- BMJ Case Reports how to write a case report

BMJ Case Reports user guide

How to write a case report BMJ Case Reports publishes four types of manuscript s

clinical case reports

global health case reports

videos and

images

Please use this guidance in conjunction with our writing templates

Global health case reports add detail about the patient’s social determinants of health, access to health care, prevailing local and national issues that affect health and well-being, and the challenges in providing care to vulnerable populations or with limited resources.

Clinical case reports are closest to classical case reports which describe unusual presentations, difficult diagnoses, challenging management decisions, pathophysiological mechanisms and complications. Adverse events, when reported, should be carefully described for learning purposes only.

Example

Example

Videos may be submitted with any of the three templates above. Crucial to all images and videos is that the patient is not identified and images and videos are cropped to show only the clinical point of interest.

Images in cases include a short description

(about 500 words) of the case cent e red around relevant clinical images or videos

Example

Example

Review our comprehensive author instructions

S elect ing a case We suggest that you write about a patient who is currently under your care , someone who can be a part of the writing process and is available for you to double - check details, clarify parts of the clinical story, is easy to follow up with in person or remotely and can offer you the individual perspective of their experience of illness and treatment.

Thus, when obtaining consent to submit and publish your manuscript, the patient is fully informed of the process and implications of online publication. As the Internet has evolved, it has become important to safeguard the patient’s identity, so we ask that all patient details are anonymi z ed – use age ranges rather than the exact age of the patient, e.g. , “a woman in her 20s” is preferable to “a 24 year old woman”, do not describe ethnicity or occupation unless essential to the clinical pathology, do not use the names of places , and do not use calendar dates ( " January 2022 would be eight months ago”). Do not upload images where the patient may be identified – check that there is no written identifying information on the images and do not upload facial images. It is common to discuss family history in detail – all individuals mentioned in the manuscript will also need to provide informed consent – use our BMJ consent form.

How to write

Involve your patient from start to finish

Type directly into our templates

Use formal medical English

Illustrate with images and diagrams

Anonymize all patient details

Informed consent from everyone mentioned

Complete all author statements

Address all reviewer comments in earnest

W rit ing a case report Please download and type directly into our templates which contain key reminders and author instructions. The templates and instructions have evolved during the last 10 years, so whether you have published with us before or this is your first manuscript submission , check the template instructions and reminders carefully.

Crucial to publication is the presentation of a solid evidence base for the arguments made in each manuscript and learning points derived precisely from the clinical material presented. Conclusions should be tempered as a reminder that these are single cases. Limitations in the interpretation of the information presented should be included in the discussion section. We do not publish manuscripts that report the efficacy or effectiveness of new treatments or phase II clinical trials. To avoid disappointment, any manuscript about novel treatments, treatment regimes or lifestyle changes should be preceded with a pre-submission i nquiry.

Our two key objectives are that all published manuscripts have substantial novel learning value and that manuscripts are patient-cent e red . What this means is that we publish both common and rare cases as long as there is something new to learn from these or as long as clinical information is presented in a manner that optimi z es learning . Ideas include illustrating clinical an d pathological correlation, reminding us of essential basic science, clarifying biochemical pathways and physiological mechanisms, presenting clinical guidelines in ways that are easy to follow, critically appraising relevant and up-to-date literature, and illustrating operative steps and anatomy.

Key steps These are the steps we suggest that you follow: 1) S elect the patient you plan to write about 2)D iscuss this with the team and all personnel relevant to aspects of the patient’s care 2)C ollect the information you need and type directly into the Word templates that we have prepared for you At the end of the templates are author statements that must be completed in full. All manuscripts should be written under the supervision of the senior clinician responsible for the patient’s care and obtaining written consent. Use our guid ance to write and avoid pitfalls that might prolong t he time it takes to send

Checklist

Consent > Have you read our patient consent

information? We do not publish without consent - search for BMJ Author Hub for our details

Visit BMJ Author Hub

> Do you have the patient’s consent to submit your manuscript? > If the patient is deceased, do you have consent from the next of kin to submit your manuscript? > Are you in contact with the patient? Will it be easy to contact them again? This is important for the additional information you may be asked to provide during revision and to update follow-up outcomes.

you a decision about the progress of your manuscript or that may result in rejection.

Access the BMJ language editing service

Writing considerations > Have you chosen to write about a topic where there is something new to learn? > Have you chosen the correct template? > Do you have all the clinical information you need (histology slides, clinical images, results)? > Are you writing in formal medical English (in full sentences, not in note form) Have you avoided medical colloquialisms or medical shorthand (for example “ labs ”, “ bloods ”? > Have you checked for typos and grammar errors? Use either formal medical British or US English. Typos and grammar errors are not routinely corrected by the journal team and will delay publication. Please check and correct your manuscript carefully before you submit.

