Protocol for development of a consensus-based reporting guideline extension for pre-hospital case reports (PREHOSPITAL-CARE)


prehospital care
case report
case study
health research reporting guidelines

How to Cite

Pearce J, Pap R, Moher D, Williams J, Simpson P. Protocol for development of a consensus-based reporting guideline extension for pre-hospital case reports (PREHOSPITAL-CARE). Australasian Journal of Paramedicine [Internet]. 2021Jan.24 [cited 2023Mar.26];18. Available from:


Case reports make important contributions to evidence-based practice. As with research of any methodological design, the quality and completeness in how the evidence is reported influences the strength of the evidence. Quality in reporting is best achieved through the use of a consensus-based reporting guideline. ‘Case Reports’ (CARE) is a 13-item reporting guideline for case reports. To make CARE more applicable, several discipline specific ‘extensions’ have been developed. Pre-hospital care is an emerging clinical discipline rich in its own specific context and character. Therefore, the aim of this project is to develop and disseminate a pre-hospital extension of the CARE reporting guideline (PREHOSPITAL-CARE).

This project will consist of four phases and will be undertaken in accordance with the Enhancing the Quality and Transparency of Health Research (EQUATOR) Network’s guidance for developers of health research reporting guidelines. Phase 1 will comprise a systematic review aimed at identifying features commonly reported in pre-hospital case reports. In phase 2, two consensus-based processes will be conducted, including a Delphi method and an interactive consensus meeting, to produce a list of items that will form the draft guideline items for PREHOSPITAL-CARE. Phase 3 will see this draft being piloted among a selected group of pre-hospital clinicians, academics and students. In the fourth and final phase, an extensive dissemination strategy will be executed, including publication of the PREHOSPITAL-CARE reporting guideline and an ‘elaboration and explanation’ (E&E) companion paper to advocate for the standardised, high-quality reporting of pre-hospital case reports.

The final outcome will be the publication of the PREHOSPITAL-CARE reporting guideline with an associated E&E paper.

The reporting of health research, including pre-hospital case reports, has been criticised for a lack of completeness and consistency. The development of PREHOSPITAL-CARE will enable the improvement and standardised reporting of pre-hospital case reports.


Gagnier JJ, Kienle G, Altman DG, et al. The CARE Guidelines: consensus-based clinical case reporting guideline development. Glob Adv Heal Med 2013;2:38-43.

Luo M, Cohen AM, Addepalli S, Smalheiser NR. Identifying main finding sentences in clinical case reports. Database (Oxford) 2020;1-12. doi: 10.1093/database/baaa041

McBride WG. Thalidomide and congenital abnormalities. Lancet 1961;1358.

Centres for Disease Control and Prevention. Pneumocystis pneumonia - Los Angeles. Morbidity and Mortality Weekly Report. 1981. Available at:

Layden JE, Ghinai I, Pray I, et al. Pulmonary illness related to e-cigarette use in Illinois and Wisconsin - final report. N Engl J Med 2020;382:903-16.

Holshue ML, DeBolt C, Lindquist S, et al. First case of 2019 novel coronavirus in the United States. ibid. 2020;382:929-36.

Nissen T, Wynn R. The clinical case report: a review of its merits and limitations. BMC Res Notes 2014;7.

Smith S, Maisrikrod S, Vu A. Making a case for case reports in the age of the pandemic. BMJ Evid Based Med 2020;0(0):bmjebm-2020-111433.

Vandenbroucke JP. In defense of case reports and case series. Ann Intern Med 2001;134:330-4.

Oldfield BJ, Saitz R. Guidance for writing case reports in addiction medicine. J Addict Med 2020;14:89-92.

Altman DG, Simera I, Hoey J, Moher D, Schulz K. EQUATOR: reporting guidelines for health research. Lancet 2008;371:1149-50.

Glasziou P, Altman DG, Bossuyt P, et al. Reducing waste from incomplete or unusable reports of biomedical research. ibid. 2014;383:267-76.

Moher D, Schulz KF, Simera I, Altman DG. Guidance for developers of health research reporting guidelines. PLoS Med 2010;7.

Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. ibid. 2009;6:e1000097.

Schulz KF, Altman DG, Moher D, The CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. Lancet 2010;375:1144-6.

Nagendrababu V, Chong BS, McCabe P, et al. PRICE 2020 guidelines for reporting case reports in endodontics: a consensus-based development. Int Endod J 2020;53:619-26.

Agha RA, Fowler AJ, Saeta A, et al. The SCARE statement: consensus-based surgical case report guidelines. Int J Surg 2016;34:180-6.

van Haselen RA. Homeopathic clinical case reports: development of a supplement (HOM-CASE) to the CARE clinical case reporting guideline. Complement Ther Med 2016;25:78-85.

Munk N, Boulanger K. Adaptation of the CARE Guidelines for Therapeutic Massage and Bodywork Publications: efforts to improve the impact of case reports. Int J Ther Massage Bodywork 2014;7:32-40.

Pearce J, Simpson P. Improving the quality and transparency of prehospital case reports using CARE. Int Paramed Pract 2019;9:57-60.

Nair R, Aggarwal R, Khanna D. Methods of formal consensus in classification/diagnostic criteria and guideline development. Semin Arthritis Rheum 2011;41:95-105.

Thangaratinam S, Redman CW. The Delphi technique. Obstet Gynaecol 2005;7:120-5.

Akins RB, Tolson H, Cole BR. Stability of response characteristics of a Delphi panel: application of bootstrap data expansion. BMC Med Res Methodol 2005;5:1-12.

Powell C. The Delphi technique: myths and realities. J Adv Nurs 2003;41:376-82.