Practical Benefits of Case Reporting
Case reports are an undervalued component of the medical literature. They represent an important mechanism for disseminating novel observations to a broad audience. Case reports form the foundation of the evidence-based pyramid; these early observations i
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Introduction Case reports represent an important avenue for clinicians aiming to disseminate novel observations to a broad audience. The value of case reports has been contested in recent decades, in part due to an increased focus on publishing scientific papers that bolster a journal’s impact factor [1]. Despite this trend, case reports remain an accessible and achievable mechanism for many practitioners to publish. This is particularly true for trainees and junior faculty seeking publications for career advancement but who lack the research skills to execute a sophisticated research study [2, 3]. This chapter will address the practical benefits of case reporting with a particular focus on the role of case reports in enhancing the medical literature, patient care, and career development.
Contribution to the Medical Literature For centuries, case reports occupied a highly respected place in the medical literature [4] (see Chap. 2). With its roots planted in the Greek classical era, the modern case report evolved as a critical mode of communication to help practitioners © Springer International Publishing Switzerland 2017 C.D. Packer et al., Writing Case Reports, DOI 10.1007/978-3-319-41899-5_4
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Chapter 4.
Practical Benefits of Case Reporting
exchange knowledge about pathophysiology and disease. Fundamentally, case reports are based on observations: they allow medical practitioners to catalog their experiences with unusual presentations of disease, innovative surgical and procedural techniques, and the effects of new drugs [5]. While medical case reporting gained relevance for centuries, the emergence of evidence-based medicine ushered in a new era focused on large-scale research to inform clinical care. Within this context, levels of evidence are stratified according to strength and rigor, with systematic reviews and randomized controlled trials occupying the apex of the evidence-based pyramid, while expert opinion, case reports, and case series form the base [6] (see Fig. 4.1). This paradigm shift, with its move away from observational data to guide clinical decision-making, led many to reconsider the merit of case reports. Indeed, the number of case reports published in high-impact journals declined dramatically over the last several decades [1]. Case reports are less likely to be cited as frequently as large research studies, which can adversely affect a journal’s impact factor [7]. Because journals generally strive for the highest possible impact factor, editors are often reluctant to publish case reports fearing a decline in ratings.
Systematic Reviews Randomized Trials Cohort Studies Case Control Studies Case Series, Case Reports Animal Research/Expert Opinion
Figure 4.1 The hierarchy of evidence
The Case For Guidelines
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Although observational – and even anecdotal in nature – case reports and case series remain a critical plank in the platform of evidence-based medicine. Publication of novel disease presentations and treatment effects spur additional research and may highlight the emergenc
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