Note: The NeoReviews editorial board would like to thank Dr. Joe Neu for his years of service to the journal as the Index of Suspicion in the Nursery Editor. Dr. Neu is succeeded by Dr. Jayasree Nair and Dr. Elizabeth Schulz.
Every month when I receive an email announcing the release of a new issue of NeoReviews, I cannot help but immediately scroll through the varied offerings. These range from Review Articles to the exciting Visual Diagnosis to Maternal-fetal Case Studies, and the newly introduced follow-up series Outcomes of NICU Graduates. However, my favorite section remains the Index of Suspicion (IOS) in the Nursery case reports. While I may be biased, having recently assumed the role of Associate Editor, IOS, I suspect the reasons I, like many other neonatologists find value in case reports, goes beyond my personal involvement in the feature.
The value of case reports in medical literature is a topic that is often discussed. While it does not provide the wealth of evidence presented in randomized control trials and case-control studies, case reports still retain their place, usually to document an unusual aspect of a patient’s condition, such as the presentation and course, treatment, or a rare diagnosis. All of these are seen in the July edition of NeoReviews in the Index of Suspicion section, beginning with an uncommon cause of late-onset sepsis in a preterm neonate with impressive findings on MRI (Extensive Brain Lesions in a Preterm Neonate). Rare causes of respiratory distress in a preterm (Late-Onset Respiratory Distress in a Very Preterm Neonate) and term infant (A Term Neonate with Persistent Respiratory Distress) round out the cases this month. These cases not only discuss the differentials and unusual diagnoses but touch upon the limited options for confirmation of diagnosis and long-term supportive care that are available to families in resource-restricted situations.
Well-written case reports, or patient-oriented research reports as they are called in some circles, not only help clinicians manage complicated patients with rare/unusual diagnoses but may also stimulate hypothesis-driven research. At the start of the COVID-19 pandemic, case reports were vital in providing clinical care teams with narrative information on the course, complications, and treatment options for this deadly virus. With a more flexible structure, case reports facilitate some “narrative” reporting by the authors, who can choose specific aspects of the case to focus on. This could, however, also be a cause for concern with biases and inconsistencies in reporting. The CARE guidelines (Gagnier et al, J Clin Epidemiol. 2014;67(1):46–51) were developed to improve the accuracy, transparency, and usefulness of case reports and have been adopted by many journals.
Case reports have value in medical education as well. Many trainees start their academic careers by publishing case reports, often presenting these at local or national conferences. Not all medical journals publish case reports, limiting available options for authors, but with the interest they garner, it does look like case reports are here to stay. For neonatal cases, we look forward to publishing many more of these at NeoReviews in the Index of Suspicion section. Check out our author guidelines for full formatting and submission details.
