How are case studies conducted? Selected cases need to be not only interesting but also hospitable to the inquiry [8] if they are to be informative and answer the research question(s). 1994, CA: Sage Publications Inc., 2. Context: Case study research (CSR) is a research approach that guides holistic investigation of a real phenomenon. In contrast to experimental designs, which seek to test a specific hypothesis through deliberately manipulating the environment (like, for example, in a randomised controlled trial giving a new drug to randomly selected individuals and then comparing outcomes with controls),[9] the case study approach lends itself well to capturing information on more explanatory 'how', 'what' and 'why' questions, such as 'how is the intervention being implemented and received on the ground?'. The case study approach. A nursing case study is a detailed study of an individual patient, which allows you to gain more information about the symptoms and the medical history of a patient and provide the proper diagnoses of the patient’s illness based on the symptoms he or she experienced and other affecting factors. Bloomfield BP, Best A: Management consultants: systems development, power and the translation of problems. 10.1057/jit.1998.8. producing findings that may be transferable to other settings)[1]. case study EBM (1) An in-depth analysis and systematic description of one patient or group of similar patients to promote a detailed understanding of their circumstances. He has helpfully characterised three main types of case study: intrinsic, instrumental and collective[8]. See more. 2003, Naples, The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2288/11/100/prepub. A case definition defines a case by placing limits on time, person and place. In collective or multiple case studies, a number of cases are carefully selected. 2009, Los Angeles: Sage, 2, Howcroft D, Trauth E: Handbook of Critical Information Systems Research, Theory and Application. CAS  However, critics might argue that selecting 'cases' in this way is insufficiently reflexive and ill-suited to the complexities of contemporary healthcare organisations. These theoretical lenses should not, however, constitute a strait-jacket and the cases should not be "forced to fit" the particular theoretical framework that is being employed. The case study approach can offer additional insights into what gaps exist in its delivery or why one implementation strategy might be chosen over another. Google Scholar. Here, quantitative measures were collected with questionnaires before, and five months after, the start of the intervention which did not yield any statistically significant results. Making sense and offering a coherent interpretation of the typically disparate sources of data (whether qualitative alone or together with quantitative) is far from straightforward. van Harten WH, Casparie TF, Fisscher OA: The evaluation of the introduction of a quality management system: a process-oriented case study in a large rehabilitation hospital. Our focus was on how the technology was being implemented. CAS  Care must be taken to ensure the anonymity of both case sites and individual participants (if agreed in advance) by allocating appropriate codes or withholding descriptors. doctors and/or nurses). This approach may be useful in medical education to provide critical analyses of teaching and learning, and to reveal the underlying elements of leadership and innovation. Stake RE: The art of case study research. In the social and life sciences, a case study is a research method involving an up-close, in-depth, and detailed examination of a particular case. A medical case study report is a published document in which doctors document and share their experiences treating patients so that other doctors can learn from them. Shanks G, Parr A: Positivist, single case study research in information systems: A critical analysis. BMJ. A theory driven approach to defining the case may help generate knowledge that is potentially transferable to a range of clinical contexts and behaviours; using theory is also likely to result in a more informed appreciation of, for example, how and why interventions have succeeded or failed[13]. 2005, 4: 7-22. They are written according to a specific format. Generally, a case can be nearly any unit of analysis, including individuals, organizations, events, or actions. A case study is a research approach that is used to generate an in-depth, multi-faceted understanding of a complex issue in its real-life context. The outcome of providing this information might be that the emotive burden associated with participation, or the organisational disruption associated with supporting the fieldwork, is considered so high that the individuals or sites decide against participation. BMJ. What are case studies used for? Article  BMJ. 2009, London: Sage Publications Ltd., 4. Privacy 10.1111/j.1365-2575.2004.00176.x. In contrast to the intrinsic case study, the particular case which is chosen is of less importance than selecting a case that allows the researcher to investigate an issue or phenomenon. Medical students eventually face the need of writing a medical case study, the main goal of which is to prove the proper analysis of the project topic and to show their ability to apply the knowledge gained while conducting independent research. 