The CARE Guidelines: Consensus-based Clinical Case Reporting Guideline Development

Overview

Journal J Med Case Rep

Publisher Biomed Central

Specialty General Medicine

Date 2013 Nov 16

PMID 24228906

Citations 428

Authors

Joel J Gagnier

Gunver Kienle

Douglas G Altman

David Moher

Harold Sox

David Riley

Affiliations

Soon will be listed here.

Abstract

Background: A case report is a narrative that describes, for medical, scientific, or educational purposes, a medical problem experienced by one or more patients. Case reports written without guidance from reporting standards are insufficiently rigorous to guide clinical practice or to inform clinical study design.Primary Objective. Develop, disseminate, and implement systematic reporting guidelines for case reports.

Methods: We used a three-phase consensus process consisting of (1) pre-meeting literature review and interviews to generate items for the reporting guidelines, (2) a face-to-face consensus meeting to draft the reporting guidelines, and (3) post-meeting feedback, review, and pilot testing, followed by finalization of the case report guidelines.

Results: This consensus process involved 27 participants and resulted in a 13-item checklist-a reporting guideline for case reports. The primary items of the checklist are title, key words, abstract, introduction, patient information, clinical findings, timeline, diagnostic assessment, therapeutic interventions, follow-up and outcomes, discussion, patient perspective, and informed consent.

Conclusions: We believe the implementation of the CARE (CAse REport) guidelines by medical journals will improve the completeness and transparency of published case reports and that the systematic aggregation of information from case reports will inform clinical study design, provide early signals of effectiveness and harms, and improve healthcare delivery.

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References

Turner L, Shamseer L, Altman D, Schulz K, Moher D . Does use of the CONSORT Statement impact the completeness of reporting of randomised controlled trials published in medical journals? A Cochrane review. Syst Rev. 2012; 1:60. PMC: 3564748. DOI: 10.1186/2046-4053-1-60. View

Horton J . Nominal group technique. A method of decision-making by committee. Anaesthesia. 1980; 35(8):811-4. DOI: 10.1111/j.1365-2044.1980.tb03924.x. View

Kaszkin-Bettag M, Hildebrandt W . Case reports on cancer therapies: the urgent need to improve the reporting quality. Glob Adv Health Med. 2013; 1(2):8-10. PMC: 3833504. DOI: 10.7453/gahmj.2012.1.2.002. View

Moher D, Liberati A, Tetzlaff J, Altman D . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009; 6(7):e1000097. PMC: 2707599. DOI: 10.1371/journal.pmed.1000097. View

Hill A . THE ENVIRONMENT AND DISEASE: ASSOCIATION OR CAUSATION?. Proc R Soc Med. 1965; 58:295-300. PMC: 1898525. DOI: 10.1177/003591576505800503. View

von Elm E, Altman D, Egger M, Pocock S, Gotzsche P, Vandenbroucke J . Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ. 2007; 335(7624):806-8. PMC: 2034723. DOI: 10.1136/bmj.39335.541782.AD. View

Thomas B . Using nominal group technique to identify researchable problems. J Nurs Educ. 1983; 22(8):335-7. DOI: 10.3928/0148-4834-19831001-05. View

Hauben M, Aronson J . Gold standards in pharmacovigilance: the use of definitive anecdotal reports of adverse drug reactions as pure gold and high-grade ore. Drug Saf. 2007; 30(8):645-55. DOI: 10.2165/00002018-200730080-00001. View

Williams P, Webb C . The Delphi technique: a methodological discussion. J Adv Nurs. 1994; 19(1):180-6. DOI: 10.1111/j.1365-2648.1994.tb01066.x. View

10.

Kelly W, Arellano F, Barnes J, Bergman U, Edwards R, Fernandez A . Guidelines for submitting adverse event reports for publication. Drug Saf. 2007; 30(5):367-73. DOI: 10.2165/00002018-200730050-00001. View

11.

Hopewell S, Clarke M, Moher D, Wager E, Middleton P, Altman D . CONSORT for reporting randomized controlled trials in journal and conference abstracts: explanation and elaboration. PLoS Med. 2008; 5(1):e20. PMC: 2211558. DOI: 10.1371/journal.pmed.0050020. View

12.

Calvert M, Blazeby J, Altman D, Revicki D, Moher D, Brundage M . Reporting of patient-reported outcomes in randomized trials: the CONSORT PRO extension. JAMA. 2013; 309(8):814-22. DOI: 10.1001/jama.2013.879. View

13.

Richason T, Paulson S, Lowenstein S, Heard K . Case reports describing treatments in the emergency medicine literature: missing and misleading information. BMC Emerg Med. 2009; 9:10. PMC: 2703616. DOI: 10.1186/1471-227X-9-10. View

14.

Riley D . Case reports in the era of clinical trials. Glob Adv Health Med. 2014; 2(2):10-1. PMC: 3833525. DOI: 10.7453/gahmj.2013.012. View

15.

Hirst A, Altman D . Are peer reviewers encouraged to use reporting guidelines? A survey of 116 health research journals. PLoS One. 2012; 7(4):e35621. PMC: 3338712. DOI: 10.1371/journal.pone.0035621. View

16.

Hopewell S, Ravaud P, Baron G, Boutron I . Effect of editors' implementation of CONSORT guidelines on the reporting of abstracts in high impact medical journals: interrupted time series analysis. BMJ. 2012; 344:e4178. PMC: 3382226. DOI: 10.1136/bmj.e4178. View

17.

Vandenbroucke J . In defense of case reports and case series. Ann Intern Med. 2001; 134(4):330-4. DOI: 10.7326/0003-4819-134-4-200102200-00017. View

18.

Kiene H, Hamre H, Kienle G . In support of clinical case reports: a system of causality assessment. Glob Adv Health Med. 2014; 2(2):64-75. PMC: 3833527. DOI: 10.7453/gahmj.2012.061. View

19.

Moher D, Schulz K, Simera I, Altman D . Guidance for developers of health research reporting guidelines. PLoS Med. 2010; 7(2):e1000217. PMC: 2821895. DOI: 10.1371/journal.pmed.1000217. View

20.

Levy M . Propranolol for infantile hemangiomas. Glob Adv Health Med. 2013; 1(2):14-6. PMC: 3833502. DOI: 10.7453/gahmj.2012.1.2.004. View