Brief description on how to write a case report.

1. H. Al-Sobayel
1
CLINICIANS AS RESEARCHERS:
PUBLISHING CASE REPORTS
Hana Al-Sobayel, PT, MSc., PhD.
4/26/11
Physical Therapy Consultant
King Saud University

2. Outline
2
Overview
¨ Preparation
¨ Writing
¨ Publishing
¨ Barriers
¨
H. Al-Sobayel
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3. 3
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4. 4
Overview
Case Report Publication
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5. 5
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6. 6
A case report, published in the American Journal of
Dermatopathology in 1981, was one of the first
published accounts of what is now called AIDS
H. Al-Sobayel
4/26/11

7. Value of Case Reports
7
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Valuable contribution to the advancement of
medical science.
Case reports are “scientific observations . . . that
are carefully documented so that they may be a
valuable education and research
resource.” (McCarthy et al. 2000)
H. Al-Sobayel
4/26/11

8. Hierarchy of Evidence
8
Systemic Review/Metaanalysis
RCT
Non randomized controlled
trials/Cohort Studies / CaseControl Studies/Audit of case
series/Case
H. Al-Sobayel
reports
4/26/11

9. 9
Preparation
Case Report Publication
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4/26/11

10. What Kind of Cases Should be Reported?
10
Unique & unusual presentation
¨ Illustrate a new principle or theory
¨ Questions regarding current theory or practice
¨ Adverse response to treatment
¨ Unusual combination of conditions or events that
cause confusion
¨ Personal impact
¨
H. Al-Sobayel
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11. Before Writing
11
Identify the journal
¨ Review “instructions for Authors”
¨ Read several case reports
¨ Ask patient to sign consent
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12. 12
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13. 13
writing
Case Report Publication
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4/26/11

14. Components of Case Report
14
abstract/introduction
¨ Case history/description
¨ literature review
¨ Discussion
¨ conclusions/recommendations.
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15. Abstract
15
Quickly scan the content of the paper
¨ Less than 100 words
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16. 16
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17. Introduction
17
¨
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Brief overview of a
larger problem
Citations from
literature
“ Osteochondroma, or osteocartilaginous
exostosis, is the most common skeletal neoplasm.
Osteochondromas are benign and may be
solitary or multiple…”
“There is potential for malignant degeneration,
estimated at approximately 1%. Solitary
osteochondroma may occur spontaneously or
after irradiation or accidental injury. When
multiple, there is a strong familial incidence and
is known as hereditary multiple exostoses (HME)
…”
Closing sentence about “We report the first case of solitary
osteochondroma arising from the anterior body
the case
of C4…”
H. Al-Sobayel
4/26/11

18. Case History/Report
18
¨
¨
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Drawn from chart notes
Description of the
patient
“A 24-year-old male was referred by an
internist for chiropractic evaluation and
radiographic examination at a local imaging
center for a chief complaint of cervicalgia and
pain in the left trapezius of 1-month duration.”
Details of physical
examination and results
“Upper extremity deep tendon reflexes were
2+ and symmetric bilaterally. An orthopedic
examination revealed provocation of pain with
cervical distraction maneuver. Testing for neural
compression and vascular signs was negative.”
Essential information to
highlight the striking
feature of the case
“The lesion was considered an incidental finding,
and for the patient's presenting complaint, the
diagnosis of cervical disk displacement (Fig 2)
(confirmed with MRI), cervicalgia, myospasm,
and accompanying vertebral segmental
dysfunction was given.”
H. Al-Sobayel
4/26/11

19. Case History/Report
19
Treatment, outcome, and follow-up
¨ Tables, flow-charts, radiographs, etc.
¨
H. Al-Sobayel
4/26/11

20. Literature Review
20
Clinical question
¨ MeSH headings used for searching
¨ Brief and concise
¨ Designed to assure the uniqueness of the case
¨ Provide a backdrop for and the position of the new
information in the biomedical literature.
¨
H. Al-Sobayel
4/26/11

21. 21
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22. Discussion
22
Most important section
¨ State the significance of the information
¨ Discuss the current literature in light of the case
¨ A hypothesis about the new information might be
generated
¨ Data collection process
¨ Discussion of the outcomes
¨
H. Al-Sobayel
4/26/11

23. Summary/Conclusions/Recommendations
23
Brief summary – the Take Home Message
¨ Lessons learned from the case
¨ Questions and recommendations for research
¨
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4/26/11

24. 24
Publishing
Case Report Publication
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25. Journal
25
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Check instructions for Authors
1000 – 1500 words
10 – 20 citations
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26. 26
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27. 27
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28. Barriers
28
Time
¨ Intimidation by publication process
¨ Editorial review
¨ Journals
¨
H. Al-Sobayel
4/26/11

29. References
29
• Aitken LM, Marshall AP. Writing a case study: ensuring a meaningful
contribution to the literature. Aust Crit Care. 2007 Nov;20(4):132-6. Epub
2007 Oct 23. PubMed PMID: 17936637.
• Cohen H. How to write a patient case report. Am J Health Syst Pharm. 2006
Oct 1;63(19):1888-92. PubMed PMID: 16990637.
• Green BN, Johnson CD. How to write a case report for publication. J Chiropr
Med. 2006 Summer;5(2):72-82. PubMed PMID: 19674676; PubMed Central
PMCID: PMC2647062.
• McCarthy LH, Reilly KE. How to write a case report. Fam Med. 2000 Mar;32
(3):190-5. PubMed PMID: 10726220.
H. Al-Sobayel
4/26/11

30. H. Al-Sobayel
THANK YOU
4/26/11
30