2010, 41: c4564-. Recognising the importance of full access and co-operative working for generating rich data, the research team decided not to pursue work at that site and instead to focus on other recruited sites. Expect the case studies and related guidance to evolve. They may establish, strengthen or weaken historical explanations of a case and, in certain circumstances, allow theoretical (as opposed to statistical) generalisation beyond the particular cases studied[12]. 2002, 52 (482): 746-51. 2005, Cheltenham, UK: Northampton, MA, USA: Edward Elgar, Blakie N: Approaches to Social Enquiry. Case studies More than ever, health professionals need reliable information from a trusted source. PubMed  Yin suggests two or three literal replications (i.e. In an intrinsic case study, the case is selected on its own merits[8]. There are several ways to address these concerns, including: the use of theoretical sampling (i.e. The paper concludes with key pointers to aid those designing and appraising proposals for conducting case study research, and a checklist to help readers assess the quality of case study reports. By using this website, you agree to our BMC Med Res Methodol 11, 100 (2011). The decision on how to select the case(s) to study is a very important one that merits some reflection. It is for this reason sometimes referred to as a "naturalistic" design; this is in contrast to an "experimental" design (such as a randomised controlled trial) in which the investigator seeks to exert control over and manipulate the variable(s) of interest. Education dissertation literature review how to write an a level english literature comparative essay the case study is a research method in which Examples of study medical case. Integr Cancer Ther. Qualitative interviews with patients however helped provide an insight into potentially beneficial process-related aspects of the programme, such as greater, perceived patient involvement in care. 2009, 6 (10): 1-11. Brazier A, Cooke K, Moravan V: Using Mixed Methods for Evaluating an Integrative Approach to Cancer Care: A Case Study. replication logic)[1]. It is important that data sources from different cases are, where possible, broadly comparable for this purpose even though they may vary in nature and depth. 2001, 358: 483-488. Case study findings can have implications both for theory development and theory testing. Info Systems J. We chose a mixture of teaching, non-teaching and Foundation Trust hospitals, and examples of each of the three electronic health record systems procured centrally by the NPfIT. It is also important to consider in advance the likely burden and risks associated with participation for those who (or the site(s) which) comprise the case study. Sampling a "deviant" or "atypical" case may however prove even more informative, potentially enabling the researcher to identify causal processes, generate hypotheses and develop theory. The researcher should define the uniqueness of the phenomenon, which distinguishes it from all others. 1998, 13: 301-311. Case studies are a qualitative research method that offers a complete and in-depth look into some of the situations that baffled medical science. Literary research paper examples referencing sources in a research paper describing a person essay spm medical Case definition study, argumentative essay 7th grade, dissertation droit de la famille l1. Here, we focus on the main stages of research activity when planning and undertaking a case study; the crucial stages are: defining the case; selecting the case(s); collecting and analysing the data; interpreting data; and reporting the findings. The value of the case study approach is well recognised in the fields of business, law and policy, but somewhat less so in health services research. For example, a case study in medicine may examine a specific patient a doctor treated, and a case study in business might study a particular firm's strategy. For continuity and ease of reference, case studies will retain their original numbering and will not be renumbered if cases are revised or removed. Article  pneumonia on chest X-ray). California Privacy Statement, In keeping with previously published work, we acknowledge the importance of theory to underpin the design, selection, conduct and interpretation of case studies[2]. 2. a. Meaning of case study. For example, in order to gain an understanding of doctors' responses to health policy initiatives, Som undertook an instrumental case study interviewing clinicians who had a range of responsibilities for clinical governance in one NHS acute hospital trust[17]. 10.1177/1471301205049188. The precise beginning and end of the case may however prove difficult to define. Lancet. Terms and Conditions, PubMed Central  J Health Serv Res Policy. 2010, 15: 4-10. These are however not necessarily mutually exclusive categories. International trade dissertation topics case study on tb meningitis, font size of research paper. 2008, [http://www.sdo.nihr.ac.uk/files/project/99-final-report.pdf], Robertson A, Cresswell K, Takian A, Petrakaki D, Crowe S, Cornford T, et al: Prospective evaluation of the implementation and adoption of NHS Connecting for Health's national electronic health record in secondary care in England: interim findings. Brazier and colleagues used a mixed-methods case study approach to investigate the impact of a cancer care programme[22]. 2010, 10 (1): 67-10.1186/1472-6947-10-67. 