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ISSN: 2165-7920

Journal of Clinical Case Reports
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Case Report

Role and Evidence of Case Reports and Case Series in Primary Care: A Discussion Paper

Schencking M*, Sonnichsen A, Redaelli M and Vollmar HC
Institute of General Practice and Family Medicine, University of Witten/Herdecke`s Faculty of Health, Dusseldorf, Germany
*Corresponding Author : Schencking M
Institute of General Practice and Family Medicine
University of Witten/Herdecke`s Faculty of Health
Dusseldorf, Germany
Tel: +49 (0)2302926712
Fax: +49 (0)2302926745
E-mail: [email protected]
Received: January 09, 2016; Accepted: March 22, 2016; Published: March 27, 2016
Citation: Schencking M, Sonnichsen A, Redaelli M, Vollmar HC (2016) Role and Evidence of Case Reports and Case Series in Primary Care: A Discussion Paper. J Clin Case Rep 6:756. doi:10.4172/2165-7920.1000756
Copyright: © 2016 Schencking M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Clinical guidelines, defined as ‘systematically developed statements to assist both practitioner and patient decisions in specific circumstances, have become an increasingly familiar part of clinical care. A central challenge in Primary Care is the question of how do we act in the field of atypical courses of diseases or clinical symptoms beside the spectrum of EBM and how could this gap be measured in scientific literature. Main purpose of this paper is a brief analysis of the actual role and evidence of clinical case reports and case series in primary care as a basis for a scientific discussion. According to the scientific-accepted Oxford levels of evidence case reports and case series belong to the level 4 of evidence. At present a significant majority of published case reports deal with descriptions of physician’s care following their clinical intuition beside the pathways of randomized controlled trials (RCT) or guidelines. Clinical symptoms of many cases will add up to what we would recognize as a ‘medical’ condition, but in up to 19% they are vague, non-specific and/or contradictory and the management of patients with such undefined symptoms can pose a daunting challenge. Even randomized controlled trials are the gold standard in clinical research and systematic reviews and meta-analysis have the highest level of evidence, there is still a need for well-prepared case reports; for instance to describe rare adverse drug effects.

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