clinical case report resources

PUBLISHING A CLINICAL CASE REPORT: A BRIEF PROCEDURE

FIND A CASE 

Always be on the lookout for clinical cases that would catch the interest of practicing clinicians. It doesn't have to be super novel or unusual, but it does have to be something of interest and not routine or trivial. Your preceptor would be the first to say if they found it interesting enough to share. Presenting the case as a poster at a local meeting will tell you if others find your case interesting and will give you feedback on improving your case presentation prior to publishing.

GATHER YOUR MATERIALS

As soon as you decide this case has publication potential, gather all material on the case, including high quality images and lab results. Make notes on what you personally remember about the patient as soon as possible so you don't forget. Get written consent from the patient before they leave your care, if you can (see below for details). 

THE WRITING PROCESS

Collect recent literature on similar cases. This is easily done using the advanced feature in Pubmed search, with "case reports" in the "Publication Type" field, and the medical topic in the "Title" or "MESH term" fields. Don't neglect referencing the most important and pertinent of these prior reports!

Read carefully, noting also the preferred journals for the topic. Discuss writing the case with your preceptor, who is always an author, and others directly involved, then decide on authorship order and how each will contribute to the paper (see below for details).  Identify 2 or 3 possible journals appropriate for the case and rank them in order of preference. This page and this article have a listing of potential journals for case reports. Write up the case in the format of the target journal, ensuring all authors have a significant role in either writing or editing the article. For useful tools to assist with writing check out this page as well as this article. Please have two or three other individuals, preferably residents or physicians, to give you feedback on the article prior to the next step. 

Finally, remember that a case report is a teaching tool. You should end the report with a clear take-home point.  

PREREVIEW AND JOURNAL SUBMISSION

WCUCOM has implemented an important process for pre-review of case reports before journal submission. This process begins with sending the completed draft of the manuscript, along with your journal preference listing, to Dr. Fastring. She will pass them along to our experienced clinician reviewer, who will assist you in final polishing of the manuscript and considering the appropriate journal(s) for publication. The reviewer will pass the recommendations on to Dr. Fastring, who will consult with Dr. Bateman if there is a cost for publication. Dr. Fastring will give the green light for submission to the agreed upon journal and will assist as needed with the submission process.

All journals have a process for submission described on their website. Before submission, read all author guidelines carefully. These are journal specific. Each journal has different requirements. If these requirements are not met, the submission will likely be desk rejected by the editor. Once you are clear on the process and have all of the required information together, submit to the journal and wait! When reviews come back, it is always best to revise the article whenever possible to meet the reviewer recommendations even if you think they are irrelevant or trivial. If you are absolutely sure the reviewers are wrong, you must make a convincing, but polite, case to the editor to address the reviewer comments. Be sure to consult with your coauthors when addressing the reviews. If the article is rejected, don't be discouraged. Consult again with Dr. Fastring to facilitate revising and submitting to another journal. 

As a side note, Dr. Fastring would appreciate a copy of the reviews so that we can continue to improve our review process.

issues to consider

patient consent

While a case report on an individual does not normally require IRB approval, there are still patient privacy issues involved. Patient consent is not required for the purposes of an academic assignment since it is not disseminated publicly. However, any publication or public presentation of the case will require de-identification by the HIPPA "safe harbor" criteria. Many, though not all, journals will require both de-identification and signed patient consent for publication. For example, here is the JMCR policy on consent for publication . For these reasons, we recommend you get written patient consent as early as possible if you have a potentially publishable case. Most larger hospitals will have standardized forms for patient consent. If your medical facility does not have one, here is an Example Patient Consent Form .  If the patient has left the facility and will likely not return soon, with your preceptor's permission you can mail the patient an explanation of what you want to do along with a completed consent form for their signature and stamped, self-addressed envelope to make it easy and free for them to supply consent. Calling the patient before mailing them will give them a heads up to expect it and an idea of what to do with it. You could even offer to meet them at their next appointment (and get information on how they are doing). 

There are journals that will publish case reports without the signed consent, presuming the patient is completely anonymous. Pay close attention to the journal's Instructions to Authors for the pertinent information.

authorship

The inclusion/exclusion of authors can be a contentious issue. The standard criteria for authorship published by the International Committee of Medical Journal Editors is the following:

1. Substantial contributions to the conception or design of the work; or the acquisition, analysis or interpretation of data for the work; AND 2. Drafting the article or revising it critically for important intellectual content; AND 3. Final approval of the version to be published; AND 4. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

For students on clinical rotations who are publishing a case they have seen, this normally includes their preceptor. Other students, residents, or clinicians that have interacted with the patient or interpreted patient information (e.g. radiologist) can potentially be authors if they fulfill all of the criteria set out above. All authors, their contributions to the publication, and their order of listing should be agreed upon as early as possible in the process. 

Students should resist the temptation to add "courtesy" authors in an effort to gain favor with prominent individuals or facilitate journal review. Such "gift authorship" is not only dishonest and degrades the contribution of the other authors, but it also becomes a liability for the false author if there is a case of misconduct associated with the publication.

