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.
Types of case reports
Most case reports are on one of six topics:
- 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.
Usefulness and validity
A case report is a type of anecdotal evidence. As such, it is less scientifically rigorous than controlled clinical data involving a larger sample size. Because typical, unremarkable cases are less likely to be published, use of case reports as scientific evidence must take into account publication bias. Nevertheless, proponents argue that case reports have value within scientific method:
- They permit discovery of new diseases and unexpected effects (adverse or beneficial) as well as the study of mechanisms, and they play an important role in medical education. 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.
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).
In some case reports, there is an extensive review of the relevant literature on the topic at-hand. These case reports can be easily identified by terms such as a "case report and review of the literature." Because of this active research involved, such case reports can be, to a degree, be considered case studies, by the true definition of the term.
Other advantages of case reports are being published quickly in comparison to randomized control trials, making them to be a kind of rapid short communication between clinicians, and being authored by busy clinicians who probably do not have the time or money to conduct large scale research.
Publishing case reports
Many international journals will publish case reports, but they restrict the number that appear in the print run because this has an adverse effect on the journal Impact Factor. Case reports are often put in the internet part of the journal and there is often still a requirement for a subscription to access them. However there are a few that are devoted to publishing case reports alone, and these are all Open Access. The first of these to start publishing, in 2001, is Grand Rounds. Other similar journals include Case Reports in Medicine, Journal of Medical Case Reports, Oncology Reports, Oncology Letters and Cases Journal; all of them publish peer reviewed case reports in all areas of medicine. Cases Journal recently merged with the Journal of Medical Case Reports but still maintains an independent internet portal. BMJ Case Reports is an online, peer-reviewed journal publishing cases in all disciplines. Radiology Case Reports and the Journal of Radiology Case Reports are open-access peer-reviewed journals focusing on medical imaging. Journal Of Surgical Case Reports is an open access peer reviewed journal that considers case reports in the field of surgery. Journal of Orthopaedic Case Reports is a new open access, peer reviewed journal that publishes Orthopaedic case reports. Oncology Reports and Oncology Letters both publish case reports exclusively as open access, peer reviewed journals in the field of oncology and cancer medicine.
Use of term outside science
The term is also used to describe non-scientific reports usually prepared for their educational value.
Famous scientific case reports
- Sigmund Freud reported on numerous cases, including Anna O., Dora, Little Hans, Rat Man, and Wolf Man
- Frederick Treves reported on "The Elephant Man"
- Paul Broca reported on language impairment following left hemisphere lesions in the 1860s.
- Joseph Jules Dejerine reported on a case of pure alexia.
- William MacIntyre reported on a case of multiple myeloma (described in the 1840s).
- Christiaan Barnard described the world's first heart transplant as a case report
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