CASESTUD Revised for 10th Tri

7/28/2019 CASESTUD Revised for 10th Tri

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Writing Your Case ReportLisa Zaynab Killinger, DC

Palmer Center for Chiropractic Research


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RememberA case report describes the

identification, management, orunusual presentation of a

condition or clinical scenario.


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Case Reports...

Should educate or share important

experiences with others

Are the foundation for future studies

Are healthcare story telling


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Choosing your Case

An unusual occurrence or presentation

An unexpected outcome (The Good, the Bad,

or the Ugly!) A new approach to an old problem (If you

used an uncommon technique, or added a new

intervention, etc)


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Stay within the limits of Case

Reports in your writing:

Not generalizable

Describes what happened in one

case, nothing more.

Does not rule out placebo effect

Does not prove effectiveness of

treatment


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Building Your Case Report:

Abstract Introduction

Methods/Case Report* Intervention and Outcome

Discussion

Conclusions


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Introduction

Introduces the case/condition of interest

Reviews and cites the scientific literature on

the topic (Chiro./Non-chiro. Lit.)

States the etiology/common txs./prognosis Includes recent, high quality references

(articles are better than books!)


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Did you answer:

What is known about the

condition of interest?


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Case Report or Clinical

Features Section

Describes the history and exam of the

patient

(Thoroughly enough to convince the

reader that you arrived at the

appropriate clinical impression and

management plan!)


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Did you answer:

How did patient present, what

were your exam findings, and

what was your clinicalimpression?


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Methods or

Intervention &Outcome

This section must describe the caregiven in enough detail that the

reader could easily duplicate the

care. (And, hopefully, duplicate

your outcomes!)


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Did you answer:

What did you do, when,

and how?


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The Outcome Piece

Describe the changes observed in the pt.

Lists results on outcome measures used (I.e:

Rand-36 or Visual Analog scores)

Describes changes in health status, pain,

symptoms, unexpected results, etc.


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Visual Analog Scale :VAS(Global Well-Being Scale, etc.)

or Verbal Analog Scale

Simply a 10 cm. line


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Rand-36

(SF-36)

A 36 question survey; patient fills it out

A valid and reliable measure of the patients

general health status

A shorter 12 question form is available Offers a great deal of information on patients

emotional and physical well being, energy,

pain, etc.

Th O t


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The Outcome

(Results) Section

Answers:

How did you documentchange (positive or negative

results) in this case?


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Discussion Includes:

Interpretations of your findings

Comparison of your case with other studie(The ones cited in your intro!)

Rationale for management plan

Discussion of limitations/flaws in yourstudy

Discuss possible reasons for the results

you observed (other variables,placebo, etc


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The Discussion Section

Answers:

How does your caseconfirm/refute previous studies

on this topic, and why did you do

what you did?


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Conclusions

Tells the reader what was learnedthrough this case

Describes why the case is significant

Suggests a direction for future

studies.

Dont make unsubstantiated claims!!!


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The Conclusion

Section Answers:

What is the next stepin studying this topic?

H t ill b


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How your case report will be

judged for quality :

Use of outcomes assessments

Lengthy follow-up

Discussion of its limitations! (If

you dont, we will!)


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More Measures of Quality:

Thorough description of methods

Discussion of the placebo effect

Good quality, recent references!!


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A Word About References

References should be numbered in the

order they appear in the article

References need to be listed

immediately following any phrase) from

another author or article. All statements of fact MUST be

referenced.

Research articles are preferred, thentextbooks, then manuals, popular press

articles, etc.

Style Scientific


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StyleScientific

Pulications/Articles

Authors Last name then first initial, other authors Title of article (onlyfirst letter capitalized) Name of

Journal(using standard abbrev and italicized)year of publicationvolume number and issuenumber (issue # in parentheses)page

numbers


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Hurwitz EL, Coulter ID, Adams

AH, et al. Use of chiropracticservices from 1985-1991 in

the United States and

Canada.Am J Public Health.

1998;88(5):771-776.


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Style-Textbooks

Author last name and first initialNameof Book(Italicized; with each main word

capitalized) Edition number

City/country of publication

Publishers name Year of

pubication page numbers


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Peters T. The Pursuit of Wow!New York:Vintage

Books;1994.


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Some things NOT to do when

writing your case report...


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DONT

Write as if you are promoting your technique,product or clinic (case reports are notadvertisements)

Submit without you AND others proofreading

your paper Use patients or doctors name

Try to generalize

Say that you proved effectiveness of

chiropractic!


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Whats wrong with this picture?

Find it and Fix it!


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...This case studydemonstrates that chiropractic

is an effective treatment for

multiple sclerosis.


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...In this case, chiropractic

adjustments to the upper

cervical spine were effective

in resolving the infantile colic.


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Asthma is the most common

chronic condition in children,responsible for staggering

healthcare expenditures, and

thousands of deaths per year

in this country alone. (?)


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The cervical films showed a

C3 PRI.

Wh t h ?


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What goes where?

For each sentence thatfollows, decide into which

section of the case study (e.g:

methods, intro) it would most

appropriately fit.


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In this case, we observed adecrease in the number and

severity of headaches..


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Asthma is the most common

chronic condition in children,responsible for staggering

healthcare expenditures, and

thousands of deaths per year

in the United States alone. (2)


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Recent studies have shown

chiropractic care to be aneffective treatment for chronic

tension-type headaches. (13,

14) The results observed inthis case, confirm the findings

of these earlier studies.


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Pace Yourself

This week and next: Choose your case As soon as you choose, start writing

intervention and outcomes sections (from thepatient file)

Allow yourself at least 10-20 total hours tocomplete this case report

Start collecting articles/references on the topicof your case for your intro section (need atleast 5-15)

As soon as you have articles, start circlingsentences to use in your paper (statementsfrom the intro and the results)


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Dont forget your abstract!

Written last; after the paper is done. Includes a main idea/sentence or two from

each section: Intro, Intervention, Outcome,

Discussion, etc.

Should be brief and succinct

Catches readers attention

(Answers: Why should you want to read

this paper?)


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Remember

This is NOT Dr. Killingers assignment Dont come ask me about due dates, page

lengths, grading criteria, etc.

Dont turn your paper in to me!! All questions about the assignment should be

directed to your CCC instructor.

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CASESTUD Revised for 10th Tri

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