Case report

From Wikipedia, the free encyclopedia

In medicine, a case report is a detailed report of the symptoms, signs, diagnosis, treatment,
and follow-up of an individual patient. Case reports may contain a demographic profile of
the patient, but usually describe an unusual or novel occurrence. Some case reports also
contain a literature 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.

Contents
1 Types
2 Roles in research and education
3 Reporting guidelines
4 Publishing
5 Use of terminology outside science
6 Famous scientific case reports
7 References
8 Further reading
9 External links

Types
Most case reports are on one of six topics:[1]

An unexpected association between diseases or symptoms.

An unexpected event in the course of observing or treating a patient.
Findings that shed new light on the possible pathogenesis of a disease or an adverse
effect.
Unique or rare features of a disease.
Unique therapeutic approaches.
A positional or quantitative variation of the anatomical structures.

Roles in research and education

A case report is generally considered a type of anecdotal evidence.[2] Given their intrinsic
methodological limitations, including lack of statistical sampling, case reports are placed at
the foot of the hierarchy of clinical evidence, together with case series.[3] Nevertheless, case
reports do have genuinely useful roles in medical research and evidence-based medicine.[4]
In particular, they have facilitated recognition of new diseases and adverse effects of
treatments.[5] (For example, recognition of the link between administration of thalidomide
to mothers and malformations in their babies was triggered by the report of a particular
case.)[6] Case reports have a role in pharmacovigilance.[5] They can also help understand the
clinical spectrum of rare diseases, as well as unusual presentations of common diseases.[4]
They can help generate study hypotheses, including plausible mechanisms of disease.[4]
Case reports may also have a role to play in guiding the personalization 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] Whereas
randomized 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's medical 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 account publication bias. Some case reports also contain
an extensive review of the relevant literature on the topic at-hand (and sometimes a
systematic 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 considered case studies in the true definition
of the term.

Case reports can also play a relevant role in medical education, providing a structure for
case-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]