Writing Case Reports and Review Articles
13-5
Discussion Section
The Discussion section interprets the case for readers, convinces readers that your diagnoses and interpretations are correct, and states the implications of the case. If you claim that your case is the first such case reported, you should also describe your literature search in this section (including what languages of publications you considered). [Note: It is always safest to add “to our knowledge” to any claim of being first.]
If other related cases have been reported, you should indicate in the Discussion how they are similar to and different from your case.
This section is also where you convince readers that your diagnosis or interpretations are correct and show that you considered other possibilities. If applicable, you should briefly discuss the differential diagnosis, including how you know your diagnosis is the correct one and why other possible diagnoses were rejected. (For an example, see the annotated case report at the end of the chapter.) You should always be sure to address any evidence that contradicts your diagnosis or interpretations. The Discussion should also make clear your take-home message for readers. What should they consider doing differently as a result of reading this case (for example, when encountering a particular set of symptoms and test results in a particular patient setting, should they consider an additional diagnosis or a new treatment)? Or what shift in medical or scientific knowledge is suggested by this case, and what is the next step in advancing that knowledge?
Abstract
Many journals require a brief abstract for each case report. The Abstract of a case report is usually unstructured (that is, contains no subheadings) and consists of 1 short paragraph. The Abstract should summarize the key points in the case, including the purpose (from the Introduction), unique features, final diagnosis, treatment, outcome (all from the Case Description), and take-home message of the case (from the Discussion). The Abstract should not include statements such as “X will be described” or “Y will be discussed”; these are not helpful to people reading your Abstract on-line.
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