°®¶¹´«Ã½

Case Reports: An Odyssey in Ethical Publication

Sept. 4, 2024

ASM is embarking on a new journey with the launch of the journal . The new, fully open access journal was announced in Jan. 2024 and . The first case reports will be published in 2025. Case reports are a valuable educational tool for diagnosis and disease progression and can raise awareness of emerging concerns and underreported pathogeneses. Detailed descriptions of signs, symptoms, diagnosis, treatment and prognosis of individuals and/or cohorts present unique ethical considerations, particularly regarding the privacy and anonymity of patients. The ASM Journals Ethics team has laid out a recommended series of tasks to help authors succeed in publishing ethically written, highest quality case reports in the areas of clinical microbiology and infectious disease.
  

Urania, the muse of astronomy and science
Urania, the muse of astronomy and science
Source: Wikimedia Commons/ Follower of Louis Tocqué
If the muses have called you to draft your epic tale of microbial battle, you must be well-prepared to embark on that odyssey. Just as access to the right tools and knowledge are essential to successful clinical intervention, a will have a much easier voyage to publication. The still apply, but here we have highlighted special considerations when writing a clinical history. For example, authors are expected to follow  for case reports when preparing their manuscript. The following tasks will help authors navigate and avoid pitfalls and delays in their quest for publication. 

First Task: Obtaining Proper Ethical Approval 

Laozi wrote that a journey of 1,000 miles begins with a single step. The first step in chronicling your case report is obtaining proper ethical approvals. When performing , a letter of approval from an Institutional Review Board (IRB), or a statement documenting the reason approval has been deemed unnecessary, are critical. If your report , an Institutional Animal Care and Use Committee (IACUC) approval or waiver is necessary. In the event your institution does not have an IRB or IACUC approval board, a statement that your research is aligned with the or the should be sufficient. Be prepared to present this documentation for your manuscript to continue forward. 

Second Task: Protecting Privacy and Obtaining Informed Consent 

is an important precursor to ethical case report publication. Be prepared to provide documentation of consent upon request, or your quest will stall. Laws and regulations, as well as social mores and customs, surrounding vary by location. Authors are responsible for ensuring that they have followed all applicable for all relevant locations. If consent is deemed to be unnecessary or unobtainable, include a justification statement explaining the reasoning behind that decision.

Personnel should be to explain to patients the purpose and risks of participating in publication. However, if written consent is unavailable, verbal consent may be documented. Patients should be aware that, once published, it is not possible to completely erase all traces of images or other documentation from internet databases. 

All identities, including those of both personnel and patients, must remain confidential. Use as few identifiable details and features as possible to maintain the case report narrative and scientific meaning. Know what constitutes (PII)—it is important to understand that PII does not solely consist of single data points. The reader should not be able to piece together the information to discover an individual's identity.  

Pseudonyms should never be based on someone’s real name. The and consent vary jurisdictionally, so it is up to the authors to ensure that data is properly anonymized.  

If your case study involves other institutions or locations, you, as the author, must ensure that the research and manuscript comply with the laws for every location involved. 

The following chart is for illustrative purposes and is not an exhaustive list of all . 

A table listing various types of data and suggestions for redaction
Example description: In 2023, Minor patient M1 was injured in the back seat of a small vehicle traveling in the Walloon region of Belgium and taken to a local hospital for treatment. (Click to enlarge image)
Source: American Society for °®¶¹´«Ã½

Third Task: Illustrating the Record 

Graphics and images will bring your case study to life and may be particularly useful, as observable symptoms and/or laboratory results can be definitively diagnostic. All apply to case reports. This means that should be acknowledged in the figure legends, and should be used to indicate individual image boundaries in mosaics or composites. Any adjustments to an image, such as contrast or brightness levels, must be applied to the whole image. may not be used to create visual content. 

Images cannot be edited to add or remove an element from the composition. Case reports are an exception only when it is necessary to conceal identifying features and maintain anonymity.  

If you intend to include images created by someone else with your case study, be sure to include citations and document . Always remember to of human subjects when using their images in a figure.   

A statue of Achilles with black boxes covering his face and name on the plinth to protect his identity.
Redacted image for a case report discussing a Greek warrior killed in battle at the city of Troy due to complications of an injury exacerbated by a unique neonatal intervention.
Source: , , via Wikimedia Commons

Final Task: Creating the Manuscript 

The final task of your quest does not have to be the most difficult. As a member of the (COPE), ASM follows COPE publication guidelines. Case reports must follow When writing your manuscript, maintain and proper methods.  

Ensure that descriptions encourage “ in use and reporting of race and ethnicity and that inclusive language supports diversity and conveys respect.” of terms avoid language that imparts bias toward or against groups or individuals. 

Many resources are available online to . ASM has suggestions for and how to properly cite data. Many organizations have useful resources on , and even involved in the collection and analysis of data. 

The key to successful publication lies in preparation. Completing the previous tasks at the outset will eliminate most roadblocks and detours. The staff at ASM Case Reports and the Journals Ethics team can answer questions or concerns regarding a report. Always remember you are not alone on this journey.  
 


ASM Case Reports is ASM’s newest fully open access journal. The journal aligns with ASM’s mission, providing a dedicated platform for the highest-quality case reports in clinical microbiology and infectious diseases. We are now now accepting submissions!


Author: Alicea Hibbard, MHA

Alicea Hibbard, MHA
Alicea Hibbard, MHA, joined the American Society for °®¶¹´«Ã½ as the Ethics and IDEAA Senior Associate in 2023.