Telling our stories of practice through the genre of the case report

Case reports are very well established in the literature. Despite the fact we live in an evidence-based age, in which the information that can be generated from a single case is positioned rather low on the hierarchy of evidence, case reports continue to be popular. It is the humanity of the accounts and the fact they are centered on the therapeutic encounter between a real patient and a treating clinical team that makes them so engaging and absorbing and that brings events to life and makes case reports such a valuable educational resource. There is quite a strong discourse in the literature around the genre of the case report and its value in capturing the uncertainty that can accompany the treatment of complex and unusual clinical problems, and the challenges that can arise for clinicians when anticipated outcomes do not occur. Case reports provide the means to record all manner of clinical events; including adverse events, rare and unusual clinical problems, and describe our roles and actions within them

Tracing data journeys through medical case reports: Conceptualizing case reports not as 'anecdotes' but productive epistemic constructs, or why zebras can be useful

Medical case reports provide an important example of data journeying: they are used to collect data and make them available for re-use to others in the field including clinicians, biomedical researchers, and health policymakers. In this paper, I explore how data journey in case reports, with particular focus on the earliest stages of the process, namely from creation and publication of case reports to the initial re-uses of them and data within them. I investigate key themes relating to case reporting and re-use, including factors which seem to smooth the path along which the data captured by a case report journey via broader citation patterns and detailed qualitative analysis of highly re-used case reports. This analysis reveals some of the key factors associated with the case reports whose data have greater amounts of journeying including publication in a general medical journal; that the data have broader implications and evidential value for topical or even urgent issues for instance in public health; and use in the case report of multiple research methods or concepts from diverse subfields. These findings along with standardization of case reporting are shown to have epistemological implications, particularly for how we understand the journeying of data.Rachel A. Anken

Advancing medicine one research note at a time: the educational value in clinical case reports

Abstract A case report—a brief written note that describes unique aspects of a clinical case—provides a significant function in medicine given its rapid, succinct, and educational contributions to scientific literature and clinical practice. Despite the growth of, and emphasis on, randomized clinical trials and evidenced-based medicine, case reports continue to provide novel and exceptional knowledge in medical education. The journal BMC Research Notes introduces a new “case reports” section to provide the busy clinician with a forum in which to document any authentic clinical case that provide educational value to current clinical practice. The aim is for this article type to be reviewed, wherever possible, by specialized Associate Editors for the journal, in order to provide rapid but thorough decision making. New ideas often garnered by and documented in case reports will support the advancement of medical science — one research note at a time.</p

Presentation with Recurrent Intractable Headache: A Patient with Moyamoya Syndrome—Case Report

This clinical case report represents an interesting manifestation of a neurovascular condition that can be easily overlooked by the practicing healthcare provider. In the United States, a Hispanic patient of non-Asian descent presented with atypical symptoms of intractable headache and nausea with no evidence of neurologic deficits. Further diagnostic work-up was performed as the patient was not responding to traditional analgesic medication administration. Ultimately, cerebral angiogram revealed vascular occlusion with collateral circulation consistent with moyamoya syndrome. Discussion of the challenges and available clinical guidance for healthcare professionals dealing with patients presenting with intractable headache are presented in this report

Key Organizational Characteristics for Integrated Approaches to Protect and Promote Worker Health in Smaller Enterprises

The aim of this study was to investigate relationships between worksite organizational characteristics (size, industrial sector, leadership commitment, and organizational supports) and integrated approaches to protecting and promoting worker health implemented in smaller enterprises. We analyzed web-based survey data of Human Resource Managers at 114 smaller enterprises (<750 employees) to identify organizational factors associated with levels of integrated approaches among their worksites. The companies' mean integration score was 13.6 (SD = 9.6) of a possible 44. In multivariate analyses, having a safety committee (P = 0.035) and top leadership support for health promotion (HP) (P = 0.004) were positively associated with higher integration scores. Smaller enterprises in one U.S. region have relatively low levels of implementing integrated safety and promotion approaches. Having a safety committee and leadership support for HP may be important contributors to implementing integrated approaches in smaller enterprises

Validation and Dimensionality of the Integration of Health Protection and Health Promotion Score

OBJECTIVE: To conduct validation and dimensionality analyses for an existing measure of the integration of worksite health protection and health promotion approaches. METHODS: A survey of small to medium size employers located in the U.S. was conducted between October 2013 and March 2014 (N=115). A survey of Department of Veterans Affairs (VA) administrative parents was also conducted from June to July 2014 (N=140). Exploratory Factor Analysis was used to determine the dimensionality of the Integration Score in each sample. RESULTS: Using Exploratory Factor Analysis, both samples indicated the presence of one unified factor. The VA survey indicated that customization improves the relevance of the Integration Score for different types of organizations. CONCLUSIONS: The Integration Score is a valid index for assessing the integration of worksite health protection and health promotion approaches and is customizable based on industry. CLINICAL SIGNIFICANCE: The Integration Score may be used as a single metric for assessing the integration of worksite health protection and health promotion approaches in differing work contexts