Balancing Novelty & Learning
One of the most common pitfalls in case reporting is the overemphasis on novelty at the expense of clinical relevance. Although an exceedingly rare syndrome may be intriguing, its value is limited if it lacks generalizability. Indeed, the “first of its kind” boast is of little importance if readers can’t directly benefit from it in their practice. Although not easy to do, the best case reports strike a balance: They highlight something unusual, but connect it to broader themes in clinical practice.
A case of dermatomyositis flaring following influenza infection, for example, is intriguing. But what makes it valuable is the discussion about immune dysregulation, preventive health and vaccinations, and how to recognize patients who may be at risk for similar presentations.
Conversely, a report of rheumatoid arthritis masquerading as polymyalgia rheumatica is not exactly rare but can be compelling if it helps clinicians recognize the red flags that prevent misdiagnosis.
When in doubt, I would recommend going back to the reason why you wanted to write this case to begin with and consider how to convey your enthusiasm to readers.
Choose the Right Journal
Identifying the right journal to submit your case report is arguably the most crucial step in the publication process. It’s deeply unfortunate that many journals no longer accept case reports. I understand the argument that case reports don’t belong in high-impact medical journals. Still, I can’t help but believe it is fundamentally their loss.
Within the field of rheumatology, there are many places where you can submit your case reports. The Rheumatologist is certainly one of them, and we welcome compelling, novel and consequential reports. Additionally, ACR Open Rheumatology has opened its pages to case reports, and Arthritis Care & Research has its Clinicopathological Conferences, a modified version of the case report. Instructions for submission can be found on their websites.
My final tip for any case report writers is to not be discouraged by rejection. Take it from me: Editors are not eager to reject your hard work. Rather, we want to see a balance of content within and throughout issues. If you dedicate yourself to honing a high-quality case report, chances are that you can get it published somewhere.
The Future of Case Reports in Rheumatology
The rise of big data and artificial intelligence has, in some ways, threatened to overshadow the value of single cases. With machine learning algorithms capable of analyzing thousands of patient records, why should we still focus on individual stories?
