CARE Guidelines for Case Reports: Framework Tools and Clinical Applications

An Academy Guide

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CARE Guidelines for Case Reports: Framework Tools and Clinical Applications

Table of Content

1. What are the CARE guidelines?

The CARE guidelines (for Case Reports) are a set of guidelines developed by an international group of experts to help with case report accuracy, transparency and appropriateness. Once you have viewed and downloaded the CARE checklist. CARE guidelines have received endorsements from many journals and publishers and translated into many languages. [1]

Two articles have been published in the Journal of Clinical Epidemiology in 2013 and 2017 about the CARE guideline development process and a manual for preparing a case report. The CARE guidelines support the Equator Network in its commitment to improve health research reporting. Scientific Writing in Health and Medicine (SWIHM) also provides an online training for preparing a case report using the CARE guidelines, and is a source to access CARE-writer, an online application for writing case reports as preprints or for submission to a scientific journal.

2. What is CARE-writer?

CARE-writer is an online tool that allows authors to follow the CARE writer guidelines, while organizing, formatting and writing systematic and transparent case reports and case report preprints. A case report that has been written with CARE-writer can be posted on preprint servers, e.g. SSRN’s Health Science Case Reports Research Network, or submitted to scientific journals.[1]

3. Why case reports?

Detail-oriented and reliable episodes of care data collection results in high-quality individualized care for patients. Good case reporting is about a clear purpose, to tell the reader why a certain observation is relevant in the context of what we already know” (Vandenbroucke 2001).[1]

The CARE guidelines for case reports provide authors and health care stakeholders with a framework to mitigate bias, increase transparency, and provide early indicators of, what works for which patients, and in what context.[2]

CARE Guidelines

Case reporting utilizing CARE guidelines help facilitate measurement of

Clinician-and patient-reported outcomes
Clinical Practice Guidelines (CPGs)’, effectiveness
Return on investment (ROI) for patients and health systems

Generalizable health systems would be health care stakeholders that could derive value from case reporting utilizing the CARE guidelines:

Patients – evaluating and comparing therapeutic options.
Clinicians – peer-to-peer communication at conferences or in their community.
Researchers – generating testable hypotheses from practicing clinical settings (e.g. Driggers 2016).
Educators – systematic case reports from real world clinical practice support case-based learning.
Authors – CARE guidelines give individuals tools to inform and streamline writing accurate and transparent case reports.
Medical Journals – the CARE guidelines support Author Guidelines and peer review.

4. Case Reports

Case reports have played a notable role throughout history. [3]

CARE Guidelines Box 2

In recognition of new or rare diseases,
In assessing the therapeutic effects, adverse events and costs of interventions,
In improving problem-based learning in medical education.

Case reports provide evidence of effectiveness in the real world, while clinical trials establish evidence of efficacy in a controlled setting. Both are required. Case reports currently constitute an increasing proportion of the articles published in peer-reviewed medicine journals, and they have provided important milestones in the understanding of AIDS, Zika virus infections, and the side effects observed with the use of thalidomide in the late 1950s. Case reports have a high sensitivity for detecting novelty and are an integral part of medical progress (Vandenbroucke 2001).

5. Case reports following CARE improve healthcare by

Providing early indications of benefits, harms, and value.
Providing information on use of resources, including cost.
Supporting clinical research with evidence from episodes of care.
Providing feedback on clinical practice guideline (CPG) implementation.
Supporting medical education.

6. The CARE Toolkit for Case Reports

The CARE guidelines and checklist offer authors tools for writing an accurate case report and offer medical journals tools for evaluating and publishing a case report. The CARE tools are the 2013 and 2017 CARE publications, the CARE checklist, translations, and CARE-writer. [3]

7. What’s coming from the CARE initiative

Updated online case report web course run through SWIHM
Updated CARE-writer that is an online app for writing up case report preprints that started in early 2020
Affiliation with SSRN’s Health Science Case Reports Research Network – the first case report preprint server.
Research into the implementation and usage of the CARE guidelines

Conclusion

The CARE guidelines are a standardized framework, providing instructions for accurate and transparent representation of case reports. This will assist authors, clinicians and researchers in providing real-world evidence that can be trusted. Tools such as CARE-writer and the checklist can facilitate consideration of important elements during the preparation and submission of case reports.

Adhering to these standards is benefitting patient care, supporting clinical research and educating future medical practitioners. Banks of journals and preprint platforms are endorsing CARE and work continues in the advancement of high-quality case reporting.

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References

CARE case report guidelines. (n.d.). Retrieved August 28, 2025, from CARE Case Report Guidelines website: https://www.care-statement.org/
Gagnier, J. J., Kienle, G., Altman, D. G., Moher, D., Sox, H., Riley, D., & CARE Group* (2013). The CARE Guidelines: Consensus-based Clinical Case Reporting Guideline Development. Global advances in health and medicine, 2(5), 38–43. https://doi.org/10.7453/gahmj.2013.008
The importance of case reports —. (n.d.). Retrieved August 28, 2025, from CARE Case Report Guidelines website: https://www.care-statement.org/case-reports