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• W4210341999 abstract "In 2017, Optometry and Vision Science revised the instructions for authors for case reports to signal a preferred focus on evidence-based clinical practice. The revised instructions included the following statement: Priority is given to cases that illustrate applications of evidence-based practice, critical thinking, novel mechanistic reasoning, or those that have importance to public health or health policy implications. Clinical case reports could focus on efficacy of treatments, implementation or demonstration of clinical trial results, illustrations of diagnostic precision or prognosis. Over the next year, the journal will implement requirements for case reports that further emphasize evidence-based care. Going forward, case reports that do not explicitly focus on the application of evidence-based principles to clinical care will not be a priority for the journal. Transitioning to this new case report format will occur over the next year, with final implementation completed within the next 2 years. The purpose of this editorial is to provide details on these revisions and guidance on how prospective authors should approach case report submissions to Optometry and Vision Science. CLINICAL IMPLEMENTATION OF EVIDENCE-BASED PRACTICE Evidence-based practice has three essential elements: a solid base of well-founded knowledge from unbiased clinical studies, a clinical practitioner who is informed and guided by this knowledge base, and respect for the individual preferences and unique context of each patient. Case reports are considered low in the hierarchy of evidence, because of their restricted sample size (e.g., limited to only one or a few individuals), the absence of comparison groups, and appropriate controls to prevent bias. Case reports are considered below observational studies, experimental studies (e.g., randomized clinical trials), or systematic reviews in the hierarchy of evidence. Nevertheless, although rigorous clinical trial results can provide reliable evidence under controlled study conditions, they cannot account for the unique circumstances of patients who may have multiple conditions or other individual characteristics not accounted for in the design of a clinical trial. Case reports continue to play an important role in clinical education, highlighting novel observations and identifying new questions that could spawn future clinical and experimental studies. Case reports have provided historically important information on new medications (e.g., penicillin), emerging diseases (Zika virus), and evolving guidance on medical interventions (hydroxychloroquine retinopathy).1Optometry and Vision Science will focus on new guidelines to help bridge the space between evidence-based practice and case reports. THE EVIDENCE-BASED CASE REPORT Successful case report submissions should no longer focus on rare and unexpected conditions—novelty alone will not be sufficient for publication. Instead, authors should focus on cases that illustrate the application of evidence from clinical trials, preferred practice guidelines, systematic reviews, and other existing standards for care. Prospective authors should report cases that illustrate clinical decision making relative to the following: Interventions— questions addressing the treatment of an illness or dysfunction Diagnosis— questions on the identification or determination of the nature and cause of a disease or condition Etiology— questions addressing the cause or disease origin, including risk factors for a certain disease or condition Prognosis— questions on the prediction of the course of a disease Prevention— questions related to reducing the chance or impact of disease by identifying and modifying risk factors, screening, and early diagnosis Case report submissions to Optometry and Vision Science should also now include additional information. They must be based on more than a unique clinical observation and clearly state the focus of the report, for example, interventions, diagnosis, and etiology. CLINICAL QUESTIONS Authors will be required to articulate a specific clinical question. Evidence-based case reports should be formatted to include a structured clinical question in the significance section of the abstract and a statement regarding the literature search strategy in the introduction. In prior editorials, I have discussed the PICO approach for developing a structured clinical question to guide the literature search strategy.2,3 The PICO acronym is defined as follows: P — patient, problem, or population of interest I — intervention (treatment, medication, diagnostic procedure, prognosis) C — comparison or control group O — outcome measure The structured clinical question should define each of these elements but may not require the definition of a comparison or control group for a clinical case report. For example, “Can intense pulsed light therapy reduce the recovery time for patients following chalazion excision?” In this sample PICO question, patients who have had chalazion excision is the group of interest. The intervention is intense pulsed light therapy, and the outcome measure is the recovery time. The statement of clinical significance should not only articulate the focus of the case report as a clinical question in PICO format but should also clearly indicate why this question is of interest for readers. SEARCH STRATEGY The introduction section of the case report must also now provide a full description of the literature search strategy, including the database searched, the search terms (which should match the PICO question), the number of records returned, and the final number of relevant sources reviewed. Finally, the Discussion section should include a clear statement articulating the rationale and importance for their case report at the beginning of the discussion. This should be supported by key findings from the literature search and a critical appraisal of the relevant existing evidence. These new case report standards are designed to increase the quality of future clinical case reports published in Optometry and Vision Science. Moreover, it is designed to influence the culture, behaviors, and expectations surrounding the interpretation and use of evidence-based guidelines in clinical eye care. We look forward to receiving your quality case report submissions. Michael D. Twa, OD, PhD, FAAO Editor in Chief University of Houston College of Optometry Houston, TX" @default.
• W4210341999 created "2022-02-08" @default.
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• W4210341999 date "2022-02-01" @default.
• W4210341999 modified "2023-09-27" @default.
• W4210341999 title "Evidence-based Case Report Guidance" @default.
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