10.1108/09513550510608903. Considering the frequency with which implementations of innovations are now taking place in healthcare settings and how well the case study approach lends itself to in-depth, complex health service research, we believe this approach should be more widely considered by researchers. For example, our selection of case study sites in the evaluation of the implementation and adoption of electronic health record systems (see Table 3) was heavily influenced by NHS Connecting for Health, the government agency that was responsible for overseeing the National Programme for Information Technology (NPfIT)[5]. Medical case studies are a part of that process, but they are more than just education material. PubMed Google Scholar. Place criteria will usually specify a geographical entity such as a town, state, or country, but may be as small as an institution, a school clas… When investigating the formal and informal ways undergraduate students learn about patient safety (Table 4), for example, we rapidly accumulated a large quantity of data. 2004, 14: 343-362. In the example given in Table 3, we decided against providing detailed information on the NHS sites and individual participants in order to avoid the risk of inadvertent disclosure of identities[5, 25]. interviews, focus groups and observations). 10.1186/1748-5908-1-1. 2002, London: Sage. Pearson P, Steven A, Howe A, Sheikh A, Ashcroft D, Smith P, the Patient Safety Education Study Group: Learning about patient safety: organisational context and culture in the education of healthcare professionals. case study EBM (1) An in-depth analysis and systematic description of one patient or group of similar patients to promote a detailed understanding of their circumstances. This information should not be considered complete, up to date, and is not intended to be used in place of a visit, consultation, or advice of a legal, medical, or any other professional. AS conceived this article. Theoretical frameworks may also play an important role in integrating different sources of data and examining emerging themes. 10.1016/S0168-8510(01)00187-7. 1985, Newbury Park: Sage Publications. 1996, Princeton: Princeton University Press. In contrast, the other three examples (see Tables 2, 3 and 4) employed collective case study designs to study the introduction of workforce reconfiguration in primary care, the implementation of electronic health records into hospitals, and to understand the ways in which healthcare students learn about patient safety considerations[4–6]. to explore why one programme is more effective than another). Key questions to consider when selecting the most appropriate study design are whether it is desirable or indeed possible to undertake a formal experimental investigation in which individuals and/or organisations are allocated to an intervention or control arm? case study - a detailed analysis of a person or group from a social or psychological or medical point of view analysis - an investigation of the component parts of … Thorax. Empirical Evaluation of Agile Software Development: The Controlled, Typical is this title from the June 2016 issue: ", In the first part, we directed students to read the, Unlike a scientific article, the abstract for a, If the student candidly discloses information in public settings, is it reasonable to assume that it can be reshared without consent in a, When the students completed the scenario, they were asked to complete a 20-question survey evaluating the, Dictionary, Encyclopedia and Thesaurus - The Free Dictionary, the webmaster's page for free fun content, Real Food (2019 Edition): The Strategy That's Transforming Sports Nutrition - Features 10 Case Studies of Products that are Successfully Harnessing the Strategy, Distinguishing case study as a research method from case reports as a publication type, COMPARISON OF AGILE PROCESS MODELS TO CONCLUDE THE EFFECTIVENESS FOR INDUSTRIAL SOFTWARE PROJECTS, Enhancing student engagement: a group case study approach, Case study methodology of DSS development for BIM software selection in construction industry, How to write a laboratory-based case study for the journal, Commentary: critical reflections on the ethical and professional considerations in writing about clients, Virtual case studies help students in developing career Skills, Case Technologies to Enhance Literacy Learning. Definition of case study in the Definitions.net dictionary. 1993, Cambridge: Polity Press. A detailed analysis of a person or group, especially as a model of medical, psychiatric, psychological, or social phenomena. Journal of Medical Case Reports will consider any original case report that expands the field of general medical knowledge, and original research relating to case reports.. Case reports should show one of the following: Unreported or unusual side effects or adverse interactions involving medications Whilst such a schema can be conceptually helpful, it may be appropriate to draw on more than one approach in any case study, particularly in the context of conducting health services research. Transparency can be achieved by describing in detail the steps involved in case selection, data collection, the reasons for the particular methods chosen, and the researcher's background and level of involvement (i.e. 1992, 40: 533-560. International Journal of Public Sector Management. A detailed... Case example - definition of Case example by The Free Dictionary. Proceedings of the European Conference on Information Systems. Eccles M, the Improved Clinical Effectiveness through Behavioural Research Group (ICEBeRG): Designing theoretically-informed implementation interventions. Or whether the wish is to obtain a more naturalistic understanding of an issue? The case study approach is, as with all research, not without its limitations. PubMed  According to Yin, case studies can be used to explain, describe or explore events or phenomena in the everyday contexts in which they occur[1]. 