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JKM > Volume 41(2); 2020 > Article
Hwang, Ku, and Nam: Evaluation of the Quality of the Case Reports in Journal of Korean Medicine from Year 2015 to 2020 : Using CARE Guidelines

Abstract

Objectives

The purpose of this study is to assess the quality of the Journal of Korean medicine case reports.

Methods

Case reports published in the Journal of Korean Medicine from January 2015 to March 2020 were selected by using Oriental Medicine Advanced Searching Integrated System (OASIS) and the journal search system of the Korean Medical Association (https://www.jkom.org). The quality of the case reports was assessed using the Consensus-based Clinical Case Reporting Guideline Development (CARE) guidelines.

Results

33 case reports were selected for the assessment. Based on the CARE guidelines, 61.54% of the case reports included necessary information, but the quality level was uneven. More than 60% of the reports were missing data regarding ‘Discussion of the strengths and limitations in your approach to this case’, ‘Intervention adherence and tolerability’, ‘Timeline’, ‘Medical, family, and psychosocial history including relevant genetic information’, ‘Patient perspective or experience’, ‘Adverse and unanticipated events’, ‘Administration of intervention’, and ‘De-identified demographic information and other patient specific information’. In most reports of over 90%, data regarding ‘Diagnostic challenges’, ‘Intervention adherence and tolerability’, and ‘Key word’ were not included.

Conclusions

Efforts are needed to improve the quality of case reports in the Journal of Korean Medicine, and it is necessary to develop appropriate guidelines for case reporting for the Journal of Korean Medicine. In addition, all articles submitted to the Journal of Korean Medicine are to be complied with submission instructions and CARE guidelines.

Figure. 1
Flow chart of case reports identified, screening, included process
jkm-41-2-80f1.gif
Figure. 2
Case Reports According to The Quality of Reporting Evaluated by Each Item of CARE Guidelines
jkm-41-2-80f2.gif
Table 1
Percentage of Items Reporting according to CARE Guide by Each Case Report
Case reports Reporting Not-Reporting

Sufficient Not-Sufficient

First author (year) n1/N % n2/N % (n1+n2)/N % n3/N %
Lee KH (2015)16) 12/26 46.15 9/26 34.62 21/26 80.77 5/26 19.23
Son K (2015) 17) 17/26 65.38 5/26 19.23 22/26 84.62 4/26 15.38
Yang J (2015)18) 16/27 59.26 6/27 22.22 22/27 81.48 5/27 18.52
Jo EH (2015)19) 12/26 46.15 10/26 38.46 22/26 84.62 4/26 15.38
Min DL (2015)20) 16/26 61.54 9/26 34.62 25/26 96.15 1/26 3.85
Lee HY (2015)21) 17/26 65.38 8/26 30.77 25/26 96.15 1/26 3.85
Kim JY (2015)22) 15/27 55.56 8/27 29.63 23/27 85.19 4/27 14.81
Sung SH ((2015)23) 15/26 57.69 7/26 26.92 22/26 84.62 4/26 15.38
Nam SH (2015)24) 16/26 61.54 5/26 19.23 21/26 80.77 5/26 19.23
Baik TH (2016)25) 16/26 61.54 5/26 19.23 21/26 80.77 5/26 19.23
Yang J (2016)26) 13/26 50.00 8/26 30.77 21/26 80.77 5/26 19.23
Seo YH (2016)27) 17/26 65.38 6/26 23.08 23/26 88.46 3/26 11.54
Jeon H (2016)28) 16/28 57.14 6/28 21.43 22/28 78.57 6/28 21.43
Yang JE (2016)29) 12/26 46.15 9/26 34.62 21/26 80.77 5/26 19.23
Son CG (2016)30) 14/26 53.85 7/26 26.92 21/26 80.77 5/26 19.23
Jo NY (2016)31) 16/26 61.54 8/26 30.77 24/26 92.31 2/26 7.69
Yang J (2016)32) 16/26 61.54 5/26 19.23 21/26 80.77 5/26 19.23
Cha J (2016)33) 18/26 69.23 3/26 11.54 21/26 80.77 5/26 19.23
Son CG (2017)34) 16/26 61.54 5/26 19.23 21/26 80.77 5/26 19.23
Song SY (2017)35) 19/28 67.86 4/28 14.29 23/28 82.14 5/28 17.86
Choi JW (2017)36) 18/27 66.67 6/27 22.22 24/27 88.89 3/27 11.11
Yang J (2018)37) 20/27 74.07 3/27 11.11 23/27 85.19 4/27 14.81
Ryu JY (2018)38) 17/26 65.38 5/26 19.23 22/26 84.62 4/26 15.38
Lee ES (2018)39) 20/27 74.07 2/27 7.41 22/27 81.48 5/27 18.52
Kim M (2018)40) 16/26 61.54 5/26 19.23 21/26 80.77 5/26 19.23
Jung MY (2018)41) 18/26 69.23 3/26 11.54 21/26 80.77 5/26 19.23
Lee S (2018)42) 16/27 59.26 6/27 22.22 22/27 81.48 5/27 18.52
Lee S (2018)43) 15/27 55.56 7/27 25.93 22/27 81.48 5/27 18.52
Cho AR (2018)44) 10/26 38.46 10/26 38.46 20/26 76.92 6/26 23.08
Geum JH (2019)45) 18/26 69.23 5/26 19.23 23/26 88.46 3/26 11.54
Shin J (2019)46) 15/26 57.69 7/26 26.92 22/26 84.62 4/26 15.38
Kim S (2019)47) 20/27 74.07 4/27 14.81 24/27 88.89 3/27 11.11
Lee SH (2020)48) 14/26 53.85 7/26 26.92 21/26 80.77 5/26 19.23
Max. of % 74.07 38.46 96.15 23.08
Min. of & 38.46 7.41 76.92 3.85
Median of % 61.54 22.22 81.48 18.52

1) ‘n1’, ‘n2’, and ‘n3’ mean the number of which items match each assessment-criteria: Sufficient, Not-sufficient, and Not-reporting, respectively.

