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EDITORIAL |
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Year : 2021 | Volume
: 1
| Issue : 3 | Page : 389-390 |
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CARE – The clinical case report checklist
Santosh G Honavar
Editor, Indian Journal of Ophthalmology, Centre for Sight, Hyderabad, Telangana, India
Date of Web Publication | 02-Jul-2021 |
Correspondence Address: Dr. Santosh G Honavar Editor, Indian Journal of Ophthalmology, Centre for Sight, Hyderabad, Telangana India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/ijo.IJO_1764_21
How to cite this article: Honavar SG. CARE – The clinical case report checklist. Indian J Ophthalmol Case Rep 2021;1:389-90 |
“In the era of evidence-based practice, we need practice-based evidence” – Michael Kidd AM
The cumulative value of well-documented case reports in building practice-based evidence cannot be overemphasized. Case reports typically present a novel clinical condition, an unexpected association between two diseases, a new mechanism of pathogenesis, a novel diagnostic tool, an innovative treatment modality and its outcome, or an adverse effect of treatment.[1],[2] Despite having been placed low in the hierarchy of evidence-based medicine, case reports play a significant role in the rapid generation of practically utilizable new knowledge and in stimulating further research. An ideal case report should be well structured to include all the necessary clinical components and distill a logical and clear message. However, the quality of case reports across journals is often uneven and is insufficiently rigorous to be aggregated for data analysis, replicated, or readily used to guide clinical decisions.[3],[4] Use of standardized, systematic norms for manuscript preparation may help optimize the quality and improve the impact of case reports.
The 13-point CAse REport (CARE) checklist is systematically structured to standardize the key components of a case report [Figure 1].[3],[4] The title should be succinct and accurate and should include the diagnosis or intervention and outcome, and identify the manuscript as a Case Report.[1],[2],[3],[4] Keywords should represent the diagnosis or intervention and include terms found in the Index Medicus database (medical subheadings, MeSH). Abstract for a case report is generally unstructured and should provide a clinical summary, highlights of the case, and take-away points within the prescribed word limit.[1],[2],[3],[4] Introduction should lay a background for reporting the case, clearly mention the purpose and emphasize why the case would contribute to the literature.[1],[2],[3],[4] The body of the case report should include patient consent; demographics; main symptoms; medical, family, and genetic history; prior treatment and outcomes; timeline of events; relevant clinical findings; details of diagnostic tests; diagnosis, and the basis for the same; sequence of therapeutic intervention and the rationale; adverse effects; follow-up event line; and the outcome.[1],[2],[3],[4] The discussion should compare the current case with similar published literature (in the form of a table if suitable) and highlight new knowledge. The discussion could also address the rationale behind the diagnosis and the choice of management if relevant. Limitations of the case should be explicitly stated and discussed.[1],[2],[3],[4] The conclusion should succinctly state the learning points from the case presented and should not extrapolate beyond the data. References should follow the Journal style and limits. Well-formatted and cropped images with a clean background and in good resolution vastly enhance the quality of the case report and the reader-interest. Tables should have a descriptive title and a legend, and figures should have a detailed legend. The CARE checklist incorporates all these parameters and helps build a publishable case report. CARE-writer (http://www.care-writer.com) is an online tool (developed by the Scientific Writing in Health and Medicine Group, a part of the integrative Medicine Institute) that helps the authors organize clinical information and format case reports using the CARE guidelines.
Case reports are at the bottom of the pyramid of evidence-based medicine, yet form the bulk of practice-based evidence. Clear and concise case reports are an invaluable source of learning material for clinicians. The CARE guidelines seem to provide a robust framework to meet the criteria for an ideal case report.
References | |  |
1. | Rison RA. A guide to writing case reports for the Journal of Medical Case Reports and BioMed Central Research Notes. J Med Case Rep 2013;7:239. |
2. | Green BN, Johnson CD. How to write a case report for publication. J Chirp Med 2006;5:72-82. |
3. | Gagnier JJ, Kienle G, Altman DG, Moher D, Sox H, Riley D. The CARE Guidelines: Consensus-based clinical case reporting guideline development. J Clin Epidemiol 67:46-51. |
4. | Kaszkin-Bettag M, Hildebrandt W. Case report on cancer therapies: The urgent need to improve the reporting quality. Global Adv Health Med 2012;1:8-10. |
[Figure 1]
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