How to Write a Publishable Acupuncture Case Report Using Medi-Chi

Why most acupuncture case reports never get published

It is almost never the clinical content. Practitioners write up genuinely interesting cases and then get knocked back for structural reasons: no clear timeline, the outcome described as "much improved" instead of measured on an instrument, needling detail so vague nobody could repeat it, no statement about consent, no mention of what else the patient was taking.

Reporting guidelines exist precisely to fix that. CARE is the consensus checklist for clinical case reports generally, and STRICTA is the acupuncture-specific extension that tells you what to report about the intervention itself — points, depth, response sought, number of sessions, needle type, practitioner background. Both are hosted on the EQUATOR Network, the clearing house for health research reporting standards [1][2][3].

The catch is that a checklist sitting in a PDF does not help much at 7pm when you are writing up a case from memory. Medi-Chi's approach is to put the guideline into the form, so the structure is already there before you type a word.

Scope note: this is a practitioner-facing workflow guide. Nothing here is medical advice, and a case report is a description of what happened with one patient — it is not evidence of effectiveness.

Where the builder lives

Everything happens inside a patient record, because that is where the clinical data already is.

1. Open Patients and choose the patient.

2. On the patient page, hit Case report.

3. The builder opens pre-filled from that patient's saved diagnoses, treatment notes and VAS history.

That pre-fill matters more than it sounds. The single most common cause of a thin case report is reconstructing the timeline months later. If you have been keeping notes in the patient record as you go, the skeleton of the manuscript already exists.

Step 1 — pick your reporting standard

At the top of the builder there is a Reporting standard selector with two options.

CARE is the default. It scores your report against the CARE checklist plus the STRICTA needling items, which is what most journals asking for a case report will expect.

NICM is a Medi-Chi house standard that layers integrative-medicine reporting on top of CARE and STRICTA: practitioner credentials, treatment setting, concomitant conventional care, herbal product identification, herb–drug safety screening, integrative rationale and inter-professional communication, ethics approval, funding and conflicts. Those are the items integrative reviewers ask about and plain CARE does not cover.

Be clear with yourself about what NICM mode is: it is our in-house standard, named after the kind of scrutiny NICM-style integrative research applies. It is not a published external guideline, so do not present it to a journal as if it were one. What it is genuinely useful for is forcing you to answer the awkward questions — what else was the patient on, who screened for interactions, who paid for this — before a reviewer does.

Step 2 — turn on de-identification

There is a De-identify the patient toggle, on by default and worth leaving on. It replaces the patient's name with "De-identified patient" throughout every export.

De-identification is more than a name swap, though, and the builder does not pretend otherwise. Ages at the extremes, rare conditions, an unusual occupation, a small town, a tongue photo — any of those can re-identify someone. The submission pack ships a de-identification and consent statement with the remaining checks listed so you tick them off deliberately rather than assuming. The de-identification checklist on our trust page walks through the same ground in more detail.

Consent is separate and non-negotiable: CARE requires patient consent for publication, and the builder records whether you have it. If it is not ticked, the cover letter in your submission pack says so in plain language rather than quietly letting it through.

Step 3 — write the case, section by section

The form is ordered the way the manuscript is ordered, so you are effectively drafting in place:

• Patient information — age, sex, occupation, presenting complaint, relevant history, past medical history, current medications.
• Clinical findings — examination, tongue and pulse. Chinese characters and pinyin are fine here; they carry information English descriptions lose.
• Diagnosis — TCM pattern and the Western diagnosis side by side. Reviewers want both; the whole point of an integrative case report is that the two are being held together.
• Intervention — the point prescription grid (point, laterality, dosage and technique, sessions), plus technique, frequency, duration and adjuncts such as moxa, cupping or gua sha.
• Outcomes — what changed, on what instrument, at what time points, plus adverse events and follow-up.
• Discussion and patient perspective — the reasoning, the limitations, and what the patient said in their own words.
• References.

The point prescription grid deserves a mention. It has presets for common presentations, you can save your own, and each row takes a dosage string like 0.30×40mm, even, 20 min. That single field is usually the difference between a report someone can replicate and one they cannot — STRICTA exists largely because acupuncture intervention descriptions were historically too vague to reproduce [2].

