Case Reports and Studies

Welcome to the first issue of the Journal of Case Reports and Studies. Within the field of medicine, a number of systems have been established to stratify the quality of research designs which have been collectively termed "levels of evidence" or a "hierarchy of evidence" approach. These approaches rank study designs with respect to their impact on internal and external validity. Typically case study designs are ranked near the bottom of these "evidence hierarchies". For example, the Centre for Evidence based medicine at Oxford university ranks case series on level 5 of a 1-6 level scale [1]. The gold standard in evidence based medicine is the randomised controlled trial (RCT) but most patients are excluded or ineligible to participate in RCTs [2]. It must be noted that these "levels of evidence" approaches are designed for research investigating the outcomes of clinical interventions or diagnostic procedures. The applicability of case reports and case studies goes beyond such research. What do we mean by case reports and case studies?