Endangered species

The importance of case reports in advancing scientific knowledge of rare diseases

Case reports are defined as the scientific documentation of a single clinical observation and have a time-honored and rich tradition in medicine and scientific publication. Case reports represent a relevant, timely, and important study design in advancing medical scientific knowledge especially of rare diseases. While there are clear limitations to the methodology of case studies in determination of treatment and establishment of new tests, the observation of a single patient can add to our understanding of etiology, pathogenesis, natural history, and treatment of particularly rare diseases, and to the training of potential junior investigators. In recent years this class of scientific publication has come under scrutiny and disfavor among some in the medical scientific publication community and case studies are frequently relegated to the lowest rung of the hierarchy of study design. In this chapter the author will review and summarize the debate around the scientific publication of case reports in the context of the study of rare diseases and will present a taxonomy that ideally will encourage further dialogue on the topic. Future research on the importance of case reports in advancing knowledge of rare diseases is recommended.

Bipolar affective disorder associated with 11q24.2 disruption—A second report

A recent report identified bipolar affective disorder in a patient with a de novo deletion 11q24.2. We record a further instance involving this cytogenetic region and bipolar affective disorder in a patient with a balanced translocation.

Significance of case reports in the advancement of medical scientific knowledge

In an Editorial Comment in 2006 Carey summarized the issues surrounding the publication of case reports in the current medical literature. In this present study, three questions about case reports are posed by the author: Do journals still publish single case reports? What do medical journals call these reports? And how should we classify reports of single clinical observations? The author examined the table of contents of 25 prominent journals and addressed the question as to whether these selected periodicals published case reports. The analysis showed that 32% of reviewed journals published case reports and 32% did not, while the remainder of journals published this class of papers but in a modified fashion and not regularly. Journals varied in what term they use to describe case reports. The author proposed a classification system for case reports in the human genetics literature. More dialogue and research is needed to examine the role of case reports in the medical scientific literature.