"Good case reporting demands a clear focus, to make explicit to the audience why a particular observation is important in the context of existing knowledge" (1).

What are case reports?

A case report is a narrative that describes, for medical, scientific, or educational purposes, a medical problem experienced by one or more patients (2).

Many original observations, unusual, new or uncommon diseases and complications of medical treatment, as well as novel diagnostic and therapeutic approaches were first identified and published as case reports (3). A case report is usually retrospective in nature and has no comparison group.

The role of case reports in uncovering important phenomena originates in the ancient past. Hippocrates’ Aphorisms, the Edwin Smith Papyrus and the Yellow Emperor’s Classic of Medicine are all compilations of case reports and anecdotes that are among the first written documentation of medical concerns (4).

Case reports serve three primary functions (4):

• Generating hypotheses for verification in subsequent longitudinal observational studies and clinical trials
• Documenting rare or unusual phenomena
• Providing clinical stories that help health care providers capture important clinical observations

Case studies differ from case reports in that they provide a comprehensive review of the literature and include a qualitative methodology . Case study research encompasses a great deal more complexity than a typical case report and often incorporates multiple streams of data combined in creative ways (5).

Benefits of case reports include:

• They provide important patient-centred clinical insight that may guide the individualization and personalization of treatments in clinical practice (3,6)
• They capture and describe important scientific and clinical observations that may be missed or undetected in ‘higher hierarchy’ designs such as clinical trials (3,6)
• They are helpful in the identification of adverse and beneficial effects, the recognition of new diseases, unusual forms of common diseases and the presentation of rare diseases (7). For example, the recognition of the link between administration of thalidomide to mothers and congenital abnormalities in their babies was triggered by a case report (8)
• They can complement conventional clinical research in the era of personalized medicine (9)
• They can help to identify new treatments, for example, propranolol as a treatment for infantile haemangioma began as a case observation of nine children (3,10)
• Viruses and diseases uncovered. For example, HIV was brought to the attention of mainstream medicine's notice through publication of a case report on Kaposi's sarcoma in a young homosexual male (3,11)
• Case reports can also play a relevant role in medical education, providing a structure for case-based learning (12)
• They provide an opportunity to describe clinical skills and clinical reasoning (engage critical thinking)
• They can enhance empathy with patients and provide perspective (4)
• The peer-review process undertaken in submitting a case-report offers valuable feedback, providing insights to clinicians beyond their training or clinical practice experiences (3)

Conclusion

The quality of the scientific reporting of case reports is variable. The CARE (CAse REporting) guidelines have been adopted by leading international journals to facilitate greater transparency and completeness in the provision of relevant information for individual cases. They also provide a framework that supports transparency and accuracy in the publication of case reports and the reporting of information from clinical encounters (12).The CARE guidelines include a reporting checklist that can be found on the EQUATOR Network (13).

The process of conceptualising, writing and submitting a case report can seem overwhelming to both aspiring and long-established clinicians, but can be rewarding both professionally and personally (3).