Care - Health and Resilience - CARE-DN - Case Report Guidelines for Dry Needling

CARE-DN checklist and Explanation & Elaboration (E&E)
developed by the Health + Resilience Institute (H+RI) e-Delphi project – Credits

Completing this form will generate a CARE-DN/CARE Acupuncture/CARE checklist in PDF format suitable for journal submission.

CARE checklist reproduced from www.care-statement.org under the terms of open use for academic and research purposes.
This tool is independent and not affiliated with or endorsed by the CARE Group.

CARE-DN
CARE Acupuncture
CARE

Consensus-Based Dry Needling Case Reporting Guideline

Use this tab to complete the CARE-DN checklist, an extension of the CARE reporting guideline, developed by H+RI in collaboration with the international CARE-DN expert panel (Cureus, 2025). For guidance on how to interpret each item, please refer to the Explanation & Elaboration document.

Phone

This field is for validation purposes and should be left unchanged.

Manuscript title:

Title

1a. The diagnosis or intervention of primary focus followed by the words “case report”.

1b. Include “dry needling” in the title.

Keywords

2a. Two (2) to Five (5) key words that identify diagnoses or interventions in this case report, including "case report".

2b. Include “dry needling”.

Abstract

3a. Introduction: What is unique about this case and what does it add to the scientific literature?

3b. Main symptoms and/or important clinical findings.

3c. The main diagnoses, therapeutic interventions, and outcomes.

3d. Conclusion—What is the main “take-away” lesson(s) from this case?

3e. Specify DN intervention clearly.

Introduction

4. One or two paragraphs summarizing why this case is unique (may include references).

Patient Information

5a. De-identified patient specific information.

5b. Primary concerns and symptoms of the patient.

5c. Medical, family, and psycho-social history including relevant genetic information.

5d. Relevant past interventions with outcomes.

Clinical Findings

6. Describe significant physical examination (PE) and important clinical findings.

Timeline

7a. Historical and current information from this episode of care organized as a timeline.

7b. Report the number of DN sessions delivered and the interval between sessions. If intervals changed during care, report what changed and why.

Diagnostic Assessment

8a. Diagnostic testing (such as PE, laboratory testing, imaging, surveys).

8b. Diagnostic challenges (such as access to testing, financial, or cultural).

8c. Diagnosis (including other diagnoses considered).

8e. Rationale for DN: clinical reasoning behind selecting DN over other treatments.

8d. Prognosis (such as staging in oncology) where applicable.

8f. Report any imaging or objective assessments used (if any) to guide diagnosis or dry needling (e.g. ultrasound, EMG, dynamometry).

Therapeutic Intervention

9a. Types of therapeutic intervention (such as pharmacologic, surgical, preventive, self-care).

9b. Administration of therapeutic intervention (such as dosage, strength, duration).

9c. Changes in therapeutic intervention (with rationale).

9d. Report targeted muscles/tissues (name each muscle treated).

9e. Report anatomical landmarks used for localization

9f. Report needle specifications (brand, material, gauge, length)

9g. Number of needles used

9h. Report depth and angle when relevant and include patient position and the approach path. Numeric depths are not required.

9i. Report the needling technique employed (e.g., static retention, pistoning, rotation) and the duration of active manipulation and, if recorded, number of bouts or frequency.

9j. Report imaging guidance if used and include the modality, brand, model, and key settings.

9k. Report whether a local twitch response was elicited (yes/no) and, if recorded, the approximate number and location.

9l. Duration of needle retention.

9M. Clinician credentials/experience.

Follow-up and Outcomes

10a. Clinician and patient-assessed outcomes (if available).

10b. Important follow-up diagnostic and other test results.

10c. ntervention adherence and tolerability (How was this assessed?) .

10d. Adverse and unanticipated events.

Discussion

11a. A scientific discussion of the strengths AND limitations associated with this case report.

11b. Discussion of the relevant medical literature with references.

11c. The scientific rationale for any conclusions (including assessment of possible causes).

11d. The primary “take-away” lessons of this case report (without references) in a one paragraph conclusion.

Patient Perspective

12. The patient should share their perspective in one to two paragraphs on the treatment(s) they received.

Informed Consent

13. Did the patient give informed consent? Please provide if requested.

Yes

CAPTCHA

Consensus-based Acupuncture Case Reporting Guideline

Use this tab to complete the CARE Acupuncture extension checklist. This checklist is reproduced from the CARE Acupuncture extension developed by Duan et al. (BMJ Evidence-Based Medicine, 2025). For detailed guidance on interpreting each item, consult the Explanation & Elaboration document.

Phone

This field is for validation purposes and should be left unchanged.

