I am working on a systematic review in neurosurgery, and the majority of data would be found in prospective and retrospective studies (100+ patients at times) however case-reports only include one single patient most of the time, would it be wise to include those case reports? And how does including them impact the risk of bias assessment? Thank you!
Ultimately, this will depend on your pre-specified research question/objectives and eligibility criteria. If your systematic review deals with an intervention compared to something else (placebo/control/standard of care), then including case reports would be unwise (because of absence of control/bias issues). If you are concerned with clinical features associated with a neurosurgical condition, then there will be instances wherein including such design will be defensible.
As far as risk of bias assessment is concerned, there are available tools that are specific to a study design. One such reference is this: https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools. Risk of bias/quality assessment, in my view, should be grouped per study design (but with the understanding that one study design may be better suited to address a research question than another).
In general, a good systematic review should only include robust level 1 data ie RCTs. Then follows prospective cohort studies and case control studies. If there’s a dearth of clinical trials, case studies and case reports may then be included.
Depends on your inclusion criteria, and what kind of outcome you would like to analyze. Personally, I deemed a case report as nice additional information, but not to be included, as there is no control or methodology to make sure a fair data. A case report could be used in systematic review if you are trying to compile clinical features or notable outcomes in each of these reports. Still, in my opinion, the first choice should be those with reputable study designs (be it RCTs, case controls, or cohorts).
Yes. If the medical condition that is going to be analyzed is not as frequent for getting an extensive information. Maybe could be a good option
Using reports of specific clinical cases is a common practice in the Health Sciences (eg Freud himself did it frequently); but yes, with the subject's knowledge and permission -if he is alive- and SAVING THE MOST ABSOLUTE AND RIGOROUS ANONYMITY.
Yes, actually, if it is a very rare topic, we can use case reports as well. But, the evidence will be of low quality. Case reports are preferred only when there are no other observational or experimental studies done on that particular topic.
we can use case report or case series if the topic is unique or rare
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