hippocrates

Scholarship requires the production of new knowledge. The specific area of scholarship Clinical Research in Practice: The Journal of Team Hippocrates encourages and publishes is “clinical decision science.” This is a unique area of scholarship that has not previously been recognized, explored, studied, or published. Since its inception, this journal has published papers that describe the use of clinical research in the decision-making process for a specific patient. By including an individual patient, we came to realize that the social context of the patient is equally as important to clinical decision-making as the actual results of clinical research. We publish manuscripts that explore applied clinical decision-making. Clinical decision science incorporates the “critical appraisal” of what is commonly known as “Evidence-based Medicine” (EBM) but is much more expansive in its scope of inquiry. We hope to achieve the original intent of the Evidence-based Medicine “movement” by extending it into the realm of clinical practice. This requires searching for the meaning of clinical evidence for a specific patient; the same “evidence” means different things to different patients. Evidence from a population of patients must be applied in a specific clinical context. Remember, Gordon Guyatt pointed out that evidence does not make decisions, doctors (together with their patients) do (BMJ 2002)

Evidence-based medicine has an implied assumption that clinicians know how to do this. We find real life examples to the contrary. Clinical decision science must acknowledge the doctor-patient relationship, so the bias and attributes of the doctor must also be accounted for, what Mary Catherine Beach and Thomas Inui call “Relationship-Centered Care” (J Gen Int Med 2006). This framing is at the heart of what we mean by Clinical Decision Science.

We understand that the production of research is a social practice and that clinicians deploy research evidence into a social context. We are interested in scholarly work that helps us understand this continuum. Clinical decision science explores how the complex interacting aspects of clinical care are described, understood, shared, and explained. We define Clinical Decision Science as a holistic examination of how clinical decisions are made. This includes both Biomedical and Medical Social Sciences, in addition to other ways of understanding human experience.

Clinical research often is focused on a disease or treatment as the unit of analysis. Doctors in clinical situations often focus on an individual patient as the unit of analysis. Too often, only biomedical reasoning is used for clinical decisions. By including the patient in a social context, Clinical Decision Science requires that the entire social system becomes the “unit of analysis”. This change in focus is what makes this journal unique. This change in focus also requires different cognitive processes for decision making. We want to highlight these unspoken skills which we know are part of clinical practice but have not yet been systematically described and incorporated into the scholarly literature. This requires what Arthur Kleinman, MD, PhD called “Medical Social Science”.

Often, we mistakenly assume that “science” is reductionist—we test a hypothesis. Is drug A better than placebo, or alternatively, Is drug A better than drug B for a specific pre-specified outcome? Science is both reductionist and integrative. Before you can test a hypothesis, you must have a scientific model that frames the specific hypothesis. We hope to build a scientific model that frames how clinical decisions are made. This will require a shift in the focus to include the patient and the complex social environment that affect how decisions are made and eventually affects the well-being of patients. We readily admit that Clinical Decision Science is in its infancy. Like all new areas of scholarship, we start with rich descriptions—case reports. We do not publish case reports of rare diseases, we hope to publish case reports that illuminate how clinical decisions are made. We encourage manuscripts that describe a phenomenon that could be generalized to help understand our area of inquiry.

Clinical Research in Practice: The Journal of Team Hippocrates is an open access, peer reviewed journal, published by the Wayne State University Library System. We are interested in a) concise Clinical Decision Reports, developed with regard to an actual clinical context, and accompanied by specific application to that clinical context, that informs our readers about how clinical decisions are enacted within a social context; b) informed consent manuscripts that summarize a body of clinical research and explain it in language a patient can understand; c) brief reports on pilot studies or data collected for conference abstracts; and d) original research manuscripts for completed research protocols. Submissions will follow a well-defined format (see the author instructions under the Policies page). Clinical Decision Reports, brief reports, and original research undergo double blind review by at minimum two peers; informed consent articles are subject to editorial and peer review.

We are particularly interested in papers that inform our readers about how evidence is actually used, misused, or not used in clinical practice, subject to the realities of the doctor-patient relationship within a social context. We hope to develop a body of scholarship responsive to the relationship-centered care paradigm. Of secondary interest are situational essay pieces describing transformation in practice based on clinical research. Letters to the Editor that advance the intent of the journal will also be considered for publication. These pieces generally undergo Editorial review.

Submissions are accepted generally. There are no charges required to submit, nor are there any fees should a submission be accepted. Authors retain copyright in all published material, implementing a Creative Commons Attribution 4.0 International (CC BY 4.0) for publication.

Publication and Contact Information

Clinical Research in Practice: The Journal of Team Hippocrates publishes two issues a year on a rolling schedule, through the Wayne State University Library System. James Meza, M.D., Ph.D. is the Editor in Chief.

Contact the publishers at:

Wayne State University Library System
Digital Publishing Unit
Teaching Commons, Purdy Library
Detroit, MI 48202
digitalcommons@wayne.edu