How to Write a Clinical Case Report
Case reports are important. Although much maligned over the last decade or so, case reports are now more widely recognised for their significant potential benefits: brilliant vehicles for delivering concise clinical-guidance messages to promote best practice; excellent teaching aids in case-based learning; the foundation for subsequent larger research programs; and a very useful training in the art of how to publish pretty-much anything at all.
However these benefits rely on two key challenges; being able to write the report in a clear and engaging way, and then being able to persuade someone else to publish it. I’ll write a few notes below on my views on report-writing, and then in the next blog in this series I’ll touch on publishing tips and strategies.
As the editor of a new case report journal, Clinical Case Reports, one of the bits of my editor-role I enjoy most is helping authors write and shape their case reports to really drive home their message effectively. My view is that a brilliant report has to be clear, concise and relevant to its audience – like a clinician to clinician telephone referral. The crucial issue about the report’s message, is that it must have one! I read so many case reports which are interesting descriptions, but as the reader I am left thinking… “Yeah, but so what??”. Every case report must set out to tell the readers something they really need to know. This message needs very high external validity – it needs to be practical (people can do ‘it’ if they want to), important (people will see the need to do ‘it’), and generalisable (‘it’ not relating exclusively to only 1 small child in the whole world who has now got better anyway!). And in this last point, I think and hope we are seeing an important evolution in case reports that could have a profound impact on their relevance to clinical medicine. In the past case reports typically had humorous (which was bad), or pseudo-humorous (even worse), titles typically describing a really really rare thing. The rarer the better. Think “The dangers of goat soup”, or the “Rare chance association of Osgood Schlatters disease and pre-tibial tuberculosis in an elderly lady football player.” Two problems here: however hard you try the title will never really be funny; and if the case is truly that rare, why does anyone else need to read about it?
My view is that generalisability is key. The reports which authors should be writing describe important clinical situations which are common, but still cause management problems. Because they are common their message will be relevant to many more clinicians than the once-in-a-lifetime reports, and their important message will make them valuable to read and understand. As we move into a clinical era where practice is increasingly influenced by guidelines and meta-data, if case reports can illustrate how the tricky bits of guidelines or systematic review recommendations can be done in those common situations, then that’s even better still!
3 top tips when writing a case report:
- Keep an eye out for challenging cases – they don’t have to be rare.
- Select one which has an important message, ideally relevant to lots of other clinicians.
- Write the report to focus on the message and present it like the best telephone referral you have ever made.
To see a recent webinar on “How to write Case Reports”, please view this recorded video at: http://bit.ly/videoCR
by Dr. Charles Young, Editor-in-Chief – Clinical Case Reports