Case Study / Case Report / Case Series

Which clinical questions does Case Study / Case Report / Case Series best answer?

• Emerging conditions, adverse reactions to treatments, atypical / abnormal behaviour, new programs or methods of treatment – all of these can be answered with case studies /case reports / case series. They are generally descriptive studies based on qualitative data e.g. observations, interviews, questionnaires, diaries, personal notes or clinical notes.

What are the advantages and disadvantages to consider when using Case Studies/ Case Reports and Case Series ?

Advantages

• Can be published quickly

• Provides very detailed information

• Allows detailed investigation into situations which would be unethical or impractical to perform using another study design

Disadvantages

• May include researcher bias

• Difficult to replicate

• Can't always be generalised to the broader population

What are the pitfalls to look for?

• One pitfall that has occurred in some case studies is where two common conditions/treatments have been linked together with no comprehensive data backing up the conclusion. A hypothetical example could be where high rates of the common cold were associated with suicide when the cohort also suffered from depression.

What are the stages of a case series study

• Conducting a case series typically involves the following stages:

• 1. Selection of Cases: Identify a group of individuals who share a common characteristic, condition, or exposure that is of interest for investigation. This could include patients with a particular disease, individuals with a specific exposure, or those who have undergone a particular treatment.

• 2. Data Collection: Collect detailed information on each case, including demographics, clinical history, symptoms, diagnostic tests, treatments received, and outcomes. Data may be obtained from medical records, interviews, surveys, or other sources.

• 3. Case Description: Describe each case individually, providing a comprehensive overview of their characteristics, clinical course, and treatment outcomes. Include relevant details such as timeline, clinical presentations, laboratory findings, imaging results, and response to interventions.

• 4. Data Analysis: Analyze the collected data by identifying common patterns, trends, or similarities among the cases. This may involve summarizing key features, calculating descriptive statistics, or conducting qualitative analyses to identify themes or emerging factors.

• 5. Results Presentation: Present the findings in a clear and organized manner, using tables, charts, or narratives. Highlight commonalities, variations, and noteworthy observations among the cases.

• 6. Discussion and Interpretation: Discuss the implications of the case series findings, considering their potential clinical significance, limitations, and generalizability. Relate the findings to existing literature, theories, or hypotheses, and explore possible explanations or further research avenues.

• 7. Conclusion: Summarize the key findings and conclusions drawn from the case series, emphasizing their relevance and potential impact on clinical practice, research, or policy.

• 8. Reporting: Prepare a comprehensive report or manuscript adhering to the guidelines and standards for case series reporting. This may include using frameworks such as CARE (CAse REport) or completing a detailed case series template.

• It's important to note that case series provide descriptive information and generate hypotheses, but they do not establish causal relationships or have the same level of evidence as controlled studies. They are often used to report rare conditions, unusual presentations, or treatment responses to help guide further research or clinical decision-making.

Types of Case Studies:

• Exploratory: Used to gain initial insights on a broad topic. Helps define research questions and variables. (e.g., How nutrition and socialization affect learning in children?)

• Intrinsic: Focuses on a unique phenomenon to understand it in depth, not for generalization. (e.g., Case Study of Volcanic Lightning)

• Collective: Analyzes multiple case studies to understand a broader phenomenon. Allows for some generalization. (e.g., How PTSD affected veterans of different wars)

• Critical Instance: Investigates a specific case to explain a cause-and-effect relationship or challenge an assumption. (e.g., A deep dive into a specific historical event)