Importance of Case Reports in Medical Literature

Abstract

In a world of evidence-based medicine, where randomized trials are considered the gold standard of evidence, case reports and case series are at the bottom of this hierarchy. Whereas randomized control trials assess the level of uncertainty about a benefit or harm, case reports have a different fundamental function. Case reports typically highlight extremely unusual and novel findings. Case reports can rarely prove causation but generate a new hypothesis and stimulate further research. Only once a hypothesis is generated (a function of case reports), randomized trials will do final evaluation of therapies or tests. Case reports or case series are the only way to bring a new disease to the attention of the medical community. AIDS is a good example in the recent history, when astute physicians noticed immunodeficiency related diseases in a patient who had no reason to be immunodeficient [1]. New side effects of drugs are also usually reported in case reports or case series. The first case reports that suggested a link between the use of appetite suppressants and valvular heart disease were published in 1997