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The CARE Guidelines—Systematically reporting information from Patient Encounters

Case reports are professional narratives that outline the diagnosis, treatment, and outcomes of the medical problems of one or more patients. Information from case reports can be shared for medical, scientific, or educational purposes. They provide a framework for early signals of effectiveness adverse events, and cost. Case reports and the systematically collected data from which they are written also provide feedback on clinical practice guidelines.

The CARE guidelines provide a framework that supports transparency and accuracy in the publication of case reports and the reporting of information from patient encounters. The acronym CARE was created from CA— the first two letters in case and RE—the first two letters in reports. The initial CARE tools are the CARE checklist and the Case Report Writing Template; tools that support the writing of case reports and provide data that informs clinical practice guidelines and provides early signals of effectiveness, harms, and cost. The CARE Group, led by David Riley, Joel Gagnier, David Moher and Gunver Kienle met at the University of Michigan in October 2012. This meeting was part two of a three part consensus-based development process that occurred between 2011 and 2013 and included: (1) Literature review and interviews; (2) Consensus meeting to draft reporting guidelines; and (3) Post-meeting review and publication of the CARE guidelines.

The CARE guidelines were simultaneously published in seven medical journals in September 2013 and presented at the International Congress on Peer Review and Biomedical Publication sponsored by the BMJ and JAMA, also in September 2013. How will the CARE guidelines improve the transparency and accuracy of published case reports and how will this improve patient care? The publication of case reports following the CARE guidelines will provide practice-based data that can be compared across interventions. systematically written, high-quality, case reports can inform clinical practice guidelines and offers early signals of effectiveness, adverse events, and costs.

The main products of the CARE group are the CARE guidelines for reporting case reports and the case reports writing template. These documents have been published in seven international medical journals and translated into 5 languages. The most recent version of the CARE guidelines consists of a checklist and some brief descriptive text that systematically collects information from all patient encounters and has the flexibility to accommodate specialty specific information. It offers a standard way for the authors of case report to summarize transparently and accurately patient encounters that will assist their critical appraisal and use in generating hypotheses and informing clinical practice guidelines.

This document has evolved since its publication in 2013 and has now been endorsed by more than a dozen medical journals and publishers. The CARE guidelines are related to other initiative designed to improve the reporting of medical interventions and research ranging from observational studies to randomized controlled trials and systematic reviews. These reporting guidelines have been incorporated in the EQUATOR Network to enhance the transparent and accurate report of research studies and medical information.

References

1. Gagnier J, Kienle G, Altman, DG, Moher D, Sox, H, Riley D, and the CARE group. Journal of Clinical Epidemiology. January 2014. 67(1), Pages 46-51. doi:10.1016/j.jclinepi.2013.08.003 2. www-care-statement.org (accessed July 14, 2014) 3. www.equator-network.org (accessed July 14, 2014)