Clinical and educational significance of case reports in medicine

A case report describes unique aspects of a medical or surgical case and provides clear clinical and educational significance in medicine given its rapid contributions to scientific literature and clinical practice. Despite the emphasis on randomised clinical trials, evidenced-based medicine, systemic reviews and meta-analyses, case reports continue to provide a novel and exceptional knowledge in medical education.


Clinical and educational significance of case reports in medicine
Michail Varras*

Editorial
Case reports provides important and detailed information for educational purposes related to clinical practice, which is often lost in larger studies 1,2 .
Case reports represent one of the oldest levels of evidence they have attracted much criticism.In recent years, randomised clinical trials, systematic reviews and meta-analyses have represented the gold standard in medical literature, while case reports are considered trivial and their conclusions have not usually undergone further investigations.
Case reports tend to have low citation value and the prevalence of these articles in high impact journals has reportedly declined 3 .Now is the time for a new approach to case reports.The long-term adverse consequences of foetal exposure to diethylstilboestrol in pregnancy originated from case reports and provided strong warnings against using new drugs 3,4 .Also, the discovery of new conditions, such as acquired immune deficiency syndrome (AIDS), severe acute respiratory syndrome (SARS) and swine flu, began with a single case and complemented evidence-based medicine 3,5,6 .In addition, drugs have been withdrawn from the market based on spontaneous case reports 3,[7][8][9][10] .The first face transplant 11 and first uterine transplant 12 were presented as single cases, and physicians learned more about the technical difficulties, immunological issues, and ethical dilemmas 3 .
Clinicians usually learn from anecdotal stories, and without a doubt, most of them have at some point of time come across memorable patients from whom they have learnt 13 .Reading case reports commonly triggers a variety of memories and ideas from personal practice and experience.Moreover, by writing about their patient's case in an educational forum, clinicians gain an opportunity to reflect on their practice; therefore, they should not be reluctant to write about their experiences 3,13 .Randomised clinical trials provide a statistical answer for very narrow clinical questions and influence tomorrow's practice, while case reports impact today's practice and provide details regarding many different aspects of a patient's medical situation, which is missed or undetected by clinical studies 13,14 .OA Case Reports has no connection with any society or associations and is a completely independent journal.
The need to launch a new journal is to promote the exchange of ideas, concepts and findings across researchers and physicians in all fields of medicine.OA Case Reports publishes the following types of scientific materials: editorials, original research study (case series), case study, case reports, reports for specific diagnostic procedures or surgical techniques, reviews, case in images, clinical images, hypothesis, methodology, study protocol, research results from pilot studies, short communication, letter to editor and meeting report, where a discussion of a specific case of phenomenon took place.
OA Case Reports aims to develop the science of case reports and raise their academic value in all fields of basic medical sciences and clinical specialties.Therefore, we invite submission of original case reports without restrictions by paper size or number of figures, tables and referees.Types of cases should include one of the following categories:

Medical Education & Research
In this editorial, the clinical values of case reports in medicine and surgery are discussed, and the details for a new journal OA Case Report are given.OA Case Report aims to develop the science of case reports and is committed to publish well-written case reports from around the world in all fields of basic medical sciences and clinical specialties.It aims to be a source of inspiration for clinicians and scientists and provide new research directions.OA Case Reports will publish research manuscripts dealing with a series of medical and surgical cases, short communications and reports on all stages of the research process; such as hypothesis, methodology, study protocols and pilot studies.OA Case Reports encourages submissions about the description of new knowledge, rare diseases, syndromes, new diagnostic tests, specific diagnostic images, rare clinicopathological correlations and surgical innovations as long as they are technically/scientifically correct.
For citation purposes: Varras M. Clinical and educational significance of case reports in medicine.OA Case Reports 2012 Dec 21;1(1):1.Apart from case report publications, OA Case Reports will publish traditional full research manuscripts, short communications, reports and articles on all stages of the research process such as hypothesis, methodology, study protocols and pilot studies.All manuscripts submitted to OA Case Reports will be subject to immediate screening by an editorial team, and appropriate manuscripts will be sent for peer review.The editorial board will be international and include experienced members from various areas of medicine.The members of the editorial board are expected to review a certain number of manuscripts each year.All manuscript will be peer reviewed on the basis of scientific merit, standards of excellence and editorial consistency by at least two peer reviewers, and identified by the editorial board before a first decision (reject, revise or accept) is made.The peer reviewers will be asked to assess the manuscript for the scientific content, actuality and relevance of the topic as well as for its presentation and clarity of writing and will indicate the revisions necessary to be made by the authors to allow publication.In case of discrepancy between the reviewers, a third reviewer will be brought in, and the ultimate decision will be made by the editor-inchief and this will be the final decision regardless of authors' disagreements.OA Case Reports will provide a fast, fair and constructive review process (first decision on manuscript within four weeks of submission), enabling publication with minimum delay and highest quality production values.
Open Access policy assures authors that their work will be available to the widest possible audience.OA Case Reports is a member of Publication Integrity and Ethics and has adopted the Ethical Rules of Disclosure of the Association for Medical Ethics.Open access provides an opportunity to present information to specialists and public and not just those with access to a library with a subscription.Many submitted articles are rejected by print journals not only due to 'non-valuable' content but also due to lack of space.The online appearance of OA Case Report will allow immediate publication of accepted articles, whilst sustaining a rapid peer review process resulting in high quality publications.
Accordingly, OA Case Report as a novel, open minded journal aims to form a rich platform of clinical information, which in the future, may be mined for the surveillance and treatment of diseases.Therefore, the database will become an important resource for clinicians, researchers and academic organisations.In 5 years' time from today, the database of OA Case Report will hopefully be an important resource for clinicians, researchers and academic organisations.OA Case Report will also become a well-established platform for Case Videos of experimental surgical and research techniques in Clinical Medical Sciences.In addition, OA Case Report will hopefully receive adequate number of submitted manuscripts each year, with proper acceptance rate for high quality publications, sustaining rapid peer review process and articles to be indexed to all relevant search engines.
Submissions of interesting and relevant manuscripts to OA Case Reports are welcomed.We encourage submissions about description of new knowledge, study protocols, pilot studies, rare diseases or syndromes, new diagnostic tests, specific diagnostic images, rare clinicopathological correlations and surgical innovations as long as they are technically and scientifically correct.Join us in this exciting new venture and submit your best cases to OA Case Reports.

Editorial
Licensee OA Publishing London 2012.Creative Commons Attribution License (CC-BY) • Reminder of an important clinical lesson.• Findings that shed new light on the possible pathogenesis of a disease.• An unexpected association between disease and symptoms.• New associations or variations in disease process.• Presentations, diagnoses and management of a new disease.• Unreported or unusual side effects or adverse interactions involving medications.• Novel diagnostic procedure.• Unexpected outcome in the course of observing or treating a patient.• Novel treatments.• Surgical innovations.• Learning from errors.• Myth exploded.