A new classification for retrospective reviews of medical records

Kurt J. Matushek Associate Editor

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Janis H. Audin Editor-in-Chief

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The retrospective review of medical records is a time-honored tradition, and much can be learned from reviewing past cases. The JAVMA has a long history of publishing studies based on the retrospective review of medical records, and beginning with the July 1, 1986, issue, the journal even developed a separate section—Reports of Retrospective Studies— devoted to the publication of such manuscripts.

Since that time, the JAVMA has published hundreds of retrospective studies. The separate section has long since been discontinued, and the retrospective studies have been incorporated with other reports of original research. But the format, including the distinctive title format and a heading devoted to the criteria used for selection of cases, has largely remained unchanged, to the point that retrospective studies published in the JAVMA are immediately recognizable as such.

Thus, it may come as a surprise to our readers and authors that the editors have decided to phase out the retrospective study format with the current issue. Why, given the nearly iconic status of the retrospective study, would we choose to do this?

For some time now, we have been uncomfortable with identifying studies based on the retrospective review of medical records as “Retrospective Studies.” By definition, these retrospective case series are retrospective studies, but other types of studies, such as case-control studies and cohort studies, may also be retrospective in nature. Thus, we have been concerned that some readers, particularly those in other fields who read the journal sporadically, may have been confused or misled by our special designation for some, but not all, studies involving analyses of retrospective data.

What's more, with the increasing emphasis on evidence-based medicine, we began to question whether these retrospective case series truly deserved a separate designation. Such studies, after all, simply provide another type of medical evidence, somewhat more reliable, in general, than a case report but less so than a high-quality randomized, controlled clinical trial. It is our belief, therefore, that retrospective case series should be treated like other original studies, and that readers should asses them not on the basis of some artificial designation but on the weight of the evidence they provide.

This does not mean that we will no longer accept manuscripts based on the retrospective review of medical records. Far from it. We continue to believe that such studies have an important role in veterinary research and encourage authors to continue to submit such manuscripts for consideration.

In actuality, the changes will be minor. The “Criteria for Selection of Cases” heading, for instance, will be replaced by the more familiar “Materials and Methods” heading, with “Case selection” as the first subheading. The “Procedures” heading will be discontinued, and a “Medical records review” subheading will be added. Authors will still be expected to include a meaningful statement of purpose and appropriate statistical analyses. And, perhaps most important, the familiar title format (including information on the number of cases and years of review) will remain unchanged.

As the saying goes, “the more things change, the more they remain the same.” Although we are phasing out the retrospective study format, we remain committed to publishing the highest quality veterinary research, including research based on retrospective reviews of medical records.

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