WHAT'S A CASE STUDY?
As far back as the 1800s, case studies (also called case reports) became established as a popular tool for medical training. At that time, a case study was intended to accumulate knowledge of clinical issues, diagnostic methods, and treatments. They were primarily written to provide an educational message about the etiology and pathogenesis of diseases and disorders, as well as improvement of patient care. Today, case studies serve the same educational functions.
Any component of a written clinical note about a patient can form the basis of a case study, such as an unusual patient complaint, atypical test findings, a rarely encountered diagnosis, or even a novel treatment plan. Fundamentally, a case study should tell a succinct story about the patient that may be readily consumed by clinicians, students, researchers, therapists, allied health personnel, and, on occasion, manufacturer representatives. Although a bell curve is commonly used to represent patient outcomes on a distribution, we accept that, for various reasons, some patients lie somewhere on the tails of the curve. These outliers often become the subjects of case studies.
Audiologists frequently say, “Two patients with the same audiogram do not always have the same complaints.” The opposite is also true. Two patients with similar chief complaints and histories may, in fact, have very different diagnoses. These nuances may be captured in a well-presented case study. Clearly, not every patient experiences the same progression of hearing loss, vestibular disease, or tinnitus, or the same degree, type, and pattern of hearing loss or related disorder. Large clinical research studies are not practical for diagnosis and treatment of every clinical condition, particularly ones with multiple factors at play.1 Controlled experimental trials usually report group-level data that may not be applied to or clinically relevant for all patients. Indeed, statistically significant findings in a large research study of people with a particular disorder may have absolutely no clinical significance to the assessment and management of individual patients with the same disorder. In contrast, published case studies are invariably clinically relevant and instructive.
HOW TO GET PUBLISHED
A major advantage of a published case study is the modest manuscript length, especially when the subject is a single patient. In most medical specialties, published case studies are brief and about issues related to one patient. Audiology case studies tend to be more extensive with substantial literature review. Some even include multiple patients, or are included as part of a research report.
The challenge in preparing a case study is to concisely and briefly tell an adequately detailed clinical story about a patient. Overall, a case study must be no less than 750 words and no more than 1,400 words. Table 1 summarizes guidelines for submission of case studies for publication in The Hearing Journal. This should make the task of writing the manuscript more tolerable for audiologists. Clinicians will enjoy an article that is organized, succinct, and contains a compelling educational message. To reach this goal, a case study manuscript should include some or all the components described below.2,3
Published case studies are a practical and clinically useful venue for disseminating important information about the assessment and management of people with hearing loss and related disorders, including auditory processing disorders, tinnitus, disorders of decreased sound tolerance, and vestibular problems. Case studies allow us to highlight those unique differences and findings that we observe in our patients and our patient populations. A case study may serve as a training tool for students and junior clinicians. Used this way, they can enhance clinical learning, and serve as a catalogue of our experiences. Published case studies may be used to advance an audiologist's career. In some instances, a case study may stimulate research, such as large experimental studies. Finally, case studies may focus on actions taken in the clinic that demonstrate safer examinations and treatments of audiology patients.
1. Rison, R.A., J.K. Shepphird, and S.R. Beydoun, When to write a neurology case report. J Med Case Rep
, 2016. 10: p. 92.
2. Budgell, B., Guidelines to the writing of case studies. J Can Chiropr Assoc
, 2008. 52(4): p. 199-204.
3. Gurudatt, C.L., Case reports: Brief overview of reporting and submission to biomedical journal. Indian J Anaesth
, 2016. 60(9): p. 695-699.
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4. Yoshida, A., et al., Obtaining subjects' consent to publish identifying personal information: current practices and identifying potential issues. BMC Med Ethics
, 2013. 14: p. 47.