Crafting a Comprehensive Case Report

1. The Case Report How to Develop and Write a Case Report Vanessa W. McNair M.D. M.P.H.

2. The Case Report • Characteristics • Limitations • The Write Up & Components • Avenues for Publication and Presentation • Strategy and Approach

4. 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

5. Case Reports • Case reports • “Scientific Observations” • Describes and analyzes diagnosis and/or management of 1 or 2 patients • Provide new knowledge to the field of health care • They can be valuable learning tools for author and reader

6. To illustrate a clinical hypothesis To support or prompt a new hypothesis To present a challenging differential diagnosis To offer insight into the pathogenesis of a disease process Describe unusual or puzzling clinical features To describe mistakes in health care with causes and consequences To describe unique or improved technical procedures To report or describe rare or novel adverse reactions To stimulate further research Case reports

7. Case Reports

8. The Write UpComponents • Title • Abstract (write this last) • Introduction • Case report (methods/results) • Discussion • Conclusion • Acknowledgements/References/Tables/Figures

9. The Write UpComponents • Title • Informative • Abstract • Brief organized summary (150-200) • Relates most important highlights of the case • Introduction • Purpose of the paper • Background info to demonstrate how the case contributes to the literature • Define unusual words

10. The Write Up Components • Case report (methods/results) • Present most salient aspects of the case • Primary aspects of patient condition and main outcome measures • Describe methods to assess and/or care for the patient • Summarize the outcomes of care

11. The Write Up Components • Discussion • Compare the case with published literature • Include discussion on how the diagnosis was confirmed and the differential diagnoses considered • List limitations and significance of each limitation • Provide suggestions or hypothesis regarding the significance or outcome • Areas for future research

12. The Write Up Components • Conclusion • Focus on what was learned • Relate to the purpose of the paper • Not a rehash; 1 paragraph • Acknowledgements • Briefly acknowledge work of a colleague • Doesn’t meet 3 criteria of authorship

13. The Write Up Components • References—peer reviewed journals • Tables/Figures • Used to visually present information • Should not reiterate text

14. The Write Up • Patient Privacy • HIPPA requires patient health information be secure • Authors generally must have consent from the patient to publish • Length • Brief and concise • Journal specific • 500 to 2000 words

15. The Write Up • Sources of instruction • The Uniform Requirements for Manuscripts Submitted to Biomedical Journals www.icmje.org • Journal specific instructions to author • Authorship • Provide substantial contributions to conception and design or acquisition of data or analysis and interpretation of data • Drafted the article or revised it critically • Has given final approval of the version to be published

16. Avenues for Presentation • Local: County Medical Society (DCMS) • Regional: State Chapter Society meetings (AAFP, AMA,SMA)/ USAFP/ Annual Research Competition • National: • AAFP National Conference/Scientific Assembly • AAFP National Resident and Student Conference

17. Avenues for Presentation • National: • NAPCRG • Society of Teachers in Family Medicine • Specialty Society Annual Conference

18. Scholarship Submission Calendar Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Call For Papers - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - USAFP NAPCRG SMA DCMS AAFP AFMRD AAFP R&S STFM Conference USAFP NAPCRG SMA AFMRD DCMS AAFP R&S AAFP STFM

19. Avenues for Publication • Journal of Family Practice • AAFP • JAMA (Grand Rounds) • The Consultant • Letter to the Editor (NEJM) • Specialty Journals

20. Avenues for Publication • Online: • Medscape Clinical Case • Journal of Case Report ($$) • BMJ ($$)

21. Strategy and Approach • Be detailed in H&P • Identify case and discuss • Literature review • Collaboration • Seek assistance with editing • Submit for Presentation/ Publication

22. Thank you! Questions?

23. References • Green BN, Johnson CD. How to write a Case report for publication. J of Chiropractic Medicine 2006; 2 (5): 72-81. • McCarthy LH, Reilly KEH. How to write a case report. Fam Med 2000;32(3):190-5. • 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) • CDC MMWR Weekly June 5 1981; 30 (21);1-3 • 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) • Evidence pyramid