In
medicine
Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care pract ...
, a case report is a detailed report of the
symptom
Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormality showin ...
s,
sign
A sign is an object, quality, event, or entity whose presence or occurrence indicates the probable presence or occurrence of something else. A natural sign bears a causal relation to its object—for instance, thunder is a sign of storm, or me ...
s,
diagnosis
Diagnosis is the identification of the nature and cause of a certain phenomenon. Diagnosis is used in many different disciplines, with variations in the use of logic, analytics, and experience, to determine " cause and effect". In systems engin ...
, treatment, and follow-up of an individual
patient
A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other health c ...
. Case reports may contain a
demographic profile
Demographic profiling is a form of demographic analysis used by marketers so that they may be as efficient as possible with advertising products or services and identifying any possible gaps in their marketing strategy. Demographic profiling can e ...
of the patient, but usually describe an unusual or novel occurrence. Some case reports also contain a
literature review
A literature review is an overview of the previously published works on a topic. The term can refer to a full scholarly paper or a section of a scholarly work such as a book, or an article. Either way, a literature review is supposed to provid ...
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
An adverse event (AE) is any untoward medical occurrence in a patient or clinical investigation subject administered a pharmaceutical product and which does not necessarily have a causal relationship with this treatment. An adverse event can ther ...
, and cost. They can be shared for medical, scientific, or educational purposes.
Types
Most case reports are on one of six topics:
* An unexpected association between
disease
A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that a ...
s or
symptom
Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormality showin ...
s.
* An unexpected event in the course of observing or treating a patient.
* Findings that shed new light on the possible
pathogenesis
Pathogenesis is the process by which a disease or disorder develops. It can include factors which contribute not only to the onset of the disease or disorder, but also to its progression and maintenance. The word comes from Greek πάθος ''pat ...
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
Anecdotal evidence is evidence based only on personal observation, collected in a casual or non-systematic manner. The term is sometimes used in a legal context to describe certain kinds of testimony which are uncorroborated by objective, independ ...
. Given their intrinsic
methodological
In its most common sense, methodology is the study of research methods. However, the term can also refer to the methods themselves or to the philosophical discussion of associated background assumptions. A method is a structured procedure for bri ...
limitations, including lack of
statistical sampling
In statistics, quality assurance, and survey methodology, sampling is the selection of a subset (a statistical sample) of individuals from within a statistical population to estimate characteristics of the whole population. Statisticians attem ...
, case reports are placed at the bottom of the
hierarchy of clinical evidence, together with
case series
A case series (also known as a clinical series) is a type of medical research study that tracks subjects with a known exposure, such as patients who have received a similar treatment, or examines their medical records for exposure and outcome. Ca ...
.
Nevertheless, case reports do have genuinely useful roles in
medical research
Medical research (or biomedical research), also known as experimental medicine, encompasses a wide array of research, extending from "basic research" (also called ''bench science'' or ''bench research''), – involving fundamental scientif ...
and
evidence-based medicine
Evidence-based medicine (EBM) is "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients". The aim of EBM is to integrate the experience of the clinician, the values of t ...
.
In particular, they have facilitated recognition of new diseases and adverse effects of treatments
(e.g., recognition of the link between administration of
thalidomide
Thalidomide, sold under the brand names Contergan and Thalomid among others, is a medication used to treat a number of cancers (including multiple myeloma), graft-versus-host disease, and a number of skin conditions including complications of ...
to mothers and malformations in their babies was triggered by a case report). Case reports have a role in
pharmacovigilance
Term Given By Tushar Sharma (UPES Batch 2025)
Pharmacovigilance (PV, or PhV), also known as drug safety, is the pharmaceutical science relating to the "collection, detection, assessment, monitoring, and prevention" of adverse effects with pharma ...
.
[ They can also help understand the clinical spectrum of ]rare diseases
A rare disease is any disease that affects a small percentage of the population. In some parts of the world, an orphan disease is a rare disease whose rarity means there is a lack of a market large enough to gain support and resources for discove ...
as well as unusual presentations of common diseases.[ They can help generate study ]hypotheses
A hypothesis (plural hypotheses) is a proposed explanation for a phenomenon. For a hypothesis to be a scientific hypothesis, the scientific method requires that one can test it. Scientists generally base scientific hypotheses on previous obser ...
