Case reports are brief papers that typically describe the condition, diagnosis, treatment, outcome, and follow-up of one or few patients. Depending on the journal, a report may be deemed publishable based on novelty, rarity, clinical relevance, and/or educational value. Common topics include new diagnostics or therapeutics, rare or newfound diseases or presentations, unexpected adverse effects or outcomes, and fresh perspectives on disease pathogenesis. Although the format of case reports is carefully outlined by many clinical journals (such as BMJ Case Reports), the proper use of certain terminology in these papers, including unique clinical phrasing, may not be clear without extensive reading and writing experience. In particular, terms that would be considered grammatically incorrect or awkwardly phrased in other forms of writing, such as newspaper articles or even other types of clinical publications, may be completely acceptable in a case report. Below, we outline two categories of diction- and phrasing-related errors in clinical reports: commonly confused terms and frequently misused terms.
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Confused terms
These pairs of terms are often used interchangeably but are not equivalent.
Case/patient: A case is an occurrence of a clinical condition (“A case of Parkinson's disease is presented”), whereas a patient is an individual with a specific condition (“A patient with Parkinson's disease visited our clinic” and not “A case of Parkinson's disease visited our clinic”). Note that a case is presented, and a patient is described.
Dose/dosage: Dose refers to the amount of medication administered at one time point (“A 325 mg dose of aspirin was administered every 4 hours”), whereas dosage describes both the amount and the rate of administration (“The dosage was 325 mg of aspirin every 4 hours”).
Survival period/rate: Survival period refers to the duration of patient survival, expressed in units of time (such as weeks or months). In contrast, survival rate refers to a percentage value that describes the proportion of patients surviving. Either term can be expressed simply as survival, as in “the overall survival of the patients was....”
Misused terms
In many of these cases, an incorrect preposition is used or a preposition is omitted. Correct phrasing, even if contingent on a single preposition, helps to increase the readability and clarity of all writing, including case reports.
Correlated/associated: The terms correlated and associated are typically followed by the preposition with instead of to.
Diagnosed/classified: A patient cannot be diagnosed as a condition but can be diagnosed as having or diagnosed with a condition. Similarly, a patient cannot be classified as a disease; classified as having is the correct usage.
Indication/indicated: A specific medical condition is an *indication for* or *indicates* the use of a specific therapy (“Bacterial infection is an indication for antibiotic use”), and the therapy itself is *indicated for* the treatment of a condition (“Antibiotics are indicated for the treatment of bacterial infection”). Moreover, a symptom is an *indication of* a condition ("Inflammation is one indication of bacterial infection"). This final usage is based on the more common definition of indicate.
Operated: A patient is always operated on rather than operated.
Predictor/indicator: Predictor and indicator should be followed by the preposition of instead of for.
Risk/risk factor: Risk should be followed by of, and risk factor should be followed by for.
We hope that today's editing tip has provided helpful guidance for your clinical writing. For further information about clinical writing, please refer to our downloadable resource. You can also read our related articles on unique terms in clinical writing and style and formatting considerations for case reports. If you have any questions about case report composition, email us at [email protected].
