Colwill M, Baillie S, Pollok R, Poullis A. Using clinical cases to guide healthcare. World J Clin Cases 2024; 12(9): 1555-1559 [PMID: 38576735 DOI: 10.12998/wjcc.v12.i9.1555]
Corresponding Author of This Article
Michael Colwill, BSc, MBBS, MRCP, Doctor, Research Fellow, Department of Gastroenterology, St George's University Hospital NHS Foundation Trust, Blackshaw Road, London SW17 0QT, United Kingdom. michael.colwill@nhs.net
Research Domain of This Article
Methodology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Mar 26, 2024; 12(9): 1555-1559 Published online Mar 26, 2024. doi: 10.12998/wjcc.v12.i9.1555
Using clinical cases to guide healthcare
Michael Colwill, Samantha Baillie, Richard Pollok, Andrew Poullis
Michael Colwill, Samantha Baillie, Richard Pollok, Andrew Poullis, Department of Gastroenterology, St George's University Hospital NHS Foundation Trust, London SW17 0QT, United Kingdom
Author contributions: Colwill M and Poullis A designed the research; Colwill M performed the literature review; Colwill M wrote the initial paper and Colwill M, Poullis A, Pollok R and Baillie S were all involved in manuscript review.
Conflict-of-interest statement: None of the authors have any conflict of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Michael Colwill, BSc, MBBS, MRCP, Doctor, Research Fellow, Department of Gastroenterology, St George's University Hospital NHS Foundation Trust, Blackshaw Road, London SW17 0QT, United Kingdom. michael.colwill@nhs.net
Received: December 29, 2023 Peer-review started: December 29, 2023 First decision: January 20, 2024 Revised: January 26, 2024 Accepted: February 27, 2024 Article in press: February 27, 2024 Published online: March 26, 2024 Processing time: 86 Days and 20.6 Hours
Abstract
Evidence-based practice (EBP) has been the gold standard in healthcare for nearly three centuries and aims to assist physicians in providing the safest and most effective healthcare for their patients. The well-established hierarchy of evidence lists systematic reviews and meta-analyses at the top however these methodologies are not always appropriate or possible and in these instances case-control studies, case series and case reports are utilised to support EBP. Case-control studies allow simultaneous study of multiple risk factors and can be performed rapidly and relatively cheaply. A recent example was during the Coronavirus pandemic where case-control studies were used to assess the efficacy of personal protective equipment for healthcare workers. Case series and case reports also play a role in EBP and are particularly useful to study rare diseases such as inflammatory bowel disease in transgender and gender non-conforming individuals. They are also vital in generating and disseminating early signals and encouraging further research. Whilst these methodologies have weaknesses, particularly with regards to bias and loss of patient confidentiality for rare pathologies, they have an important part to play in EBP and when appropriately utilised can significantly impact upon clinical practice.
Core Tip: Evidence-based practice is used by physicians to select the optimum treatment for their patients. The hierarchy of evidence lists systematic reviews and meta-analyses as the highest quality of evidence however this is not always appropriate or possible which is when clinical cases, either as case-control studies or case reports, can be utilised. This paper will look at the strength and weaknesses of these methodologies and use recent examples to demonstrate the impact they can have on clinical practice.
