can you write a case report on yourself

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Can I write a case report on myself? and as a single author?

• Thread starter bbentertainment
• Start date Sep 7, 2020

bbentertainment

Full member.

• Sep 7, 2020

lawrencewellsbourne

you can absolutely do it, some of the greatest achievements in science and medicine were accomplished this way. you are definitely going to need a research advisor.  

bbentertainment said: Long story short: 4th year med student; I have been following my PCP for a few years for a rare presentation of a specific disorder. Usually see him every year or so just for follow-up as it is under control. Was recently thinking about writing up a case report about it myself and had started a draft and tried to call PCP office to ask him about it. 1.) is this ethical/allowed? 2.) I have tried calling his office to inquire if he would be okay with me doing this and if he would want to be part of it. Secretaries have said they'd leave him a msg but I still haven't gotten a call back and dont have a f/u for a while. (from what i understand and from searching online..my PCP is kinda old school and isn't into any research). Given the above, am i allowed to write a case report on myself? Can I submit one as a single author, or does a case report always require a physician to be on it? Was just wondering if this is possible and if so would like to work on one for eras Click to expand...

DrStephenStrange

Neurology pgy-2.

7331poas said: Im confused. Are you the patient here? Are you sure that your case is actually novel? Click to expand...

DrStephenStrange said: He said rare not novel. Click to expand...

7331poas said: Ill rephrase: are you sure your case is actually publishable? Click to expand...

bbentertainment said: Done some lit review and haven't seen much on this specific presentation. To answer the above poster, yes I would be the patient. I guess ultimately up to a reviewer if they would accept the case report after i submitted. I guess my main question is still: am i allowed to do this? and can i write it myself as the only author? Click to expand...

IlDestriero

You can write it up and submit it. You may have more success if you get a senior physician in the relevant field on it as well. If all else fails, you can publish it in an open access journal as long as your check clears.  

IlDestriero said: You can write it up and submit it. You may have more success if you get a senior physician in the relevant field on it as well. If all else fails, you can publish it in an open access journal as long as your check clears. Click to expand...

My advice, as stated by the others, would be to get a second author to co write the paper with you. Of course you should disclose to your co-author that you are the actual patient being discussed. That way you can still be the first author and there will not be any perceived impropriety because you are the patient. By the way, in your disclosures, you do not have to let them know that you are the patient about which the case report is being written. All you need to let them know is that the patient (you, in this case) has given consent for publication.  

• Sep 8, 2020

I have published a case report in a pubmed indexed journal... As you said, a case report is probably the easiest type of manuscript to get published. But, a pub is a pub. I really doubt most PD’s will care which journal it’s published in. There are plenty of journals that are pubmed indexed that accept case reports. I’m sure you can find one of them to submit to.  

I mean it’s fine but if you include it on your CV and it’s brought up during residency interviews I probably wouldn’t mention that it’s about you because that’s awkward af for the interviewer.  

bbentertainment said: Thanks for the advice. Follow-up question: I am looking for possible journals to submit to. I know many are pubmed indexed, many are also not. Many also have extremely heftier prices than some other journals. If I were to submit and get accepted into a journal that was NOT pubmed indexed for example, is this frowned upon by program directors reviewing my application? Click to expand...

OnePunchBiopsy

Allergies: clinic.

Can you write one? Yes. Is it worth the time and effort? Not really.  

42% Full Member

yeah i agree its better to get a mentor to be the second author and help guide the process  

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Writing a case report about my own medical problems without treating physician

I am a postdoc in epidemiology. Last year I had a very rare viral infectious disease that got me admitted to the hospital for more than a week, and it is worth a case report because it's a fairly unknown disease and physicians had troubles in finding out what it was. I had discussed writing a case report with my treating physicians, but eventually they stopped answering my emails or picking up the phone.

Therefore, I wonder if it's OK to write the case report myself, about myself, with the help of a senior physician that works with me and is willing to help, without involving the physicians who treated me. I have all the tests, diagnosis, course of the disease, and my own patient consent.

• publications

• I cannot think of any ethical problem with this, and anybody who knew you did it would usually be required to keep that information confidential. –  Anonymous Physicist Commented Apr 4, 2022 at 17:17
• 1 There are not many medical researchers on this site. If you find the answer, please come back and post it. –  Anonymous Physicist Commented Apr 6, 2022 at 23:39
• @AnonymousPhysicist Yes I will, thanks for your input! –  adrian1121 Commented Apr 7, 2022 at 10:08

2 Answers 2

As correctly pointed out by @Anonymous Physicist, the “Common Rule” defines research as:

A systematic investigation, including research development, testing, and evaluation, designed to develop or contribute to generalizable knowledge.

