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Editors’ commentary
  1. Phil E M Smith,
  2. Geraint N Fuller
  1. Correspondence to Dr Geraint N Fuller, Gloucester Royal Hospital, Gloucester, UK; geraint.fuller{at}

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Fashions change, which is rather the point of fashion. Clinical practice and science aim to work at a higher plane, change being the result of evidence, of greater understanding, and of knowledge. So not like fashion.

Medical journals used to arrive through the letter box, sometimes at home but mostly at the library. Paper copies are the exception, with most journals simply appearing online, and their table of contents via email. The contents have changed too. Clinical trials and meta-analyses now dominate mainstream journals; case reports, previously a regular feature, have disappeared or been relegated to letter sections. Any case reports that journals do publish typically describe novel findings—for example, fuelling an epidemic of COVID-19-related reports. Although case reports still get published in large numbers—42 939 in 2000 and 89 205 in 2020—almost all are in dedicated online publications, so out of sight. The upshot of this is that case reports are now easier to publish, …

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