Clinical Success Stories: Are They Really Meaningful in Research Parlance?

Sir William Osler said:

‘Always note and record the unusual…. Publish it. Place it on permanent record as a short concise note. Such communications are always of value’.

This issue of Homoeopathic Links is a special supplement on case reports, which are well documented and evidence based. The goal of evidence based medicine (EBM) is to integrate research evidence, clinical judgment, and patient preferences in a way that maximizes benefits and minimizes harms to the individual patient.[1] The concept of “customized treatment” is gaining ground because the outcomes of tailor made treatment are more beneficial to individual patients than the generalized approach. Case reports may be defined as the scientific documentation of a single clinical observation and have a time honoured and rich tradition in medicine and scientific publication.[2] The value of case reports has been underestimated in the recent times as they have been relegated to the evidence ladder's lowest rungs (evidence level C), at par with anecdotal observation and expert opinion. But such anecdotal observations may be of immense value in adding a new dimension to further research for example the transmission of smallpox in letters prompted researchers to study the stability and infectivity of variola virus and thereby suggest appropriate measures to counter these. The New York Medical Journal in 1901 reported that smallpox had developed in a young lady in Saginaw, Michigan, after she received a letter from her sweetheart, a soldier in Alaska who had written a letter while recovering from this disease. The infection spread to 33 other persons from her. Disinfection of letters was practised to prevent this spread.[3]

Publication History

Article published online:
30 September 2022

• References

• 1 Research Report: Introduction to N-of-1 Trials: Indications and Barriers (Chapter 1). Effective Health Care Program, Agency for Healthcare Research and Quality, Rockville, MD. Available from https://effectivehealthcare.ahrq.gov/products/n-1-trials/research-2014-4
• 2 Gopikrishna V. A report on case reports. J Conserv Dent 2010; 13 (04) 265-271
• 3 A letter blamed for an epidemic of small-pox. N Y Med J 1901; 73: 600
• 4 Elizabeth OLillie. et al. The n-of-1 clinical trial: the ultimate strategy for individualizing medicine?. Available from https://pubmed.ncbi.nlm.nih.gov/21695041/ accessed on 20.08.2022
• 5 Huth EJ. Writing and Publishing in Medicine. Baltimore: Lippincott Williams and Wilkins; 1999: 103-110
• 6 Teut M, van Haselen RA, Rutten L, Lamba CD, Bleul G, Ulbrich-Zürni S. Case Reporting in homeopathy-an overview of guidelines and scientific tools. Homeopathy 2022; 111 (01) 2-9
• 7 FM Abu-Zidan, AK Abbas, AF Hefny. Clinical case series: a concept analysis. Afr Health Sci 2012; Dec; 12 (04) 557-562
• 8 Available from https://www.care-statement.org
• 9 van Haselen RA. Homeopathic clinical case reports: development of a supplement (HOM-CASE) to the CARE clinical case reporting guideline. Complement Ther Med 2016; 25: 78-85