What are Expanded Case Summaries?

Expanded case summaries are brief case reports written by doctors training in Intensive Care Medicine. They usually involve a brief vignette about a patient that has raised a clinical question, followed by a evidence-based review or discussion addressing that clinical question. They are usually short (around 1500 words in length) but are fully referenced (usual maximum 10 references). ICM trainees must complete 10 case summaries by the end of training, which are all assessed to meet the required standard by an established ICM Consultant.

Guidance on how to write Expanded Case Summaries can be found on the FICM website here and here.

Why publish them online?

Each case summary is an up-to-date (at the time of writing) topic review addressing a clinical question that is relevant to intensive care practice and the curriculum in ICM. Each trainee writes ten of them during their training, but once they are approved by a consultant they are usually filed away. That’s a phenomenal amount of time, effort and condensed knowledge that is being masked from view, and effectively wasted.

We want to release the knowledge and information hidden away in the expanded case summaries and create an educational resource for ICM practice and a useful revision aid for the FFICM exam. (Not to mention the critical care components of the FRCA, FCEM, MRCP and FRCS examinations!)

What about patient confidentiality?

All Expanded Case Summaries are anonymised by the author before being assessed by a consultant in ICM.

Most Expanded Case Summaries contain a significant level of detail about the patient’s clinical details and management, and would likely require the patient’s consent to publish in case report format or risk a breach of confidentiality. As we are publishing these online, theoretically a description of a patient’s illness and care during their admission could be recognisable by the patient or their family.

Therefore we have taken the editorial decision to significantly reduce the detail in the patient vignette section of the case summaries and obscure or alter certain details regarding the age, sex or other features of the patient. We are leaving the discussion and references intact. This is to minimise the possibility of patient confidentiality being breached as the history and management will be much more generic. Although losing the detailed patient’s story may affect the educational value of each case summary, we feel that there is still significant knowledge to be gained from the topic review contained in the discussion and references of each case summary.

What about the risk of plagiarism?

Plagiarism is a risk of being published in any medium. We would strongly recommend that any consultant involved in assessing and marking Expanded Case Summaries makes use of online anti-plagiarism software that is freely available online. (While we aren’t going to advocate any specific software try this link for some recommendations.)

The risk in this case is largely on the plagiarist and could have significant career consequences if they are found out. The GMC Duties of a Doctor include this statement in Domain 4>Maintaining Trust>Communicating Information: 71. You must be honest and trustworthy when writing reports, and when completing or signing forms, reports and other documents. Any trainee found to be plagiarising these case summaries could potentially be subject to discipline locally, and could be referred to the GMC as they would be in breach of the above duty.

Won’t the case summaries go out of date?

Possibly. ICM is a field that moves slowly in some areas and quickly in others. Some case summaries may effectively become defunct as new evidence comes to light (e.g any case summaries  on therapeutic hypothermia post cardiac arrest prior to the publication of the TTM trial could be considered to be out of date now). We aim to categorise the case summaries by year of writing so that it is more obvious when you’re reading an older case summary. We may withhold publication of older case summaries submitted to us if newer developments have superseded the evidence in those case summaries.

Each summary will have the year it was completed displayed on the top right of the header image. The example below shows that this ECS was completed in 2013

ECMO for Respiratory Failure

How can I contribute?

If you would like to contribute your case summaries – great! Thanks very much. We’re grateful to accept case summaries from any ICM trainees at any stage of training.

A few conditions:

You agree to the above modifications to each summary (i.e. alterations to the patient vignette to protect patient confidentiality). We will otherwise have minimal editorial input into the content of the case summaries, and aren’t vouching for the accuracy of the summary, the referencing or interpretation of the evidence.

Please let us know your name, job title, region and hospital, and the year the case summary was written. You will join our contributor list on our Meet the Team page

We are only going to accept case summaries that have been assessed and ‘passed’ by an ICM consultant. If you are currently a trainee in ICM, please let us know  the name of the consultant who marked the case summary. This is for quality assurance purposes only, and the name of the consultant will not be published online. If you have completed training in ICM (i.e. post-CCT), we don’t need to know who marked them.

All case summaries will be credited to the author unless specifically requested to be published anonymously.

Please contact us at icmcasesummaries@gmail.com and thanks very much for your support.