Dural Connection Internet Edition    Volume 3, Number 3


This edition presents a "How To" write a case history for publication for the novice with email addresses for most of the important sources. Although this is but one possible format, it serves as a good beginning template. There is a brief note following from Dr. Robert Ward, editor for the Journal of Chiropractic Education on why it is so important to write case reports.  See also new text by Matthew McCoy, DC (editor of the Journal of Vertebral Subluxation Research) -- "The case study report: A step by step guide."




Other than a "commentary" the writing of a case report is considered the "easiest" paper to write for publication. However, those with limited experience may find that the research world can be somewhat difficult in which to navigate until you become more familiar with it. Therefore what might be easy to some might be quite difficult initially for others.

Although there are a multitude of ways to format case histories, I am presenting what has worked for me, as a template for prospective authors of such papers. This is intended to be non-confining and facilitative only. Ultimately the best format for writing a Case Report is to follow the "Uniform Requirements for Manuscripts Submitted to Biomedical Journals" rules. This can be found in its entirety at:

 
The "Uniform Requirements for Manuscripts Submitted to Biomedical Journals"can also be found in the "Instructions for Authors" section in the beginning of any recent Journal of Manipulative and Physiological Therapeutics.

There is an excellent site that lists the chiropractic related peer reviewed journals along with each journals link and instruction for authors. It is as follows:


This site contain links to Web sites which provide instructions to authors for over 3,000 journals in the health and life sciences, chiropractic included. For those who do not have Web access, contact with the librarian at a chiropractic college in your region can be very useful.



This lists the title, author(s) address, and methods of contact.


     A. The abstract creates a summary for your paper and is usually around 150 - 250 words. There are specific formats for an abstract and each journal has their particular preference. Information for what is needed to write "Structured Abstracts for Case Reports" is located at:


You can also find the article entitled, "Structured Abstracts for Case Reports", in the Mar/Apr 1993 edition of Journal of Manipulative and Physiological Therapeutics ,   vol. 16, no. 3.

     B. Keywords are usually key words or phrases that an indexer can use to cross-index your paper. It is best to use Index Medicus Medical Subject Headings (MeSH). To find the MeSH terms you may want to contact a librarian or explore on-line:



     A. Opening Statement

In the opening statement you present the topic you will be discussing and the purpose of your case report. This section is used to suggest to the reader what is about to come and why it is important to them. In this section it is also important to explain why this paper is being written. (1 - 2 paragraphs)

     B. Current Accepted Allopathic or Traditional Approaches to Treatment.

This sections presents traditional approaches commonly found in mainstream medical literature. An example might be found in a book like "The Merck Manual". It is necessary to reference discussions, minimizing the use of books, which are not peer reviewed and are considered to possibly be biased.  A medline search for articles that give a basis for your position will often be quite helpful and productive.  (3 - 10 paragraphs)

    C. Research Supporting Chiropractic's Treatment of Presenting Condition.

In this section a search of Medline and Mantis' site on your topic's chiropractic, osteopathic, or other alternative methods of treatment can be discussed. It is useful to focus both upon peer reviewed chiropractic studies and when necessary explore books, proceeding from conferences and whatever else is available related to your main topic. (3 - 10 paragraphs)


     A. The Patient's Presenting Symptoms

     B. Examination Findings (MRI, Neuroconductive Studies, specialized studies, etc.)

    C. Treatment Rendered

     D. Results of Treatment and Follow-up Studies


     A. Reproducible Description of Method(s) of Care Used in this Case History

This section describes in detail the treatment rendered, in a way that makes it possible for the reader to reproduce your treatment. It is important to reference, if you can, the techniques and treatments to published papers or, if necessary, the books in which the technique is presented. (3 - 10 paragraphs)

     B. Rationale for the Particular Method(s) of Care Used with this Patient

This section provides the rationale behind the method of treatment rendered, and includes presentation of the research -- the anatomical, physiological, neurological, etc., explanations of treatment protocol choices. References supporting those assertions are essential so that they do not appear to have been completely baseless. (3 - 10 paragraphs)


      A. This section sums up the paper in a few sentences and then also describes the purpose of the paper in one or two sentences.

