The Case Report

How to Develop and Write a Case Report

Vanessa W. McNair M.D. M.P.H.

The Case Report

n Characteristics n  Limitations n The Write Up & Components n Avenues for Publication and

Presentation n  Strategy and Approach

Historic Cases

KAPOSI'S SARCOMA IN HOMOSEXUAL MEN—A REPORT OF EIGHT CASES KennethB. Hymes, JeffreyB. Greene, Aaron Marcus, DanielC. William, Tony Cheung, NeilS. Prose, Harold Ballard, LindaJ. LaubensteinThe Lancet 19 September 1981 (Volume 318 Issue 8247 Pages 598-600 DOI: 10.1016/S0140-6736(81)92740-9)

PNEUMOCYSTIS PNEUMONIA—LOS ANGELES

Published in CDC MMWR Weekly June 5 1981; 30 (21);1-3 5 young homosexual males were treated for biopsy confirmed PCP at 3 differently hospitals from October 1980-May 1981 2 of the patients died

Case Reports

n  Case reports n  “Scientific Observations” n  Describes and analyzes diagnosis and/or

management of 1 or 2 patients n  Provide new knowledge to the field of health

care n  They can be valuable learning tools for author

and reader

Case reports

n  To illustrate a clinical hypothesis

n  To support or prompt a new hypothesis

n  To present a challenging differential diagnosis

n  To offer insight into the pathogenesis of a disease process

n  Describe unusual or puzzling clinical features

n  To describe mistakes in health care with causes and consequences

n  To describe unique or improved technical procedures

n  To report or describe rare or novel adverse reactions

n  To stimulate further research

Case Reports

The Write Up Components

n  Title n  Abstract (write this last) n  Introduction n  Case report (methods/results) n  Discussion n  Conclusion n  Acknowledgements/References/Tables/Figures

The Write Up Components

n  Title n  Informative

n  Abstract n  Brief organized summary (150-200) n  Relates most important highlights of the case

n  Introduction n  Purpose of the paper n  Background info to demonstrate how the case

contributes to the literature n  Define unusual words

The Write Up Components

n  Case report (methods/results) n  Present most salient aspects of the case n  Primary aspects of patient condition and main

outcome measures n  Describe methods to assess and/or care for

the patient n  Summarize the outcomes of care

The Write Up Components

n  Discussion n  Compare the case with published literature n  Include discussion on how the diagnosis was

confirmed and the differential diagnoses considered

n  List limitations and significance of each limitation

n  Provide suggestions or hypothesis regarding the significance or outcome

n  Areas for future research

The Write Up Components

n  Conclusion n  Focus on what was learned n  Relate to the purpose of the paper n  Not a rehash; 1 paragraph

n  Acknowledgements n  Briefly acknowledge work of a colleague n  Doesn’t meet 3 criteria of authorship

The Write Up Components

n References—peer reviewed journals

n Tables/Figures n Used to visually present information n Should not reiterate text

The Write Up

n  Patient Privacy n  HIPPA requires patient health information be secure n  Authors generally must have consent from the patient

to publish

n  Length n  Brief and concise n  Journal specific n  500 to 2000 words

The Write Up

n  Sources of instruction n  The Uniform Requirements for Manuscripts Submitted

to Biomedical Journals www.icmje.org n  Journal specific instructions to author

n  Authorship n  Provide substantial contributions to conception and

design or acquisition of data or analysis and interpretation of data

n  Drafted the article or revised it critically n  Has given final approval of the version to be

published

Avenues for Presentation

n  Local: County Medical Society (DCMS)

n  Regional: State Chapter Society meetings (AAFP, AMA,SMA)/ USAFP/ Annual Research Competition

n  National: n  AAFP National Conference/Scientific Assembly n  AAFP National Resident and Student

Conference

Avenues for Presentation

n  National: n  NAPCRG n  Society of Teachers in Family Medicine n  Specialty Society Annual Conference

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Call For Papers

Conference

USAFP

USAFP

NAPCRG

NAPCRG

SMA

SMA

AFMRD

STFM

AFMRD

STFM

AAFP

AAFP

AAFP R&S

AAFP R&S

DCMS

DCMS

Avenues for Publication

n  Journal of Family Practice n  AAFP n  JAMA (Grand Rounds) n  The Consultant n  Letter to the Editor (NEJM) n  Specialty Journals

Avenues for Publication

n  Online: n  Medscape Clinical Case n  Journal of Case Report ($$) n  BMJ ($$)

Strategy and Approach

n  Be detailed in H&P n  Identify case and discuss n  Literature review n  Collaboration n  Seek assistance with editing n  Submit for Presentation/ Publication

Thank you!

Questions?

References

n  Green BN, Johnson CD. How to write a Case report for publication. J of Chiropractic Medicine 2006; 2 (5): 72-81.

n  McCarthy LH, Reilly KEH. How to write a case report. Fam Med 2000;32(3):190-5.

n  Albrecht J, Werth VP, Bigby M. The role of case reports in evidence-based practice with suggestions for improving their reporting. J of Am Acad of Derm 2009; 60(3)

n  CDC MMWR Weekly June 5 1981; 30 (21);1-3 n  KAPOSI'S SARCOMA IN HOMOSEXUAL MEN—A REPORT OF EIGHT CASES

Kenneth B. Hymes, Jeffrey B. Greene, Aaron Marcus, Daniel C. William, Tony Cheung, NeilS. Prose, Harold Ballard, Linda J. Laubenstein The Lancet 19 September 1981 (Volume 318 Issue 8247 Pages 598-600 DOI: 10.1016/S0140-6736(81)92740-9)

n  Evidence pyramid