How to write a case study

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Contents

Last Update

  • Updated.jpg 11 August 2013

Introduction

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Case studies are an important form of descriptive research in medicine that outline an interesting disease trajectory, or patient case. Case-based methods are used often in medicine by clinicians when they want to share their observations of a rare disease course or an unusual or unique presentation of an injury or syndrome. Yin defines the case study method as a form of empirical inquiry that investigates and analyzes medical phenomena in its "real-life context". Case studies are also central to problem-based learning methods in medicine.

Authors of case studies can take descriptive or explanatory approaches, but typically their decisions, policies, institutions or other aspects in the case are closely inventoried and analyzed. The case study method also provides an analytical frame within which an issue or clinical intervention can be examined. Some examples of the case study in medicine include the diagnosis and treatment of rare diseases or, in psychiatry, the treatment of a mental illness. In medical education, case studies can be used to discuss practically any educational intervention from course design to problem-based learning.

The case study can be a valuable method of research, with distinctive characteristics that make it ideal for many types of investigations; it can also be used in combination with other research methods. Its reliability should make it more widely used if its features are well-understood and applied accordingly by researchers.

What are case studies?

  • Short, written summaries or syntheses of real-life cases (e.g., health services or treatment of patients)
  • Cases require the author to isolate and think through key issues involved against both theory and background environments
  • An exploration of appropriate strategies for the resolution of the 'case'
  • A weighing of the pros and cons (ie., reflection) of the remedial options/strategies
  • Final recommendations and rationale for the best resolution

Types of case studies

  • Explanatory case study: used to share observations and findings with researchers/clinicians
  • Exploratory: a case study used as a prelude to further in-depth research; it allows researchers to gather information before developing research questions and hypotheses
  • Descriptive case study involves starting with a descriptive theory; subjects are then observed and the information gathered is compared to the pre-existing theory
  • Intrinsic case study is where researcher has a personal interest in the case
  • Collective case study is one where a group of individuals is studied
  • Instrumental case study is when an individual or group allows researchers to understand more than what is obvious to observers

Case study methods

  • Prospective: a type of case study in which an individual or group of people is observed in order to determine outcomes. For example, individual patients might be observed over a period of time to witness/retell the progression of a disease
  • Retrospective: a type of case study that involves looking at historical information; for example, researchers may start with an outcome, such as a disease, and then work backwards by examining the patient's life to determine risk factors or events that may have contributed to its development

Sources of information used in case studies

Different sources of information and methods can be used by researchers to gather evidence about the subject of the case. Yin and State have identified at least six major sources of information used for data collection to write the case study:

  1. Direct observation: this strategy involves observing subjects in a natural setting; individual observers are sometimes used but so are groups of observers
  2. Interviews: an important method for gathering information; interviews involve structured survey questions or open-ended questions
  3. Documents: letters, newspaper articles, administrative records, patient health records, etc
  4. Archival records: census records, survey records, name lists, etc
  5. Physical artifacts: tools, objects, instruments and other artifacts often observed during a direct observation of the subject
  6. Participant observation: involves the researcher actually serving as a participant in events and observing the actions and outcomes

Describe a library service, project or initiative

  • Find out whether similar case studies have been written before
  • Frame the research problems or issues as questions; describe what led to them
  • State who got involved in the service or project; what role(s) librarians took
  • Identify the major issues, decisions made and other data used to do research
  • List the options you considered, and why you made certain decisions
  • Write a structured abstract that focuses on key elements including outcomes and lessons learned

Case studies are flexible in that they can be presented in a number of ways. That said, any evaluation of results should include the methods used in the study and all supporting information (i.e., copies of instruments and guides used). Case studies may stand alone or be included as part of larger projects.

Pros / cons

The primary advantage of the case study is that it provides a more detailed view of a specifc disease, patient or intervention than might otherwise be the case through other methods. Case studies allow researchers to present data from multiple methods (i.e., surveys, interviews, document review and observation), which is a form of triangulation. In some evaluation and research fields, case studies are seen to be less rigorous than surveys or other methods. One reason for this is the fact that qualitative research is perceived as unscientific by many, and case study research is not as systematic in its data collection. Finally, due to its perceived lack of rigour, the case study is not generalizable or unbiased in its findings or conclusions.

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