, including plausible mechanisms of disease.[ Case reports may also have a role to play in guiding the ]personalization
Personalization (broadly known as customization) consists of tailoring a service or a product to accommodate specific individuals, sometimes tied to groups or segments of individuals. A wide variety of organizations use personalization to improv ...
of treatments in clinical practice.[
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. Whereas ]randomized clinical trial
A randomized controlled trial (or randomized control trial; RCT) is a form of scientific experiment used to control factors not under direct experimental control. Examples of RCTs are clinical trials that compare the effects of drugs, surgical te ...
s 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 is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care practic ...
situation (e.g. patient history
The medical history, case history, or anamnesis (from Greek: ἀνά, ''aná'', "open", and μνήσις, ''mnesis'', "memory") of a patient is information gained by a physician by asking specific questions, either to the patient or to other peo ...
, physical examination
In a physical examination, medical examination, or clinical examination, a medical practitioner examines a patient for any possible medical signs or symptoms of a medical condition. It generally consists of a series of questions about the patien ...
, diagnosis
Diagnosis is the identification of the nature and cause of a certain phenomenon. Diagnosis is used in many different disciplines, with variations in the use of logic, analytics, and experience, to determine " cause and effect". In systems engin ...
, psychosocial
The psychosocial approach looks at individuals in the context of the combined influence that psychological factors and the surrounding social environment have on their physical and mental wellness and their ability to function. This approach is ...
aspects, follow up).
Because typical, unremarkable cases are less likely to be published, use of case reports as scientific evidence must take into account publication bias
In published academic research, publication bias occurs when the outcome of an experiment or research study biases the decision to publish or otherwise distribute it. Publishing only results that show a significant finding disturbs the balance o ...
. Some case reports also contain an extensive review of the relevant literature on the topic at-hand (and sometimes a systematic review
A systematic review is a Literature review, scholarly synthesis of the evidence on a clearly presented topic using critical methods to identify, define and assess research on the topic. A systematic review extracts and interprets data from publ ...
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
A case study is an in-depth, detailed examination of a particular case (or cases) within a real-world context. For example, case studies in medicine may focus on an individual patient or ailment; case studies in business might cover a particular fi ...
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.[
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.]
Reporting guidelines
The quality of the scientific reporting of case reports is variable, and sub-optimal reporting hinders the use of case reports to inform research design or help guide clinical practice.[ In response to these issues, reporting guidelines are under development to facilitate greater transparency and completeness in the provision of relevant information for individual cases.][ The CARE (i.e. CAse REport) guidelines include a reporting checklist that is listed on the ]EQUATOR Network
The EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network is an international initiative aimed at promoting transparent and accurate reporting of health research studies to enhance the value and reliability of medical resear ...
, an international initiative aimed at promoting transparent and accurate reporting of health research studies to enhance the value and reliability of medical research literature. This 13-item checklist includes indications regarding the title, key words, abstract, introduction, patient information, clinical findings, timeline, diagnostic assessment, therapeutic interventions, follow-up and outcomes, discussion, patient perspective, and informed consent
Informed consent is a principle in medical ethics and medical law, that a patient must have sufficient information and understanding before making decisions about their medical care. Pertinent information may include risks and benefits of treatme ...
.[ An explanation and elaboration article (a manual for writing case reports following the CARE guidelines) was published in the Journal of Clinical Epidemiology in 2017.
]
Publishing
Many international journals publish case reports, but they restrict the number that appear in the print run because this has an adverse effect on the journal's impact factor
The impact factor (IF) or journal impact factor (JIF) of an academic journal is a scientometric index calculated by Clarivate that reflects the yearly mean number of citations of articles published in the last two years in a given journal, as i ...
.[ Case reports are often published online, and there is often still a requirement for a subscription to access them. However, an increasing number of journals are devoted to publishing case reports alone, most of which are ]open access
Open access (OA) is a set of principles and a range of practices through which research outputs are distributed online, free of access charges or other barriers. With open access strictly defined (according to the 2001 definition), or libre op ...
