CARE Checklist & Case Report Guide
Use this structured template and tracking guide to align your clinical case reports with the CARE (CAse REport) guidelines. This framework serves as an essential resource for clinicians, medical residents, and academic authors to ensure accuracy, thoroughness, and transparency when publishing unique or educational clinical cases in peer-reviewed medical journals.
The Purpose and Importance of the CARE Guidelines
The CARE guidelines provide an evidence-based framework for clinical case reports to ensure they are complete and transparent. While randomized controlled trials and systematic reviews guide broad clinical practice, individual case reports are often the first line of evidence to alert the medical community to novel presentations, rare adverse events, unexpected treatment responses, or emerging infectious diseases.
If a case report fails to outline the precise timelines, specific medication dosages, or the patient's baseline history, the report loses its educational and scientific value. The CARE framework addresses this by providing a standardized blueprint that covers the entire clinical encounter, helping authors write highly structural narratives that contribute meaningfully to medical literature.
The CARE Checklist Core Sections
The CARE framework utilizes a specialized checklist that guides the author through a comprehensive patient timeline:
Title & Abstract: The title must include the phrase "case report" or "case series" alongside the primary clinical problem or intervention. The abstract must provide a structured summary detailing the patient’s primary symptoms, the main clinical findings, the primary diagnoses, the interventions administered, and the ultimate clinical outcome.
Introduction: A brief background summarizing why this specific case is unique, educational, or adds value to the existing medical literature.
Patient Information: Relevant demographic details (such as age, biological sex, and ethnicity) combined with the primary symptoms or complaints. It requires a detailed history of past medical conditions, relevant family history, current lifestyle factors, and previous interventions or outcomes.
Clinical Findings: A thorough description of the relevant physical examination findings and clinical signs observed during presentation.
Timeline: A chronological account of the entire clinical presentation, highlighting key dates, diagnostic tests, therapeutic interventions, and clinical outcomes.
Diagnostic Assessment: Explicit details regarding all diagnostic methods used, including laboratory evaluations, imaging modalities, and histopathological findings. Authors must discuss diagnostic challenges, differential diagnoses considered, and the final prognosis.
Therapeutic Interventions: Precise documentation of all treatments administered, including specific generic names, exact weight-based or fixed dosages, administration routes, and duration of therapy.
Follow-up and Outcomes: Detailed clinical tracking of the patient's progress over time, including clinician-assessed and patient-reported outcomes, follow-up test results, and compliance with the intervention. Crucially, authors must report any adverse or unexpected events.
Discussion: A critical analysis highlighting the strengths and limitations of the case management. Authors should compare their findings with existing literature and offer clear, practical clinical takeaways.
Patient Perspective: Where possible and appropriate, the patient should share their personal perspective or experience regarding the care they received.
Informed Consent: A mandatory statement confirming that the patient provided explicit, signed informed consent for the publication of the case details and any accompanying images.
Key Clinical Nuances: Safety and Precision
When preparing a clinical case report for publication, special attention must be paid to pharmacological clarity and patient confidentiality:
Pharmacological Specificity: Avoid using vague descriptions of medical management. All therapeutic agents must be documented using standardized, internationally recognized generic terminology rather than local brand names, with exact dosing intervals clearly stated.
De-identification: Ensuring complete patient anonymity is a core requirement of the CARE framework. All direct identifiers (such as names, specific identification numbers, or precise locations) must be removed from the text and any clinical photographs or imaging studies to maintain medical privacy standards.
CARE Guideline References
Gagnier, J. J., Kienle, G., Altman, D. G., et al. (2013). The CARE guidelines: consensus-based clinical case reporting guideline development. BMJ Case Reports, 2013, bcr2013201554.
Riley, D. S., Barber, M. S., Kienle, G. S., et al. (2017). CARE guidelines for case reports: explanation and elaboration document. Journal of Clinical Epidemiology, 89, 218-235.
Gagnier, J. J., Kienle, G., Altman, D. G., et al. (2014). The CARE guidelines: consensus-based clinical case reporting guideline development. Journal of Clinical Epidemiology, 67(1), 46-51.
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