Christian Koch on publishing case reports and TV’s Dr House

We caught up with Professor Christian Koch, one of our Deputy Editors for Journal of Medical Case Reports, for a few insights on his work with the journal.

What would you say is the ‘best’ paper you have reviewed and why?

CK: I have handled many “good” papers, each unique in its own way. However, one of the very best ones I can remember was one that dealt with the question whether several tumors in an individual could represent a syndrome, although only a subset of “potential” candidate genes had been tested and was negative (J Med Case Reports. 2007 Mar 28;1:9).

This should remind us of the initial observations and publications of the combination of medullary thyroid cancer and pheochromocytoma in some patients (for instance, Sipple syndrome or Multiple endocrine neoplasia type 2) many decades ago and the discovery of the RET proto-oncogene in 1985 and finally the implication of its role in MEN2 in 1993.

All this underscores that careful observation, a sharp mind, and sometimes an approach similar to the one of “Dr. House” (on TV) will not only help our individual patients but many others in the future.

Why do you feel it is important to publish case reports?

CK: We are in an era of “evidence-based medicine”. However, we finally begin to realize that much of the so-called evidence is derived from heterogeneous patient populations and not necessarily applicable to our individual patients we see on a daily basis. Numerous recent studies including ENHANCE, ACCORD, ADVANCE, and the VA Diabetes Outcome Trial, have shown us that heterogeneity of patients, equipment, investigators, etc. can limit our thrive for evidence on a large scale and make us think about personalized, individualized medicine…. that is, why publishing case reports is important in my mind.

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