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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
Outline
2

Overview
¨  Preparation
¨  Writing
¨  Publishing
¨  Barriers
¨ 

H. Al-Sobayel

4/26/11
3

H. Al-Sobayel

4/26/11
4

Overview
Case Report Publication

H. Al-Sobayel

4/26/11
5

H. Al-Sobayel

4/26/11
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
Value of Case Reports
7

¨ 

¨ 

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
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

Preparation
Case Report Publication

H. Al-Sobayel

4/26/11
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

4/26/11
Before Writing
11

Identify the journal
¨  Review “instructions for Authors”
¨  Read several case reports
¨  Ask patient to sign consent
¨ 

H. Al-Sobayel

4/26/11
12

H. Al-Sobayel

4/26/11
13

writing
Case Report Publication

H. Al-Sobayel

4/26/11
Components of Case Report
14

abstract/introduction
¨  Case history/description
¨  literature review
¨  Discussion
¨  conclusions/recommendations.
¨ 

H. Al-Sobayel

4/26/11
Abstract
15

Quickly scan the content of the paper
¨  Less than 100 words
¨ 

H. Al-Sobayel

4/26/11
16

H. Al-Sobayel

4/26/11
Introduction
17

¨ 

¨ 

¨ 

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
Case History/Report
18

¨ 
¨ 

¨ 

¨ 

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
Case History/Report
19

Treatment, outcome, and follow-up
¨  Tables, flow-charts, radiographs, etc.
¨ 

H. Al-Sobayel

4/26/11
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

H. Al-Sobayel

4/26/11
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
Summary/Conclusions/Recommendations
23

Brief summary – the Take Home Message
¨  Lessons learned from the case
¨  Questions and recommendations for research
¨ 

H. Al-Sobayel

4/26/11
24

Publishing
Case Report Publication

H. Al-Sobayel

4/26/11
Journal
25

¨ 
¨ 
¨ 

Check instructions for Authors
1000 – 1500 words
10 – 20 citations

H. Al-Sobayel

4/26/11
26

H. Al-Sobayel

4/26/11
27

H. Al-Sobayel

4/26/11
Barriers
28

Time
¨  Intimidation by publication process
¨  Editorial review
¨  Journals
¨ 

H. Al-Sobayel

4/26/11
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
H. Al-Sobayel

THANK YOU
4/26/11

30

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Writing 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 4/26/11
  • 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 ¨  ¨  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
  • 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 4/26/11
  • 11. Before Writing 11 Identify the journal ¨  Review “instructions for Authors” ¨  Read several case reports ¨  Ask patient to sign consent ¨  H. Al-Sobayel 4/26/11
  • 14. Components of Case Report 14 abstract/introduction ¨  Case history/description ¨  literature review ¨  Discussion ¨  conclusions/recommendations. ¨  H. Al-Sobayel 4/26/11
  • 15. Abstract 15 Quickly scan the content of the paper ¨  Less than 100 words ¨  H. Al-Sobayel 4/26/11
  • 17. Introduction 17 ¨  ¨  ¨  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 ¨  ¨  ¨  ¨  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
  • 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 ¨  H. Al-Sobayel 4/26/11
  • 25. Journal 25 ¨  ¨  ¨  Check instructions for Authors 1000 – 1500 words 10 – 20 citations H. Al-Sobayel 4/26/11
  • 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