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A Tutorial for Case Studies

Writing a Commentary for A Peer Reviewed Research Journal

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It takes time and effort to create your paper and submit it for consideration to publish in the Journal of Vertebral Subluxation Research.  You can take a great step for the advancement of scholarly activity and research in chiropractic.

So You Want to Write a Case Study?
A Tutorial

We at JVSR put together this overview and tutorial in an effort to encourage practitioner based research. The first part is an overview about what you can do as a field doctor and why you should do it and the second part is a step by step tutorial on how to write a Case Study.

Introduction

Many times you must have read a case study in a chiropractic research journal and said, "I had a patient just like that!"  How often have you witnessed the power of the adjustment in your own office and wished you could share the details with the entire profession? Case studies are an essential part of chiropractic research and journals are always looking for well-prepared case studies from field doctors like yourself. Read on if you want to join the ranks of the published authors in our profession, and contribute to chiropractic at the same time!

Research isn't just for ivory-tower scholars.

This is the first thing to realize. Our colleges, research facilities and organizations are important , but chiropractic research cannot progress without the input of independent field doctors. The reports they provide to our scholarly, peer reviewed journals represent a significant contribution to chiropractic research literature. The practitioner is where the rubber meets the road and is the place where everything we are about as a profession takes place.

What kind of research can you possibly do in your own office?

Among our most valuable research tools are the patients who walk through your doors and we need reports from the field about the people you are taking care of and how they respond to what you do. Studying how chiropractic helps them in their specific situations can teach us a great deal. It is because case studies are so vital to chiropractic research that reports from field doctors about cases they've handled in their offices are published in many major research journals.

For instance one doctor recently cared for a young girl who suffered form dysmenorrhea. His case study, published in a major research journal, detailed the case and the positive changes documented in this patient while under chiropractic care. Another paper discussed the management of a case  of knee pain in a 35 year old male patient.  These are the same types of patients with the same health situations that you probably see in your own practice every day, responding in similar ways to subluxation correction.

Imagine if 100 chiropractors reported successful results following subluxation reduction in a patient who had AIDS, or ear infections or whatever. Those 100 case reports collectively represent data that can be used to educate patients, government, third parties etc., on the merits of subluxation-based chiropractic. And don't feel that your case must include some dramatic life threatening illness that the patient recovered from.  Case studies are needed on every aspect of chiropractic care.

Also, it's very important for you to remember that your case study can be solely about the reduction or correction of subluxation in your patient and does not have to be about the amelioration of some other disease or condition. It's important for chiropractic research to focus on subluxation reduction and correction as an outcome in and of itself. After all you  might have a wellness patient without symptoms or other disease manifestations  who experiences an improvement in quality of life as a result of the correction of their subluxations.

How can doing these case studies help you?

Naturally, the most important thing is that you'll be contributing to your profession's growth and vitality. By sharing information about the cases  you encounter in your practice, you will be helping your colleagues better understand how they can best serve their patients. Imagine if every one of the 50,000 practicing chiropractors in our profession were to write just  one case study, We'd have a great deal of literature supporting and documenting what we do.

But there are several other more direct benefits to you. Being published in a professional or scientific journal carries a great deal of prestige. Take a look at the resumes of doctors who are invited to speak at community presentations, appointed to board positions, hold office in your association, get to work with sports teams or big corporations. Chances  are, you'll see a listing for "Publications."  Being a published research author is often what sets some doctors apart and gives them a vital edge over equally qualified colleagues.

The public also puts great weight on being published. If patients and prospective patients learn that your research report was published in a major chiropractic or other professional journal, it will almost surely increase your credibility and standing in their eyes.

Where do you begin?

Many doctors are in the same situation. They see interesting cases in their practice, keep excellent notes and document their case management and outcomes -- but they don't think they have the experience or background needed to turn that data into a publication quality manuscript which can be submitted to a journal. This is where they are wrong.

If you graduated from college you have had plenty of experience writing papers. The problem is that publishing in a journal is unfamiliar territory and as you know there are lots of rules to follow. This need not be a barrier since a good editor should be willing to help guide you through the process.

What follows is an outline of the components of a case study article. It is followed by links to several case studies that have appeared in JVSR. You can use the outline and the case studies to write up your own case study. Once you have it written you are more than welcome to forward to me, Dr. Matthew McCoy, the editor of JVSR (editor@jvsr.com) and I would be happy to review it and walk you through the rest of the editing process. If you'd like you could also contact me prior to beginning in case you had any questions or wanted to know whether or not your particular case would make  a good case study article. You can also look at examples of case studies from other health related journals in libraries or on the web to get ideas and guidance on how to organize and write your case study.

