medical case study articles

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Medical case study articles


In general, all case reports include the following components: an abstract, an introduction, a case, and a discussion. Some journals might require literature review. The abstract should summarize the case, the problem it addresses, and the message it conveys. Abstracts of case studies are usually very short, preferably not more than words. The introduction gives a brief overview of the problem that the case addresses, citing relevant literature where necessary.

The introduction generally ends with a single sentence describing the patient and the basic condition that he or she is suffering from. This section provides the details of the case in the following order:. The author should ensure that all the relevant details are included and unnecessary ones excluded. This is the most important part of the case report; the part that will convince the journal that the case is publication worthy. This section should start by expanding on what has been said in the introduction, focusing on why the case is noteworthy and the problem that it addresses.

This is followed by a summary of the existing literature on the topic. If the journal specifies a separate section on literature review, it should be added before the Discussion. This part describes the existing theories and research findings on the key issue in the patient's condition.

The review should narrow down to the source of confusion or the main challenge in the case. Finally, the case report should be connected to the existing literature, mentioning the message that the case conveys. The author should explain whether this corroborates with or detracts from current beliefs about the problem and how this evidence can add value to future clinical practice.

A case report ends with a conclusion or with summary points, depending on the journal's specified format. This section should briefly give readers the key points covered in the case report. Here, the author can give suggestions and recommendations to clinicians, teachers, or researchers. Some journals do not want a separate section for the conclusion: it can then be the concluding paragraph of the Discussion section. Informed consent in an ethical requirement for most studies involving humans, so before you start writing your case report, take a written consent from the patient as all journals require that you provide it at the time of manuscript submission.

In case the patient is a minor, parental consent is required. For adults who are unable to consent to investigation or treatment, consent of closest family members is required. Patient anonymity is also an important requirement.

Remember not to disclose any information that might reveal the identity of the patient. You need to be particularly careful with pictures, and ensure that pictures of the affected area do not reveal the identity of the patient. National Center for Biotechnology Information , U. Journal List Heart Views v. Case presentation: Several sentences describe the history and results of any examinations performed. The working diagnosis and management of the case are described.

Discussion: Synthesize the foregoing subsections and explain both correlations and apparent inconsistencies. If appropriate to the case, within one or two sentences describe the lessons to be learned. Introduction: At the beginning of these guidelines we suggested that we need to have a clear idea of what is particularly interesting about the case we want to describe.

The introduction is where we convey this to the reader. It is useful to begin by placing the study in a historical or social context. If similar cases have been reported previously, we describe them briefly. If there is something especially challenging about the diagnosis or management of the condition that we are describing, now is our chance to bring that out.

Each time we refer to a previous study, we cite the reference usually at the end of the sentence. Case presentation: This is the part of the paper in which we introduce the raw data. First, we describe the complaint that brought the patient to us.

Next, we introduce the important information that we obtained from our history-taking. Also, we should try to present patient information in a narrative form — full sentences which efficiently summarize the results of our questioning. We may or may not choose to include this list at the end of this section of the case presentation.

The next step is to describe the results of our clinical examination. Again, we should write in an efficient narrative style, restricting ourselves to the relevant information. It is not necessary to include every detail in our clinical notes. If we are using a named orthopedic or neurological test, it is best to both name and describe the test since some people may know the test by a different name. X-rays or other images are only helpful if they are clear enough to be easily reproduced and if they are accompanied by a legend.

Be sure that any information that might identify a patient is removed before the image is submitted. At this point, or at the beginning of the next section, we will want to present our working diagnosis or clinical impression of the patient. Management and Outcome: In this section, we should clearly describe the plan for care, as well as the care which was actually provided, and the outcome. It is useful for the reader to know how long the patient was under care and how many times they were treated.

Additionally, we should be as specific as possible in describing the treatment that we used. If we used spinal manipulation, it is best to name the technique, if a common name exists, and also to describe the manipulation. Remember that our case study may be read by people who are not familiar with spinal manipulation, and, even within chiropractic circles, nomenclature for technique is not well standardized.

However, whenever possible we should try to use a well-validated method of measuring their improvement. For case studies, it may be possible to use data from visual analogue scales VAS for pain, or a journal of medication usage. It is useful to include in this section an indication of how and why treatment finished. Did we decide to terminate care, and if so, why? Did the patient withdraw from care or did we refer them to another practitioner? Discussion: In this section we may want to identify any questions that the case raises.

