How to write a case report – Pubrica

1. HOWTOWRITEA CASEREPORT AnAcademicpresentationby Dr.NancyAgnes,Head,TechnicalOperations,Pubrica Group:www.pubrica.com Email:sales@pubrica.com

2. Today'sDiscussion Outline In brief Introduction Whatkindof Cases shouldbereported? Thecomponentsofacasereport OvercomingBarrierstoWritingCaseReports Conclusion

3. INBRIEF The preparation of case reports, using existing recommendationsand arandomsampleof recent case reports, researchers developed a fill-in-the-blanks worksheet for doctors to record specificscientific findings. The case report worksheet, which was initially designedtohelpfamilypracticeresidentsto writecasereports,cannowbeusedby and physicians in any practice environment specialitytocompileandreportimportant,rare, ornewsworthy cases.

4. INTRODUCTION Case reportsare"scientific findingsthathave been meticulously collected to serve as a useful educationaland research guide." Sir William Osier, who was the author of a number of those experimental findings, urged other doctors to do the same "Always take care of something out ofthe ordinary. Once you've made and documented the rare or uniquediscovery, youcan publish it." Contd... Contd...

5. The American Journal ofDermatopathologyreleaseda case study. A case study was searched using keywords for different fields (e.g., obstetrics andgynaecology,paediatrics,neurologyandneurosurgery,dermatology, generalinternal medicine,andfamily medicine),and arandomsampleof reportedcasereports was chosen.

7. WHAT KIND OFCASES SHOULD BEREPORTED? Accordingtoouranalysisofpublished casesand applicable standards,casereportsshoulddescribe a uniquepresentation,notjust modifyingapreviously mentionedcase. A new or rare site for a previously identified illness, for example, would not qualify as a one-of-a-kind occurrence unless it is followed by previously undocumented signs or necessitatedanespeciallytime-consumingand expensivediagnosis procedure. Contd...

8. Inlinewiththetraditionofpublished casereports, mostcase reportsconcern specialities and subspecialties that documentunusual orexceptionalclinicalexperiences.

9. THECOMPONENTSOFA CASEREPORT Introduction,casepresentation,anddebate were listed as the three main components of most recently written material on how to write casereports." We propose that these five parts be included in acasestudy,basedonallofthe recommendationsfrompreviouslypublished guidance, as well as the structural elements of many previously published publications and our observations: Contd...

11. ABSTRACT Abstracts and the title are an integral part of each article'selectronicbibliographicbackgroundin databaseslike MEDLINE. Abstracts enable users to easily scan an article's content to see if it is interesting enough to warrant furtherreading. Manypublicationsthat maybe relevanttoa clinical condition may be overlooked if abstracts arenot used. Contd...

12. We recommendincluding abriefabstractthatincludestheclinical issueordilemma,anoutlineoftheliteraturereview,and abrief statement summarising why this case is rare and interesting in place of orin addition to an introduction. CASEHISTORY/REPORT The case history or case report, which is usually taken from chart notesandisacorecomponentofwrittencasestudies,isthe secondsection. It shouldstartwith abriefintroductiontothepatient(s)and a descriptionof the currentcondition. Writers should providedetailsaboutthe medical evaluationand any test findings thatoffer insight intothe actual situation. Contd...

13. Still,notalltestresultsshouldbeprovided,and"redherrings"shouldbeavoided because they are likely to createcomplications for otherdoctors. Includenormallaboratory values for samplesthataren'taswidelyordered. Thepurposeistoincludeonlythemostimportantdetailstohighlightthecase's moststrikingcharacteristics." This section should includetheoriginaldiagnosis, care,andfollow-up schedule. Tables,flowcharts,photographs,radiographs,andfigurescanbeincludedto elucidatethe case.

14. LITERATUREREVIEW The organised literature search, described for systematic reviews, methodologysectionforcasereports. similar islisted to that inthe Awell-constructedclinicalquery shouldbe formulated,"accompaniedbyanexplanationofthe index words or MeSH headings used for the searches such that anyone can replicate the search, such as MeSH terms to address the clinical question, "What arethepotentialcausesofintractableperioralrashin a 10-year-oldboy?""Dermatitis,perioral,"or"facial dermatoses,"for example. Contd...

15. Theliterature reviewshouldbe conciseandprecise,intendedto ensure the case's uniqueness and provide a context for and role of the latestevidence in the biomedical literature. DISCUSSION Themostcriticalpartofacasestudyisthediscussionarea. This iswhere thewriters explainwhy knowledge is important. What about this patient described your attention or was unusual? Whyisitnecessarytowritethisdown?Whatwould your colleaguesdiscover?Noticethatnotall subsetsofthe worksheet's topic section wouldextend toall casesmentioned. Contd...

16. Choosetheplacesthatcanbetterhelpelucidatethesituation,keeping in mind the two case reporting watchwords:brevityand consistency. Thebulkofcasestudiesreportedinjournalsarefewerthanthree journal pageslong,andthe vast majority areonearticleorless. SUMMARY/CONCLUSIONS/RECOMMENDATIONSSECTION Finally, ashortoutline, conclusion,or recommendations section—the take-home message—should be included in the report. This segmentshouldincludeanylessonslearnedbythe practitionerwhen caringforthispatient, suchasfamily, emotional,orquality-of-lifelessons,physician-patient contact barriers,or compliance problems. Contd...

17. "Why," for example, is a good question to ask? "Now that I've had this training, what will I do better next time?" or "May I make any advice to other clinicians?" Study recommendations can also be included. Thissectionshouldbeshortaswell,usuallynomorethanoneor twolines.

18. OVERCOMINGBARRIERSTO WRITINGCASEREPORTS A meeting of obstacles stands in the way practitioners choose to write case reports or other manuscripts for publication. Themostsignificantimpedimentistime. Byguidingthe clinician'sdatacollection,the case report worksheet will help speed up preparing a case report (those scientific observations that comprise a casereport). Contd...

19. Thecommentsandconclusionscanbeeasilyformattedintoa manuscript for submissionuntilthey'redone.

20. CONCLUSION Case studiesmustbe concise,providenewor uniqueinformation,andorganiseandpresent clinicalfindings in aregular,systematicmanner. Editors and editorial boards of primary care and family medicinejournals shouldestablishbasic requirements for approving case reports (type of article, volume, etc.) and include those criteria in eachjournal's instructions for authors. The case study worksheet provides a standardised guide to writing case reports that can compile and arrange experimental findings into engaging and publishablecasereports.

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