REFERENCES

Publications, whether they are case reports or other types of journal articles, should reference the primary literature only. Please do not reference websites or clinical tools like AllOfUs. Case reports presented on a poster will normally have at least six references. Case reports published as journal articles can have additional references, normally totaling up to a dozen references briefly reviewing the most pertinent literature. A more exhaustive review is no longer a traditional case report and is not treated as such by the journal. Please carefully read the instructions to authors for the journal. Normally they have strict word limits on case reports, which means limits on the literature review as well. 

RESOURCES FROM dR. cLIFF pACKER

• Writing Case Reports: A Practical Guide from Conception through Publication (expensive but e-book can be rented)

• Case reports in medical education (CME video)

• Presenting Your Case: A Concise Guide for Medical Students

• A Case Suspended in Time: The Educational Value of Case Reports

• Chronic hypokalemia due to excessive cola consumption: a case report

supplemental literature on medical case reports

• The Case for the Case Report

• Case Reports, Case Series – From Clinical Practice to Evidence-Based Medicine in Graduate Medical Education

• Telling a Clinical Story: The Role of Case Reports in a General Journal

•  Writing Case Reports: How to Enjoy the Journey

• Tips on Delivering Oral Case Reports

CASE REPORTS PUBLISHED BY WCUCOM STUDENTS

WCUCOM case reports in PUBMED  (click link for an advanced search of PUBMED)

2023

• Acute Mesenteroaxial Volvulus in the Setting of Chronic Paraesophageal Hernia: A Case Report

• Novel Variants in the VCP Gene Causing Multisystem Proteinopathy 1

2022

• Atypical Presentation of DRESS Syndrome With Associated Acute Kidney Injury in a Male Patient Following Vancomycin Exposure

• Preoperative Diagnosis of Gallbladder Agenesis: A Case Report

• Tumor Necrosis Factor α Inhibitor–Induced Lupuslike Syndrome in a Patient Prescribed Certolizumab Pegol

• Lacrimal gland extranodal marginal zone B-cell lymphoma (EMZL) with high-grade transformation: A case report

• Mustarde flap for primary nasal sidewall defect post-Mohs micrographic surgery

• Intraoperative localization and "snowman" muscle pledget repair for ventral dural defect in a case of spontaneous intracranial hypotension

2021

• Effects of Hyperbaric Oxygen Therapy on a 47-Year-Old Male with a C6 Spinal Cord Injury and a Chronic Gluteal Pressure Wound.

• Case of Seizures With Sudden Discontinuation of Zolpidem

• Holocord spontaneous pneumorrhachis in the setting of refractory emesis

• A Rare Case: Nonuremic Calciphylaxis

• Bilateral superiorly based malar transposition flaps for nasal tip reconstruction: A case report

• Extradural arachnoid cyst in the thoracic spine: Case report

• Depression and Somatic Symptoms in a Non-Western Physician

• A Case of Subacute Necrotizing Fasciitis due to Serratia marcescens

2020

• Ischemic Colitis in Buerger’s Disease: Case Presentation and Review

• Chronic, nonhealing leg ulcer

• Extradural arachnoid cyst in the thoracic spine: Case report

• Self-Mutilation of the Fingers After a Supracondylar Humerus Fracture: The Deleterious Effects of a Median Nerve Palsy: A Case Report

• Euglycemic diabetic ketoacidosis in a lung cancer patient using empagliflozin

• Fatal retroperitoneal hematoma in a patient receiving enoxaparin for bilateral pulmonary emboli

• Mumps Orchitis in an 18-Year-Old Male Admitted for Severe Sepsis Secondary to Community-Acquired Pneumonia (pages 15-17)

2019

• Safety and preliminary efficacy of functional electrical stimulation cycling in an individual with cervical cord injury, autonomic dysreflexia, and a pacemaker: Case report

• A Case Report: Acute Myocardial Infarction in a 29-year-old Male

• Mumps Infection in a Previously Vaccinated Child with a Positive Rapid Strep Test  (pages 10-12)

• Atypical Presentation of Lipoblastoma of a 9-Month-Old

• Development of Periungual Pyrogenic Granuloma with Associated Paronychia Following Isoretinoin Therapy: A Case Report and a Review of the Literature

• Renal Cell Carcinoma Metastasis to the Maxillary Sinus

2018 and prior

• Successful Transplantation of Pediatric Kidneys Despite Vascular Injuries

• Transcatheter Aortic Valve Replacement in Treatment of Aortic Stenosis

• Recurrent High-Grade Invasive Mucoepidermoid Carcinoma of Larynx: A Case Report and Review of the Literature

• Severe Cardiomyopathy After Huffing Dust-Off

• Clonidine Overdose in a Toddler Due to Accidental Ingestion of a Compounding Cream

• Pitfalls to Avoid in the End-Stage Renal Disease Patient

• Diffuse anterior scleritis and secondary glaucoma as a manifestation of adultT-cell prolymphocytic leukemia