Manuscript title:

Title

1. The words ‘case report’ or ‘case series’ should be in the title along with the area of focus.

Keywords

2. Two to five keywords—include ‘case report’ and ‘acupuncture’

Abstract

3a. Introduction: What is unique about this case and what does it add to the scientific literature?

3b. The main symptoms of the patient and the important clinical findings should be described both in conventional medicine and traditional medicine, if applicable.

3c. Define the main diagnoses and therapeutic interventions. Provide both conventional medicine diagnosis and TM diagnosis with TM pattern, if applicable. Interventions add a selection of points, operation, treatment procedures and auxiliary intervention measures.

3d. Conclusion of this case.

Introduction

4. Summarising the background of the case and the reason why this case is unique or meaningful with references.

Patient Information

5a. De-identified demographic information and other patient-specific information.

5b. Main concerns and symptoms of the patient and/or TM-related symptoms should be included (eg, night sweats, afternoon tidal fever and aversion to heat (or cold)), if applicable

5c. Medical, family and psychosocial history including relevant genetic information (also see timeline), if applicable.

5d. Relevant past interventions with outcomes.

Clinical Findings

6. Describe the relevant physical examination (PE) and other significant clinical findings, especially TM signs on tongues and pulse, eg, string pulse, red tongue, pale face, if applicable.

Timeline

7. Patient’s history organised in a timeline

Diagnostic Assessment

8a. Diagnostic methods shall be described both/either in conventional medicine method and/or TM syndrome differentiation (eg, eight principles differentiation, Zang-fu organs differentiation and six meridians differentiation).

8b. Diagnostic reasoning including the analysis process of conventional medicine and/ or TM differentiation based on its relevant symptoms and signs.

8c. Prognostic characteristics (such as staging in oncology) where applicable.

8d. Prognosis (such as staging in oncology) where applicable.

Therapeutic Intervention

9a. Style/principle of acupuncture treatment (eg, Traditional Chinese Medicine, Korean Medicine, Japanese Medicine, Western medical acupuncture), type of acupuncture (eg, electroacupuncture, fire acupuncture, ear acupuncture or scalp acupuncture) and combined therapy of acupuncture or other interventions (eg, moxibustion, herbs, lifestyle advice, Western medicine).

9b. Acupuncture prescription (eg, type of needle, selection of points, operation, depth and angle of insertion, direction of twitch, the manipulation method (involving thrusting, lifting and rotating techniques), intensity of these manipulation methods, response sought, needle retention time, treatment procedures and auxiliary intervention measures)

9c. Any changes in acupuncture prescription (eg, acupuncture points, manipulation, needle types) during the treatment should be clearly explained, with its TM theory if applicable.

9d. Practitioner background regarding acupuncture (eg, qualification-training hours, work place, practice history, education background, other relevant experience)

Follow-up and Outcomes

10a. Clinician and patient-assessed outcomes (if available).

10b. Describe important follow-up diagnostic and acupuncture treatment, especially the changes of TM syndrome differentiation and other test results if applicable.

10c. ntervention adherence and tolerability (How was this assessed?) .

10d. Adverse and unanticipated events. Specific adverse events of acupuncture, eg, fainting during acupuncture treatment, needle breakage, stuck needle should be reported if applicable.

Discussion

11a. Discussion of the strengths and limitations in your approach to this case. Description of the potential advantages and disadvantages of acupuncture compared with conventional treatment, if applicable

11b. Discussion of the relevant medical literature with references.

11c. The rationale for conclusions (including assessment of possible causes). Please be cautious in drawing general conclusions in unique cases

11d. The primary ‘take-away’ lessons of this case report.

Patient Perspective

12. The retrospective survey of acupuncture (eg, therapeutic efficacy, accessibility, advantages, cost and individualised treatment experience) should be emphasised.

Ethics and informed consent

13. Please provide ethics and informed consent if requested.

CAPTCHA

Consensus-based Clinical Case Reporting Guideline

Use this tab to complete the standard CARE checklist for your case report. This checklist is based on the CARE Guidelines developed by Gagnier et al. (BMJ Case Reports, 2013). For guidance on how to interpret each CARE item, please refer to the official Explanation & Elaboration document.

This field is for validation purposes and should be left unchanged.

Manuscript title:

Title

1. The diagnosis or intervention of primary focus followed by the words “case report”.

Keywords

2. Two (2) to Five (5) key words that identify diagnoses or interventions in this case report, including "case report".

Abstract

3a. Introduction: What is unique about this case and what does it add to the scientific literature?

3b. Main symptoms and/or important clinical findings.

3c. The main diagnoses, therapeutic interventions, and outcomes.

3d. Conclusion—What is the main “take-away” lesson(s) from this case?

