How To Write a Case Report: The Introduction Section

By Jerrilyn Cambron, LMT, DC, MPH, PhD
July 16, 2012

How To Write a Case Report: The Introduction Section

By Jerrilyn Cambron, LMT, DC, MPH, PhD
July 16, 2012

As a massage therapist, you are on the front lines of client care. Aside from caring for clients, many practitioners would like to get involved in the research efforts, but they just aren't sure how. But you can shape the research that is being conducted in the scientific community by writing a case report based on a client within your own practice. You do not have to be a scientist or researcher to contribute to the body of knowledge within your profession. Case reports are the perfect way for you to get involved.

A case report is an article in a scientific publication that describes a practitioner's experience with a particular case. At times, researchers read such cases and become inspired to pursue bigger studies on the topic. But to get a case report published in a journal, these reports must be written based on the journal's instructions to authors. We have previously discussed this and several other important preliminary steps in "Writing a Case Report: Where to Start" in the March 2011 issue of Massage Today.

Research articles are usually divided into sections (introduction, methods, results, discussion and conclusions). Case reports have a similar structure, except instead of methods and results sections, a case report has a "presentation of the case" section instead. Each section of a research article has a specific purpose and certain elements are expected to be present. The introduction section is the initial section that "introduces" the reader to the topic of the case. This section usually includes three parts: a brief discussion on previous research on this topic (if there is any), the significance of this case to the health care field and the objective of the case report.

The first part of the introduction is an overview of the previous research conducted on this topic. It is important to be aware of any previously published studies that might have been written, including other case reports. If other studies are published, you might need to consider whether or not your case adds to the literature so I recommended that a thorough literature search is done before you begin writing. There are many resources for finding additional literature on the topic of your case. PubMed.gov is one of the best resources because this site is run by the National Library of Medicine and includes abstracts from thousands of scientific journals from around the world. If you haven't used PubMed before, there are wonderful tutorials on their site that will help you find your way around. You could also ask your local or university librarian for help.

The best research citations to use in your introduction would be relatively new (within the past five years), from a scientific journal such as the International Journal of Therapeutic Massage and Bodywork (www.IJTMB.org) or the Journal of Bodywork and Movement Therapies (www.bodyworkmovementtherapies.com), and covering the same or a similar topic. Typically journals do not allow you to include citations that are from a magazine, website, course or interview. Sometimes there are topics that do not have any published information on massage as a treatment option for the condition you intend to write about. In these situations, you might want to include references on the standard of care for that condition. Or you might want to include references on massage therapy for a similar condition, even if it is not the exact same condition. Ultimately, the introduction is written for the reader to get a better understanding of what is already in the literature about the condition of interest, how this condition is usually treated and perhaps why massage would be a possible alternative.

Along with some background information, the introduction should also include the significance of the case. You need to make sure the readers understand why this case is important. Actually, the significance may differ based on who your readers are. If you are writing a case report for a massage therapy journal, the case may be significant because you are describing treatment for a condition commonly seen in a massage practice. If you are writing a case report for a medical journal, the case may be significant because massage is a conservative treatment option not usually considered. Other possible reasons why the case report might be significant could be based on number of people who suffer with the condition on an annual basis or the amount of money that is spent each year on the condition. There are many different reasons why an article would be significant and it is your job to make sure the readers understand even if you think it's obvious.

The final part of the introduction should be the objective of your case report. This is usually the last sentence of the introduction, right before the start of the case description. The objective is a statement that clearly states the reason for writing your case. For example, a case report objective might read, "The purpose of this case report is to describe the decrease of pain and numbness in a client with bilateral carpal tunnel syndrome after six weeks of massage therapy."

There are several things that should NOT be included in an introduction to a case report. First, you want to introduce the topic not discuss the actual case. Therefore, you should not include details about your client until the case description section. The introduction should only give the background on why this case report was written and some background on the condition of interest. Second, be sure that you do not overstate the importance of this case or the findings. You want to remain neutral and not make sweeping statements such as, "This case will prove that massage therapy is beneficial for all patients with low back pain." Finally, to repeat a very important previous point, be sure that the references cited are scientific publications. Other sources of information are usually not acceptable.

Overall, writing case reports is a great way for massage therapists to get involved in the research efforts. The next article in this series will discuss what you should write in the case description section of the report.