. The first of these to start publishing, in 2001, was ''Grand Rounds
Grand rounds are a methodology of medical education and inpatient care, consisting of presenting the medical problems and treatment of a particular patient to an audience consisting of doctors, pharmacists, residents, and medical students. It wa ...
''.
There are a number of websites that allow patients to submit and share their own patient case reports with other people. PatientsLikeMe
PatientsLikeMe is the world’s largest integrated community, health management, and real-world data platform. Through PatientsLikeMe, a growing community of more than 830,000 people with over 2,900 conditions share personal stories and informat ...
and Treatment Report are two such sites.
Use of terminology outside science
The term is also used to describe non-scientific reports usually prepared for educational reasons.
Famous scientific case reports
* Sigmund Freud
Sigmund Freud ( , ; born Sigismund Schlomo Freud; 6 May 1856 – 23 September 1939) was an Austrian neurologist and the founder of psychoanalysis, a clinical method for evaluating and treating psychopathology, pathologies explained as originatin ...
reported on numerous cases, including Anna O.
Bertha Pappenheim (27 February 1859 – 28 May 1936) was an Austrian-Jewish feminist, a social pioneer, and the founder of the Jewish Women's Association (''). Under the pseudonym Anna O., she was also one of Josef Breuer's best-documented pat ...
, Dora, Little Hans
Herbert Graf (10 April 1903 – 5 April 1973) was an Austrian-American opera producer. Born in Vienna in 1903, he was the son of Max Graf (1873–1958), and Olga Hönig. His father was an Austrian author, critic, musicologist and member of Si ...
, Rat 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"(1909). This was the second of six case histories ...
, and Wolf Man
* Frederick Treves reported on "The Elephant Man
Joseph Carey Merrick (5 August 1862 – 11 April 1890), often erroneously called John Merrick, was an English man known for having severe deformities. He was first exhibited at a freak show under the stage name "the Elephant Man" and then wen ...
"
* Paul Broca
Pierre Paul Broca (, also , , ; 28 June 1824 – 9 July 1880) was a French physician, anatomist and anthropologist. He is best known for his research on Broca's area, a region of the frontal lobe that is named after him. Broca's area is involve ...
reported on language impairment following left hemisphere lesions in the 1860s.
* Joseph Jules Dejerine
Joseph Jules Dejerine (3 August 1849 – 26 February 1917), was a French neurologist.
Biography
Joseph Jules Dejerine was born to French parents in Geneva, Switzerland, where his father was a carriage proprietor. During the Franco-Prussian War ...
reported on a case of pure alexia
Pure alexia, also known as agnosic alexia or alexia without agraphia or pure word blindness, is one form of alexia which makes up "the peripheral dyslexia" group. Individuals who have pure alexia have severe reading problems while other language-r ...
.
* William MacIntyre reported on a case of multiple myeloma
Multiple myeloma (MM), also known as plasma cell myeloma and simply myeloma, is a cancer of plasma cells, a type of white blood cell that normally produces antibodies. Often, no symptoms are noticed initially. As it progresses, bone pain, an ...
(described in the 1840s).
* Christiaan Barnard
Christiaan Neethling Barnard (8 November 1922 – 2 September 2001) was a South African cardiac surgeon who performed the world's first human-to-human heart transplant operation. On 3 December 1967, Barnard transplanted the heart of accident-v ...
described the world's first heart transplant
A heart transplant, or a cardiac transplant, is a surgical transplant procedure performed on patients with end-stage heart failure or severe coronary artery disease when other medical or surgical treatments have failed. , the most common proce ...
as a case report
* W. G. McBride, Thalidomide Case Report (1961). ''The Lancet'' 2:1358.
See also
* Case presentation A case presentation is a formal communication between health care professionals such as doctors and nurses regarding a patient's clinical information.
Essential parts of a case presentation include:
* Identification
* Reason for consultation/admis ...
References
*
Further reading
*
*
*
*
External links
Case reports – The CARE guidelines
{{Medical research studies
Medical terminology
Medical literature
Clinical research
Reports