10.1136/bmj.322.7294.1115. The case study approach allows in-depth, multi-faceted explorations of complex issues in their real-life settings. Case definitions are used in ongoing public health surveillance to track the occurrence and distribution of disease within a given area, as well as during outbreak investigations in field epidemiology. Stake's work has been particularly influential in defining the case study approach to scientific enquiry. 1995, 311: 444-446. Miles MB, Huberman M: Qualitative data analysis: an expanded sourcebook. PubMed  Seeking potential, alternative explanations, and being explicit about how interpretations and conclusions were reached, help readers to judge the trustworthiness of the case study report. An initial coding frame can help capture these issues and can be applied systematically to the whole dataset with the aid of a qualitative data analysis software package. the nature of different cancer care programmes), before considering the emerging similarities and differences in cross-case comparisons (e.g. Our study of patient safety in undergraduate curricula drew on an evaluation-based approach to design and analysis, which emphasised the importance of the academic, organisational and practice contexts through which students learn (Table 4)[6]. SC, KC and AR wrote this paper with GH, AA and AS all commenting on various drafts. We provide the knowledge and tools they need to make more informed decisions in their clinical practice. case Epidemiology A countable instance in the population or study group of a particular disease, health disorder, or condition under investigation; sometimes, an individual with the particular disease. 1994, Thousand Oaks, CA: Sage Publishing, 2. Case study sites may also be pre-selected for the researcher, with decisions being influenced by key stakeholders. Part of Dementia. Crowe, S., Cresswell, K., Robertson, A. et al. Google Scholar. These can, for example, help to understand and explain causal links and pathways resulting from a new policy initiative or service development (see Tables 2 and 3, for example)[1]. A case study can be defined in a variety of ways (Table 5), the central tenet being the need to explore an event or phenomenon in depth and in its natural context. Case study definition is - an intensive analysis of an individual unit (such as a person or community) stressing developmental factors in relation to environment. questionnaires, audits and analysis of routinely collected healthcare data) and more commonly qualitative techniques (e.g. Recently the world media reported the legal case where the parents of 18-month-old boy with a terminal muscle-wasting disease expected to die within a year appealed to the court in order to stop the doctors from turning off the ventilator necessary to sustain his life. Article  The case study approach is particularly useful to employ when there is a need to obtain an in-depth appreciation of an issue, event or phenomenon of interest, in its natural real-life context. Google Scholar, Yin R: Case study research: design and methods. In a collective case study, researchers may choose to present the findings from individual cases separately before amalgamating across cases. being explicit about how the researcher has influenced data collection and interpretation). case study definition: 1. a detailed account giving information about the development of a person, group, or thing…. For example, we drew on a socio-technical framework to help explain the connections between different elements - technology; people; and the organisational settings within which they worked - in our study of the introduction of electronic health record systems (Table 3)[5]. analytical generalisation) or to test theory by replicating the findings in a second or even a third case (i.e. Case Records of the Massachusetts General HospitalNov 26, 2020 Case 37-2020: A 35-Year-Old Man with Lymphadenopathy and Petechiae Armand P., Heeger A.P., Kanjilal S., and Krystel-Whittemore M. | … BMC Medical Research Methodology 2000, 320: 50-52. PubMed Central  This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Though inherently challenging, the research case study can, if carefully conceptualised and thoughtfully undertaken and reported, yield powerful insights into many important aspects of health and healthcare delivery. Mays N, Pope C: Qualitative research in health care: Assessing quality in qualitative research. statement and 2002, 60 (1): 17-37. The illustrative 'grand round', 'case report' and 'case series' have a long tradition in clinical practice and research. Medical Care Case Study Legal, moral, and ethical controversies happen often in health care. 10.1016/S0140-6736(01)05627-6. Hellström I, Nolan M, Lundh U: 'We do things together': A case study of 'couplehood' in dementia. Qualitative research