2) ‘N’ means the number of applicable item.

Table 2
Percentage of Items Reporting according to CARE Guide by Each Year
Year Reporting Not-Reporting

Sufficient Not-Sufficient Total

Max. of % Min. of % Median of % Max. of % Min. of % Median of % Max. of % Min. of % Median of % Max. of % Min. of % Median of %
2015 (n=9) 65.38 46.15 59.26 38.46 19.23 29.63 96.15 80.77 84.62 19.23 3.85 15.38
2016(n=9) 69.23 46.15 61.54 34.62 11.54 23.08 92.31 78.57 80.77 21.43 7.69 19.23
2017(n=3) 67.86 61.54 66.67 22.22 14.29 19.23 88.89 80.77 82.14 19.23 11.11 17.86
2018(n=8) 74.07 38.46 63.46 38.46 7.41 19.23 85.19 76.92 81.48 23.08 14.81 18.52
2019–2020(n=4) 74.07 53.85 63.46 26.92 14.81 23.08 88.89 80.77 86.54 19.23 11.11 13.46
Table 3
Percentage of Case Reports with Reporting Items of CARE Guide by Each Item
Topic Items Sufficient Not-Sufficient * Not-Reporting
n/N % n/N % n/N %
Title 1 The words “case report” should be in the title along with the area of focus 25/33 75.76 8/33 24.24 - -
Key word 2 2 to 5 key words that identify areas covered in this case report 2/33 6.06 31/33 93.94* - -
Abstract 3a Introduction-What is unique about this case?
What does it add to the medical literature?
30/33 90.91 2/33 6.06 1/33 3.03
3b The main symptoms of the patient, the important clinical findings, the main diagnoses, therapeutics interventions, and outcomes 24/33 72.73 9/33 27.27 - -
3c Conclusion—What are the main “take-away” lessons from this case? 32/33 96.97 1/33 3.03 - -
Introduction 4 One or two paragraphs summarizing why this case is unique with references 33/33 100.00 - - - -
Patient information 5a De-identified demographic information and other patient specific information 13/33 39.39 20/33 60.61* - -
5b Main concerns and symptoms of the patient 32/33 96.97 1/33 3.03 - -
5c Medical, family, and psychosocial history including relevant genetic information (also see timeline). Relevant past interventions and their outcomes 7/33 21.21 26/33 78.79* - -
Clinical findings 6 Physical examination findings 30/33 90.91 3/33 9.09 - -
Timeline 7 Important information from the patient’s history organized as a timeline 7/33 21.21 25/33 75.76* 1/33 3.03
Diagnostic assessment 8a Diagnostic methods (such as PE, laboratory testing, imaging, surveys) 32/33 96.97 1/33 3.03 - -
8b Diagnostic challenges (such as access, financial, or cultural) - - - - 33/33 100.00*
8c Diagnostic reasoning including other diagnoses considered 17/33 51.52 13/33 39.39 3/33 9.09
8d Prognostic characteristics (such as staging in oncology) where applicable 5/33 15.15 - - 28/33 84.85*
Therapeutic interventions 9a Types of intervention (such as pharmacologic, surgical, preventive, self-care) 33/33 100.00 - - - -
9b Administration of intervention (such as dosage, strength, duration) 13/33 39.39 20/33 60.61* - -
9c Changes in intervention (with rationale) 6/33 18.18 1/33 3.03 26/33 78.79*
Follow-up and outcomes 10a Clinician and patient-assessed outcomes (when appropriate) 32/33 96.97 1/33 3.03 - -
10b Important follow-up diagnostic and other test results 32/33 96.97 - - 1/33 3.03
10c Intervention adherence and tolerability (How was this assessed?) 1/33 3.03 1/33 3.03 31/33 93.94*
10d Adverse and unanticipated events 13/33 39.39 1/33 3.03 19/33 57.58*
Discussion 11a Discussion of the strengths and limitations in your approach to this case 16/33 48.48 17/33 51.52* - -
11b Discussion of the relevant medical literature 28/33 84.85 5/33 15.15 - -
11c The rationale for conclusions (including assessment of possible causes) 21/33 63.64 12/33 36.36 - -
11d The primary “take-away” lessons of this case report 33/33 100.00 - - - -
Patient perspective 12 When appropriate the patient should share their perspective on the treatments they received 3/33 9.09 1/33 3.03 29/33 87.88*
Informed consent 13 Did the patient give informed consent? Please provide if requested 6/33 18.18 4/33 12.12 23/33 69.70*

1) ‘n’ means the number of which case reports match each assessment criteria of items: Sufficient, Not-sufficient, and Not-reporting, respectively.

2) ‘N’ means that the number of case reports having applicable item.

3) ‘*’ indicates that the percentage of not-, or not-sufficiently reporting item more than 50%.

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