TUTORIAL SECTION

HOW TO ORGANIZE AND WRITE A CASE STUDY

Below, I have indicated the major sections appropriate for a chiropractic case study and have indicated the information, which should be contained in each, and how it should be organized.

A case report could include the following headings and or categories:

1. Abstract
2. Introduction
3. Case report
4. Discussion
5. Conclusion
6. References

THE ABSTRACT

The abstract or synopsis summarizes the main points of the case study including (1) the purpose of the case report. (2) The basic procedures followed. (3) The main findings and (4) The principal conclusions.  The abstract might include the following types of information:

• Objective-Why is the case study being presented?

• Clinical features-This should be a brief overview of the patient's presentation & diagnosis.

• Intervention and Outcomes-This is a brief overview of what was done and  What happened as a result.

• Conclusions-This is a brief statement of what you feel the significance of the case is.

Read several abstracts in JVSR to get an idea about how these are worded  And the information they contain.

THE INTRODUCTION

This discussion should give the reader a general overview of the topic you are about to discuss relative to your case presentation. It could consist  of one to two paragraphs as to why this case is important. If you were writing about the effects of subluxation reduction on a child with cerebral palsy you might want to discuss the condition in general. The same would be true with more mundane topics as neck pain, headaches and other neuromusculoskeletal conditions.

THE CASE REPORT

This section should detail the pertinent history, chief complaint (if there was one) and exam findings regarding the case under discussion.  You should discuss what type of care was instituted and the results of that care. This is one of the most important parts of a case report.  Document the care in such a way that the procedures performed are readily identifiable.    Describe progress from one visit to the next.

Give biographical information about the patient if appropriate. You want to describe the type of methodology you used to find and characterize the subluxation(s), the techniques you used, the type of subluxation(s) addressed and the levels.

And again remember that your case study can be solely about the reduction  Or correction of subluxation in your patient and does not have to be about the amelioration of some other disease or condition. It's important for chiropractic research to focus on subluxation reduction and correction as an outcome in and of itself.

So in a case like this you want to discuss the findings that led you to  Your diagnosis of subluxation in that patient and how those parameters improved following administration of care. For example, maybe you are an upper cervical practitioner and rely on the use of radiographic mensuration, leg checks, and thermography as subluxation indicators and outcome assessment.  Discuss your findings pre and post adjustment or throughout the duration of care.

THE DISCUSSION

This section could include a more detailed discussion of the condition under investigation.  A brief or more extensive review of the literature would be appropriate as well as a review of the literature relative to common treatment protocols. Review any chiropractic literature related to this condition. Perhaps others have written on the topic and have seen similar results as you. You could conclude this section by making hypotheses regarding the literature and your experience with this case.

THE CONCLUSION

This should be a concise discussion of what you concluded as a result of your review of literature and your experience in this case as well as the significant features of the case. Discussion of the clinical importance of the case can also be presented here.  A statement regarding limitations of your study and the prospect for future research could be included here.

REFERENCES

List all relevant references that support your case study report and the statements made therein. Although initially appearing tedious, guidelines exist on how to list the references and once you get going it's pretty simple and straightforward. Consult The Journal of Vertebral Subluxation Research website for guidelines on how to lay out your reference section  and look at some previous articles for examples.

While the task of sitting down to write a case study may seem daunting at first it becomes less so once you start putting it together. I encourage  you to start, put everything down you think belongs there and follow the outline above as much as possible. Don't worry about making it perfect yet. Start with a title. Then enjoy the accomplishment of having completed that since this will inspire you to continue with the Abstract. Then enjoy overcoming that hurdle and continue on with the rest. If you get stuck on a section, skip it and start on another. And once you've gotten to a point where you don't think you can take it any further, contact me and we'll see what we can do together. And of course you can contact me at any point along the way. Don't wait another minute, get started today!

Suggested Examples for Case Studies

Structural Changes in the Cervical Spine Following Spinal Adjustments in a Patient with Os Odontoideum: A Case Report
Graham J Dobson, D.C. Bio 
Abstract

Cervicothoracic Subluxation and Hot Flashes in a Perimenopausal Subject: A Time-Series Case Report
Marion Weber, D.C. Bio, and Charles S. Masarsky, D.C. Bio
Abstract

Conferences: Sherman College
Improvement in Paraspinal Muscle Tone,  Autonomic Function and Quality of Life in Four Children with Cerebral Palsy Undergoing Subluxation Based Chiropractic Care: Four Retrospective Case Studies  [October 2000, Vol 4, No. 1]
Dr. Matthew McCoy Bio, Dr. Ekaterina Malakhova Bio and Dr. Yuri Safronov Bio
Abstract |  Subscriber Full Article | Site License