Introduction

4. One or two paragraphs summarizing why this case is unique (may include references).

Patient Information

5a. De-identified patient specific information.

5b. Primary concerns and symptoms of the patient.

5c. Medical, family, and psycho-social history including relevant genetic information.

5d. Relevant past interventions with outcomes.

Clinical Findings

6. Describe significant physical examination (PE) and important clinical findings.

Timeline

7. Historical and current information from this episode of care organized as a timeline.

Diagnostic Assessment

8a. Diagnostic testing (such as PE, laboratory testing, imaging, surveys).

8b. Diagnostic challenges (such as access to testing, financial, or cultural).

8c. Diagnosis (including other diagnoses considered).

8d. Prognosis (such as staging in oncology) where applicable.

Therapeutic Intervention

9a. Types of therapeutic intervention (such as pharmacologic, surgical, preventive, self-care).

9b. Administration of therapeutic intervention (such as dosage, strength, duration).

9c. Changes in therapeutic intervention (with rationale).

Follow-up and Outcomes

10a. Clinician and patient-assessed outcomes (if available).

10b. Important follow-up diagnostic and other test results.

10c. ntervention adherence and tolerability (How was this assessed?) .

10d. Adverse and unanticipated events.

Discussion

11a. A scientific discussion of the strengths AND limitations associated with this case report.

11b. Discussion of the relevant medical literature with references.

11c. The scientific rationale for any conclusions (including assessment of possible causes).

11d. The primary “take-away” lessons of this case report (without references) in a one paragraph conclusion.

Patient Perspective

12. The patient should share their perspective in one to two paragraphs on the treatment(s) they received.

Informed Consent

13. Did the patient give informed consent? Please provide if requested.

Yes

CAPTCHA

Consensus-Based Dry Needling Case Reporting Guideline For guidance on how to interpret each CARE-DN item, please refer to the Explanation & Elaboration document.

Phone

This field is for validation purposes and should be left unchanged.

Manuscript title:

Title

1a. The diagnosis or intervention of primary focus followed by the words “case report”.

1b. Include “dry needling” in the title.

Keywords

2a. Two (2) to Five (5) key words that identify diagnoses or interventions in this case report, including "case report".

2b. Include “dry needling”.

Abstract

3a. Introduction: What is unique about this case and what does it add to the scientific literature?

3b. Main symptoms and/or important clinical findings.

3c. The main diagnoses, therapeutic interventions, and outcomes.

3d. Conclusion—What is the main “take-away” lesson(s) from this case?

3e. Specify DN intervention clearly.

Introduction

4. One or two paragraphs summarizing why this case is unique (may include references).

Patient Information

5a. De-identified patient specific information.

5b. Primary concerns and symptoms of the patient.

5c. Medical, family, and psycho-social history including relevant genetic information.

5d. Relevant past interventions with outcomes.

Clinical Findings

6. Describe significant physical examination (PE) and important clinical findings.

Timeline

7a. Historical and current information from this episode of care organized as a timeline.

7b. Report the number of DN sessions delivered and the interval between sessions. If intervals changed during care, report what changed and why.

Diagnostic Assessment

8a. Diagnostic testing (such as PE, laboratory testing, imaging, surveys).

8b. Diagnostic challenges (such as access to testing, financial, or cultural).

8c. Diagnosis (including other diagnoses considered).

8e. Rationale for DN: clinical reasoning behind selecting DN over other treatments.

8d. Prognosis (such as staging in oncology) where applicable.

8f. Report any imaging or objective assessments used (if any) to guide diagnosis or dry needling (e.g. ultrasound, EMG, dynamometry).

Therapeutic Intervention

9a. Types of therapeutic intervention (such as pharmacologic, surgical, preventive, self-care).

9b. Administration of therapeutic intervention (such as dosage, strength, duration).

9c. Changes in therapeutic intervention (with rationale).

9d. Report targeted muscles/tissues (name each muscle treated).

9e. Report anatomical landmarks used for localization

9f. Report needle specifications (brand, material, gauge, length)

9g. Number of needles used

9h. Report depth and angle when relevant and include patient position and the approach path. Numeric depths are not required.

9i. Report the needling technique employed (e.g., static retention, pistoning, rotation) and the duration of active manipulation and, if recorded, number of bouts or frequency.

9j. Report imaging guidance if used and include the modality, brand, model, and key settings.

9k. Report whether a local twitch response was elicited (yes/no) and, if recorded, the approximate number and location.

9l. Duration of needle retention.

9M. Clinician credentials/experience.

Follow-up and Outcomes

10a. Clinician and patient-assessed outcomes (if available).

