A "care report" typically refers to a detailed account of the medical condition or a specific case or condition. It aims to document unique or interesting aspects of the patient's diagnosis, treatment, and outcomes. We publish that contribute to medical literature, share knowledge, and enhance the understanding of various diseases, treatments, and clinical approaches.

The CARE guidelines (for CAse REports) were developed by an international group of experts to support an increase in the accuracy, transparency, and usefulness of case reports. Articles about the CARE guideline development process and a “manual” for writing case reports have been published in 2013 and 2017 in the Journal of Clinical Epidemiology. The CARE guidelines support the Equator Network’s mission to improve health research reporting.  The CARE guidelines for case reports help authors reduce risk of bias, increase transparency, and provide early signals of what works, for which patients, and under which circumstances.

JKAHS advocates to follow the CARE guidelines while writing and reporting case reports and suggest our authors to stick with the following points:

1. Title – The diagnosis or intervention of primary focus followed by the words “case report”.

2. Key Words – 2 to 5 key words that identify diagnoses or interventions in this case report (including "case report").

3. Abstract – It can be structured or unstructured. If structured, following points needs to be covered:

   • Introduction – What is unique about this case and what does it add to the scientific literature?

   • The patient’s main concerns and important clinical findings.

   • The primary diagnoses, interventions, and outcomes.

   • Conclusion – What are one or more “take-away” lessons from this case report?

4. Introduction – Briefly summarizes why this case is unique and may include medical literature references.

5. Patient Information

   • De-identified patient specific information.

   • Primary concerns and symptoms of the patient.

   • Medical, family, and psychosocial history including relevant genetic information.

   • Relevant past interventions and their outcomes.

6. Clinical Findings – Describe significant physical examination (PE) and important clinical findings.

7. Timeline – Historical and current information from this episode of care organized as a timeline (figure or table).

8. Diagnostic Assessment

   • Diagnostic methods (PE, laboratory testing, imaging, surveys).

   • Diagnostic challenges.

   • Diagnosis (including other diagnoses considered).

   • Prognostic characteristics when applicable.

9. Therapeutic Intervention

   • Types of therapeutic intervention (pharmacologic, surgical, preventive).

   • Administration of therapeutic intervention (dosage, strength, duration).

   • Changes in therapeutic interventions with explanations.

10. Follow-up and Outcomes

    • Clinician- and patient-assessed outcomes if available.

    • Important follow-up diagnostic and other test results.

    • Intervention adherence and tolerability. (How was this assessed?)

    • Adverse and unanticipated events.

11. Discussion

    • Strengths and limitations in your approach to this case.

    • Discussion of the relevant medical literature.

    • The rationale for your conclusions.

    • The primary “take-away” lessons from this case report (without references) in a one paragraph conclusion.

12. Patient Perspective – The patient should share their perspective on the treatment(s) they received.

13. Informed Consent – The patient should give informed consent. (Provide if requested.)

 

Writing a Case Report

Introduction

Before writing a case report accurately and transparently, following points should be keepin mind:  

First: Select a case and identify the message you wish to communicate, as well as your audience. Is this case report about an outcome, a diagnostic assessment, an intervention, a new or rare disease, or something else?

Second: Gather the necessary information to accurately write WHAT happened as a timeline and as a narrative. Create the timeline of your case report—a visual summary of WHAT happened in the case report (see examples of timelines that follow the CARE guidelines) before writing the narrative section.

Third: Complete the remainder of the case report using specialty-specific information if necessary with appropriate scientific references and explanations. Support WHY an outcome occurred with reference to the scientific and historic literature whenever possible. Write the abstract last.

De-Identification: Patient information must be de-identified and informed consent obtained prior to submitting your case report to a journal.

Writing Sequence

Part 1 — Working Title, WHAT happened: Timeline and Narrative

1. Develop a descriptive and succinct working title that describes the phenomenon of greatest interest (symptom, diagnostic test, diagnosis, intervention, outcome).

2. WHAT happened. Gather the clinical information associated with patient visits in this this case report to create a timeline as a figure or table. The timeline is  a chronological summary of the visits that make up the episodes of care from this case report.

3. Narrative of the episode of care (including tables and figures as needed).

   • The presenting concerns (chief complaints) and relevant demographic information.

   • Clinical findings: describe the relevant past medical history, pertinent co-morbidities, and important physical examination (PE) findings.

   • Diagnostic assessments: discuss diagnostic testing and results, a differential diagnosis, and the diagnosis.

   • Therapeutic interventions: describe the types of intervention (pharmacologic, surgical, preventive, lifestyle) and how the interventions were administered (dosage, strength, duration, and frequency). Tables or figures may be useful.

   • Follow-up and outcomes: describe the clinical course of the episode of care during follow-up visits including (1) intervention modification, interruption, or discontinuation; (2) intervention adherence and how this was assessed; and (3) adverse effects or unanticipated events. Regular patient report outcome measurement surveys such as PROMIS® may be helpful.

Part 2 — WHY it might have happened: Introduction, Discussion, Conclusion

1. The introduction should briefly summarize why this case report is important and cite the most recent CARE article (Riley DS, Barber MS, Kienle GS, AronsonJK, et al. CARE guidelines for case reports: explanation and elaboration document. JClinEpi 2017 Sep;89:218-235. doi: 10.1016/jclinepi.2017.04.026).

2. WHY it might have happened. The discussion describes case management, including strengths and limitations with scientific references.

3. The conclusion, usually one paragraph, offers the most important findings from the case without references.

Part 3 — Abstract, Keywords, References, Acknowledgements, and Informed Consent

1. Abstract. Briefly summarize in a structured or unstructured format the relevant information without citations. Do this after writing the case report. Information should include: (1) Background, (2) Key points from the case; and (3) Main lessons to be learned from this case report.

2. Keywords. Provide 2 to 5 keywords that will identify important topics covered by this case report.

3. References. Include appropriately chosen references from the peer-reviewed scientific literature.

4. Acknowledgements. A short acknowledgements section should mention funding support or conflicts of interest, if applicable.

5. Informed Consent and Patient Perspective. The patient should provide informed consent (including a patient perspective) and the author should provide this information if requested. Some journals have consent forms which must be used regardless of informed consents you have obtained. Rarely, additional approval (e.g., IRB or ethics commission) may be needed. The patient should share their perspective on the treatment(s) they received in one to two paragraphs. It is often best to ask for informed consent and the patient’s perspective before you begin writing your case report.

6. Appendices (If indicated).

REFERENCES: 
https://www.equator-network.org/
https://www.care-statement.org/