      B. It is proper rhetoric at this point to avoid drawing any conclusions other than the treatment rendered in this one case led to the positive or negative outcome. Usually this includes a suggestion that, based on this case history, further investigation into the condition presented in this study is needed. (1 -2 paragraphs)


Here is where you can thank anyone related or assisting you with your paper. Be sure to provide written permission for any person to be mentioned in the acknowledgment.

VIII. Reference Page(s)

Each journal might have their own format; requirements for submission should be checked.

    A. There are many on-line search engines but my favorites are for:

        1. Medline Searches:  http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed  
            This site is free, except for downloading the article in its entirety.

        2. MANTIS (Chiropractic and Allied Health Care) Searches:
            http://www.chiroaccess.com/
           There is a charge for using Mantis but it is the best source of chiropractic peer reviewed literature anywhere.
        
        3.  ChiroIndex.Org:  (Chiropractic Based) Searches:  http://www.chiroindex.org/
             Recently updated chiropractic search engine, now with abstracts and better yet it is FREE!

    B. Access to MANTIS is free for those who are members of the Foundation for Chiropractic Education and Research (FCER). Join now since MANTIS internet access is invaluable and you support chiropractic research at the same time.. FCER can be contacted toll-free at 800-622-6309 • Fax 515-282-3347   • E- mail: :FCERNow@aol.com

    C. Telephone:

        1. This might be limited but, FCER also has a "Literature Search"  Hotline and can be contacted at: (800)   743-3282.

        2. Most Chiropractic College Librarians are unbelievably helpful and capable of helping with literature searches.

        3. Call SOTO-USA and you will be forwarded to someone who will try to help also at: (336) 793-6524

At this point the author may want to again look at the journal submission requirements, check with the journal editor, or speak with someone associated with journal submissions. Generally, everyone is more than happy to help. New writers are usually encouraged, assisted and welcomed.


A recent excellent text by Matthew McCoy, DC, editor of the Journal of Vertebral Subluxation, has been published, entitled "The Case Study Report, The Individual's Experience, Conceiving, Writing & Submitting Cases Studies on Chiropractic: A Step by Step Guide. "

From the Preface

This book is divided up into three parts or sections. The first part outlines the nuts and bolts of putting together a case study starting with a piece on why case studies are so important to the chiropractic profession. This is followed by detailed information on how to describe chiropractic interventions and the outcomes that result from the application of our science and art.  Guidance on literature searching, putting together your references and what to expect during the peer review and publication process is also provided.

Part II takes you through an actual case study section by section and attempts to reinforce and give you an example of how a case study is built and what the end product looks like.

Part III is a series of articles that pragmatically explore the very serious situation that the chiropractic profession finds itself in when it comes to its research infrastructure and culture. Also included in this section is a paper by Dr. Christopher Kent on Models of Vertebral Subluxation which is important reading for anyone trying to describe subluxation related research findings. While Part III is the last section I strongly encourage the reader to review this section first before tackling the nuts and bolts of putting together a case.    

The Case Study Report - $125.00  Order Now!

A good guide to writing case reports from start to finish and extremely helpful: Green BN, Johnson CD, Writing Patient Case Reports for Peer-Reviewed Journals: Secrets of the Trade Journal of Sports Chiropractic & Rehabilitation. 2000 Sep; 14(3):  51-9.
 
ABSTRACT: Objective:  To describe and discuss the process used to write a case report for publication in a peer-reviewed journal. Methods:  Narrative review of the literature.  Discussion:  The importance for case reports is presented as well as the explanation of how to write them in a standardized format.  Steps in preparing a case report are described and discussed starting with selecting a title and concluding with preparing appropriate illustrations.  Conclusion:  Case reports are important contributions to the health sciences literature.  Proper preparation of this research design is necessary in order for it to be published in a credible manner.


Merritt L.  Case reports: an important contribution to chiropractic literature. Journal of the Canadian Chiropractic Association. Jun 2007; 51(2): 72-4.

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