10b. Important follow-up diagnostic and other test results.

10c. ntervention adherence and tolerability (How was this assessed?) .

10d. Adverse and unanticipated events.

Discussion

11a. A scientific discussion of the strengths AND limitations associated with this case report.

11b. Discussion of the relevant medical literature with references.

11c. The scientific rationale for any conclusions (including assessment of possible causes).

11d. The primary “take-away” lessons of this case report (without references) in a one paragraph conclusion.

Patient Perspective

12. The patient should share their perspective in one to two paragraphs on the treatment(s) they received.

Informed Consent

13. Did the patient give informed consent? Please provide if requested.

Yes

CAPTCHA

Consensus-based Acupuncture Case Reporting Guideline Use this tab to complete the CARE Acupuncture checklist. This checklist is reproduced from the CARE Acupuncture extension developed by Duan et al. (BMJ Evidence-Based Medicine, 2025). For detailed guidance on interpreting each item, consult the Explanation & Elaboration document.

Consensus-based Clinical Case Reporting Guideline Use this tab to complete the standard CARE checklist for your case report. This checklist is reproduced from the CARE Guidelines developed by Gagnier et al. (BMJ Case Rep. 2013). For guidance on how to interpret each CARE item, please refer to the official Explanation & Elaboration document.

This field is for validation purposes and should be left unchanged.

Manuscript title:

Title

1. The diagnosis or intervention of primary focus followed by the words “case report”.

Keywords

2. Two (2) to Five (5) key words that identify diagnoses or interventions in this case report, including "case report".

Abstract

3a. Introduction: What is unique about this case and what does it add to the scientific literature?

3b. Main symptoms and/or important clinical findings.

3c. The main diagnoses, therapeutic interventions, and outcomes.

3d. Conclusion—What is the main “take-away” lesson(s) from this case?

Introduction

4. One or two paragraphs summarizing why this case is unique (may include references).

Patient Information

5a. De-identified patient specific information.

5b. Primary concerns and symptoms of the patient.

5c. Medical, family, and psycho-social history including relevant genetic information.

5d. Relevant past interventions with outcomes.

Clinical Findings

6. Describe significant physical examination (PE) and important clinical findings.

Timeline

7. Historical and current information from this episode of care organized as a timeline.

Diagnostic Assessment

8a. Diagnostic testing (such as PE, laboratory testing, imaging, surveys).

8b. Diagnostic challenges (such as access to testing, financial, or cultural).

8c. Diagnosis (including other diagnoses considered).

8d. Prognosis (such as staging in oncology) where applicable.

Therapeutic Intervention

9a. Types of therapeutic intervention (such as pharmacologic, surgical, preventive, self-care).

9b. Administration of therapeutic intervention (such as dosage, strength, duration).

9c. Changes in therapeutic intervention (with rationale).

Follow-up and Outcomes

10a. Clinician and patient-assessed outcomes (if available).

10b. Important follow-up diagnostic and other test results.

10c. ntervention adherence and tolerability (How was this assessed?) .

10d. Adverse and unanticipated events.

Discussion

11a. A scientific discussion of the strengths AND limitations associated with this case report.

11b. Discussion of the relevant medical literature with references.

11c. The scientific rationale for any conclusions (including assessment of possible causes).

11d. The primary “take-away” lessons of this case report (without references) in a one paragraph conclusion.

Patient Perspective

12. The patient should share their perspective in one to two paragraphs on the treatment(s) they received.

Informed Consent

13. Did the patient give informed consent? Please provide if requested.

Yes

CAPTCHA

Title

Keywords

Abstract

Introduction

Patient Information

Clinical Findings

Timeline

Diagnostic Assessment

Therapeutic Intervention

Follow-up and Outcomes

Discussion

Patient Perspective

Informed Consent

Title

Keywords

Abstract

Introduction

Patient Information

Clinical Findings

Timeline

Diagnostic Assessment

Therapeutic Intervention

Follow-up and Outcomes

Discussion

Patient Perspective

Ethics and informed consent

Title

Keywords

Abstract

Introduction

Patient Information

Clinical Findings

Timeline

Diagnostic Assessment

Therapeutic Intervention

Follow-up and Outcomes

Discussion

Patient Perspective

Informed Consent

Title

Keywords

Abstract

Introduction

Patient Information

Clinical Findings

Timeline

Diagnostic Assessment

Therapeutic Intervention

Follow-up and Outcomes

Discussion

Patient Perspective

Informed Consent

Title

Keywords

Abstract

Introduction

Patient Information

Clinical Findings

Timeline

Diagnostic Assessment

Therapeutic Intervention

Follow-up and Outcomes

Discussion

Patient Perspective

Informed Consent

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