Writing a Case Report: Where to Start
LMT, DC, MPH, PhD
February 16, 2011
Writing a Case Report: Where to Start
LMT, DC, MPH, PhD
February 16, 2011
Over the past few years, many massage therapists have asked me how to write a case report. There is such a great need for more research in this profession, I wish I could meet their expectations and rattle off a simple answer, as though I am giving directions to my Aunt Diane's house. Unfortunately, it is not that easy. However, there are certainly many therapists who have written and published case reports, showing all of us that it is possible - with the right directions.
Case reports can have a tremendous impact on our profession: recognition in the public sector, acceptance in the medical community, and advancement in our treatments and client outcomes, to name a few.
Published case reports have the potential to improve nearly every aspect in the massage profession. This is the first article in a series on writing case reports for the massage therapy profession. Generally, case reports describe the diagnosis, treatment and follow-up of an individual patient, which we will cover in proceeding articles. However, to get you started on your path to authorship, here are five important steps to follow before you ever begin writing.
Five Steps Before You Write
First and foremost, you need to choose a case to report. While this may seem obvious, it can be somewhat daunting to narrow down. Consider what interests you. Think about which clients you enjoy discussing with your colleagues, such as the client who was not expecting improvement but who now considers massage therapy the "miracle cure". Perhaps you want to discuss the client who had a negative reaction with one form of health care, but then greatly improved after bodywork sessions.
There are also plenty of unusual cases that would be of interest. Perhaps a gunshot victim for whom you increased the mobility of some of his scar tissue; or the person with an amputation who felt "whole" again after massage. Or, perhaps you want to discuss the typical clients you treat so that there is more evidence in the literature on massage therapy for back pain, headaches, stress disorders, and such. You will be spending time with this case, so it is a good idea to choose one you enjoy discussing.
Second, you need to consider why you want to write about a case. Is it because the case was so unique that you want to tell your fellow massage therapists about it? Do you want to write because you want to inform other health care professionals about the improvements that occurred due to massage therapy? Are you hoping to increase your credibility by publishing a case report in a peer-reviewed journal? Were you looking for evidence on massage for a particular condition and could not find anything, so you want to help add to the evidence base? Do you want to win the Massage Therapy Foundation's case report contest? Or do you want to accomplish all of these?
Understanding why you want to publish will help your motivation levels as you work towards your goal, and you can use that energy to keep yourself moving through the process. Understanding what is motivating you to write a case report will also help you better define your audience.
Knowing your audience is the third major hurdle you need to consider before you start writing. For example, let's say you had a pregnant client with low back pain, and you were able to help manage her back pain throughout her pregnancy. Would you want to tell your fellow massage therapists about your treatment protocol so that they might be able to utilize your methods? Or would you want to tell obstetricians about the benefits of our non-pharmaceutical approach to pain reduction, such as in this case of a pregnant women with back pain?
Both aspects might be important, but they would be written very differently and, most likely, they would be written for different journals. In a journal that is focused on the massage profession such as the International Journal of Therapeutic Massage and Bodywork or the Journal of Bodywork and Movement Therapy, we would expect the article to include a more specific description of the therapy so that fellow massage therapists would be able to replicate the treatment. However, if the case was written for submission to an obstetrics journal, you might need to include a bit more background information, describing massage therapy for the pregnant woman because obstetricians may not know what their patients should expect from a pregnancy massage. Try to imagine who might be reading the journal, and write as though you are speaking directly to them.
Choosing the journal to which you want to submit your case report is the fourth issue to consider before you start writing. There are many ways to find the best journal for your case report. One way is to go to a medical library and look at the different journals. Another way is to search online.
There is a great online resource from the University of Toledo, Mulford Health Science Library (http://mulford.utoledo.edu/instr/.) This resource allows you to type in a keyword and find journals that include that topic. For example, using our case report on a pregnant woman with back pain, we could go to this Web site and type in the word "obstetrics." According to the Web site of more than 6,000 journals, 18 have a focus on obstetrics and the list is provided. If we type in the word "pregnancy" we get only two journals. The word "massage" doesn't produce any journals, but the keywords "alternative medicine" produces three journals.
The real beauty of this site is that you can click on the name of any of these journals and you will be taken to that journal's "Instructions to Authors" section. Instructions to authors can be considered the "rules of writing" for that journal. Every journal has different instructions for authors, and it is your job to make sure you know what the expectations are before you start writing. For example, one journal might allow a case report to be 3,000 words but another only allows 1,000 words. You will increase your chances of acceptance if you know the rules before you start.
Finally, I strongly suggest you read several case reports from the journal to which you intend to submit your case report. I suggest this because it gives you a flavor of how the article should be written. Try to pay attention to the article's style and formatting: section headings, the length, the number of figures or tables, and the style of writing. Published case reports went through the peer-review process and were found to be good enough to be published. If you want your case to be published in the same journal, your report needs to be of the same quality.
These five steps to take before you start writing your case report (choose the case, determine why you are writing it, know your audience, choose the journal, and read previous examples) might make the difference between getting your case accepted for publication and having it rejected.
In the next article, we will begin our discussion on how to write a case report.