Dr. Emmanuel Abara FRCS(C) FACS FICSRichmond Hill Urology Practice & Prostate Institute (RHUPPI)Northern Ontario School of Medicine (NOSM)

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

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

Physicians in active clinical practiceFaculty seeking to review their

knowledge on Case Report publishing

FellowsResidentsResearch AssistantsLearners

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

We need to understand the reasons for the intent to publish

To assist in structure of the articleTo help target the journal and audienceTo include in an introductory Letter to the Editor

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

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

Abstract IntroductionThe Case ReportDiscussionConclusion; Lessons LearnedReferencesAcknowledgement

Abstract: Brief summary (not required by all journals)

Introduction: Background information and why the case is being reported

Case Report History

▪ Presenting features▪ Past Medical History▪ Social and Family History▪ Drug History

Physical Examination Investigations Differential Diagnosis Treatment Outcome

Anonymise the patient(s) as much as possible

Avoid names and initialsOmit non-essential personal detailsTable of results can be helpfulPhotos of clinical signs and

diagnostic studies are invaluable

Clarify key issuesRefer to other cases in the literatureA short review of the literature is

appropriate Include the methodology used for

literature searchMessage or lesson(s) learned

Get advice early! Especially regarding: Key Message and

Reason for the Case ReportGet others not involved in the

management of the case to proofread the article and consider their comments carefully

ConsentConsider privacy lawsDuty 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

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

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

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

A Case Report may be the beginning of a glorious and successful career in medical writing!