Case reports are often considered the lowest level of evidence in clinical research and are sometimes even overlooked in favor of animal experiments or in vitro studies with more objective quantifiable data and indices. This is because they appear more scientific than case studies that simply talk about how a patient has improved. However, for clinicians, case studies provide valuable information. Reading a case report is like calling a senior colleague or supervisor for advice when you're curious about something. When a new patient comes to the clinic, it can be confusing to know what information to gather, which acupuncture techniques to use, and how long the treatment should last. Case reports provide very practical information in these situations, which cannot be found in RCTs or meta-analyses. So, why should we pay careful attention to case reports, and what are the essential facts that can only be obtained from case reports for clinicians? Here are top 3 reasons why you should check case reports.
1. Gain insight into individualized treatment methods
Case reports provide detailed information on the actual treatment methods applied to individual patients, taking into account their unique circumstances. This offers a valuable perspective on how clinicians have adapted standard methods to better address specific patient needs.
2. Informations about treatment duration and patient response
Case reports reveal how long a successful treatment took and how patients responded to the treatment over time. These insights help clinicians develop a better understanding of the expected duration and various stages of a treatment, providing a more realistic expectation for patient progress. While general RCTs also show the duration and effectiveness of treatment, the results may not accurately represent actual patients, as the treatment duration can be too short or too long. This is because the experiment ends once the predetermined treatment period has passed.
Patients do not improve all at once. Throughout a long treatment period, their condition may worsen, improve rapidly, or improve slowly. Case reports record not only the results but also the detailed 'course' of the treatment, allowing for an indirect treatment experience.
3. Obtain practical information and experience
Case reports offer practical information that can be directly applied to patient care, such as the frequency of acupuncture sessions, the type of acupuncture used, and other treatment details. Studying case reports can be likened to observing the treatment of an experienced acupuncturist, providing valuable indirect experience that can inform your own practice.
I believe that studying case reports is like observing the treatment of an excellent acupuncturist. This indirect experience through case reports is especially important for rare diseases that are not commonly seen. You can gain this valuable experience with just a few clicks on your computer. Case reports that we commonly search for are not easily found on PubMed or EMBASE. I recommend using Google Scholar or searching for PDFs on Google. In particular, many case reports are published only in Chinese, Korean, or Japanese. If you can read these languages, try searching with various keywords.
PubMED search tip
1. acupuncture search
case reports[ptyp] acupuncture[mesh] 'name of disease'
example) case reports[ptyp] acupuncture[mesh] insomnia[ti]
2. herb/ formula search
case reports[ptyp] "Drugs, Chinese Herbal"[mesh] 'name of disease'
example) case reports[ptyp] "Drugs, Chinese Herbal"[mesh] "sleep initiation and maintenance disorders"[MeSH Terms]
Recommended sample case report
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6392783/
Try to apply this modality to your practice