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Evaluating Case Series in Surgery

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Evidence-Based Surgery

Abstract

While case series are low in the hierarchy of evidence , they remain the most common study reported in the surgical literature. A number of case series have reported landmark interventions or disease classifications for surgeons, and they remain popular in reporting rare cases and novel procedures. They have high external validity and are fast and cheap to perform. Case series can be used to prepare for a higher level study by demonstrating feasibility and establishing patient and outcome parameters. Alone, they are sufficient to establish an intervention’s safety and a test’s diagnostic accuracy. However, case series lack a control group by definition and are commonly performed with a retrospective design. It is important for surgeons to be familiar with their appraisal . This chapter provides a guide to readers on evaluating a case series in surgery .

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References

  1. Agha RA, Fowler AJ, Rajmohan S, Barai I, Orgill DP, PROCESS Group. Preferred reporting of case series in surgery; the PROCESS guidelines. Int J Surg [Internet]. 2016;36(Pt A):319–23. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27770639.

  2. Chan K, Bhandari M. Three-minute critical appraisal of a case series article. Indian J Orthop [Internet]. 2011;45(2):103–4. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21430861.

  3. Joyce KM, Joyce CW, Kelly JC, Kelly JL, Carroll SM. Levels of evidence in the plastic surgery literature: a citation analysis of the top 50 “classic” papers. Arch Plast Surg [Internet]. 2015;42(4):411–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26217560.

  4. Kooistra B, Dijkman B, Einhorn TA, Bhandari M. How to design a good case series. J Bone Joint Surg Am [Internet]. 2009;91(Suppl 3):21–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19411496.

  5. Coroneos CJ, Ignacy TA, Thoma A. Designing and reporting case series in plastic surgery. Plast Reconstr Surg [Internet]. 2011;128(4):361e–8e. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21544010.

  6. Audigé L, Hanson B, Kopjar B. Issues in the planning and conduct of non-randomised studies. Injury [Internet]. 2006;37(4):340–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16483576.

  7. Okumura Y, Mori K, Yamagata Y, Fukuda T, Wada I, Shimizu N, et al. Two-stage operation for thoracic esophageal cancer: esophagectomy and subsequent reconstruction by a free jejunal flap. Surg Today [Internet]. 2014;44(2):395–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24292600.

  8. Takeno S, Takahashi Y, Moroga T, Yamamoto S, Kawahara K, Hirano T, et al. Reconstruction using a free jejunal graft after resection of the cervical esophagus for malignancy. Hepatogastroenterology [Internet]. 2013;60(128):1966–71. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24719936.

  9. Laing TA, Van Dam H, Rakshit K, Dilkes M, Ghufoor K, Patel H. Free jejunum reconstruction of upper esophageal defects. Microsurgery [Internet]. 2013;33(1):3–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22821641.

  10. Poh M, Selber JC, Skoracki R, Walsh GL, Yu P. Technical challenges of total esophageal reconstruction using a supercharged jejunal flap. Ann Surg [Internet]. 2011;253(6):1122–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21587114.

  11. Bernard T, Armstrong-Wells J, Goldenberg N. The institution-based prospective inception cohort study: design, implementation, and quality assurance in pediatric thrombosis and stroke research. Semin Thromb Hemost [Internet]. 2012;39(1):10–4. Available from: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0032-1329551.

  12. Sedgwick P. Prospective cohort studies: advantages and disadvantages. BMJ [Internet]. 2013;347(1):f6726. Available from: http://www.bmj.com/cgi/doi/10.1136/bmj.f6726.

  13. Sedgwick P. Bias in observational study designs: prospective cohort studies. BMJ [Internet]. 2014;349(2):g7731. Available from: http://www.bmj.com/cgi/doi/10.1136/bmj.g7731.

  14. Voineskos SH, Coroneos CJ, Ziolkowski NI, Kaur MN, Banfield L, Meade MO, et al. A systematic review of surgical randomized controlled trials: part I. Risk of bias and outcomes: common pitfalls plastic surgeons can overcome. Plast Reconstr Surg [Internet]. 2016;137(2):696–706. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26818309.

  15. Bala MM, Akl EA, Sun X, Bassler D, Mertz D, Mejza F, et al. Randomized trials published in higher vs. lower impact journals differ in design, conduct, and analysis. J Clin Epidemiol [Internet]. 2013;66(3):286–95. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23347852.

  16. Lubsen J, Kirwan B-A. Combined endpoints: can we use them? Stat Med [Internet]. 2002;21(19):2959–70. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12325112.

  17. Pusic AL, Klassen AF, Scott AM, Klok JA, Cordeiro PG, Cano SJ. Development of a new patient-reported outcome measure for breast surgery: the BREAST-Q. Plast Reconstr Surg [Internet]. 2009;124(2):345–53. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19644246.

  18. Carey TS, Boden SD. A critical guide to case series reports. Spine (Phila Pa 1976) [Internet]. 2003;28(15):1631–4. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12897483.

  19. de Jong D, Vasmel WLE, de Boer JP, Verhave G, Barbé E, Casparie MK, et al. Anaplastic large-cell lymphoma in women with breast implants. JAMA [Internet]. 2008;300(17):2030–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18984890.

  20. Akl EA, Briel M, You JJ, Lamontagne F, Gangji A, Cukierman-Yaffe T, et al. LOST to follow-up Information in Trials (LOST-IT): a protocol on the potential impact. Trials [Internet]. 2009;10:40. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19519891.

  21. Schulz KF, Grimes DA, Altman DG, Hayes RJ. Blinding and exclusions after allocation in randomised controlled trials: survey of published parallel group trials in obstetrics and gynaecology. BMJ [Internet]. 1996;312(7033):742–4. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8605459.

  22. Van Allen EM, Lui VWY, Egloff AM, Goetz EM, Li H, Johnson JT, et al. Genomic correlate of exceptional erlotinib response in head and neck squamous cell carcinoma. JAMA Oncol [Internet]. 2015;1(2):238–44. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26181029.

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Correspondence to Christopher J. Coroneos .

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Coroneos, C.J., Chin, B.H. (2019). Evaluating Case Series in Surgery. In: Thoma, A., Sprague, S., Voineskos, S., Goldsmith, C. (eds) Evidence-Based Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-05120-4_18

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  • DOI: https://doi.org/10.1007/978-3-030-05120-4_18

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-05119-8

  • Online ISBN: 978-3-030-05120-4

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