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Focus and Value Added: The New Case Report

kfitzger{at}pitt.edu

In the early 1990s, Editor in Chief Emeritus Jules Rothstein, PT, PhD, FAPTA, and the Physical Therapy (PTJ) Editorial Board recognized the need for more case reports in the physical therapy literature. Descriptions of physical therapist practice were relatively few in number and often lacking in credibility and replicable detail. Rothstein and the Editorial Board viewed case reports as an important venue for sharing the experiences and challenges that physical therapists faced in clinical, managerial, and educational environments and for describing the creative ways in which physical therapists dealt with those experiences and challenges. The editors also realized that physical therapists needed guidance in how to tell their stories effectively.

In 1996, APTA published Writing Case Reports: A How-to Manual for Clinicians, a step-by-step "field manual" that guided potential authors through the process of writing and submitting a case report. Edited by Irene McEwen (with contributions from Vincent Basile, PT, MS, Gail Jensen, PT, PhD, FAPTA, Daniel Riddle, PT, PhD, FAPTA, Lisa Riolo, PT, PhD, NCS, and myself), the manual became one of the most popular reference works offered by APTA. More than 100 case reports have been published using these guidelines, and we believe the quality of case reports improved dramatically during the 10 years following the manual's debut.

Over the years, we have received feedback from readers as well as from authors of case reports. Some have commented that many case reports are too lengthy, containing details on aspects of the case that may not necessarily relate to the main purpose originally intended by the author—and thus defusing the primary message. Others have commented that the technical details about procedures are adequate, but the clinical reasoning underlying the selection and use of the procedures is not always clearly expressed.

Based on this feedback, we have decided that it's time for case reports to evolve to the next level. The general format of case reports that has been used by PTJ since 1996 will not change, as we believe it remains an excellent template for organizing these manuscripts. What's new:

• There will be a 3,500 word limit to bring the length of case reports in PTJ in line with case reports in other health care journals. Tables, figures, and online-only appendixes will be encouraged to allow for detailed descriptions of examination and intervention procedures for those readers who want them.
  
• Because there are so many different aspects of physical therapy that could be described in a case report, a "one size fits all" format is not realistic. Therefore, we have established the "focus-based case report," with a format that allows authors to provide detail on aspects of the case that relate directly to the main focus or purpose. Focus areas include diagnostics/prognostics, clinical measurement, interventions, application of theory to practice, risk management, and administrative/educational processes. Authors will be required to state their focus and follow the format specific to the focus; the guidelines can be found at http://www.ptjournal.org/misc/ifora.dtl. In addition, reviewers will be instructed to review case reports in accordance with the focus-based format of the case, thus making the peer-review process more efficient.
  
• To augment the description of the clinical reasoning behind various aspects of the case, authors will be required to discuss clinical impressions and implications throughout the report. For example, in an "Initial Clinical Impression" subsection after the patient history, the author would reflect on the information obtained so far; state what he or she believed to be the primary problem and diagnosis at that point and what differential diagnosis needed to be addressed; and, based on those thoughts, describe the plan for the next action to be taken—the examination. Clinical impressions also would be given after the examination section and throughout the intervention section.
  

Editor in Chief Rebecca Craik and I believe that these "upgrades" will help authors share their cases even more effectively than before. For our readers, the new format should increase the usefulness of the information and the sheer enjoyment of reading their colleagues' stories. We are grateful for the feedback that we have received over the years from the physical therapy community on the quality of our case reports, and we encourage readers to let us know what they think of the upgrades and to make further suggestions as we move forward.

	Footnotes

 
Special thanks to Irene McEwen, PT, PhD, FAPTA, for her insights as we move forward and to Tara Jo Manal, PT, MPT, OCS, SCS, John Childs, PT, PhD, MBA, OCS, FAAOMPT, and Patricia Ohtake, PT, PhD, for their thoughtful contributions and assistance in developing the new formats.

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This Article Extract Full Text (PDF) Submit a response Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Fitzgerald, G K. Search for Related Content PubMed Articles by Fitzgerald, G K. Related Collections All Editorials Social Bookmarking                      What's this?