title: Case reports: Should we do away with them?
abstract: OBJECTIVE
  There has been a gradual decline in the number of case reports published in leading medical journals in recent years. Since case reports are not highly cited they have an adverse effect on the journal impact factor. On the other hand sharing new experiences, challenges, or discoveries with colleagues is essential for medical community. Should case reports be eliminated from the journals or published only in journals devoted to case reports?
  
  
  METHODS
  Observational study.
  
  
  METHODS
  Web of Science database was searched, between 2005 and 2009, with terms: "anesthesia", "anesthesiology" and "case report" yielding 25 969, 9532, and 661 publications, respectively. Since some reports contained large number of cases, only those involving up to three cases (n = 425) were evaluated by the authors with respect to their type, contribution to knowledge and/or practice (Likert scale) and times they were cited.
  
  
  RESULTS
  Distribution of answers to the statement "Case has added to my knowledge and/or improved my practice" was; 3% (strongly disagree), 10.5% (disagree), 33.2% (neither agree nor disagree), 39.3% (agree) and 13.7% (strongly agree). Average citations per item was 4.43 (1883/425), 7.32 (4838/661), and 7.82 (74 529/9532). As to the types of the reports; 50% unexpected event in the course of anesthesia, 31% unusual and instructive cases, 9.6% novel/unique anesthetic techniques, 6% novel use of equipment, 1.6% new information on diseases of importance to anesthesiology and 1% scientific observations.
  
  
  CONCLUSIONS
  Case reports have been an important source of clinical guidance and scientific insight, and play an important role in medical education. They can be published quickly, providing publication opportunity for juniors and for clinicians who may not have the time or finance to conduct large-scale research. On the other hand some argue, that case reports are irrelevant in current medical practice and education, being at the bottom of the hierarchical ladder of medical evidence. We conclude that case reports should not be done away with but be published in websites and journals like the venue to be launched in 2013 by the International Anesthesia Research Society, devoted entirely to them to meet the need for the publication of interesting cases.
authors.affiliation: Department of Anesthesiology, Baskent University Faculty of Medicine, Ankara, Turkey. Electronic address: acamkiran@gmail.com.
authors.forename: Aynur Camkiran
authors.initials: AC
authors.lastname: Firat
authors.affiliation: Department of Anesthesiology, Baskent University Faculty of Medicine, Ankara, Turkey. Electronic address: drcoskunaraz@gmail.com.
authors.forename: Coskun
authors.initials: C
authors.lastname: Araz
authors.affiliation: Department of Anesthesiology, Baskent University Faculty of Medicine, Ankara, Turkey. Electronic address: zeynepk@baskent-ank.edu.tr.
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Kayhan
mesh_terms: D000758:Anesthesia; D006801:Humans; D055811:Journal Impact Factor; D010506:Periodicals as Topic / Q000592:standards / Q000639:trends*; D011643:Publishing / Q000592:standards / Q000639:trends*
keywords: Anesthesia; Case; Case report; Case series; Education; Journal