Writing Case Reports for GCSS
Below are two articles - one offering tips for selecting interesting case studies and one with specific instructions on how to write a case report.
How To Write A Case Report
Steven T. Tanaka, DC, Publications Committee
Case reports are the foundation of scientific writing in health care. In my research when I am writing papers and from the requests for papers from other chiropractors, I find that case reports are very important to the practicing chiropractor. There are numerous articles for writing case reports for peer-reviewed journals and are “must reads” when learning to write case reports that can be submitted to these journals. A few are listed at the end of this article.
For The ‘G’ Note and the GCSS web site, our rules for writing case reports are much less stringent, as you might have seen from those that we have published. Our goal is for as many Gonstead chiropractors to submit the cases that they would like others to read and learn from without being intimidated by the complicated procedures that are required for peer-reviewed journals. On the other hand, we want to present enough information for the reading clinician to get a clear picture.
We are looking for both cases which you successfully helped and those you didn’t and might have even referred out. We are also looking for cases that you might consider ordinary or routine, as these are rarely presented, but we often see patients with these presentations.
This is the minimum that we would like if you want to submit a case study for the newsletter and web site. We have removed some parts that are required for peer-reviewed journals and have emphasized some to provide a Gonstead perspective. If you absolutely cannot write, send us whatever you have, and we will work with it. If you would like the worksheet for writing GCSS case reports, contact me: STTDC@aol.com or firstname.lastname@example.org.
INTRODUCTION: This is a section that should be included if the case is unusual. It it is not too unusual, a sentence or two as introduction is helpful. Here you introduce the type of case, why you feel it is important to write about it, medical treatments, and any chiropractic literature that is available. If your ability to to literature searches is less than ideal, we can research and write this section up for you.
CASE REPORT: I will break this topic into sections.
Presentation: include the date the patient presented to the office, the age and sex of the patient, race if important, and any other important information about the patient. Next you describe how the patient presented and any relevant historical information.
Medical/Neurologic/Provocative-Orthopedic Exam Findings: give a summary of these findings.
Chiropractic Analysis Findings: present visual, instrumentation, palpation, and any other chiropractic findings. Include the level of instrumentation findings (you might mention the type of instrument you use, particularly, if you use an instrument other than a Nervo-Scope).
X-Ray/Imaging: State the x-ray views taken (e.g., AP and lateral full spine) and your findings. If there is disc thinning at the level marked, use the Gonstead D1-D6 disc degeneration system. Either take digital photos of your x-rays and send them on CD or send your x-rays to us, and we will digitize them (turnaround is within days).
Course of Care: Date of the initiation of care until an end date. State the segment(s) adjusted and how (e.g., L5 PRS-sp push, T8 PLI-T single-hand pisiform knee chest, or Atlas ASRP cervical chair). Give some idea of visit frequency and any changes to how you adjusted the patient or changes to what you adjusted. If any adjunctive care was used, such as, exercises, ice, and/or nutritional supplements were provided, please state what was used. You want the reader to have a good idea of the care that you gave. Also give some idea of what the patient felt during the care.
Post-Findings: Summarize post-findings. If post-x-rays were taken, please describe your findings. Compare the post-finding to the initial findings.
COMMENTS: This is where we diverge from “proper” case reports destined for peer-reviewed journals. They have separate discussion and conclusion sections. For our purposes, if you have any comments about the case, please note them here. We usually add a comment about the case.
Tips For Selecting Interesting Case Studies
Roger Coleman, DC—GCSS Director of Research
You've been hearing a lot about our wanting interesting cases that we can write-up into case studies for submitting to CHIROACCESS. So, we thought that a few tips might make the job of selecting cases a little easier.
1. Don't worry about it if you pick a case we can't use. We have to get started on this, and we need your help. So, if you have a case that you think is interesting or different, then contact Mark Lopes, DC and discuss the case with him.
2. This is really easy. If Dr. Lopes feels the case might work for our project, then you just have to send him a copy of the file. Be sure to remove the name of the patient or anything else that would identify the individual, such as, "He is the past president of the United States". That might give away their identity.
3. Dr. Lopes and I will write up the study, and we will involve you to the extent that you wish to be involved. If you want a lot of input, or a little, that's how we will work. We won't just write the case and send it in. We are collaborating, and this should be an interesting project for those who have not previously had this experience.
4. Do not write about, put on the web, discuss in public or otherwise put-out information about the case. We are writing it for publication, and no matter where we send the manuscript, it is important that it be handled correctly.
5. Wait until you have finished the bulk of treatment on the case before you contact us. You should not change your care in any way. We are here to work with you on the article after the case is mostly completed.
6. Think about it for a minute. There are probably lots of cases that have some feature that may be of interest to your fellow DCs.
7. Remember, this is for GCSS. So, if there was adjusting involved in the case, it needs to be in accordance with the Gonstead technique. It could be a case where you didn't treat the case for some reason, but there were still interesting features. Example: A case where you found a fracture, and the radiograph allowed you to avoid adjusting an otherwise unknown fracture.
8. Two years ago at Meeting of the Minds, there were presentations of a number of interesting cases. Any of those would have been good for this project, so I know you are seeing a lot of cases that we could use.
9. To spread the word about the Gonstead technique, we need to be in the public eye. You can help.
10. You may have a case that would be better suited for submitting to a journal other than CHIROACCESS. If that is the case, we can work together to comply with all the rules of a different journal.
11. Just be involved. You can learn a lot from this process, and at the same time, have an opportunity to inform and improve the members of GCSS and the profession as a whole.