in health care. Sheikh A, Panesar SS, Lasserson T, Netuveli G: Recruitment of ethnic minorities to asthma studies. Time criteria may include all cases of a disease identified from, for example, January 1, 2008 to March 1, 2008. Barbour RS: Checklists for improving rigour in qualitative research: a case of the tail wagging the dog?. Carefully formulated research question(s), informed by the existing literature and a prior appreciation of the theoretical issues and setting(s), are all important in appropriately and succinctly defining the case[8, 12]. We draw in particular on four of our own recently published examples of case studies (see Tables 1, 2, 3 and 4) and those of others to illustrate our discussion[3–7]. The title of medical case report should reflect the content clearly; so that readers can quickly find the information they are looking for. In contrast, the instrumental case study uses a particular case (some of which may be better than others) to gain a broader appreciation of an issue or phenomenon. Repeated reviewing and sorting of the voluminous and detail-rich data are integral to the process of analysis. Our aim in writing this piece is to provide insights into when to consider employing this approach and an overview of key methodological considerations in relation to the design, planning, analysis, interpretation and reporting of case studies. 2006, 1: 1-8. 10.1136/bmj.320.7227.114. cough and fever) and the results of clinical tests (e.g. Malterud K: Qualitative research: standards, challenges, and guidelines. What are the potential pitfalls and how can these be avoided? All content on this website, including dictionary, thesaurus, literature, geography, and other reference data is for informational purposes only. PubMed Central  Case studies may be approached in different ways depending on the epistemological standpoint of the researcher, that is, whether they take a critical (questioning one's own and others' assumptions), interpretivist (trying to understand individual and shared social meanings) or positivist approach (orientating towards the criteria of natural sciences, such as focusing on generalisability considerations) (Table 6). Pursuing this same example, when does the process of implementation and adoption of an electronic health record system really begin or end? In our example of evaluating implementations of electronic health record systems, given the restricted number of early adopter sites available to us, we sought purposively to select a diverse range of implementation cases among those that were available[5]. Lincoln Y, Guba E: Naturalistic inquiry. PubMed Central  The authors reported how this case study approach provided a number of contextual factors likely to influence the effectiveness of the intervention and which were not likely to have been obtained from quantitative methods alone. Bombastic words for essay writing spm. predicting similar results) if the theory is straightforward and five or more if the theory is more subtle. the extent to which the method is appropriate to answer the research question)[8, 18–21]. Case study research has sometimes been criticised for lacking scientific rigour and providing little basis for generalisation (i.e. A case definition must be clear, simple, and concise, allowing it to be easily applied to all individuals in the population of interest. case-control study: a nonexperimental research design using an epidemiological approach in which previous cases of the condition are used in lieu of new information gathered from a randomized population. Learn more about this type of research by reading the article. Cookies policy. Article  Stake provides a critique checklist for a case study report (Table 9)[8]. Green J, Thorogood N: Qualitative methods for health research. An intrinsic case study is typically undertaken to learn about a unique phenomenon. Sarah Crowe. 1999, 34: 1209-1224. This was, for example, the case in our study of the recruitment of minority ethnic participants into asthma research (Table 1) as our earlier work had demonstrated the marginalisation of minority ethnic people with asthma, despite evidence of disproportionate asthma morbidity[14, 15]. Som CV: Nothing seems to have changed, nothing seems to be changing and perhaps nothing will change in the NHS: doctors' response to clinical governance. How to use case in a sentence. its scope, beginning and end), the relevant social group, organisation or geographical area of interest to the investigator, the types of evidence to be collected, and the priorities for data collection and analysis (see Table 7)[1]. Doolin has, for example, noted that in the context of undertaking interpretative case studies, researchers can usefully draw on a critical, reflective perspective which seeks to take into account the wider social and political environment that has shaped the case[11]. For an instrumental case study, selecting a "typical" case can work well[8]. Google Scholar, Pinnock H, Huby G, Powell A, Kielmann T, Price D, Williams S, et al: The process of planning, development and implementation of a General Practitioner with a Special Interest service in Primary Care Organisations in England and Wales: a comparative prospective case study. Sociological Review. The former is ideally studied using a controlled experimental design, whereas the latter is more appropriately studied using a case study design.