CARE Case Report Guidelines

The CARE (CAse REport) Guidelines are a reporting standard for clinical case reports and small case-report series, developed to improve the completeness, transparency, and reusability of a published case so that its clinical lesson can be extracted and evaluated by other clinicians and by systematic reviewers. CARE was developed in 2013 by an international consensus group — Joel Gagnier, Gunver Kienle, Douglas Altman, David Moher, Harold Sox, David Riley, and the CARE Group — and the guideline was published simultaneously in seven medical journals. CARE is indexed by the EQUATOR Network, the umbrella library of health-research reporting guidelines, alongside CONSORT for randomised trials and STROBE for observational studies.

What CARE requires

The CARE checklist sets out 13 items an author should address when writing up a single patient case or a small case series: title, keywords, abstract, introduction, patient information, clinical findings, timeline, diagnostic assessment, therapeutic intervention, follow-up and outcomes, discussion, patient perspective, and informed consent. A companion explanation-and-elaboration document annotates each item with worked examples of adequate reporting, and an interactive authoring tool, CARE-writer, is available on the CARE Statement website to walk authors through the checklist item by item.

Why it exists

Case reports are frequently the first published signal of a novel adverse drug reaction, an unusual disease presentation, or a diagnostic or therapeutic innovation. Before CARE, case reports were written up inconsistently — often omitting a clear timeline, the diagnostic reasoning behind a workup, or complete outcome data — which made it difficult for clinicians and reviewers to judge or reuse them. CARE gives journals, editors, and peer reviewers a shared checklist against which to require and screen case report submissions, in the same way CONSORT standardised trial reporting and STROBE standardised observational-study reporting.

Where CARE does not apply

A multi-patient cohort, case-control, or cross-sectional study should follow STROBE rather than CARE, and a randomised controlled trial should follow CONSORT. CARE is scoped specifically to the single-patient or small-case-series report, not to a comparative or interventional study design — choosing the wrong checklist for the study design is one of the more common reporting-guideline errors editors flag at submission.

References

• Gagnier JJ, Kienle G, Altman DG, Moher D, Sox H, Riley D; CARE Group. ‘The CARE guidelines: consensus-based clinical case report guideline development,’ published simultaneously across seven journals, 2013.
• EQUATOR Network, CARE reporting guideline page.
• CARE Statement — official checklist, explanation and elaboration document, and CARE-writer authoring tool.