Define case report
- AKA clinical case report
- description of clinical practice usually on a specific individual
- non-experimental
- retrospective (most of the time) or prospective
Define single subject design
- prospective
- extended baseline (helps show stability in their baseline before treatment)
- controlled conditions
Define case study
- qualitative design
- experimental
What is the Hierarchy of clinical research design
- meta analysis
- systematic review
- RCT
- cohort study
- outcomes studies
- case control study
- cross sectional study
- case series
- case report
Case series vs case report
- case series usually has multiple subjects
- case report usually has one subject
What is the purpose of a case report
- share clinical experience
- illustrating EBP
- develop or build foundation for future research
- build problem solving skills
- test theory
- persuade and motivate
- help develop practice guidelines and pathway s
What do case reports do
- help bridge the knowledge and clinical care gap
- describe important clinical learning and how it can impact clinical practice
- encourage reader and peer engagement
What are the different types of case reports (5)
- differential diagnosis
- critical decision making
- MsK imaging
- innovative interventions
- unique pathological presentations
Case reports are mostly what type of design
- retrospective
- this highlights why it is important to document and the outcome measures
Why is it important to use proper outcome measures and special tests
- use established outcome measures and tests because you never know when a patient case will be unique and useful in a case report
Why are outcome measures important in case reports
- helps discriminate among patients
- helps assess change over time properly
- with proper baselines can show stability before therapy
What is the impact of using a case report
- can change clinical practice and help create a framework for treatment
- suggests area for further research
Why are case reports not very generalizable
- poor internal validity because focused on a specific patient
- single person can’t be generalizable to the larger population and vice versa
What are the quality guidelines for a case report
- no guidelines exist
- BUT ICF model can provide structure
How is the ICF model helpful in case report s
- provides framework to help describe a particular patient for a case report
What is the general structure of a case report
- intro/background
- methods/case description
- results
- discussion and conclusion
What is included in the introduction/background
- relevant literature review (on the patients condition or intervention)
- identify the knowledge gap to show the purpose of the case report and convince readers on the importance of the study
What is included in the methods/case description
describing the patient through:
- demographics
- past medical history (relevant and concise)
- unique presentation/diagnosis
examine the data and describe the evaluation process
How do you examine the data
- contrast other available options and why that specific test or intervention was used
- was it reliable and valid
Why do we describe the evaluation process
- describing the clinical decision making process can help provide framework for treatment
What are 2 ways to improve the readability of a case report
- present information in chronological order so its logical and easy to read
- avoid information that is not relevant to the case
Explain the differential diagnosis piece in case reports
- describe how the PT diagnosis was determined
- describe relevant findings
- present a clear rational for the diagnosis
Describe the treatment section in case report
- detail relevant aspects of care
- clinician or researcher should be able to reproduce the intervention
- document similar to a clinical note
What is in the results section
- describe the outcomes (facts only)
- consider using tables or graphs to help the reader