It is not our duty to provide a complete physiological explanation for everything that we observed. This is usually impossible. If there is a well established item of physiology or pathology which illuminates the case, we certainly include it, but remember that we are writing what is primarily a clinical chronicle, not a basic scientific paper. Finally, we summarize the lessons learned from this case. Acknowledgments: If someone provided assistance with the preparation of the case study, we thank them briefly.

It is neither necessary nor conventional to thank the patient although we appreciate what they have taught us. It would generally be regarded as excessive and inappropriate to thank others, such as teachers or colleagues who did not directly participate in preparation of the paper. References: References should be listed as described elsewhere in the instructions to authors.

Only use references that you have read and understood, and actually used to support the case study. Do not use more than approximately 15 references without some clear justification. Try to avoid using textbooks as references, since it is assumed that most readers would already have this information. Also, do not refer to personal communication, since readers have no way of checking this information. Legends: If we used any tables, figures or photographs, they should be accompanied by a succinct explanation.

A good rule for graphs is that they should contain sufficient information to be generally decipherable without reference to a legend. Permissions: If any tables, figures or photographs, or substantial quotations, have been borrowed from other publications, we must include a letter of permission from the publisher. Also, if we use any photographs which might identify a patient, we will need their written permission.

In addition, patient consent to publish the case report is also required. Introductory sentence: e. This 25 year old female office worker presented for the treatment of recurrent headaches. Describe the essential nature of the complaint, including location, intensity and associated symptoms: e. Her headaches are primarily in the suboccipital region, bilaterally but worse on the right. Sometimes there is radiation towards the right temple. She describes the pain as having an intensity of up to 5 out of ten, accompanied by a feeling of tension in the back of the head.

When the pain is particularly bad, she feels that her vision is blurred. Further development of history including details of time and circumstances of onset, and the evolution of the complaint: e. This problem began to develop three years ago when she commenced work as a data entry clerk.

Her headaches have increased in frequency in the past year, now occurring three to four days per week. Describe relieving and aggravating factors, including responses to other treatment: e. The pain seems to be worse towards the end of the work day and is aggravated by stress. Aspirin provides some relieve. She has not sought any other treatment. Include other health history, if relevant: e. Otherwise the patient reports that she is in good health. Summarize the results of examination, which might include general observation and postural analysis, orthopedic exam, neurological exam and chiropractic examination static and motion palpation : e.

Examination revealed an otherwise fit-looking young woman with slight anterior carriage of the head. Cervical active ranges of motion were full and painless except for some slight restriction of left lateral bending and rotation of the head to the left.

These motions were accompanied by discomfort in the right side of the neck. Cervical compression of the neck in the neutral position did not create discomfort. However, compression of the neck in right rotation and extension produced some right suboccipital pain.

Cranial nerve examination was normal. Upper limb motor, sensory and reflex functions were normal. With the patient in the supine position, static palpation revealed tender trigger points bilaterally in the cervical musculature and right trapezius. Motion palpation revealed restrictions of right and left rotation in the upper cervical spine, and restriction of left lateral bending in the mid to lower cervical spine.

There were no carotid bruits. Describe as specifically as possible the treatment provided, including the nature of the treatment, and the frequency and duration of care: e. The patient undertook a course of treatment consisting of cervical and upper thoracic spinal manipulation three times per week for two weeks.

Manipulation was accompanied by trigger point therapy to the paraspinal muscles and stretching of the upper trapezius. Additionally, advice was provided concerning maintenance of proper posture at work. The patient was also instructed in the use of a cervical pillow. The patient maintained a headache diary indicating that she had two headaches during the first week of care, and one headache the following week. Furthermore the intensity of her headaches declined throughout the course of treatment.

Describe the resolution of care: e. During the last week of care she experienced no headaches and reported feeling generally more energetic than before commencing care. Following a total of four weeks of care 10 treatments she was discharged. Synthesize foregoing sections: e. The distinction between migraine and cervicogenic headache is not always clear. However, this case demonstrates several features ….

Summarize the case and any lessons learned: e.

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