Step 4 — read the completeness panel while you write

Underneath the form sits the completeness checker. It scores your report live against the standard you selected, shows a percentage, and lists every outstanding item with a fix hint and a CARE, STRICTA or NICM badge so you know where the requirement comes from.

Three things about how it grades, because this is where it earns its keep:

It grades quality, not just presence. A field with three words in it comes back as "needs work", not "complete". Outcomes without a recognised instrument — NRS, VAS, ODI, NDI, PHQ-9, GAD-7, MIDAS, HIT-6, WOMAC and friends — get flagged, because "patient felt better" is not a measurement. History without any date, week count or session count gets flagged for a missing timeline. In NICM mode, herbal entries need a Latin binomial and a dose before they pass, safety screening needs actual screening language rather than a reassuring adjective, and credentials need a registration number or an experience cue.

Required items weigh double. The score is not a flat percentage of boxes ticked. Until every required item is at least present, the panel shows how many are outstanding instead of a "submission ready" badge.

It never blocks you. It is advisory by design. Internal audits, teaching drafts and half-finished write-ups are legitimate uses of the builder, so the export buttons always work. The checker tells you where you stand; it does not hold the door shut.

A practical way to use it: draft the clinical story first without looking at the panel, then work the outstanding list top-down. The required items are the ones a reviewer will bounce you on.

Step 5 — export in the format you actually need

Four buttons in the footer, four different jobs:

• Copy — the whole report as markdown on the clipboard, for pasting into an email or another editor.
• Download .md — plain text, good for version control or a co-author who lives in a text editor.
• Download .docx — a formatted Word manuscript with proper headings and tables. This is what most journals ask for, and it is why the .docx export exists at all.
• Print / save as PDF — a print-optimised layout for a supervisor, a file copy or a case presentation.

If you selected NICM, the integrative section flows through into all of them as its own block, with the standard named in the header so nobody has to guess what it was written against.

Step 6 — build the submission pack

The last button builds a zip containing everything a submission usually needs:

• the manuscript in .docx and .md
• a cover letter, dated and addressed, with your title, authors, affiliation and standard filled in
• the completeness report as a table — every item, its scheme, its status and the suggested fix
• the de-identification and consent statement
• a README explaining what each file is and how to submit

The cover letter is honest about the state of the report. If consent was not recorded, it says so and tells you not to submit until it is. If de-identification was off when you exported, it says to review the manuscript for identifiers first. Those warnings are there so a rushed export cannot quietly become a privacy incident.

One caveat worth repeating: NICM does not publish a case report upload API or a public submission portal, so "upload" here means a complete, correctly-named bundle you attach to whatever channel your target journal or institution gives you [4]. The pack is built to be attachable as-is.

A realistic first case

If you want a case that is likely to survive review, pick one with these features:

• A clear before and after on a real instrument. Chronic pain cases work well because NRS and functional scales are routine.
• A defensible timeline. Dates, session counts, and ideally a follow-up point after treatment stopped. A result that holds at three months is far more interesting than a result at session four.
• Something that makes it worth writing. An unexpected response, an unusual pattern presentation, a harm or near-miss, a case where the TCM framing changed the plan. "Standard case responded as expected" is not a paper.
• Honest confounders. New medication, a holiday, physiotherapy in parallel. Naming them makes the report stronger, not weaker — and in NICM mode the concomitant care field asks you directly.

Write the discussion as if a sceptical colleague is reading it, because one will be. Say what else could explain the result. A case report that acknowledges its own limits reads as competent; one that claims causation from a single patient reads as advertising.

What this does not do

Being straight about the boundaries:

• It does not assess clinical merit. The score says your reporting is complete, not that your case is worth publishing.
• It does not write the case for you. Every field is yours; there is no AI drafting the clinical narrative, because a case report is a factual account of what you did.
• It does not submit anything on your behalf. You attach the pack and send it.
• It is not peer review, and the completeness report says so in writing so nobody mistakes it for one.

The short version

Open the patient, hit Case report, pick CARE or NICM, leave de-identification on, fill the form in clinical order, work the completeness panel down to zero required items, then export .docx or build the submission pack.

The guidelines are already in the form. That is the whole idea — you concentrate on the clinical story, and the structure that gets a report accepted is handled as you go.