CaReL Guidelines: A Consensus-Based Guideline on Case Reports and Literature Review (CaReL)

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Sakshi Prasad
Mahmoud Nassar
Ahmed Y. Azzam
Francisco García-Muro-San José
Mahnaz Jamee
Rim Kasem Ali Sliman
Giuseppe Evola
Ayman M. Mustafa
Hiwa O. Abdullah
Berun A. Abdalla
Shvan H. Mohammed
Fahmi H. Kakamad
Abdulwahid M. Salih
Nicola Tartaglia
Giovanna Pavone
Giuliano D’Onghia
Silviu Daniel Preda
Sofia Maraki
Ivona Butorac Ahel
Carlo Pietro Campobasso
Jacek K. Szymański
Andrea Bottari
Laura Fortuna
Stefano Giuseppe Caraffi
Ilaria Mormile
Gaetano Riemma
Emmanuel Roilides
Serena Xodo
Nives Pecina-Slaus
Matteo Paganini
Giacomo Brisca
Giorgia Perniola
Matteo Frigerio
Rok Civljak
Salvatore Sardo
Marco Colizzi
Luminita Iliuta
Eric Chun-Pu Chu
Tummidi Santosh
Ahmed El Shamarka
Hossam Tharwat Ali
Reşat Özaras
Alparslan Dilsiz
Baha’eddin A. Muhsen
Maysa Al-Hussaini
Ricardo Grillo
G.V. Oliveira
Neil H. Riordan
Ishag Adam
Abdulqadir J. Nashwan
Nima Rezaei
Rasoul Goli
Abhigan Babu Shrestha
Sajina Shrestha
Jairo Corchuelo-Ojeda
Imen Ben Ismail
Umaharan Thamotharampillai


Case report , Literature review , CaReL guideline , Case study, Scholarly community



Clinical case reports enrich medical literature by presenting rare medical issues. However, case reports that do not adhere to a standard template often lack rigor and limit their usefulness in clinical guidance. Several guidelines for reporting case reports have been structured, while further improvements are still required. The current guideline (CaReL) aims to enhance the comprehensiveness of case reports by integrating a detailed literature review.


In total, 56 researchers were selected based on specific publication criteria for structuring the guidelines. The guideline development was based on a two-step consensus process, including a literature review and survey distribution. Responses underwent scrutiny to ensure reliability and validity. Content validity was assessed, with revisions made to achieve a content validity index exceeding 0.78.  The guideline's feasibility and effectiveness were evaluated by pilot testing, with feedback incorporated for finalization, ensuring the robustness and practicality of the guideline.


The CaReL guidelines can improve the quality of case reports through a comprehensive checklist with an increased emphasis on literature review. In addition to traditional sections with their subsections discussed in previous guidelines, the checklist also focuses on literature review in the abstract and discussion.


The CaReL guidelines offer a comprehensive structure for documenting case reports. They highlight the importance of incorporating a literature review to better introduce medical issues to readers and scholars and embedding reported cases into the current scientific state of the art. Implementing these guidelines can promote knowledge sharing and improve patient care

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