Simply reading the “Common Rule” definition of research, it would seem that a case report would not qualify as “research” because it is non-systematic. If a case report is not research, then it would seem that it does not need to be reviewed by an Institutional Review Board (IRB).

But, like so much related to the requirement (or non-requirement) for review of particular activities by the IRB (or ethics board), policies about case reports in the United States are not uniform among institutions. And there are further regulatory wrinkles due to HIPAA and problems that may arise from journal policies.

Writing up and publishing a case report generally uses protected health information, that is information that permits an individual to be identified. Access to and use of this information is regulated by the Health Information and Portability Act (HIPAA) and, at the institutional level, decisions about access to and use of such information is overseen by a “privacy board” or a “privacy officer.” The IRB often, but not always, serves both as an ethics board and a privacy board.

An institution might not require IRB review of a case report but would require review by a privacy board or a privacy office (or the IRB acting as a privacy board).

Empiric Data from 2017

A 2007 JAMA publication reported on the policies with regard to review requirements for case reports at medical schools in the United States. [1]

Of 124 medical schools surveyed, 116 (94%) responded. The following results were reported:

“Ninety-one (78%) of the responding schools did not require IRB approval for a case report.”

“None of the 25 [that required IRB approval] required full IRB board review; 17 (68%) required IRB notification; and 8 (32%) did not have a fixed policy but considered whether the report should have full or expedited review on an individual basis. Six (24%) conducted reviews because they considered case reports to be research, 8 (32%) for privacy requirement, and 11 (44%) for both purposes.”

The Journal Problem

A further problem that can arise when attempting to publish about work that was not reviewed by an IRB is a requirement by a journal that the work being presented has been reviewed by an IRB (whether or not it was required to be reviewed) or a request by a journal for documentation from the IRB that the work was NOT required to be reviewed.

Bottom Line

The advice by others to “ask your IRB” seems apt. The advice might be expanded a bit to suggest (given the additional complexities that arise because an author of the case report is also the patient whose information is being reported) that the OP ask their IRB to review the work formally and issue a formal approval of a plan to publish the information by those who will be authors/co-authors. This is the safest thing to do (although bureaucratic)

[1] Panda M, Heath GW, Desbiens NA, Moffitt B. Research Status of Case Reports for Medical School Institutional Review Boards. JAMA. 2007;298(11):1277-1278. doi:10.1001/jama.298.11.1277 https://jamanetwork.com/journals/jama/fullarticle/208845 Johns Hopkins University

• Great answer! I suggested some formatting, please feel free to edit if I botched anything. –  cag51 ♦ Commented May 19, 2022 at 2:04
• @cag51 Your edits are a real improvement. I realized after I wrote this (and got an airplane to go a wedding sans electronics) that I should have spent more time on the formatting. Thank you!!! –  Diana Petitti Commented May 23, 2022 at 1:53

I don't know what an ethics board would say about this, and you need to check. If they approve then I see no issue, though you may need to anonymize the attending physicians.

But whether you can actually publish it would be up to a publisher.

Be honest, of course, about the fact that you are the subject of the study unless an ethics board rules otherwise.

• 3 Not sure about the first sentence -- this article suggests that a physician publishing a case history does not usually require approval from a research ethics board (though if the institution has a board that is willing to review this, it's certainly one way for OP to get an answer to their question). –  cag51 ♦ Commented Apr 1, 2022 at 12:59
• "The Common Rule defines research as: “a systematic investigation, including research development, testing, and evaluation, designed to develop or contribute to generalizable knowledge.”" So, at least under US regulation, a non-systematic case study is not research and is not regulated by an ethics board. But ask anyway. –  Anonymous Physicist Commented Apr 4, 2022 at 17:14
• 2 None of the case reports I read recently mentioned ethics review. –  Anonymous Physicist Commented Apr 4, 2022 at 17:15

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Case Report on yourself

Is it possible to do a case report on yourself? I have some pretty interesting things going on health wise (not going to disclose) and was wondering if there was any sort of conflict that prevented you from doing a case report on yourself.

Also being that I am a resident physician, would I need a supervising attending? (aka my PCP or specialist that I see)

P.S. I’m not even trying to pad my resumè. I genuinely think what’s going on is really interesting and would like to do a report on it.

