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How to Write a Case Report 101

“Interesting case! Should we report it?”. Dr. Emmanuel Abara FRCS(C) FACS FICS Richmond Hill Urology Practice & Prostate Institute (RHUPPI) Northern Ontario School of Medicine (NOSM). How to Write a Case Report 101. Conflict Disclosure Information:

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How to Write a Case Report 101

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  1. “Interesting case! Should we report it?” Dr. Emmanuel Abara FRCS(C) FACS FICS Richmond Hill Urology Practice & Prostate Institute (RHUPPI) Northern Ontario School of Medicine (NOSM) How to Write a Case Report 101

  2. Conflict Disclosure Information: Presenter: Emmanuel O. Abara MB FRCSC.FACS.FICS Title of Presentation: “Interesting Case! Should we report it?”: How to Write a Case Report 101 I have no financial or personal relationships to disclose

  3. Learning Objectives • Determine what types of cases are worth reporting and why • Understand how to structure a Case Report • Learn what audience to reach and what journals to publish in • Understand the Ethics of Publishing

  4. Target Audience • Physicians in active clinical practice • Faculty seeking to review their knowledge on Case Report publishing • Fellows • Residents • Research Assistants • Learners

  5. Background • Case report is like story telling in medicine • Should be clear, short and useful for its purpose • Is the written form of the verbal presentation of a case history • Case reports are the lowest cadre in the world of evidence-based medicine • Can be powerful and instructional

  6. Why a Case Report? We need to understand the reasons for the intent to publish • To assist in structure of the article • To help target the journal and audience • To include in an introductory Letter to the Editor

  7. Possible Reasons For a Case Report • Very rare disease • Association of diseases • Rare presentations of more common diseases • Outcome of a novel treatment • Reporting a particular outcome of a case management • Mistakes, complications and lessons learned • A new disease entity

  8. Choice of Journal • Select a number of journals • Review the various formats of the journals • Make a decision which format may fit your Case Report best, e.g.: “Lesson of the Year” or “Photo Quiz” • Review published case reports in the journal of choice • Follow the guidelines and instructions precisely, especially regarding word count, figures and tables

  9. Structure Your Case Report • Abstract • Introduction • The Case Report • Discussion • Conclusion; Lessons Learned • References • Acknowledgement

  10. Review of Contents • Abstract: Brief summary (not required by all journals) • Introduction: Background information and why the case is being reported

  11. Review of Contents Case Report • History • Presenting features • Past Medical History • Social and Family History • Drug History • Physical Examination • Investigations • Differential Diagnosis • Treatment • Outcome

  12. Essentials • Anonymise the patient(s) as much as possible • Avoid names and initials • Omit non-essential personal details • Table of results can be helpful • Photos of clinical signs and diagnostic studies are invaluable

  13. Discussion • Clarify key issues • Refer to other cases in the literature • A short review of the literature is appropriate • Include the methodology used for literature search • Message or lesson(s) learned

  14. Get Help, Second Opinion, or Third Opinion • Get advice early! • Especially regarding: Key Message and Reason for the Case Report • Get others not involved in the management of the case to proofread the article and consider their comments carefully

  15. Ethics of Publishing a Case Report • Consent • Consider privacy laws • Duty of confidentiality persists even if the patient has died, e.g.: Role of Next-of-Kin • Deliver a copy of published paper to the patient or relative

  16. Ethics of Publishing a Case Report: Criteria for Publication Without Patient’s Consent • Publication should be in the public interest • Every effort to contact patient or next-of-kin should have failed • Every effort to anonymise the case report should be made • Average person unlikely to withhold consent

  17. Ethics of Publishing a Case Report:Authorship • Consider assent to publish from other clinicians involved in the care of the patient • Authors included need to have intellectual input • Avoid a “soccer team” of authors • Many journals may limit the number of authors • Letters and consent from various named co-authors may be required

  18. Article Submission • Have all the consents and assents to publish • Follow all the instructions and guidelines of the journal webpage • Write and include a cover letter to the editor

  19. “Publish or Perish”or“Publish and Prosper” A Case Report may be the beginning of a glorious and successful career in medical writing!

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