In contrast to comparative research, case studies are individual reports related to the care and management of individual patients, and form the core of the namesake Journal of Medical Case Reports. While they are considered less rigorous than controlled clinical data involving larger samples sizes, and their anecdotal nature can lead to publication bias favouring rarer presentations, the persistence of case reports in the era of evidence-based medicine supports their value within the scientific method, particularly with the increasing focus on individualised care.
Most health professionals first encounter case reports during training; however, while many things in medical training are standardised, case reports are not. The EQUATOR network of guidelines on reporting health research has over 200 guidelines, but none of these are for case reports. There is a vast array of contrasting literature on how to construct a case report, from what sections to include, to what topics to cover, but now, for the first time, the important issue of standardising case report formats has been addressed by a team of 27 key opinion leaders, including several members of the Journal of Medical Case Reports Editorial Board.
Following the Guidance for Developers of Health Research Reporting Guidelines, Gagnier and colleagues developed a three-phase consensus process consisting of:
1. Pre-meeting literature review followed by interviews to generate items for a case-report checklist
2. Face-to-face consensus meeting for drafting a reporting guideline
3. Post-meeting feedback and pilot testing, followed by finalisation of the guidelines.
The 13-item CAse REport (CARE) guidelines checklist was presented on 10 September 2013 at the International Peer Review and Biomedical Publication Congress and published simultaneously in seven medical journals, including the Journal of Medical Case Reports. The guidelines and checklist are also available from www.CARE-statement.org, the EQUATOR network and through Cases Database.
The CARE guidelines aim to provide an international, non-specific journal framework for the reporting of case studies, ensuring completeness and transparency. The standardisation of case reporting will present the opportunity for their outcomes to be systematically collected and combined into larger datasets, such as through Cases Database, facilitating the early discovery of effectiveness and potential hazards; and allowing for cross-cultural comparisons as to what works for real patients, in real situations, revolutionising how we think about ‘evidence’ in medicine.