Inmedicine, acase report is a detailed report of thesymptoms,signs,diagnosis, treatment, and follow-up of an individualpatient. Case reports may contain ademographic profile of the patient, but usually describe an unusual or novel occurrence. Some case reports also contain aliterature review of other reported cases. Case reports are professional narratives that provide feedback on clinical practice guidelines and offer a framework for early signals of effectiveness,adverse events, and cost. They can be shared for medical, scientific, or educational purposes.
Most case reports are on one of six topics:[1]
A case report is generally considered a type ofanecdotal evidence.[2] Given their intrinsicmethodological limitations, including lack ofstatistical sampling, case reports are placed at the bottom of thehierarchy of clinical evidence, together withcase series.[3] Nevertheless, case reports do have genuinely useful roles inmedical research andevidence-based medicine.[4] In particular, they have facilitated recognition of new diseases and adverse effects of treatments.[5] For example, the recognition of the link between administration ofthalidomide to mothers and malformations in their babies was triggered by a case report.[6] Case reports have a role inpharmacovigilance.[5] They can also help understand the clinical spectrum ofrare diseases as well as unusual presentations of common diseases.[4] They can help generate studyhypotheses, including plausiblemechanisms of disease.[4] Case reports may also have a role to play in guiding thepersonalization of treatments in clinical practice.[4]
Proponents of case reports have outlined some particular advantages of the format. Case reports and series have a high sensitivity for detecting novelty and therefore remain one of the cornerstones of medical progress; they provide many new ideas in medicine.[7] Whereasrandomized clinical trials usually only inspect one variable or very few variables, rarely reflecting the full picture of a complicated medical situation, the case report can detail many different aspects of the patient'smedical situation (e.g.patient history,physical examination,diagnosis,psychosocial aspects, follow up).[8]
Because typical, unremarkable cases are less likely to be published, use of case reports as scientific evidence must take into accountpublication bias. Some case reports also contain an extensive review of the relevant literature on the topic at-hand (and sometimes asystematic review of available evidence). Reports adopting this sort of approach can be identified by terms such as a "case report and review of the literature". Reports containing broader active research such as this might be consideredcase studies in the true definition of the term.
Case reports can also play a relevant role in medical education by providing a structure forcase-based learning.[4]
A particular attraction of case reports is the possibility of quick publication (with respect to more extensive studies such as randomized control trials), allowing them to act as a kind of rapid short communication between busy clinicians who may not have the time or resources to conduct large scale research.[8]
The quality of the scientific reporting of case reports is variable, and sub-optimal reporting hinders the use of case reports to inform research design or help guide clinical practice.[4] In response to these issues, reporting guidelines are under development to facilitate greater transparency and completeness in the provision of relevant information for individual cases.[4] The CARE (i.e. CAse REport) guidelines include a reporting checklist that is listed on theEQUATOR Network,[9] an international initiative aimed at promoting transparent and accurate reporting of health research studies to enhance the value and reliability of medical research literature. This 13-item checklist includes indications regarding the title, key words,abstract, introduction, patient information, clinical findings, timeline, diagnostic assessment, therapeutic interventions, follow-up and outcomes, discussion, patient perspective, andinformed consent.[4] An explanation and elaboration article (a manual for writing case reports following the CARE guidelines) was published in the Journal of Clinical Epidemiology in 2017.[10]
Many international journals publish case reports, but they restrict the number that appear in the print run because this has an adverse effect on the journal'simpact factor.[11] Case reports are often published online, and there is often still arequirement for a subscription to access them. However, an increasing number of journals are devoted to publishing case reports alone, most of which areopen access.[12][11] The first of these to start publishing, in 2001, wasGrand Rounds.[13][14]
There are a number of websites that allow patients to submit and share their own patient case reports with other people.PatientsLikeMe[15] and Treatment Report[16] are two such sites.
The term is also used to describe non-scientific reports usually prepared for educational reasons.
{{cite journal}}: CS1 maint: multiple names: authors list (link)