Case report
Encyclopedia
In medicine
, a case report is a detailed report of the symptom
s, sign
s, 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.
. As such, it is less scientifically rigorous than controlled clinical data involving a larger sample size
. Proponents argue that case reports have value within scientific method
:
Whereas randomized clinical trials are 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).
. 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
, 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.
There are a number of websites that allow patients to submit and share their own case reports with other people. Patients Like Me and Treatment Report are two such sites.
Medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
, a case report is a detailed report of the symptom
Symptom
A symptom is a departure from normal function or feeling which is noticed by a patient, indicating the presence of disease or abnormality...
s, sign
Medical sign
A medical sign is an objective indication of some medical fact or characteristic that may be detected by a physician during a physical examination of a patient....
s, diagnosis
Diagnosis
Diagnosis is the identification of the nature and cause of anything. Diagnosis is used in many different disciplines with variations in the use of logics, analytics, and experience to determine the cause and effect relationships...
, treatment, and follow-up of an individual patient
Patient
A patient is any recipient of healthcare services. The patient is most often ill or injured and in need of treatment by a physician, advanced practice registered nurse, veterinarian, or other health care provider....
. Case reports may contain a demographic profile
Demographic profile
A demographic or demographic profile is a term used in marketing and broadcasting, to describe a demographic grouping or a market segment...
of the patient, but usually describe an unusual or novel occurrence.
Types of case reports
Most case reports are on one of six topics:- An unexpected association between diseaseDiseaseA disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...
s or symptomSymptomA symptom is a departure from normal function or feeling which is noticed by a patient, indicating the presence of disease or abnormality...
s. - An unexpected event in the course of observing or treating a patient.
- Findings that shed new light on the possible pathogenesisPathogenesisThe pathogenesis of a disease is the mechanism by which the disease is caused. The term can also be used to describe the origin and development of the disease and whether it is acute, chronic or recurrent...
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 evidenceAnecdotal evidence
The expression anecdotal evidence refers to evidence from anecdotes. Because of the small sample, there is a larger chance that it may be true but unreliable due to cherry-picked or otherwise unrepresentative of typical cases....
. As such, it is less scientifically rigorous than controlled clinical data involving a larger sample size
Sample size
Sample size determination is the act of choosing the number of observations to include in a statistical sample. The sample size is an important feature of any empirical study in which the goal is to make inferences about a population from a sample...
. Proponents argue that case reports have value within scientific method
Scientific method
Scientific method refers to a body of techniques for investigating phenomena, acquiring new knowledge, or correcting and integrating previous knowledge. To be termed scientific, a method of inquiry must be based on gathering empirical and measurable evidence subject to specific principles of...
:
- 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. (Vandenbroucke, 2001)
Whereas randomized clinical trials are 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
Medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
situation (e.g. patient history, physical examination
Physical examination
Physical examination or clinical examination is the process by which a doctor investigates the body of a patient for signs of disease. It generally follows the taking of the medical history — an account of the symptoms as experienced by the patient...
, diagnosis
Diagnosis
Diagnosis is the identification of the nature and cause of anything. Diagnosis is used in many different disciplines with variations in the use of logics, analytics, and experience to determine the cause and effect relationships...
, psychosocial
Psychosocial
For a concept to be psychosocial means it relates to one's psychological development in, and interaction with, a social environment. The individual needs not be fully aware of this relationship with his or her environment. It was first commonly used by psychologist Erik Erikson in his stages of...
aspects, follow up).
Advantages
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.Famous scientific case reports
- Sigmund FreudSigmund FreudSigmund Freud , born Sigismund Schlomo Freud , was an Austrian neurologist who founded the discipline of psychoanalysis...
reported on numerous cases, including Anna O.Anna O.Anna O. was the pseudonym of a patient of Josef Breuer, who published her case study in his book Studies on Hysteria, written in collaboration with Sigmund Freud. Her real name was Bertha Pappenheim , an Austrian-Jewish feminist and the founder of the Jüdischer Frauenbund .Anna O...
, Dora, Little Hans, Rat ManRat Man"Rat Man" was the nickname given by Sigmund Freud to a patient whose 'case history' was published as Bemerkungen über einen Fall von Zwangsneurose ['Notes Upon A Case Of Obsessional Neurosis']...
, and Wolf ManSergei PankejeffSergei Konstantinovitch Pankejeff was a Russian aristocrat from Odessa best known for being a patient of Sigmund Freud, who gave him the pseudonym of Wolf Man to protect his identity, after a dream Pankejeff had of a tree full of white wolves.- Biography :The Pankejeff family Sergei... - Frederick TrevesSir Frederick Treves, 1st BaronetSir Frederick Treves, 1st Baronet, GCVO, CH, CB was a prominent British surgeon of the Victorian and Edwardian eras, now most famous for his friendship with Joseph Merrick, "the Elephant Man".-Eminent surgeon:...
reported on "The Elephant ManJoseph MerrickJoseph Carey Merrick , sometimes incorrectly referred to as John Merrick, was an English man with severe deformities who was exhibited as a human curiosity named the Elephant Man. He became well known in London society after he went to live at the London Hospital...
" - Paul BrocaPaul BrocaPierre Paul Broca was a French physician, surgeon, anatomist, and anthropologist. He was born in Sainte-Foy-la-Grande, Gironde. He is best known for his research on Broca's area, a region of the frontal lobe that has been named after him. Broca’s Area is responsible for articulated language...
reported on language impairment following left hemisphere lesions in the 1860s. - Joseph Jules DejerineJoseph Jules DejerineJoseph Jules Dejerine , was a French neurologist.Joseph Jules Dejerine was born to French parents in Geneva, Switzerland, where his father was a carriage proprietor. During the Franco-Prussian War Dejerine worked as a volunteer in a Geneva Hospital and in the spring of 1871 decided to pursue his...
reported on a case of pure alexiaAlexia (disorder)Alexia occurs when damage to the brain causes a patient to lose the ability to read...
. - William MacIntyreWilliam MacIntyreWilliam MacIntyre was a British physician known for publishing the first case report of multiple myeloma in 1850.MacIntyre graduated from the University of Edinburgh in 1811....
reported on a case of multiple myelomaMultiple myelomaMultiple myeloma , also known as plasma cell myeloma or Kahler's disease , is a cancer of plasma cells, a type of white blood cell normally responsible for the production of antibodies...
(described in the 1840s). - Christiaan BarnardChristiaan BarnardChristiaan Neethling Barnard was a South African cardiac surgeon who performed the world's first successful human-to-human heart transplant.- Early life :...
described the world's first heart transplant as a case report
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 FactorImpact factor
The impact factor, often abbreviated IF, is a measure reflecting the average number of citations to articles published in science and social science journals. It is frequently used as a proxy for the relative importance of a journal within its field, with journals with higher impact factors deemed...
. 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
Impact factor
The impact factor, often abbreviated IF, is a measure reflecting the average number of citations to articles published in science and social science journals. It is frequently used as a proxy for the relative importance of a journal within its field, with journals with higher impact factors deemed...
. 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
Journal of Medical Case Reports
Journal of Medical Case Reports is an open access, peer-reviewed online journal that will consider any original case report that expands the field of general medical knowledge...
, and Cases Journal
Cases Journal
Cases Journal was an open access, peer-reviewed medical journal publishing any case reports from any area of healthcare that were understandable, ethical, authentic, and included all information essential to its interpretation. The journal had no publication criteria based on the interest level of...
; 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.
There are a number of websites that allow patients to submit and share their own case reports with other people. Patients Like Me and Treatment Report are two such sites.