Case studies are an invaluable record of the clinical practices of a profession. While case studies cannot provide specific guidance for the management of successive patients, they are a record of clinical interactions which help us to frame questions for more rigorously designed clinical studies. Case studies also provide valuable teaching material, demonstrating both classical and unusual presentations which may confront the practitioner. Quite obviously, since the overwhelming majority of clinical interactions occur in the field, not in teaching or research facilities, it falls to the field practitioner to record and pass on their experiences. On the other hand, field practitioners generally are not well-practised in writing for publication, and so may hesitate to embark on the task of carrying a case study to publication. It is the intent of these guidelines to assist the relatively novice writer – practitioner or student – in efficiently navigating the relatively easy course to publication of a quality case study.
This set of guidelines provides both instructions and a template for the writing of case reports for publication. You might want to skip forward and take a quick look at the template now, as we will be using it as the basis for your own case study later on. A link to the template can be found below, and, like all of these pages, can be converted to "printer friendly" format by clicking the link at the bottom of the page.
Authors will find that each journal has its own guidelines for the structure of manuscripts, and so the template which we provide may require some modification. On the other hand, journals generally follow a specific set of guidelines called the “Uniform Requirements for Manuscripts Submitted to Biomedical Journals” the latest version of which (2006) can be downloaded from the internet at:
Aspiring authors should attempt to follow the uniform guidelines as closely as possible, but understand that most journals do allow for some flexibility, and that individual cases my require some departure from the recommendations which we or publishers provide.
After this brief introduction, the guidelines below will follow the headings of our template. Hence, it is possible to work section by section through the template to quickly produce a first draft of your study. As most publishers require electronic submission of manuscripts, case studies should be written in a standard word-processing programme, and electronic figures should be prepared in a format acceptable to the publisher. Therefore, it is most sensible to have a particular journal in mind prior to setting out on writing your study. All journals publish, from time to time, and post on their web sites, detailed instructions about their specific requirements.
More importantly, however, you must have a clear sense of the value of the study which you wish to describe. Therefore, before beginning to write the study itself, you should gather all of the materials relevant to the case – clinical notes, lab reports, x-rays etc. – and form a clear picture of the story that you wish to share with your profession. At the most superficial level, you may want to ask yourself “What is interesting about this case?” Keep your answer in mind as your write, because sometimes we become lost in our writing and forget the message that we want to convey.
Another important general rule for writing case studies is to stick to the facts. A case study should be a fairly modest description of what actually happened. Speculation about underlying mechanisms of the disease process or treatment should be restrained. Field practitioners and students are seldom well-prepared to discuss physiology or pathology. This is best left to experts in those fields. The thing of greatest value that you can provide to your colleagues is an honest record of clinical events.
Finally, remember that a case study is primarily a chronicle of a patient’s progress, not a story about the practitioner or their treatment. Editorial or promotional remarks do not belong in a case study, no matter how great our enthusiasm. It is best to simply tell the story and let the outcome speak for itself.With these points in mind, let’s begin the process of writing the case study.