Key issues that affect publication > Are you certain that there is no overlap between what you are writing now and what you or someone else has already published elsewhere? Run a check for overlapping text or plagiarism before you submit. We do not accept manuscripts after preprint. > Has this case been published by you or someone else already? Another clinical team may be publishing a case report about the same patient. > Has the senior clinician responsible for the patient’s care supervised the writing of the manuscript and taken written informed consent from the patient? Have you included their contact details? > Have you cleared publication with the head of department or institutional ethics committee? > Is this patient enrolled in a clinical trial? > Is the case the subject of litigation or complaint? > Has this case appeared in the media? > Some published BMJ Case Reports are picked up by the media. Is your patient aware of this? Is the senior clinician responsible for the clinical care of the patient and writing of the case aware of this? > Have you completed the author statements in our template? We are unable to proceed with the peer review process without these.

Access the BMJ language editing service

> Have you checked all numerical values, results, percentages, drug doses and frequencies, and units of measurement in the manuscript? > Have you fully anonymi z ed the manuscript? (No exact age, no calendar dates, etc) > Have you removed the patient’s face from all images and videos? > Have you presented the clinical information in an effective way? Use diagrams . > Are your conclusions based on the clinical information in the case report and a thorough appraisal of up-to-date literature?

> Are your references in the Vancouver style?

Presenting information effectively Add illustrative diagrams – draw these using straightforward computer software and note in the figure legend that they are original diagrams that you have drawn. Clinical timelines should be summari z ed diagrammatically and make the patient’s clinical course much easier to follow. Clinical images are easier to interpret when they are annotated beside an accompanying diagram. Operative procedures are clarified when line diagrams are used to illustrate relevant anatomy, operative steps and potential pitfalls. If you use images that have been published elsewhere or have been downloaded from commercial image bases, we require proof of permission to publish and licensing agreements.

Example of clinical timelines drawn by the authors

Example of clinical and anatomical correlation

Example of mechanism of complications

Patient information

The patient perspective This is optional and should be an account of the patient’s experience: their interpretation of their signs and symptoms, access to healthcare, treatment, and life at home, work , and in the community after discharge. The patient should write in their own words. The authors should correct grammar and typos before submission. If the patient has dictated his or her perspective, the authors should transcribe (and state that they have done so). Please do not upload short statements of patient thanks or appreciation - these will not be published. Patient authored manuscripts We do not publish manuscripts where the patient is the sole author. If one of the co-authors is the patient described in the manuscript, the editorial office should be informed and the author statements appropriately completed at initial submission. These manuscripts should be carefully considered by the patient-author and the co-authors as anonymi z ation of patient details is difficult and the declaration that a co-author is a patient appears in the author statements at the end of the published manuscript. Please contact the editor and/or editorial office before submission to avoid disappointment.

The peer review process After you submit, your manuscript is sent for peer review. This takes time as we search for experienced clinicians who share your clinical interests and are available to provide expert reviews. Our guidance to reviewers is available for you to view so that you have a better idea what to expect visit authors.bmj.com for details.

Visit BMJ Author Hub

check that you are using formal medical US or UK English and that the tone is neutral, objective and scientific. It is the authors’ responsibility to check that grammar and vocabulary are correct. All manuscripts should be proofread and typos corrected before submission. BMJ has a language editing service available to authors. Visit authors.bmj.com for more details. Numerical values and international units of measurement should be checked in every version of the manuscript and in the final proof before the article is published. Please confirm in writing that these are correct. In general, 50% of all submissions are accepted.

The initial emphasis during peer review is on the content of what you write and what may be learned. When the reviewers’ comments are forwarded to you by the editor, you are invited to respond in full and mark the revisions you have made in tracked changes . If you do not agree with comments you have received, explain why in your responses. Your revision is sent again for peer review and subsequent comments usually relate to precise clarifications that need to be made in clinical detail or scientific arguments. The process becomes more difficult and lengthy when language and format issues arise, so please, carefully

Global Health Competition

Become a Global Health Associate Editor Every year authors of global health case reports are given the opportunity to join the editorial team for a year or more. This is an opportunity to gain some editorial experience or join our team on research or educational projects. Students and graduates may apply. Simply select Global Health Competition when you submit a global health case report. Visit the BMJ Case Reports homepage for more information at casereports.bmj.com and contact the editor-in-chief at eic.bmjcases@bmj.com .

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