A case report is one of the easiest pieces of literature to write.  Unfortunately, it may be one of the most difficult pieces to get published.  Many journals no longer accept case reports leaving clinicians to turn to journals specifically created to publish case reports.  These journals frequently publish on an open access model, meaning that authors must pay to have their work published.  However, case reports can present a great opportunity to hone clinical writing skills and the work can be used in posters and presentations at conferences, even if not published.

A case report discusses the management of one or more patients with unusual medical conditions or in unusual circumstances.  Multiple cases of unusual circumstances can be considered a case series (i.e. a mumps outbreak).  Residents may come across these circumstances frequently as they begin practice and less frequently as they see more cases. 

 Basic steps to writing a case report are outlined below:

• Any unusual case should first elicit a literature search. The amount of literature found will give you a good idea as to the value of the item as a case report.  
• Check with the other residents working with the same patient, including those on different services, and attending clinicians.  Most journals will require an attending physician be included on the paper.  Case reports frequently limit the number of authors, so you may need to discuss who will write up and try to publish the case.
• Most published or presented case reports now require proof of patient permission to publish. If you come across something interesting, get a signed statement of permission to use the information from the patient while you are still seeing them. Either way respect patient's wishes on whether or not they want their case published.  
  • Generic patient permission at the bottom of this section.
• Components of a case report: one concisely worded page limited to 1,000 to 1,500 words.  Check the journal-specific publishing guidelines for detailed information.  

Case reports have five possible sections:

• Title - Be descriptive, but concise.
• Abstract - Not always required.  If required, abstract would be 100 word summary of the case to include the clinical question or diagnostic problem followed by why it is important and the outcome.
• Introduction:  State objective and incorporate literature review.  Describe why this case is novel or deserving of attention.  Number of sources may be limited to 3-10 articles.  Since by definition case report is unusual, your literature search may not focus on your exact case, but rather an aspect of your case.  Introduction can be used to contrast what is known and normal to what you are seeing.
• Case:  Report on the patient demographics, their presentation, assessment (lab and diagnostic results), outcome measures, and treatment, as applicable.  Keep details limited to those important to the case.  
• Discussion/Conclusion - Briefly sum up the case and what was learned in one paragraph. 

One or two relevant visual aids (photos or imaging) may be useful to your case. Do not include, if they do not add to the case.

Now that you've got the basics of writing a case report, you're probably eager to start writing about that super interesting patient you just had, but before your fingers start typing, here is a hot tip to save you time and maybe a headache in the future...

Start by picking the journal that best matches your case topic

I know it feels backwards but trust me and thank me later. When picking a journal look for:

- Cost. Is there an associated fee to publish with this journal? If yes, check with your department to see if there is funding to cover the cost.

- Consent. Does this journal require patient consent in order to publish?

- Word Count. Some journals have limits on report length; don't get carried away and realize you need to chop your report down.

- Format. Journals can be picky on how the case study or its citations are formatted.

You're busy! This advice is the epitome of "work smarter, not harder", know who you're writing to before you start. As always, reach out to a librarian liaison or the writing center for help.

Find more information in an interactive video format provided by Dr. Steven McKee, Internal Medicine, UAMS. Click the image below to proceed or click here: 

https://rise.articulate.com/share/dRKhLTA4L55oKSwjKrnoRyuRP1HPNfN6#/

If you are completing a case series, a case report containing information from 4 or more patients, you will need to submit a human subjects research form through CLARA for an IRB review.  More information on CLARA and the IRB can be found in the Research section of this guide.

A very complete listing of journals accepting case reports as well as advice on how to choose a journal is provided in the article below:

How to choose the best journal for your case report

In general:

• Ask senior and/or published clinicians in your field for suggested journals.
• Do an online review of possible journals, or contact your library to assist with this, or look at the list included in the article above.
• Once you have found a journal, review the requirements. Many newer case report journals are based on the open-access model.  This means your article will be freely available to all, but you will need to pay for publication. If this is not a problem, do a further review of the publisher. 
  • Is the journal peer-reviewed? 
  • Can you navigate the publisher site to easily find what you need? 
  • Is the site complete? 
  • Is the journal indexed in PubMed? 
  • What is the impact factor? (New journals will not have one)
  • What are the costs? 

If in doubt, contact the library for a review of the journal before submitting.​

Possible Journal Options: While this is not exhaustive, it is a good listing of possible journals that accept case reports in a number of fields:

• General listing: http://libguides.gwumc.edu/casereports