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The do’s and don’ts of writing and publishing case reports

March 6, 2023 | 5 min read

Lessons from a recent Researcher Academy webinar

As a method of documenting a single clinical observation, case reports offer timely and valuable information, especially with regards to rare diseases. They show medical professionals how fellow practitioners have acted in similar situations and thus aid in the decision-making process by sharing best practices. Not only do they significantly contribute to the knowledge pool, they also help add to a researcher’s own publication portfolio. Producing a good case report requires much more than just an interesting case, however.

To assist researchers with this task, Professors Oliver Kurzai and Adilia Warris, editors of the journal  Medical Mycology Case Reports opens in new tab/window  shared tips on writing high impact case reports in the latest Researcher Academy  webinar opens in new tab/window . We are pleased to share here some quick do’s and don’ts from the webinar.

Tell a story

The best way to compose a case report is to tell a story. This can be accomplished by arranging the events in chronological order, being specific about your differential diagnostic considerations, elucidating the arguments for your clinical decision-making process, and following up to round off the story neatly. This will create an imaginary journey where your readers can follow every development of the case and understand why you have performed specific tests or made certain decisions during a particular treatment.

Get the details right

Make sure to describe the relevant signs and symptoms which have resulted in the differential diagnosis, both positive and negative in order to provide readers with the context in which you have made your decisions. You can also include in your case reports descriptions of actual values for blood test results, detailed dosages for medications prescribed or other variables that should be taken into account with respect to the outcome of the situation.

Employ pictures/figures where relevant

A picture, as they say, is worth a thousand words, especially for case reports where findings can be clearly and efficiently illustrated via images. Don’t make use of pictures without justification, however – do so only if they have a function. For example, macroscopic and microscopic images of a newly-identified causative microorganism are an essential whereas a picture of the model you have clearly explained elsewhere in the text may be overkill.

Formulate short and sharp titles

The title is the first selling point of your case report. Therefore, you would want it to be interesting and something that grasps the reader’s attention. Make sure you phrase it concisely, but still in an eye-catching way. Take a look at the examples shared by the speakers below.

An OK title: " Treatment of cerebral mucormycosis with drug therapy alone: a case report"

Versus a compelling title:  "Successful outcome of cerebral mucormycosis with drug therapy alone"

Secure written consent from patient

Due to its nature of being a detailed description of an individual patient’s clinical presentation and therapy, a case report almost always contains information that could be traced back to the individual in question. Thus, a written, informed consent from the patient is a key requirement for the publication. Keep in mind that your patient is your partner in completing a case report, therefore make sure to discuss the report proactively with them including being explicit about any potential images that you are going to use, especially if they show or could identify the patient.

Don’t write your case report before doing your homework

If your case is not unique or interesting enough, there is a high chance that it will not be published. Even when your case is unique but is not well-documented or misses some crucial diagnostic elements, the same outcome might still ensue. This is not only a waste of your precious time but also a discouragement which might prevent you from producing more case reports in the future. To avoid this outcome, make sure to carry out careful research  before  writing your case reports. Make sure it meets all necessary characteristics and requirements before spending a lot of time and effort on the writing part.

Don’t publish a case report without the patient’s consent

As explained above, informed patient consent is mandatory for the publication of your case reports. Ignoring this requirement can result in a rejection for your work and worse, ruin your relationship and reputation with patients. However, there is an exception for publishing a case report without patient consent when the benefit of publication toward to society outweighs potential harm for individual. This happens when the case report contains an extremely important public health message but impossible to obtain informed consent despite all efforts as the patient has died, for example.

Don’t forget, moreover that clinical practitioners are not required to, and should not reveal personal patient information to a journal that is not relevant to the case.

Don’t include everything

“Less is more” goes the popular adage… It is not recommended to provide an extensive overview or discuss every single aspect of the patient’s disease in the introduction and conclusion. This will only serve to disengage readers and will distract them from the main ideas you want to communicate. If you want to give a focused introduction and discussion, make sure your case report mentions only the key messages and information related and relevant to these points.

To learn more about other insightful tips on how to write influential case reports and more importantly to get them published, you can watch the full webinar recording at the  Researcher Academy opens in new tab/window . If, after doing so you still have unresolved questions, why not post in the  Researcher Academy Mendeley group opens in new tab/window , where the team will endeavour to find expert answers for you.

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